Document:

EX-10.81

 Exhibit 10.81 

Final 
 AMENDED AND RESTATED

 MASTER SERVICES AGREEMENT 

Between 
 Health Net, Inc.

 and 
 Cognizant
Healthcare Services, LLC 
 Dated 

November 21, 2014 
 “***”
= CONFIDENTIAL PORTIONS OF THIS DOCUMENT HAVE BEEN OMITTED AND HAVE BEEN SEPARATELY FILED WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO AN APPLICATION FOR CONFIDENTIAL TREATMENT UNDER RULE 24B-2 UNDER THE SECURITIES EXCHANGE ACT OF 1934,
AS AMENDED. 

  

					
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 TABLE OF CONTENTS 

 

													
	 	 	 	 	 	  	 	  	Page	 
	 	1.	  	 	 	PREAMBLE	  	 	1	  
				 	 	1.1	  	  	Background and Purpose	  	 	1	  
				 	 	1.2	  	  	Goals and Objectives	  	 	3	  
				 	 	1.3	  	  	Structure of Agreement	  	 	4	  
				 	 	1.4	  	  	Construction of Preamble	  	 	7	  
			
	 	2.	  	 	 	DEFINITIONS	  	 	7	  
				 	 	2.1	  	  	Defined Terms	  	 	7	  
				 	 	2.2	  	  	Other Terms	  	 	16	  
			
	 	3.	  	 	 	SERVICES	  	 	17	  
				 	 	3.1	  	  	Provision of the Services	  	 	17	  
				 	 	3.2	  	  	Implied Services	  	 	18	  
				 	 	3.3	  	  	Evolution of the Services	  	 	18	  
				 	 	3.4	  	  	Users of the Services	  	 	18	  
				 	 	3.5	  	  	Non-Exclusive; Variability	  	 	19	  
				 	 	3.6	  	  	Cooperation and Coordination with Other Parties	  	 	19	  
				 	 	3.7	  	  	“Master” Nature of the Terms and Conditions	  	 	20	  
				 	 	3.8	  	  	New Services	  	 	20	  
				 	 	3.9	  	  	Joinder Agreements	  	 	21	  
				 	 	3.10	  	  	Contract documents to be completed after Effective Date	  	 	22	  
			
	 	4.	  	 	 	TERM AND REGULATORY APPROVALS	  	 	22	  
				 	 	4.1	  	  	Initial Term	  	 	22	  
				 	 	4.2	  	  	Renewal Terms	  	 	23	  
				 	 	4.3	  	  	Regulatory and Customer Approvals	  	 	23	  
			
	 	5.	  	 	 	PERFORMANCE	  	 	24	  
				 	 	5.1	  	  	Performance, Generally	  	 	24	  
				 	 	5.2	  	  	Place of Performance	  	 	24	  
				 	 	5.3	  	  	Time of Performance	  	 	25	  
				 	 	5.4	  	  	Manner of Performance	  	 	26	  
				 	 	5.5	  	  	Quality Assurance and Continuous Improvement	  	 	27	  
				 	 	5.6	  	  	Critical Deliverables	  	 	27	  
			
	 	6.	  	 	 	SERVICE LEVELS	  	 	27	  
				 	 	6.1	  	  	General	  	 	27	  
				 	 	6.2	  	  	Failure to Perform	  	 	27	  
				 	 	6.3	  	  	Removal of Performance Group Guarantee Customers	  	 	28	  

  

					
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	7.		 	SUPPLIER PERSONNEL		 	28	  
			 	7.1	  		Provision of Suitable Personnel		 	28	  
			 	7.2	  		Screening and Background Checks		 	28	  
			 	7.3	  		Responsibility for Supplier Personnel, Generally		 	29	  
			 	7.4	  		Key Supplier Positions		 	29	  
			 	7.5	  		Removal and Replacement of Supplier Personnel		 	30	  
			 	7.6	  		Controlling Turnover of Supplier Personnel		 	30	  
			 	7.7	  		Subcontracting		 	31	  
			 	7.8	  		Supplier Personnel No Longer on Health Net Account		 	32	  
			 	7.9	  		Training		 	33	  
			
	8.		 	HEALTH NET RESPONSIBILITIES		 	33	  
			 	8.1	  		Appointment of Health Net Program Management Office (PMO) Personnel		 	33	  
			 	8.2	  		Health Net Cooperation Duties		 	33	  
			 	8.3	  		Savings Clause		 	34	  
			 	8.4	  		Minimum Revenue Commitment.		 	34	  
			
	9.		 	CHARGES		 	34	  
			 	9.1	  		Pass-Through Expenses		 	34	  
			 	9.2	  		Incidental Expenses		 	35	  
			 	9.3	  		Taxes		 	35	  
			 	9.4	  		Estimating Model		 	37	  
			 	9.5	  		Most Favored Customer		 	37	  
			
	10.		 	INVOICING AND PAYMENT		 	37	  
			 	10.1	  		Invoicing		 	37	  
			 	10.2	  		Payment Due		 	38	  
			 	10.3	  		Accountability		 	38	  
			 	10.4	  		Proration		 	38	  
			 	10.5	  		Refundable Items		 	38	  
			 	10.6	  		Deductions		 	38	  
			 	10.7	  		Disputed Charges		 	38	  
			
	11.		 	TRANSFER OR USE OF RESOURCES		 	39	  
			 	11.1	  		Transfer of Resources		 	39	  
			 	11.2	  		Use of Health Net Resources		 	39	  
			 	11.3	  		Required Consents		 	44	  
			 	11.4	  		Health Net Resources Provided to Supplier Personnel Working On-site		 	45	  
			 	11.5	  		Service Description Update		 	46	  

  

					
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	12.		 	RESOURCE ACQUISITIONS DURING THE TERM		 	47	  
			 	12.1	  		General Responsibility and Compatibility		 	47	  
			 	12.2	  		Software Used to Provide the Services		 	48	  
			 	12.3	  		Health Net Rights to Certain Software		 	48	  
			 	12.4	  		Colocation Facilities.		 	53	  
			
	13.		 	TRANSITION		 	54	  
			 	13.1	  		Overview		 	54	  
			 	13.2	  		“Transition” Defined		 	54	  
			 	13.3	  		Transition Changes		 	55	  
			 	13.4	  		Transition Documents		 	56	  
			 	13.5	  		Conduct of the Transition		 	57	  
			 	13.6	  		Health Net Cooperation and Support		 	57	  
			 	13.7	  		In Flight Projects		 	57	  
			 	13.8	  		Completion of Transition Projects		 	57	  
			
	14.		 	DATA SECURITY AND PROTECTION		 	58	  
			 	14.1	  		[Reserved.]		 	58	  
			 	14.2	  		Health Net Data, Generally		 	58	  
			 	14.3	  		Data Security		 	58	  
			 	14.4	  		Intrusion Detection/Interception		 	60	  
			 	14.5	  		Litigation and Investigation Requests		 	61	  
			 	14.6	  		Compliance with Data Privacy and Data Protection Laws, Regulations and Policies		 	62	  
			 	14.7	  		Security Breach		 	62	  
			 	14.8	  		Import/Export Controls		 	64	  
			 	14.9	  		Compliance with Gramm-Leach-Bliley		 	64	  
			
	15.		 	INTELLECTUAL PROPERTY RIGHTS		 	65	  
			 	15.1	  		Certain IP-related Definitions		 	65	  
			 	15.2	  		Independent IP, Generally		 	66	  
			 	15.3	  		Rights in Deliverables		 	66	  
			 	15.4	  		Incorporation of Third-Party Independent IP in a Deliverable		 	68	  
			 	15.5	  		Work Products		 	69	  
			 	15.6	  		Delivery of Deliverables and Other Materials		 	69	  
			 	15.7	  		Use of Material Subject to Open Source Licenses		 	69	  
			 	15.8	  		Intellectual Property Rights Agreements with Supplier Personnel		 	69	  
			 	15.9	  		Bankruptcy		 	70	  
			 	15.10	  		Mental Impressions		 	70	  

  

					
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	16.		 	TERMINATION		 	70	  
			 	16.1	  		Termination By Health Net		 	70	  
			 	16.2	  		Termination Related Payments.		 	73	  
			 	16.3	  		Termination By Supplier		 	74	  
			 	16.4	  		Extension of Termination/Expiration Date		 	74	  
			 	16.5	  		Partial Termination		 	74	  
			 	16.6	  		Disengagement Assistance		 	75	  
			 	16.7	  		Survival		 	76	  
			 	16.8	  		Bid Assistance		 	77	  
			
	17.		 	GOVERNANCE AND MANAGEMENT		 	78	  
			 	17.1	  		Contract Governance Structure and Processes		 	78	  
			 	17.2	  		Procedures Manual		 	78	  
			 	17.3	  		Technology Plans		 	79	  
			 	17.4	  		Action Plans and Step In Rights		 	80	  
			 	17.5	  		Change Control		 	82	  
			
	18.		 	AUDITS AND RECORDS		 	84	  
			 	18.1	  		Audit Rights		 	84	  
			 	18.2	  		Supplier Audits		 	85	  
			 	18.3	  		Supplier’s Internal Controls		 	87	  
			 	18.4	  		Audit Follow-up		 	87	  
			 	18.5	  		Confidentiality of Audits		 	87	  
			 	18.6	  		Records Retention		 	87	  
			 	18.7	  		Financial Reports		 	88	  
			 	18.8	  		Overcharges		 	88	  
			
	19.		 	REPRESENTATIONS, WARRANTIES AND COVENANTS OF SUPPLIER		 	88	  
			 	19.1	  		Work Standards		 	88	  
			 	19.2	  		Maintenance		 	89	  
			 	19.3	  		Efficiency and Cost-Effectiveness		 	89	  
			 	19.4	  		Deliverable		 	89	  
			 	19.5	  		Documentation		 	89	  
			 	19.6	  		Compatibility		 	89	  
			 	19.7	  		Non-Infringement		 	90	  
			 	19.8	  		Viruses		 	91	  
			 	19.9	  		Disabling Code		 	91	  

  

					
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			 	19.10	  		Date and Currency Compliance		 	91	  
			 	19.11	  		Corporate Social Responsibility		 	91	  
			 	19.12	  		Subcontractor Confidentiality and Data Protection		 	92	  
			 	19.13	  		No Improper Inducements		 	92	  
			 	19.14	  		Foreign Corrupt Practices Act		 	92	  
			 	19.15	  		Claims Procedures, Appeals and External Review		 	93	  
			 	19.16	  		ABS Platform		 	93	  
			
	20.		  
	 MUTUAL REPRESENTATIONS AND WARRANTIES; DISCLAIMER
		 	93	  
			 	20.1	  		Mutual Representations and Warranties		 	93	  
			 	20.2	  		Disclaimer		 	94	  
			
	21.		  
	 CONFIDENTIALITY
		 	94	  
			 	21.1	  		“Confidential Information” Defined		 	94	  
			 	21.2	  		Obligations of Confidentiality		 	95	  
			 	21.3	  		No Implied Rights		 	96	  
			 	21.4	  		Compelled Disclosure		 	96	  
			 	21.5	  		Confidential Treatment of this Agreement		 	96	  
			 	21.6	  		Disclosure of Information Concerning Tax Treatment		 	96	  
			 	21.7	  		Return or Destruction		 	97	  
			 	21.8	  		Duration of Confidentiality Obligations		 	97	  
			
	22.		  
	 INSURANCE
		 	98	  
			
	23.		  
	 INDEMNIFICATION
		 	98	  
			 	23.1	  		Indemnification By Supplier		 	98	  
			 	23.2	  		Infringement Indemnity Claims		 	100	  
			 	23.3	  		Indemnification By Health Net		 	100	  
			 	23.4	  		Indemnification Procedures		 	102	  
			 	24.1	  		General Intent		 	106	  
			 	24.2	  		Limitations of Liability		 	106	  
			 	24.3	  		Force Majeure		 	110	  
			
	25.		  
	 RULES OF CONSTRUCTION
		 	111	  
			 	25.1	  		Entire Agreement		 	111	  
			 	25.2	  		Contracting Parties; No Third Party Beneficiaries		 	111	  
			 	25.3	  		Contract Amendments and Modifications		 	111	  
			 	25.4	  		Governing Law		 	112	  
			 	25.5	  		Relationship of the Parties		 	112	  
			 	25.6	  		Consents and Approvals		 	112	  

  

					
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			 	25.7	  		Waiver		 	112	  
			 	25.8	  		Remedies Cumulative		 	112	  
			 	25.9	  		References		 	112	  
			 	25.10	  		Rules of Interpretation		 	113	  
			 	25.11	  		Order of Precedence		 	113	  
			 	25.12	  		Severability		 	113	  
			 	25.13	  		Counterparts		 	113	  
			 	25.14	  		Reading Down		 	114	  
			
	26.		  
	 DISPUTE RESOLUTION
		 	114	  
			 	26.1	  		Informal Dispute Resolution		 	114	  
			 	26.2	  		Litigation		 	115	  
			 	26.3	  		Continued Performance		 	115	  
			 	26.4	  		Equitable Remedies		 	115	  
			 	26.5	  		Waiver of Jury Trial		 	116	  
			 	26.6	  		Disclaimer of Uniform Computer Information Transactions Act		 	116	  
			
	27.		  
	 GENERAL
		 	116	  
			 	27.1	  		Binding Nature and Assignment		 	116	  
			 	27.2	  		Ethics Hotline		 	117	  
			 	27.3	  		Nondiscrimination		 	117	  
			 	27.4	  		Beneficiary Hold Harmless		 	117	  
			 	27.5	  		Notices		 	118	  
			 	27.6	  		Non-solicitation of Employees		 	118	  
			 	27.7	  		Compliance with Laws		 	119	  
			 	27.8	  		Covenant of Good Faith		 	120	  
			 	27.9	  		Public Disclosures		 	120	  
			 	27.10	  		Service Marks		 	120	  
			 	27.11	  		Guaranty		 	120	  
			 	27.12	  		Mutually Negotiated		 	121	  

  

					
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 Master Services Agreement 

This Master Service Agreement, dated November 21, 2014, but effective as of November 2, 2014 (the “Effective Date”),
is between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, CA 91367 (“Health Net”), and Cognizant Healthcare Services, LLC
(“Supplier”), a Delaware limited liability company having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a “Party” and collectively, the
“Parties”). The Parties agree that the following terms and conditions shall apply to the services to be provided by Supplier to Health Net under this Agreement, in consideration of certain payments to be made by
Health Net, all as more specifically described below. 
 References to “Supplier” in this Agreement may include Supplier Personnel where such
interpretation is required by the context of the particular clause or provision in question. The interpretation will be adopted which best preserves the Parties’ mutual intention that certain Supplier obligations to Health Net pursuant to the
Agreement are to be executed by Supplier Personnel performing such actions. 
  

	1.	PREAMBLE 

  

	1.1	Background and Purpose 

 This Agreement is made and entered into with reference to the
following: 
  

	 	(a)	Health Net is among the nation’s largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company’s health plans and government contracts
subsidiaries provide health benefits to individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid, Department of Defense, including
TRICARE, and Veterans Affairs programs. Health Net’s behavioral health services subsidiary, Managed Health Network, Inc., provides behavioral health, substance abuse and employee assistance programs to individuals, including Health Net’s
own health plan members. Health Net’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical
groups and self-funded benefits programs. 

  

	 	(b)	Supplier and its Affiliates are providers of business process and information technology outsourcing services and have provided various business process and information technology services to Health Net since 2006.

  

	 	(c)	Health Net and Cognizant Technology Solutions U.S. Corporation (CTSUS) are parties to the following existing agreements (collectively, the “Existing Agreements”): 

 

	 	(i)	that certain Master Staff Augmentation and Application Development Services Agreement dated May 3, 2006, as amended (the “SA/AD Agreement”); 

 

	 	(ii)	that certain Master Services Agreement dated September 30, 2008, as amended (the “AO Agreement”); and 

  

	 	(iii)	that certain Master Services Agreement dated January 23, 2009, as amended (the “Original BPO Agreement”). 

  

					
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	 	(d)	Supplier is a wholly owned subsidiary of CTSUS, which is a wholly owned subsidiary of Cognizant Technology Solutions Corporation. 

  

	 	(e)	Supplier is interested in expanding its existing business process outsourcing offerings and establishing a business process as a service (“BPaaS”) service offering for health insurance companies,
including to Health Net. Supplier plans to launch its BPaaS offering with Health Net (utilizing certain assets to be conveyed by Health Net to Supplier) to attract and engage BPaaS customers in the health care industry. 

 

	 	(f)	Supplier is also interested in providing IT and perhaps other types of services to Health Net, andHealth Net is interested in procuring such BPaaS services, IT services and perhaps other services from Supplier. After a
comprehensive evaluation and negotiation process, Health Net selected Supplier to provide the Services described in this Agreement, during the Term of this Agreement and pursuant to the terms and conditions of this Agreement. 

 

	 	(g)	The Parties reached agreement on contract terms and entered into that certain Master Services Agreement effective as of November 2, 2014 (the “Original Agreement”). Concurrently with the
execution of the Original Agreement, Supplier and Health Net entered into an Asset Purchase Agreement (“APA”) for the sale by Health Net to Supplier of the Acquired Assets, including the ABS Platform, for Supplier’s use
in providing BPaaS Services under this Master Services Agreement. 

  

	 	(h)	After entering into the Original Agreement, the Parties agreed to make certain modifications to certain of the contract documents. The Parties are entering into this Amended and Restated Master Services Agreement to
implement such modifications. The Parties further agree that: 

  

	 	(i)	the Effective Date of the Original Agreement (i.e., November 2, 2014) shall be the Effective Date of this Amended and Restated Master Services Agreement; 

 

	 	(ii)	this Amended and Restated Master Services Agreement replaces and supersedes in all respects the Original Agreement, and any remaining references herein to the Original Agreement (including references to the Master
Services Agreement) shall be deemed to be a reference to this Amended and Restated Master Services Agreement; 

  

	 	(iii)	references in the following agreements relating to the Master Services Agreement dated as of November 2, 2014 shall be understood to refer to this Amended and Restated Master Services Agreement, as it may be
amended from time to time in accordance with this Agreement: (A) Schedule V (Guaranty)(including the actual signed version of this agreement), (B) Schedule 1-A to the Supplemental Terms and Conditions for BPaaS Services (Escrow
Agreement)(including the actual signed version of this agreement), (C) the Initial SOWs, (D) the APA, (E) the Business Associate Agreement, (F) the Transition Manual, and (G) Amendment #5 to Master Services Agreement (the AO
Amendment); and 

  

	 	(iv)	the term “Amended and Restated Master Services Agreement” is interchangeable with the term “Agreement” as used throughout this Agreement. 

  

					
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	1.2	Goals and Objectives 

  

	 	(a)	Health Net and Supplier have the following over-arching goals and objectives associated with the execution of this Agreement and their performance hereunder: 

 

	 	(i)	Expand the Parties’ existing long term strategic relationship; 

  

	 	(ii)	A seamless transition of functions from Health Net and its vendors to Supplier in a manner that is designed to ensure minimal business disruption and business risk to both Parties; 

 

	 	(iii)	Convert Health Net’s existing BPO services model into an outcome-based service delivery model; 

  

	 	(iv)	Establish a relationship that could provide the basis for Supplier to create an industry-leading BPaaS delivery model for Supplier to then deliver BPaaS Services to Health Net as well as additional Supplier customers;

  

	 	(v)	Through Supplier’s provision of the Services to Health Net, allow Health Net to focus its efforts on creating membership growth for its existing products and plans as well as driving business expansion into new
service offerings (which may include dual eligibility and TRICARE); 

  

	 	(vi)	Improve the quality, effectiveness and efficiency of Health Net’s operations, including through Supplier’s modernization of the Acquired Assets, ABS Platform and the overall solution and service delivery
method so as to: 

  

	 	(A)	more accurately track activities related to the compliance with Laws, including compliance with the Patient Protection Affordable Care Act (PPACA) and compliance of reporting Quality Improvement expenses; and

  

	 	(B)	generally permit Health Net to focus on providing higher quality of care to its Beneficiaries. 

  

	 	(vii)	Improve customer service and stakeholder satisfaction including consistent repeatable process models to reduce compliance risk; 

  

	 	(viii)	Where applicable, provide Health Net with a predictable and inclusive pricing model based on Health Net business metrics; 

  

	 	(ix)	Redesign and streamline existing complex service level agreements to simplify service level administration while continuing to provide a quantifiable means by which Health Net can measure the accuracy, timeliness and
quality of Supplier’s delivery of services; 

  

	 	(x)	A mutually beneficial relationship with a professional service provider; 

  

					
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	 	(xi)	Implement a smooth and timely Transition and Transformation of personnel, systems, suppliers and processes (including the transfer to Supplier of Health Net’s strategic information technology assets and process
delivery knowledge) with no disruption in Supplier’s provision of service to Health Net and no disruption to Health Net in its general conduct of its business; and 

 

	 	(xii)	Support Supplier’s strategic goal of leveraging this industry leading delivery model developed by Supplier from Health Net’s existing delivery solution and the Acquired Assets to provide like services to other
Supplier customers. 

  

	 	(b)	The goals and objectives set out in this Section 1.2 are intended to be a general introduction to, and statement of the spirit of, this Agreement. Although this Section 1.2 does not expand or reduce the scope
of the Parties’ obligations under this Agreement, other portions of this Agreement may measure Supplier’s performance, in part, based on the extent to which Supplier achieves certain objectives. 

 

	1.3	Structure of Agreement 

 This document (the “Terms and
Conditions”) sets out the basic terms and conditions under which the Parties will conduct the transactions contemplated by this Agreement. In addition, there will be a number of schedules attached to the Terms and Conditions, including:

 Schedule A (Cross Functional Services) 

Schedule A-1 (Cross Functional Solution Description) 

Schedule A-2 [Reserved] 

Schedule A-3 (Future SOW Template) 

Schedule A-4 (IT Continuity and Disaster Recovery Services) 

Schedule B (Service Levels) 

Schedule B-1 (Certain Service Levels) 

Schedule B-2 (Compliance Service Level Metrics) 

Schedule B-3 (Performance Guarantee Group Service Level Metrics) 

Schedule B-4 (Stakeholder Satisfaction Survey) 

Schedule C (Charges) 

Schedule C-1 (BPaaS—PMPM Variable Rates) 

Schedule C-2 (BPaaS—Detailed LOB Structure and Tower-Level PMPM Variable Rates) 

Schedule C-3 (Forecasted Supplier-Procured IT Assets Charge) 

  

					
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 Schedule C-4 (BPaaS Membership Baseline) 

Schedule C-5 (AD Projects—Examples) 

Schedule C-6 (IT SOW – Resource Categories) 

Schedule C-7 (IT SOW – Annual Services Charge) 

Schedule C-8 (IT SOW – Resource Baselines) 

Schedule C-9 (IT SOW – ARC/RRC Rates) 

Schedule C-10 (IT SOW – Supplier-Procured Assets) 

Schedule C-10-1 (BOM with Pricing) 

Schedule C-11 (Financial Responsibility Matrix) 

Schedule C-12 (Termination Charges) 

Schedule C-13 (BPO T&M Rates) 

Schedule C-14 (IO T&M Rates) 

Schedule C-15 (T&M Time Codes) 

Schedule C-16 (Medical Management Rates) 

Schedule C-17 (Pass-Through Expenses) 

Schedule D (Key Supplier Positions) 

Schedule E (Transitioned Employees) 

Schedule F (Supplier Facilities) 

Schedule G (Governance) 

Schedule G-1 (Supplier Organization) 

Schedule G-2 (Meeting Framework) 

Schedule G-3 (Management Reports) 

Schedule H (Change Control Process) 

Schedule H-1 (Change Control Notice) 

Schedule I (Insurance) 

Schedule J (Project Framework) 

  

					
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 Schedule J-1 (Deliverable Acceptance Procedures) 

Schedule J-2 (Form of Work Order) 

Schedule J-3 (Project Estimation Model) 

Schedule K (Regulatory Compliance Addendum) 

Schedule K-1 (Supplemental Regulatory Detail) 

Schedule K-2 (CMS Offshore Attestation Requirements) 

Schedule K-3 (AHCCS Subcontract) 

Schedule L (Disengagement Assistance) 

Schedule M (Supplier Competitors) 

Schedule N (Non-Disclosure Agreement) 

Schedule O (Health Net Provided Resources) 

Schedule P (Health Net Policies) 

Schedule Q (Security Requirements) 

Schedule R (Critical Deliverables) 

Schedule S (Procedures Manual TOC) 

Schedule T (Joinder Agreement) 

Schedule U (Aspect Assignment and Assumption Agreement) 

Schedule V (Guaranty) 

Schedule W (Glossary) 

Schedule X (In-Flight and Accelerated Projects) 

Schedule X-1 (In-Flight Project List) 

Schedule X-2 (Accelerated Project List) 

Schedule Y (Offshore Prohibitions and Requirements) 

Schedule Z (Transition) 

Schedule Z-1 (Acceptance of Transition Deliverables and Milestones) 

Schedule Z-2 (Summary of Onshore and Offshore Counts and Ratios) 

  

					
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 Schedule Z-3 (Health Net Transition Support Role Descriptions) 

Schedule Z-4 (Health Net Transition Support Personnel Levels) 

Schedule Z-5 (Health Net Provided Transition Work Space) 

Schedule Z-6 (Ramp-Down Plan) 

Schedule Z-7 (Offshore Ramp-Up Plan) 

Schedule Z-8 (Required Onshore Positions) 

Schedule Z-9 (Staff Augmentation Plan) 

Schedule Z-10 (Consolidated BPaaS Transition Plans) 

Schedule Z-11 (IT Transition Plan) 

Schedule Z-12 (Call Center Transition Plan) 

Annex 1 (Supplemental Terms and Conditions for BPaaS Services) 

Schedule 1-A (Escrow Agreement) 
  

	1.4	Construction of Preamble 

 The provisions of this Section 1 (Preamble) are intended to provide a
general introduction to this Agreement and a context in which to interpret this Agreement’s terms and conditions in circumstances where their meanings are unclear or ambiguous. It is not intended to alter the plain meaning of this Agreement or
to alter the scope of the Parties’ express obligations under it. 
  

	2.	DEFINITIONS 

  

	2.1	Defined Terms 

 The following capitalized terms, when used in this Agreement, will have
the meanings given them below: 
  

	 	(a)	“ABS Platform” has the meaning given to it in the APA. 

  

	 	(b)	“Accelerated Projects” has the meaning given in Schedule C (Charges). 

  

	 	(c)	“Adverse Change in Supplier’s Financial Circumstances” means if Supplier (i) files a petition in bankruptcy; (ii) has an involuntary petition in bankruptcy filed against it which
is not challenged within twenty (20) days and dismissed within sixty (60) days; (iii) becomes insolvent; (iv) makes a general assignment for the benefit of creditors; (v) admits in writing its inability to pay its debts as
they mature; or (vi) has a receiver appointed for its assets. 

  

	 	(d)	“Affected Employees” has the meaning given in Schedule E (Transitioned Employees). 

  

					
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	 	(e)	“Affected Services” mean Services for which Health Net is requesting Disengagement Assistance. 

  

	 	(f)	“Affiliate” means, with respect to an entity, any other entity or person Controlling, Controlled by or under common Control with such entity. 

 

	 	(g)	“Agreement” means this Terms and Conditions document as well as all Schedules, Annexes and attachments attached hereto, and any SOWs entered into pursuant to this Agreement as well as all
Exhibits thereto, the Transition Manual, all as may be amended by the Parties from time to time in accordance with Section 27.5 (Contract Amendments & Modifications) or as otherwise provided in the Agreement. 

 

	 	(h)	“APA” has the meaning given in Section 1.1(g). 

  

	 	(i)	“Application” or “Application Software” means Software that performs specific End User-related data processing, data management and telecommunications tasks.

  

	 	(j)	“Acquired Assets” will have the meaning set forth in the APA. 

  

	 	(k)	“Auditor” has the meaning set forth in Section 18.1 of the Agreement. 

  

	 	(l)	“Beneficiary” means a person who has enrolled in and/or is eligible to receive services under a Benefit Program at the time services are rendered. The Parties acknowledge that the term
“member,” “enrollee” and “insured” may be used by Health Net, and for purposes of this Agreement, the term Beneficiary includes the term “member,” “enrollee” and “insured” wherever used.

  

	 	(m)	“Benefit Program” means a plan offered or administered by Health Net, its Affiliates or any of their respective customers whereby any of the foregoing are obligated to provide or arrange for
health care services, or compensation therefore, to Beneficiaries in accordance with the provisions contained in such plans. 

  

	 	(n)	“BPaaS Discretionary Projects” has the meaning given in Schedule C (Charges). 

  

	 	(o)	“BPaaS Non-Discretionary Projects” has the meaning given in Schedule C (Charges). 

  

	 	(p)	“BPaaS Roadmap Projects” has the meaning given in Schedule C (Charges). 

  

	 	(q)	“BPaaS Services Commencement Date” shall mean the later to occur of (i) the date that is ten (10) Business Days after the date that Health Net receives the last required approval from
the Regulators to proceed with the transactions contemplated by this Agreement, and (ii) March 1, 2015. 

  

	 	(r)	“BPaaS Services” means collectively the Services to be provided by Supplier under this Agreement, excluding the Non-BPaaS IT Services and any other Services that may be expressly designated as
not part of the BPaaS Services in any Future SOWs. 

  

	 	(s)	“Breakup Fee” means a fee in the amount of *** to be paid by Health Net if Health Net exercises its right to terminate this Agreement pursuant to Section 16.1(n). 

 

	 	(t)	“Business Day” has the meaning given in Schedule B (Service Levels). 

  

					
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	 	(u)	“Business Hours” means 08:00 – 17:00, local time (from the perspective of the applicable Service Recipient), during a Business Day, provided that the foregoing shall not supersede any
business, operational or similar hours set forth in a SOW (including Solution documents attached thereto). 

  

	 	(v)	“Commercially Available” means Software that is routinely licensed to the general public by Supplier or a third party, as applicable, through separately established standard terms and conditions
and standard charges, and for which such Software Supplier or the third party (as applicable) provides ongoing maintenance, support and Software Updates. 

  

	 	(w)	“Commercially Reasonable Efforts” means taking all such steps and performing in such a manner as a well-managed company would undertake where it was acting in a determined, prudent and reasonable
manner to achieve a particular desired result for its own benefit. 

  

	 	(x)	“Control” and its derivatives, such as “Controlling” means with regard to any entity the legal, beneficial or equitable ownership, directly or indirectly, of:
(i) fifty percent (50%) or more of the capital stock (or other ownership interest if not a stock corporation) of such entity ordinarily having voting rights; or (ii) (A) twenty percent (20%) or more of the capital stock (or
other ownership interest if not a stock corporation) and (B) either (1) a greater percentage than any other juridical person or (2) management control in fact or by agreement. 

 

	 	(y)	“Disengagement Assistance” means, collectively, the Functions that Health Net requests from Supplier to enable an orderly transfer of Services from Supplier to Health Net or its designees without
interruption or adverse effect to Health Net in connection with the reduction or cessation of any Services (in whole or in part), or the expiration or earlier termination (for any reason) of this Agreement (in whole or in part) or any SOW (in whole
or in part), including (i) the Functions described in Section 16.5 (Disengagement Assistance) and Schedule L (Disengagement Assistance), and (ii) as requested by Health Net, any or all of the Affected Services provided by
Supplier prior to the effective date of reduction, cessation, termination or expiration of the Affected Services, which for clarity Health Net may require Supplier to perform after expiration or termination of the Agreement with respect to such
Affected Services. 

  

	 	(z)	“Disengagement Assistance Period” means, for each request by Health Net for Disengagement Assistance, the period of time requested by Health Net for Supplier to provide Disengagement Assistance
pursuant to Section 16.6 (Disengagement Assistance), provided that in no event shall any Disengagement Assistance Period extend beyond the date that is *** following the effective date of expiration or termination of this Agreement in
whole, as such effective date may be extended pursuant to Section 16.4. 

  

	 	(aa)	“DMHC” means the Department of Managed Health Care of the State of California. 

  

	 	(bb)	“Documentation” means written materials (including materials published on an Internet or Intranet site or otherwise online) that are available or necessary to instruct or assist End Users,
operators or systems personnel in the installation, development, maintenance, operation, use or modification of any Equipment, Software, system, or Deliverable (including applicable functional and technical specifications), as such documentation is
updated from time to time. 

  

					
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	 	(cc)	“Effective Date” has the meaning set forth in the first paragraph of the Terms and Conditions of this Agreement. 

 

	 	(dd)	“Employee Transfer Date” has the meaning given in Schedule E (Transitioned Employees). 

  

	 	(ee)	“End Users” means direct users of the Services provided under this Agreement. 

  

	 	(ff)	“Equipment” means any computer and telecommunications machines or other hardware (without regard to the entity owning or leasing it), including all associated attachments, features, accessories
and peripheral devices and related services (e.g., maintenance and support services, upgrades, and subscriptions services). For purposes of allocating financial, operational, management, or other responsibilities with respect to Equipment,
references to Equipment shall also include any associated maintenance and services agreements relating to such Equipment that are in effect and disclosed by the contracting Party to the other Party. 

 

	 	(gg)	“Exchange” shall mean the California Health Benefit Exchange (“Covered California”) and any Laws applicable to such entity, and any other comparable entity operating in a state in which
Health Net or a Health Net Affiliate conducts business. 

  

	 	(hh)	“Exchange Agreement” shall mean the agreement between Health Net and the Exchange in California that establishes the terms under which Health Net shall participate in the Exchange’s Covered
California program, and any comparable agreement between Health Net or a Health Net Affiliate and an Exchange in a state in which Health Net or a Health Net Affiliate conducts business. 

 

	 	(ii)	“Financial Responsibility” means having responsibility for furnishing, maintaining and paying for resources (or certain services related to such resources) without seeking reimbursement from the
other Party. 

  

	 	(jj)	“Former Health Net Affiliate” means: (i) any entity Affiliated with Health Net at any time during the Term (such designation expiring at the end of the twenty-fourth
(24th) month after the date that such entity ceases to Control, be Controlled by, or be under common Control with, Health Net); or (ii) the purchaser of all or substantially all of the assets and/or customers of any line of business of
Health Net or any of its Affiliates (such designation (A) applying only with respect to the business or customers so acquired; and (B) expiring at the end of the twenty-fourth (24th) month after the date of such purchase.) At Health
Net’s option, each Former Health Net Affiliate shall be deemed to be an Affiliate of Health Net. 

  

	 	(kk)	“Functions” has the meaning given in Section 3.1(a) (Services, Defined). 

  

	 	(ll)	“Health Insurance Portability and Accountability Act” or “HIPAA” means Public Law 104-191 and its implementing regulations. 

 

	 	(mm)	“Health Net Data” means all data and information in any form (and all Derivative Works thereof), including Confidential Information, payment card information, Protected Health Information and
Personally Identifiable Information, belonging to or concerning any of Health Net; its Affiliates; its Service Recipients; and each of their respective and prospective members, customers, employees, providers or other suppliers that (i) is
present in Software or Equipment operated by Supplier for the benefit of Health Net, a Health Net 

  

					
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	 	  	Affiliate or another Service Recipient, or (ii) is directly or indirectly accessed or obtained by Supplier from, in connection with, or as a result of the Services, or is derived therefrom. For the avoidance of
doubt, “Health Net Data” does not include publicly available information or Supplier Confidential Information. 

  

	 	(nn)	“Health Net Facilities” means facilities that are owned or leased by Health Net (or a Health Net Affiliate). 

 

	 	(oo)	“Health Net Leased Equipment” means Equipment leased by Health Net (or a Health Net Affiliate). 

  

	 	(pp)	“Health Net Licensed Software” means Software owned (i.e., in which the copyright is owned) by a party other than Health Net (or a Health Net Affiliate) that is licensed by Health Net (or
a Health Net Affiliate). 

  

	 	(qq)	“Health Net Owned Equipment” means Equipment owned by Health Net (or a Health Net Affiliate). 

  

	 	(rr)	“Health Net Owned Software” means Software owned (i.e., in which the copyright is owned) by Health Net (or a Health Net Affiliate). 

 

	 	(ss)	“Health Net Policies” means the applicable standards, policies and procedures of Health Net (and its Affiliates) provided to Supplier in connection with this Agreement (including by Health Net
providing Supplier a link to an online repository where they may be accessed), whether existing as of the Effective Date (including those policies identified in Schedule P (Health Net Policies) or in any SOW) or adopted by Health Net during
the Term, and in each case as may be modified by Health Net during the Term. 

  

	 	(tt)	“Health Net Third Party Service Contracts” means third party service contracts of Health Net (or a Health Net Affiliate). For clarity, maintenance and support and services
agreements relating to Software that are in effect and that are disclosed by Health Net to Supplier shall be deemed to be part of the Software and not Health Net Third Party Service Contracts. 

 

	 	(uu)	“Identity-Related Costs” means the following costs that are reasonable and incurred by Health Net relating to a Security Breach: *** 

 

	 	(vv)	“Indemnity Claim” means any demand, or any civil, criminal, administrative or investigative notice, inquiry, claim, action, or proceeding (including arbitration) sent to, or commenced or
threatened against, an entity or person. 

  

	 	(ww)	“Initial SOWs” shall mean collectively the following Statements of Work: 

  

	 	(i)	Statement of Work # 1 (Claims Management Services), 

  

	 	(ii)	Statement of Work # 2 (Membership and Configuration Services), 

  

	 	(iii)	Statement of Work # 3 (Contact Center Services), 

  

	 	(iv)	Statement of Work # 4 (IT Services), 

  

					
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	 	(v)	Statement of Work # 5 (Quality Assurance Services), 

  

	 	(vi)	Statement of Work # 6 (Appeals and Grievances Services), and 

  

	 	(vii)	Statement of Work # 7 (Medical Management Services). 

  

	 	(xx)	“IPRs” or “Intellectual Property Rights” means all intellectual and industrial property rights recognized in any jurisdiction, including copyrights, mask work rights,
moral rights, trade secrets, patent rights, rights in inventions, trademarks, trade names and service marks (including applications for, and registrations, extensions, renewals, and re-issuances of, the foregoing). 

 

	 	(yy)	“Law” means, if and to the extent applicable: (i) any law, statute, regulation, ordinance or subordinate legislation in force from time to time, including any such item that relates to
TRICARE, the Veteran’s Administration, and the Centers for Medicare and Medicaid (“CMS”); (ii) the common law; (iii) any binding court order, judgement or decree (including consent agreements); (iv) any directive,
policy, rule, order, corrective action plan, communication, standards or other mandate that is made or given by any government, an agency thereof, or any regulatory body (including an Exchange, the DMHC and the U.S. Department of Health and Human
Services), of any country, the European Union, or other national, federal, commonwealth, state, provincial or local jurisdiction, and of any exchange or association (including the New York Stock Exchange, the National Association of Securities
Dealers whose regulations are binding on either Party pursuant to a self-regulating mechanism approved by a governmental entity; and (v) any communication from a Regulator to Health Net or Supplier indicating a course of action be taken or not
taken that, if disclosed by the Regulator to Health Net is thereafter disclosed by Health Net to Supplier. 

  

	 	(zz)	“Line of Business” means the lines of business established by Health Net into which its operations relevant to the scope of the Services are organized for certain purposes. As of the Effective
Date, there are five (5) such Lines of Business, as follows: (i) Individual – Commercial; (ii) Group – Commercial; (iii) Medicare; (iv) State Health Programs; and (v) Duals. The Lines of Business shall also
include any additional Lines of Business for which pricing is developed pursuant to Schedule C (Charges). 

  

	 	(aaa)	“Losses” means all losses, liabilities, damages, liens, claims and costs, and all related expenses and other charges suffered or reasonably incurred as a result of or in connection
with an Indemnity Claim, including reasonable attorneys’ fees and disbursements, costs of investigation, litigation, settlement, and judgment, and any taxes, interest, penalties, and fines. 

 

	 	(bbb)	“Minimum Revenue Commitment” or “MRC” has the meaning given in Schedule C (Charges). 

 

	 	(ccc)	“Non-BPaaS IT Projects” has the meaning given in Schedule C (Charges). 

  

	 	(ddd)	“Non-BPaaS IT Services” has the meaning in SOW #4 (IT Services). 

  

	 	(eee)	“Non-Commercially Available” means, with respect to Software, Software that is not Commercially Available. 

  

					
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	 	(fff)	“Object Code” shall mean Software code resulting from the translation or processing of Software in Source Code form by a computer into machine language, which is a form that is not convenient to
human understanding of the Software. 

  

	 	(ggg)	“Open Source Code” means any Software that requires as a condition of its use, modification or distribution that it be disclosed or distributed in source code form or made available at no charge.
Open Source Code includes software licensed under the GNU General Public License (GPL) or the GNU Lesser/Library GPL. 

  

	 	(hhh)	“Open Source License” means a license to Software that complies with the Open Source Initiative’s definition of “Open Source.” 

 

	 	(iii)	“Out-of-Pocket Expenses” means reasonable, demonstrable and actual out-of-pocket expenses incurred by Supplier for Equipment, materials, supplies, or services provided to or for Health Net that
are expressly subject to reimbursement by Health Net pursuant this Agreement, but not including Supplier’s actual or allocated overhead costs, administrative expenses or other mark-ups. 

 

	 	(jjj)	“Protected Health Information” and “PHI” shall have the meaning given to such term at 45 C.F.R. § 160.103, as may be amended by Law from time to time.

  

	 	(kkk)	“Personally Identifiable Information” means any information about an individual including any information that could be used to identify an individual such as Protected Health Information.

  

	 	(lll)	“Proprietary Business Rules” shall have the definition in the APA. 

  

	 	(mmm)	“Regulator” means any governmental or quasi-governmental entity (i) with investigatory or oversight capability regarding Health Net, a Health Net Affiliate, or a Former Health Net Affiliate,
or of any Services under this Agreement, including CMS, DMHC and Arizona Health Care Cost Containment System (“AHCCCS”), or (ii) that is party to a Regulatory Contract. 

 

	 	(nnn)	“Regulatory Contract” means any contract between Health Net and a governmental or quasi-governmental entity under which the governmental or quasi-governmental entity is paying for services
provided to Beneficiaries (e.g., Medicaid, Medi-Cal, CHIPs), but excluding contracts in which the governmental or quasi-governmental entity is merely acting as the employer paying for health insurance coverage for its employees. 

 

	 	(ooo)	“Related SOW” shall mean a SOW that is impacted by the event that gives rise to the right to terminate under Section 16, such as the SOW under which the breach or Service Level Failure
occurred. Related SOW shall also include any SOW which Health Net, in its reasonable discretion, determines should also be terminated because of business, operational or financial reasons, including that the Services provided under the immediately
impacted SOW should be grouped with Services under other SOWs in order to achieve a desired business, operational or financial result. 

  

	 	(ppp)	“Required Consents” means such consents as may be required for (i) the assignment to a Party, or the grant to a Party of rights of access and use, of resources otherwise provided to or
licensed by the other Party, and (ii) with respect to any resource (e.g., Software, Equipment, third party services) for which the corresponding contract is to be assigned to 

  

					
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	 	  	Health Net or its designee pursuant to Disengagement Assistance (including any resource utilized or introduced after the Effective Date during the Term), the disclosure of the corresponding contract terms to Health Net
or its designee, or the assignment of such contract to Health Net or it designee, as part of Disengagement Assistance. 

  

	 	(qqq)	“Security Breach” means (i) any actual circumstance that compromises the privacy and/or security of any Health Net Data or Health Net Software or systems which are possessed or operated by
(or for) or are under the control of Supplier or a third party that received such Health Net Data (directly or indirectly) through Supplier (with the exception of a third party to which Health Net directs Supplier in writing to provide Health Net
Data, including auditors, regulators and contractors but excluding Subcontractors); or (ii) any loss or unauthorized acquisition, access, destruction, alteration, disclosure or use (in all cases whether intentional or not) of, or the inability
to locate, Health Net Data which was delivered to, created, maintained or accessed by, Supplier or a third party that received such Health Net Data (directly or indirectly) through Supplier (with the exception of a third party to which Health Net
directs Supplier in writing to provide Health Net Data, but excluding Subcontractors). For purposes of defining “in control” as that term is used in clause (i) of this definition, Supplier shall be deemed to be in control of Health
Net Data, Health Net Software or systems in the IBM data center to the extent (A) Supplier provides or is required to provide systems monitoring or related management or other Services that affect the security of such Health Net Data, Health
Net Software or systems, (B) Supplier is obligated to manage IBM or any other third party under this Agreement, (C) the provisions set forth in Schedule Q (Security) are applicable to the Services to be provided by Supplier with
respect to such Health Net Data, Health Net Software or systems, or (D) any other circumstance in which Supplier’s acts or omissions could have prevented the Security Breach if Supplier had exercised due care and complied with is
obligations under this Agreement. 

  

	 	(rrr)	“Service Tower” means the Services to be provided by Supplier under each Statement of Work, as well as the Cross Functional Services to support such Service Tower. The Service
Towers as of the Effective Date are: 

  

	 	(i)	Cross Functional Services Tower means the Cross Functional Services as defined in Schedule A (Cross Functional Services); 

  

	 	(ii)	Claims Service Tower means the Claims Services as defined in Statement of Work # 1 (Claims Management Services); 

  

	 	(iii)	Membership Service Tower means the Membership and Configuration Services as defined in Statement of Work # 2 (Membership and Configuration Services); 

 

	 	(iv)	Contact Center Service Tower means the Contact Center Services as defined in Statement of Work # 3 (Contact Center Services); 

 

	 	(v)	Non-BPaaS IT Service Tower means the IT Services as defined in Statement of Work # 4 ( IT Services); 

  

	 	(vi)	Quality Assurance Service Tower means the Quality Assurance Services as defined in Statement of Work # 5 (Quality Assurance Services); 

  

					
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	 	(vii)	Appeals and Grievances Service Tower means the Appeals and Grievances Services as defined in Statement of Work # 6 (Appeals and Grievances Services); and 

 

	 	(viii)	Medical Management Service Tower means the Medical Management Services as defined in Statement of Work # 7 (Medical Management Services). 

 

	 	(sss)	“Software” means (i) program code (in Object Code and Source Code forms) and all supporting documentation, media, on-line help facilities and tutorials, including any Software Updates,
(ii) frameworks, utilities, macros, software configurations, templates and tools used to deliver services or enhance the productivity or quality of services, and (iii) Derivative Work of any item described in clauses (i) and (ii). For
purposes of allocating financial, operational, management, or other responsibilities with respect to Software, references to Software shall also include any associated maintenance and support agreements relating to such Software that are in effect
and are disclosed by the contracting Party to the other Party. 

  

	 	(ttt)	“Software Update” means any modification, enhancement, upgrade, update, new version or release, or Derivative Work of Software. 

 

	 	(uuu)	“SOW Effective Date” means, (i) with respect to the Initial SOWs, the Effective Date of this Agreement, and (ii) with respect to any Future SOW, the effective date set forth in the
applicable SOW. 

  

	 	(vvv)	“SOW Service Commencement Date” means, with respect to Future SOWs, the date set forth in the applicable SOW that Supplier Personnel shall commence performing the applicable SOW Services in a
live production environment. 

  

	 	(www)	“SOW Services” means, for each SOW, (i) the Services described in such SOW, and (ii) the Services described in Schedule A (Cross Functional Services) and elsewhere in the
Agreement as they apply to the Services described in such SOW. 

  

	 	(xxx)	“SOW Term” has the meaning given in Section 4.1 (Initial Term). 

  

	 	(yyy)	“Source Code” means the computer code of Software in programming languages, including all comments and procedural code, and all related development documents (e.g., flow charts,
schematics, statements of principles of operations, End User manuals, architectural standards, documentation, and any other specification that are used to create or that comprise the computer code, of the Software concerned). 

 

	 	(zzz)	“Statement of Work” or “SOW” has the meaning given in Section 3.7(a). 

  

	 	(aaaa)	“Subcontractor” means (i) a third party engaged by Supplier to provide any portion of the Services, (ii) any entity to which a Subcontractor further subcontracts (or
otherwise sub-delegates) any of its subcontracted duties or obligations, and (iii) any other entity to which any such subcontracted duties or obligations are further subcontracted (or otherwise sub-delegated), below the level of the agreement
between Supplier and a Subcontractor. 

  

	 	(bbbb)	“Supplier Competitor” means those entities listed in Schedule M (Supplier Competitor). 

  

					
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	 	(cccc)	“Supplier Personnel” means, collectively, any and all personnel furnished or engaged by Supplier to perform any part of the Services, including: (i) the employees of Supplier;
(ii) Subcontractors; and (iii) the employees of such Subcontractors. 

  

	 	(dddd)	“Supplier Provided Software” means Software that is used by Supplier to provide the Services that is either (i) made available by Supplier to Health Net, its Affiliates, Former Health Net
Affiliates and Service Recipients to receive or use the Services, or (ii) reasonably necessary for Health Net and its Affiliates’ and their respective service providers to provide and deliver, and for Health Net, its Affiliates, Former
Health Net Affiliates and Service Recipients to receive and use, services that are substantially similar to the Services, during the Disengagement Assistance Periods and for two years thereafter as contemplated by Section 12.3.

  

	 	(eeee)	“Supplier Software” means any Software that is owned by Supplier or its Affiliates. 

  

	 	(ffff)	“Technology Platform” has the meaning given in Annex 1 (Supplemental Terms and Conditions for BPaaS Services). 

 

	 	(gggg)	“Terms and Conditions” means this document, which is identified in the footer as the Terms and Conditions. 

  

	 	(hhhh)	“Third Party Software” means any Software that is owned by a third party (i.e., not Health Net or its Affiliates or Supplier or its Affiliates). 

 

	 	(iiii)	“Transition Documents” has the meaning given in Section 13.4(a). 

  

	 	(jjjj)	“Transition Manual” shall mean that certain manual containing Transition-related plans and material agreed to by the Parties on or about the Effective Date. 

 

	 	(kkkk)	“Transitioned Employees” has the meaning given in Schedule E (Transitioned Employees). 

  

	 	(llll)	“Use” means to access, use, execute, display, copy, perform, distribute copies of, maintain, modify, enhance, and create Derivative Works of the subject material(s). 

 

	2.2	Other Terms 

  

	 	(a)	Other Capitalized Terms. Other capitalized terms used in this Agreement but not defined above are defined where they are used and have the meanings there indicated, and in the Glossary attached hereto as Schedule
W (Glossary). Those terms, acronyms, and phrases utilized in the business process outsourcing or health and wellness industries which are not otherwise defined in this Agreement shall be interpreted in accordance with their generally
understood meaning in such industry or business context. 

  

	 	(b)	References to Schedules. References to a Schedule include such Schedules at the Terms and Conditions level and the corresponding Exhibit covering the same topic at the SOW level. For example, a reference to
Schedule P (Health Net Policies) also includes Exhibit F (Health Net Policies) to any SOW. 

  

					
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	3.	SERVICES 

  

	3.1	Provision of the Services 

  

	 	(a)	Services, Defined. Supplier will provide the following services, functions, obligations, responsibilities, activities and tasks (collectively, “Functions”) as they may be supplemented,
enhanced, modified or replaced pursuant to this Agreement (collectively, the “Services”): 

  

	 	(i)	the Functions described in Schedule A (Services), each SOW, and elsewhere in this Agreement, other than (1) those expressly designated as Functions for which Health Net is responsible, and (2) those
prohibited by Law to be delegated by Health Net to a third party for performance; 

  

	 	(ii)	any Functions performed during the twelve (12) months preceding the applicable SOW Effective Date: 

  

	 	(A)	by Supplier pursuant to any of the Existing Agreements, excluding the SA/AD Agreement; or 

  

	 	(B)	by Health Net’s or its Affiliates’ personnel (including employees and contractors) performing in a Service Tower who were displaced pursuant to this Agreement, or whose Functions were displaced pursuant to
this Agreement; 

  

	 	(iii)	any other Functions required in order for Supplier to be in compliance with the requirements of each Health Plan, product and provider network (collectively, “Health Net Plans”), whether existing as of the
Effective Date or created by Health Net during the Term, and in each case as same may be modified by Health Net during the Term. 

  

	 	(b)	Services Commencement. 

  

	 	(i)	Initial SOWs. For the Initial SOWs, Supplier shall commence performance of the applicable SOW Services on the BPaaS Services Commencement Date. 

 

	 	(ii)	Future SOWs. For each Future SOW, Supplier shall commence performance of the applicable SOW Services on the applicable SOW Service Commencement Date. 

 

	 	(c)	Relationship to the BPO Agreement. 

 For clarity, the BPO Agreement shall remain in
effect until the BPaaS Services Commencement Date, at which time the BPO Agreement shall be automatically terminated and of no further force or effect, at no charge or cost to Health Net; provided, however, that such termination shall
be without prejudice to any rights and remedies that may have accrued prior to the effective date of such termination. 

  

					
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	3.2	Implied Services 

 If any Functions (other than those Functions either (i) expressly
retained as a Function to be performed by Health Net under this Agreement or (ii) prohibited by Law to be delegated by Health 
 Net to
a third party for performance thereof), are reasonably required for, and incidental to or inherent in, the proper performance and provision of the Services (regardless of whether they are specifically described in this Agreement) they shall be
deemed to be implied by and included within the scope of the Services to be provided by Supplier to the same extent and in the same manner as if specifically described in this Agreement. 

 

	3.3	Evolution of the Services 

 Throughout the Term, Supplier will seek to improve the
quality, efficiency and effectiveness of the Services to keep pace with technological, business process outsourcing and Medicare Part D advances and support Health Net’s (and its Affiliates’) evolving business needs and efforts to maintain
competitiveness in the markets in which it (and they) competes. Without limiting the generality of the foregoing, Supplier will: (i) identify and apply ‘best practice’ techniques and methodologies in performing and delivering the
Services; and (ii) train Supplier Personnel in new techniques and technologies used generally within Supplier’s organization or the business process outsourcing services industry, and (ii) make investments to maintain the currency of
Supplier’s tools, infrastructure and other resources used by Supplier to render the Services. Changes in the Services pursuant to this Section 3.3 will not be considered New Services (as defined in Section 3.8(a)). 

 

	3.4	Users of the Services 

  

	 	(a)	Supplier will provide the Services to Health Net and, as designated by Health Net from time to time, its Affiliates, Former Health Net Affiliates, licensees, customers, providers (e.g., physicians, medical groups,
hospitals., etc), contractors and other entities with which Health Net has a business relationship (each such entity a “Service Recipient”). For purposes of this Agreement, Services provided to such entities shall be deemed
to be Services provided to Health Net. The following apply with respect to all Service Recipients: 

  

	 	(i)	Health Net shall be directly responsible for (A) the payment of all Charges associated with Supplier’s provision of Services to Service Recipients under this Agreement and (B) as and to the extent related
to any Service Recipient’s use of the Services, the performance, breach or other wrongful conduct of any such Service Recipient; and 

  

	 	(ii)	notice provided by Supplier to Health Net under this Agreement will constitute notice to Service Recipients, and Service Recipients will send notices required by this Agreement to Supplier only through Health Net.

  

	 	(b)	With respect to Former Health Net Affiliates, Supplier will continue to provide the Services being provided as of the date of divestiture as is requested by Health Net for as long as such entity continues to meet the
definition of “Former Health Net Affiliate” (or such shorter period of time designated by Health Net). There shall be no additional charge or fee (i.e., in addition to the charges for the actual Services as provided in
this Agreement) for the provision of Services to Former Health Net Affiliates. 

  

	 	(c)	The Services provided to Health Net, Health Net Affiliates and Former Health Net Affiliates under this Agreement may be utilized by Health Net, Health Net Affiliates and Former Health Net Affiliates for the benefit of
members of health plans owned by Health Net, a Health Net Affiliate, a Former Health Net Affiliate or any third party (including any 

  

					
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 third party which may have purchased such health plan from Health Net, a Health Net Affiliate
or a Former Health Net Affiliate), or to meet its obligations under any contract that Health Net, a Health Net Affiliate or a Former Health Net Affiliate has with a third party to provide services of the type provided under this Agreement (including
administrative services only (ASO) arrangements). 
  

	3.5	Non-Exclusive; Variability 

  

	 	(a)	This Agreement is non-exclusive. Subject to the minimum revenue commitment requirements set forth in Schedule C (Charges), nothing in this Agreement shall be construed to limit in any way Health Net’s
ability to reduce the volumes of the Services being provided by Supplier, or to provide itself, or have other third parties provide (or propose to provide), services that are the same as or similar to the Services, including with respect to any
in-scope Functions. Nothing in this Agreement shall limit Supplier’s ability to provide, or propose to provide, services to third parties that are the same as or similar to the Services, including with respect to any in-scope outsourcing
Functions. Health Net (and its Affiliates) may contract with other suppliers for any products and services, including products and services that are similar to or competitive with the Services or that are part of the Services. In the case of Health
Net’s withdrawal of portions of the Services from Supplier (including a withdrawal by Health Net of any volumes of Services or in-scope Functions from the scope of this Agreement), the charges shall be adjusted in accordance with the terms
provided in Schedule C (Charges) and the unit rates set forth therein. 

  

	 	(b)	The Services are variable in volume. Such variations are provided for in the charging mechanisms set forth in Schedule C (Charges). Supplier shall be responsible for adjusting the resources used to provide the
Services to accommodate the changes in volume (regardless of the amount of time remaining in the Term) in such a manner as to comply with all Service Levels. In the case of Health Net’s addition of Services to Supplier (including an increase by
Health Net of any volumes of Services or in-scope Functions to the scope of this Agreement), the charges shall be adjusted in accordance with the terms provided in Schedule C (Charges) and the unit rate set forth therein. Supplier shall not
be entitled to receive an adjustment to the Charges resulting from such variations in volume except as set forth in the applicable SOWs or Schedule C (Charges). 

 

	 	(c)	Except as set forth in Schedule C (Charges) regarding the minimum revenue commitment, Health Net (and its Affiliates) makes no commitment for any minimum or maximum volume, scope, or value of the Services under
this Agreement or to any minimum or maximum payments to be made to Supplier. 

  

	3.6	Cooperation and Coordination with Other Parties 

  

	 	(a)	If Health Net performs itself, or retains a third party other than Supplier to perform, any services that interface or interact with the Services, or that formerly were part of the Services, Supplier will, in accordance
with and subject to Section 3.6(b), cooperate and coordinate with Health Net or such third party as reasonably required for Health Net or the third party to perform such services subject in each case to the applicable requirements of
Section 21.2 that pertain to the third party entering into a Non-Disclosure Agreement relating to Supplier’s Confidential Information. Supplier’s cooperation and coordination will include, as applicable: (i) providing reasonable
access to the facilities being used by Supplier to provide the Services as necessary for Health Net or the third party to perform its 

  

					
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 work; (ii) providing reasonable access to the Equipment and Software used in providing
the Services except to the extent prohibited under any applicable agreements with third parties; provided that this clause (ii) shall not limit Health Net’s rights under Sections 12 and 15; and (iii) providing such information
regarding the operating environment, system constraints and other operating parameters as a person with reasonable commercial skills and expertise would find reasonably necessary for Health Net or the third party to perform its work. 

 

	 	(b)	Health Net shall require that third parties retained by Health Net who utilize Supplier’s resources comply with Supplier’s reasonable security and confidentiality requirements and, as relevant, with
Supplier’s reasonable work standards, methodologies and procedures, if provided in writing by Supplier to Health Net and such third parties. Supplier shall immediately notify Health Net if an act or omission of such a third party may cause a
problem or delay in providing the Services and shall work with Health Net to prevent or circumvent such problem or delay. 

  

	3.7	“Master” Nature of the Terms and Conditions 

  

	 	(a)	The Parties intend that these Terms and Conditions serve as a “master” agreement which will govern the Services and any additional services which the Parties agree will be provided by Supplier to Health Net
under this Agreement. The Parties shall enter into statements of work (each a “Statement of Work” or “SOW”) that will reflect the terms under which Services shall be provided by Supplier to Health Net.

  

	 	(i)	As of the Effective Date, the Parties are entering into the Initial SOWs. 

  

	 	(ii)	If, after the Effective Date, the Parties agree upon additional services that they desire to be governed by these Terms and Conditions, they shall enter into additional SOWs (“Future SOWs”) each
in substantially the same format and containing the same information as in the Initial SOWs and required by Schedule A-3 (SOW Template). 

  

	 	(A)	Upon execution of any Future SOW, such Future SOW shall be governed by and subject to these Terms and Conditions and the other terms of this Agreement; provided, however, that a Future SOW may override any provision of
these Terms and Conditions or any such other term of this Agreement only if, and to the extent that: (i) such Future SOW expressly identifies the provision(s) the Parties intend to override, (ii) such change applies solely to such SOW; and
(iii) the executed version of such Future SOW has been approved by legal counsel for both Parties, as evidenced in writing on the executed version of it. 

  

	 	(B)	With respect to each Future SOW, Health Net and Supplier will jointly determine whether it is necessary or desirable to update any schedule(s) to the Terms and Conditions. 

 

	3.8	New Services 

  

	 	(a)	“New Services” means Functions Health Net requests Supplier to perform under this Agreement 

  

	 	(i)	that are materially different from, and in addition to, the Services; and 

  

					
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	 	(ii)	for which there is no existing charging mechanism in this Agreement. 

  

	 	(b)	Supplier will not perform any additional Functions that would constitute New Services prior to informing Health Net what the additional charges would be for performing them, and receiving Health Net’s prior written
authorization to proceed, all in accordance with Section 17.5 and the Change Control Process. If Supplier does perform the additional Functions without Health Net’s prior written authorization, they will be deemed to have been performed as
part of the Services at no charge. 

  

	3.9	Joinder Agreements 

  

	 	(a)	General. 

  

	 	(i)	The Parties acknowledge and agree that certain Health Net Affiliates desire to contract directly with Supplier for the Services to be provided to such Health Net Affiliates. The Parties agree that any such Health Net
Affiliate that wishes to do so may enter into a joinder agreement with Supplier in the form attached hereto as Schedule T (Joinder Agreement) (each such agreement a “Joinder Agreement”, and each party to a Joinder
Agreement, a “Joinder Party”). 

  

	 	(ii)	Except as provided in Section 3.9(d), any such Health Net Affiliate that enters into a Joinder Agreement (each, a “Health Net Joinder Party”) shall be solely responsible for the Charges with respect to
such Services provided to such Health Net Joinder Party by Supplier, and the Joinder Parties shall comply with the terms of such Joinder Agreement. For the avoidance of doubt, in no event shall a Health Net Joinder Party be responsible for any
Charges for Services provided by Supplier to Health Net or any other Health Net Affiliate. 

  

	 	(iii)	Except as otherwise expressly provided in a Joinder Agreement, all applicable provisions of this Agreement, as the same may be amended or modified from time to time in accordance with Section 25.3, shall be binding
on the Joinder Parties to such Joinder Agreement. Any such amendment or modification to this Agreement shall be binding on such Joinder Parties without any further action by the Parties or such Joinder Parties. 

 

	 	(b)	Resolution of Joinder Disputes. 

 Unless otherwise required by Law, any claim or dispute arising
out of or related to a Joinder Agreement (“Joinder Disputes”) may be brought pursuant to Section 26 by the applicable Joinder Party against the corresponding Joinder Party under such Joinder Agreement. 

 

	 	(c)	Relationship of this Agreement and Joinder Agreements. 

 This Agreement and any Joinder
Agreements are separate, but related agreements. In no event shall this Agreement or any Joinder Agreement be or form the basis for an agreement, directly or indirectly, between Health Net and any Health Net Joinder Party. All Joinder Agreements
shall expire upon termination (for any reason) or expiration of this Agreement. This Agreement shall remain in effect notwithstanding the termination (for any reason) or expiration of a Joinder Agreement. 

  

					
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	 	(d)	Guaranty. 

 Health Net hereby guarantees the payment of all sums payable by Health Net Joinder
Party to Supplier under the Joinder Agreement and shall cause the due and punctual performance and observance by Health Net Joinder Party of all acts and obligations to be performed or observed by Health Net Joinder Party under the Joinder
Agreement. 
  

	3.10	Contract documents to be completed after Effective Date 

 The Parties agree that they
will work in good faith and cooperate with each other to complete the following documents within thirty (30) days after the Effective Date: 
  

	 	(a)	Schedule A-3 (Future SOW Template); 

  

	 	(b)	Schedule J (Project Framework); 

  

	 	(i)	Schedule J-1 (Deliverable Acceptance Procedures); 

  

	 	(ii)	Schedule J-2 (Form of Work Order Project); 

  

	 	(iii)	and Schedule J-3 (Project Estimation Model); and 

  

	 	(c)	Schedule W (Glossary); 

  

	 	(d)	Schedule U (Aspect Assignment and Assumption Agreement). 

 Upon agreement in writing by
the Parties to any such Schedule, it shall be deemed to be attached to this Agreement without the need for an amendment. 
  

	4.	TERM AND REGULATORY APPROVALS 

  

	4.1	Initial Term 

  

	 	(a)	The term of this Agreement shall commence on the Effective Date and expire on the date that is seven (7) years after the BPaaS Services Commencement Date, unless it is terminated earlier or is extended pursuant to
the terms of this Agreement (such period, together with all extensions thereof, the “Term”). 

  

	 	(b)	The term of each SOW shall commence on the SOW Effective Date for such SOW. The Initial SOWs shall expire on the date that this Agreement expires, unless this Agreement or such Initial SOW is terminated earlier or is
extended pursuant to the terms of this Agreement. The Future SOWs shall expire on the date set forth in such Future SOWs, unless such Future SOW is terminated earlier or is extended pursuant to the terms of this Agreement. The foregoing period,
together with all extensions thereof, is known as the “SOW Term”; provided, however, that no SOW Term will extend beyond the Term of this Agreement. 

  

					
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	4.2	Renewal Terms 

  

	 	(a)	By giving notice to Supplier no less than three (3) months prior to the then-existing expiration date of this Agreement, Health Net may extend the Term for a period designated by Health Net of up to one
(1) year (“Renewal Period”)on the terms and conditions (including any productivity improvements) then in effect, provided however, that the Parties agree that the charges in effect during any such renewal period shall be subject to
the mutual agreement of the Parties. 

  

	 	(b)	Health Net shall have two (2) such extension options of up to one (1) year each. With respect to each SOW, Health Net shall have the same rights to extend the applicable SOW Term that it has to extend this
Agreement under this Section; provided, however, that no SOW Term will extend beyond the Term of this Agreement. 

  

	 	(c)	Supplier shall follow the following process in connection with establishing the charges during the Renewal Periods.*** 

  

	4.3	Regulatory and Customer Approvals 

  

	 	(a)	The Parties acknowledge that Health Net must obtain both regulatory approvals and customer consents in order for the Functions that the Parties contemplate to be included in the scope of this Agreement to be actually
included in the scope of this Agreement after the Effective Date. Health Net will keep Supplier informed of progress in obtaining such approvals Health Net will notify Supplier of any regulatory filing or information request, prior to filing or
disclosure, in which any Confidential Information of Supplier (not including this Agreement or the terms hereof) may be disclosed. In the event that any Confidential Information of Supplier will be disclosed, Health Net will request and use
reasonable efforts to obtain confidential treatment of such information, if requested by Supplier. 

  

	 	(b)	In the event that Health Net is not able to obtain such a consent or approval, or in the event that Health Net obtains a regulatory approval or customer consent that is later revoked, (i) Health Net will notify
Supplier and provide such information regarding such denial or revocation as is reasonably requested by Supplier (which information will be deemed Health Net Confidential Information), (ii) Health Net shall have the right to remove any impacted
Services, reduce any volumes associated with such Services, reduce the number of Supplier Personnel associated with such Services (and otherwise modify their skill mix) and remove any impacted Functions from the scope of this Agreement, and
(iii) Health Net shall have the right to terminate this Agreement (in whole or in part) or any SOW (in whole or in part) as of a date specified by Health Net by giving Supplier at least ninety (90) days prior written notice of such
termination. 

  

	 	(c)	The Parties hereby agree that if any Regulator sends to Health Net an email, letter, or other written statement which indicates, in effect, that such Regulator considers the outsourcing of the Services which the Parties
have added or may add after the Effective Date, the volumes associated with such Services, the business process Functions associated with such Services, or Supplier’s solution to provide such Services (e.g., location from which such
Services will be performed), to make Health Net out of compliance with such Regulator, then (i) Health Net shall provide copies of such notices to Supplier, and (ii) in order to maintain compliance with such Regulator, Health Net shall
have the right to remove any impacted Services, reduce any volumes associated with such Services, reduce 

  

					
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 the number of Supplier Personnel associated with such Services and otherwise modify their
skill mix, and remove any impacted Functions associated with such Services, from the scope of this Agreement, and (iii) terminate this Agreement (in whole or in part) or any SOW (in whole or in part) as of a date specified by Health Net by
giving Supplier at least ninety (90) days prior written notice of such termination. 
  

	 	(d)	*** 

  

	 	(ii)	If Health Net provides Supplier with notice that Health Net is exercising its right under clauses 4.3(b)(ii) or 4.3(c)(ii) after the BPaaS Services Commencement Date, then such modification shall be addressed via the
Change Control Process and any Charges associated with such Change Order shall be governed by Section 19.1(a) of Schedule C (Charges). 

  

	 	(iii)	If Health Net provides Supplier with notice that Health Net is exercising its right under clauses 4.3(b)(iii) or 4.3(c)(iii) after the BPaaS Services Commencement Date, then Section 18.1 of Schedule C
(Charges) shall govern. 

  

	 	(e)	To the extent relevant to the performance of the Services or any of Supplier’s other obligations under this Agreement, Supplier shall comply with provisions arising out of Health Net’s contracts for federal
business, including restrictions against providing services from offshore and audit requirements, as such provisions are set forth in this Agreement, included in the Health Net Policies, or otherwise communicated to Supplier. 

 

	5.	PERFORMANCE 

  

	5.1	Performance, Generally 

 Supplier is responsible for managing and successfully
performing, completing, and delivering the Services, subject to the overall direction of Health Net and with the cooperation and support of Health Net as specified in this Agreement. 

 

	5.2	Place of Performance 

  

	 	(a)	Schedule F (Supplier Facilities) sets forth the Supplier and Approved Subcontractor facilities from which Supplier will perform the Services (collectively, the “Supplier Facilities”).
Section 1 of Schedule F (Supplier Facilities) sets forth the offshore Supplier Facilities. Section 2 of Schedule F (Supplier Facilities) sets forth the onshore Supplier Facilities. Schedule F (Supplier Facilities) also
sets forth the type of Services that Supplier is permitted to provide from each such Supplier Facility. 

  

	 	(i)	Supplier may not provide Services from a Supplier Facility unless (A) such Service is expressly permitted to be provided from such Supplier Facility as described in Schedule F (Supplier Facilities), or
(B) Supplier has received Health Net’s prior written consent for such Services to be provided from such Supplier Facility. 

  

	 	(ii)	Health Net may specify, upon prior written notice to Supplier from time to time during the Term, which (if any) Services must be performed on-shore, and Supplier shall comply with any such notice; provided, that any
cost impact from such request, including the costs of performing the Services that are relocated, shall be addressed through the Change Control Process. 

  

					
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	 	(iii)	Supplier shall perform the Services at (i) offshore Supplier Facilities in space that is dedicated to Health Net and with secure access; and (ii) at onshore Supplier Facilities in space that has secure access.

  

	 	(iv)	Supplier may also perform certain of the Services from Health Net Facilities, as described in Section 11.2(f). 

  

	 	(b)	During the Term, Supplier will not change any location from which it provides Services to Health Net, or materially reallocate the volume or nature of work processed between locations from which it provides Services to
Health Net, without Health Net’s prior written approval, which approval (i) may be granted or withheld in Health Net’s discretion and (ii) may be conditioned upon Health Net (or the applicable Health Net Affiliate or Health Net
lines of business) providing prior notification to, and receiving approval from, applicable Regulator(s) and customers. 

  

	 	(c)	Supplier will manage any approved relocations in accordance with this Agreement and provide a migration plan to be prepared by Supplier and approved in writing by Health Net. Prior to seeking Health Net’s approval
of any proposed relocation, Supplier will fully examine and evaluate the risks and anticipated effects of the contemplated relocation on the Services and Health Net, including the operational, technical, security, regulatory, and other effects, and
will prepare and submit to Health Net an analysis of such effects. Supplier will be responsible for all costs, taxes and other expenses incurred by Supplier. Supplier will also be responsible for any new or additional costs, taxes and other expenses
incurred by Health Net and reasonably demonstrated to Supplier that are related to any Supplier-initiated relocation of an operational facility from which the Services are provided, except such new or additional costs, taxes and other expenses
incurred by Health Net, if any, that Health Net has expressly agreed in writing in its discretion to bear and not seek reimbursement from Supplier in connection with such Supplier proposed relocation. 

 

	5.3	Time of Performance 

  

	 	(a)	Supplier will (and will provide the resources necessary to) perform and complete the Services diligently and in a timely manner and in accordance with any applicable time schedules set forth in this Agreement. The
Parties agree that any “hard coded” dates set forth in this Agreement (i.e., references to specific calendar dates (such as a reference to “April 1, 2015” rather than a reference to “thirty (30) days after the BPaaS
Services Commencement Date”), shall be extended on a day-for-day basis reflecting the number of days after March 1, 2015 that the BPaaS Services Commencement Date actually occurs unless and to the extent that the Parties agree otherwise in
writing. 

  

	 	(b)	Supplier will promptly notify Health Net upon becoming aware of any circumstances that may reasonably be expected to jeopardize the timely and successful completion (or delivery) of any Service or other obligation of
Supplier. Supplier will use Commercially Reasonable Efforts to avoid or minimize any delays in performance and will inform Health Net of the steps Supplier is taking or will take to do so, and the projected actual completion (or delivery) time.

  

					
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	 	(c)	If Supplier believes a delay in performance by Health Net (or a third party service provider engaged by or on behalf of Health Net other than Supplier, Supplier’s Affiliates or subcontractors, or a Supplier Managed
Third Party) has caused or will cause Supplier to be unable to perform its obligations on time, Supplier will promptly so notify Health Net and use Commercially Reasonable Efforts to perform its obligations on time notwithstanding Health Net’s
(or such third party service provider’s) failure to perform. If Supplier’s use of Commercially Reasonable Efforts to perform on time in such a circumstance would cause Supplier to incur Out-of-Pocket Expenses, Supplier will so notify
Health Net. In that case, Supplier’s obligation to continue its efforts to work around the Health Net-caused delay will be subject to Health Net agreeing to reimburse Supplier for its additional Out-of-Pocket Expenses incurred in the course of
such efforts. 

  

	5.4	Manner of Performance 

  

	 	(a)	Except as this Agreement expressly provides otherwise, Supplier will perform the Services and cause the Technology Platform to operate in compliance with the following: 

 

	 	(i)	all applicable Service Levels, whether existing as of the Effective Date or added during the Term in accordance with the methodologies and processes set forth in Schedule B (Service Levels), 

 

	 	(ii)	the Procedures Manual; 

  

	 	(iii)	the Health Net Policies, provided that: 

  

	 	(A)	Supplier’s obligation to comply with any Health Net Policy that is not listed in Schedule P (Health Net Policies) on the Effective Date (including the link to the on line repository for Health Net Policies
as of the Effective Date) or is not listed in the applicable SOW as of the SOW Effective Date or with respect to any change to any Health Net Policy whether listed in Schedule P (Health Net Policies) or in an SOW, will commence ten
(10) Business Days after the new Health Net Policy is disclosed to Supplier, or such shorter period of time as required by the circumstances; 

  

	 	(B)	Health Net will deliver to Supplier copies of any changes made by Health Net (excluding changes proposed by Supplier) to Health Net Policies with which Supplier will be expected to comply, sufficiently in advance of the
date such changes are to be effective to allow Supplier to plan for and implement changes in its procedures or performance to comply with the changes in the Health Net Policies; and 

 

	 	(C)	Health Net shall utilize the Change Control Procedure to implement any modified or new Health Net Policy that can reasonably be expected to increase the expenses or obligations of Supplier in any non-de minimis way,
provided that financial responsibility for modified and new Health Net Policies relating to a change in or a new Law shall be governed by Section 17.5(e)(ii)(B); 

 

	 	(iv)	all other compliance obligations of Supplier under this Agreement, including compliance with data security requirements in Section 14 and compliance with Law obligations in Section 27.7; 

  

					
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	 	(v)	the terms of Annex 1 (Supplemental Terms and Conditions for BPaaS Services), and Schedule Y (Offshore Prohibitions and Requirements); and 

 

	 	(vi)	in cases where this Agreement does not prescribe or otherwise regulate the manner of Supplier’s performance of the Services, proven best practices followed by the leading providers of similar services.

  

	 	(b)	In cases where this Agreement does not prescribe or otherwise regulate the manner or quality of Supplier’s performance, Supplier will render the Services with at least the same degree of accuracy, quality,
timeliness, responsiveness and efficiency as was generally achieved or obtained by (or for) Health Net (and its Affiliates) prior to Supplier assuming responsibility under this Agreement for the affected Functions. 

 

	 	(c)	Supplier shall conduct a risk assessment, no less than annually, that is consistent with and that supports Health Net’s Enterprise Risk Assessment program and processes, which identifies risks to the proper
performance of the Services and report on the results of such risk assessment to Health Net, along Supplier’s plans to monitor and mitigate any identified risks. 

 

	5.5	Quality Assurance and Continuous Improvement 

 In performing the Services, Supplier will
follow commercially reasonable quality assurance procedures designed to ensure that the Services are performed with a high degree of professional quality and reliability. Such procedures shall include checkpoint reviews, testing, acceptance, and
other procedures for Health Net to confirm the quality of Supplier’s performance. Supplier, as part of its total quality management process, will provide continuous quality assurance and quality improvement through: (i) the identification
and application of proven techniques and tools from other installations within its operations; and (ii) the implementation of concrete programs, practices and measures designed to improve performance (including the Service Levels). Supplier
will utilize project management tools, including productivity aids and project management systems, as appropriate in performing the Services. 
  

	5.6	Critical Deliverables 

 Supplier shall provide the Critical Deliverables to Health Net in
accordance with Schedule R (Critical Deliverables). 
  

	6.	SERVICE LEVELS 

  

	6.1	General 

 Quantitative performance standards for certain of the Services
(“Service Levels”) are set forth in Schedule B (Service Levels). Supplier’s obligation to pay Service Level Credits is further described in Schedule B (Service Levels). 

 

	6.2	Failure to Perform 

 Supplier will place the Amount at Risk (as defined in Schedule B
(Service Levels)) at risk each month for Service Level Credits. Health Net may allocate the Pool Percentage Available for Allocation among Critical Service Levels for the purpose of calculating Service Level Credits, as further described in
Schedule B (Service Levels). 

  

					
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	6.3	Removal of Performance Group Guarantee Customers. 

  

	 	(a)	If Supplier fails to meet the annual Performance Guarantee Group Service Levels with respect to a Performance Guarantee Group such that the failure for such Performance Guarantee Group is *** Health Net shall have the
right to withdraw such Performance Guarantee Group from this Agreement. *** 

  

	 	(b)	*** 

  

	 	(c)	A withdrawal under this Section 6.3 shall be implemented via the Change Control Process. 

  

	7.	SUPPLIER PERSONNEL 

  

	7.1	Provision of Suitable Personnel 

 Subject to any lesser qualifications of any
Transitioned Employees, Supplier will assign an adequate number of Supplier Personnel to perform the Services who are properly educated, trained, familiar with and fully qualified for the Services they are assigned to perform, and Supplier shall
ensure (to the extent reasonably possible) that any outgoing Supplier Personnel leaving the Health Net account spend a reasonable period of time training the new Supplier Personnel who will be replacing such outgoing personnel. Supplier is
responsible for taking action at its own expense such that Supplier Personnel assigned to perform Services have the legal right to work in the countries in which they are assigned to work. 

 

	7.2	Screening and Background Checks 

  

	 	(a)	Supplier shall, at no additional expense to Health Net, and prior to placing any Supplier Personnel (other than a Transferred Personnel) at Health Net or on the Health Net account, complete background checks for all
such personnel (“Background Checks”). Background Checks shall include, without limitation, verification of work history, I-9 completion (to the extent required by the laws of the United States), verification of passports,
reference checks from at least three (3) prior employers (if such personnel have had three prior employers, and if not then from such personnel’s prior employers), drug testing and such other background checks as Health Net may request.
Background Checks shall also identify State, county, federal and other applicable jurisdictions felonies and misdemeanor convictions and verify the social security number of such personnel, if applicable to such personnel. The personnel will be
asked for education and, with respect to United States resident personnel, the last seven (7) years of residences. Background Checks shall also include a determination as to whether the person has been identified by the Department of Treasury
Office of Foreign Assets Control (“OFAC”) as an individual with whom U.S. persons are prohibited from engaging in transactions. Also, all Supplier Personnel’s background checks will be done by an external
agency that is contracted with Supplier. 

  

	 	(b)	Unless otherwise prohibited by applicable Law, Supplier Personnel may be tested for drugs and/or alcohol whenever Supplier or Health Net has reasonable suspicion that the personnel is under the influence of drugs and/or
alcohol in the workplace or has violated the Health Net Policy on substance abuse. Such personnel have the right to refuse to submit to drug or alcohol testing; however, any personnel who do so will be subject to removal from the Health Net account.
Results of Background Checks and drug testing will remain Supplier’s Confidential Information and will not be provided to Health Net, but any negative or questionable Background Check or drug test of personnel will require Supplier

  

					
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 to remove or not assign such personnel. Supplier shall hire all Supplier Personnel and other
personnel involved in the Health Net account strictly in accordance with all Laws applicable to the hiring and employment of individuals including, without limitation, the Fair Labor Standards Act, Immigration Reform and Control Act and all equal
employment opportunity Laws. 
  

	7.3	Responsibility for Supplier Personnel, Generally 

 Supplier will manage, supervise and
provide direction to Supplier Personnel and cause them to comply with the obligations and restrictions applicable to Supplier under this Agreement. Supplier will make Supplier Personnel aware of, and cause them to comply with, Health Net Policies,
including those pertaining to safety and security. As between Supplier and Health Net, Supplier is responsible for all wages, salaries and other amounts due Supplier Personnel, and for all tax withholdings, unemployment insurance premiums, pension
and social welfare plan contributions, and other employer obligations with respect to Supplier Personnel. Supplier is responsible for the acts and omissions of Supplier Personnel under or relating to this Agreement. 

 

	7.4	Key Supplier Positions 

  

	 	(a)	“Key Supplier Positions” means the Supplier positions identified in Schedule D (Key Supplier Personnel—Account Level) and in each SOW. The Supplier Personnel approved by Health Net as
of the Effective Date to fill the Key Supplier Positions are identified, as applicable, in Schedule D (Key Supplier Personnel—Account Level) and in each SOW. Notwithstanding anything to the contrary in Section 25.3, the Parties
agree that such Supplier Personnel approved to fill Key Supplier Positions may be changed by either (i) amendment to the Agreement or the applicable SOW or (ii) an email exchange between the Parties. If any individual designated to fill a
Key Supplier Position as of the Effective Date turns out to be out of scope before the BPaaS Services Commencement Date and therefore is not hired by Supplier, and (1) if such designated individual was a not a Transitioned Personnel, then the
Parties will backfill that position and Health Net shall have the right to recommend a replacement for such person and Supplier shall give priority to such recommended replacement, or (2) if such designated individual was a Transitioned
Personnel, then Health Net shall have the right to designate a replacement for such person from other rebadged personnel, provided Health Net engages in good faith discussions with Supplier as to such selection. 

 

	 	(b)	Supplier will cause each of the Supplier Personnel filling the Key Supplier Positions (whether as of the Effective Date, or replacement personnel filling such Key Supplier Position during the Term) to devote full time
and effort to the provision of the Services, except as otherwise indicated in Schedule D (Key Supplier Personnel—Account Level). 

  

	 	(c)	Before the initial and each subsequent assignment of an individual to a Key Supplier Position, Supplier will notify Health Net of the proposed assignment, introduce the individual to appropriate Health Net
representatives and, consistent with Supplier’s personnel practices, provide Health Net a curriculum vitae and other information about the individual reasonably requested by Health Net. Upon request, Supplier will provide Health Net
representatives an opportunity to meet with the individual. If Health Net in good faith objects to the proposed assignment, the Parties will attempt to resolve Health Net’s concerns on a mutually agreeable basis. If the Parties have not been
able to resolve Health Net’s concerns within five (5) Business Days, Supplier may not assign the individual to that position and must propose the assignment of another suitably qualified individual. 

  

					
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	 	(d)	Health Net may from time to time change the positions designated as Key Supplier Positions under this Agreement. However, without Supplier’s consent, the number of Key Supplier Positions may not exceed the
then-current total number of Key Supplier Positions. 

  

	 	(e)	Without prior written approval by Health Net, Supplier will not reassign or replace any person assigned to a Key Supplier Position until (i) in the case of the Supplier Personnel initially assigned to a Key
Supplier Position, one year after the completion of the Transition of the Functions for which such Key Supplier Position is responsible, and (ii) in the case of replacements of Supplier Personnel assigned to a Key Supplier Position, one year
after the individual’s assignment to the Key Supplier Position. Subject to the preceding sentence, Supplier will give Health Net, where reasonably possible, at least sixty (60) days advance notice of a proposed change in personnel filling
a Key Supplier Position, and will discuss with Health Net any objections Health Net may have. Supplier will arrange, at no charge for the proposed replacement to work side-by-side with the individual being replaced during the notice period to
effectuate a seamless transfer of knowledge prior to the incumbent leaving the Key Supplier Position. Individuals filling Key Supplier Positions may not be transferred or re-assigned until a suitable replacement has been approved by Health Net, and
no such re-assignment or transfer may occur at a time or in a manner that would have an adverse impact on delivery of the Services or Health Net’s operations. Supplier will establish and maintain an up-to-date succession plan for the
individuals serving in Key Supplier Positions. Supplier may remove an individual filling a Key Supplier Position after notification to Health Net for reasons of death, disability, resignation or termination from employment by Supplier, or otherwise
as mutually agreed by the Parties. In addition, Supplier may suspend an individual filling a Key Supplier Position after notification to Health Net if the individual is under investigation in connection with a Security Breach. 

 

	7.5	Removal and Replacement of Supplier Personnel 

  

	 	(a)	Health Net may immediately remove any Supplier Personnel from any Health Net Facilities if the person is threatening or abusive, commits a crime, engages in an act of dishonesty while performing Services for Health Net
or violates any Health Net Policy pertaining to safety, security or use of Health Net Facilities. If Health Net determines in good faith that the continued assignment to Health Net’s account of any of the Supplier Personnel is not in the best
interests of Health Net, then, at Health Net’s request, Supplier shall promptly remove such Supplier Personnel from the Health Net account. 

  

	 	(b)	Supplier shall not reassign any Supplier Personnel providing services under the AO Agreement to work on the TriZetto platform or provide services to a Supplier customer utilizing the TriZetto platform for two
(2) years after the Effective Date without first obtaining Health Net’s prior written consent. No Supplier Personnel performing services under the AO Agreement shall be removed until there has been proper and sufficient knowledge transfer
to his or her designated replacement. 

  

	7.6	Controlling Turnover of Supplier Personnel 

 Health Net and Supplier agree that it is in
their mutual best interests to keep the turnover rate of Supplier Personnel to a reasonably low level. Accordingly, if Health Net believes that Supplier’s turnover rate is excessive, and so notifies Supplier, Supplier will provide data
concerning its turnover rate and meet with Health Net to discuss the reasons for, and impact of, the turnover rate.If appropriate, Supplier will submit to Health Net its proposals for reducing the turnover rate and the 

  

					
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 Parties will mutually agree on a program to bring the turnover rate down to an acceptable
level. In any event, Supplier will use Commercially Reasonable Efforts to keep the turnover rate to a reasonably low level. Notwithstanding any turnover of Supplier Personnel, Supplier remains obligated to perform the Services in compliance with the
requirements of this Agreement. 
  

	7.7	Subcontracting 

 Supplier may subcontract or delegate the performance of Services only in
accordance with the following: 
  

	 	(a)	Supplier may subcontract the performance of Services to any of its wholly-owned Affiliates. 

  

	 	(b)	Supplier shall enter into and maintain a subcontract with TPUSA, Inc. (“TPUSA”) for the performance of the Contact Center Services provided to Health Net by TPUSA as of the
Effective Date. Except in cases of TPUSA’s gross negligence, willful misconduct or material breach of a material provision, or significant liability or financial risk to either Health Net or Supplier, Supplier shall not terminate or allow such
subcontract to expire without Health Net’s prior written consent. If Supplier terminates the TPUSA subcontract, Supplier shall provide Health Net with written notice of such termination within forty eight (48) hours of sending such
termination notice. Any replacement of TPUSA shall be subject to Health Net’s prior written consent in accordance with Section 7.7(d) and carried out pursuant to a transition plan developed by Supplier and approved by Health Net. Health
Net’s consents and approvals required under this paragraph shall not be unreasonably withheld or delayed. 

  

	 	(c)	Supplier may, in the ordinary course of business, subcontract for third party services or products (which include services and products from non-wholly owned Supplier Affiliates) that satisfy each of the following
conditions: (i) are not dedicated to performance of Services for Health Net, (ii) are not material to a Function constituting a part of the Services, (iii) do not result in a material change in the way Supplier conducts its business,
and (iv) any such third party does not have access to Health Net’s Confidential Information (including Protected Health Information); provided (1) such subcontract does not adversely affect Health Net; and (2) in each case
Supplier provides at least forty-five (45) days prior written notice of the same to Health Net. If Health Net expresses concerns to Supplier about a subcontract covered by this paragraph, Supplier will discuss such concerns with Health Net and
work to resolve Health Net’s concerns on a mutually acceptable basis. 

  

	 	(d)	Except as provided in Sections 7.7(a), 7.7(b) and 7.7(c), Supplier shall not subcontract for performance of, or delegate any of its responsibilities under this Agreement without first obtaining the prior written
approval of Health Net, which approval (i) may be granted or withheld in Health Net’s discretion, (ii) may be conditioned upon Health Net (or the applicable Health Net Affiliate or Health Net lines of business) providing prior
notification to, and receiving approval from, applicable Regulator(s) and customers, and (iii) may be conditioned on Supplier’s obtaining the right from the proposed Subcontractor to assign the related subcontract to Health Net upon the
expiration or any earlier termination of the Services being provided by such Subcontractor, and at such time and upon Health Net’s request, Supplier shall so assign the subcontract to Health Net. When seeking such approval, Supplier will
(i) give Health Net forty-five (45) days prior written notice specifying the components of the Services affected, the scope of the proposed subcontract, 

  

					
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 the identity and qualifications of the proposed Subcontractor and the results of any due
diligence carried out with regard to the proposed Subcontractor; and (ii) at Health Net’s request, provide Health Net a description of the scope and material terms (other than financial) of the proposed subcontract. Health Net may require
Supplier to replace any previously approved Subcontractor found, in the reasonable judgment of Health Net, to be unacceptable. Any Subcontractor authorized by this Section 7.7 or approved by Health Net, in its discretion, shall be an
“Approved Subcontractor” hereunder. 
  

	 	(e)	Approved Subcontractors for each SOW as of the SOW Effective Date are listed in the applicable SOW. Notwithstanding anything to the contrary in Section 25.3, after the SOW Effective Date, the Parties may add
additional Approved Subcontractors, or remove previously approved Approved Subcontractors, by an amendment or by execution of a letter or other informal written document with a signed counter-signature by the receiving Party. 

 

	 	(f)	Supplier will require (i) all Subcontractors with whom Supplier enters into a subcontracting agreement after the Effective Date for performance of any Services to be bound to Supplier by all applicable terms of
this Agreement and to assume toward Supplier all of the applicable obligations and responsibilities that Supplier, by this Agreement, has assumed toward Health Net, and (ii) all Subcontractors (other than those covered by subsection (i)) with
whom Supplier entered into a subcontracting agreement for performance of the services provided to Health Net under the Original BPO Agreement to be bound to Supplier as required by the Original BPO Agreement. 

 

	 	(g)	Supplier may use Approved Subcontractors to perform the Services to the extent permitted by Health Net’s approval. Supplier is responsible for managing all Subcontractors. Supplier remains responsible for all
Functions delegated to Subcontractors to the same extent as if such Functions were to be performed by Supplier acting through its officers, directors, employees, and agents and, for purposes of this Agreement, such Functions will be deemed Functions
performed by Supplier. Supplier will be Health Net’s sole point of contact regarding the Services, including with respect to payment. 

  

	 	(h)	Supplier may disclose Health Net Confidential Information only to Approved Subcontractors who have agreed in writing to protect the confidentiality of such Confidential Information in a manner substantially equivalent
to that required of Supplier under this Agreement and to permit both Supplier and Health Net, or both, to enforce such terms directly against such Subcontractor. As between the Parties, Supplier shall be responsible for all acts and omissions of
(i) Supplier’s independent contractors and other Subcontractors as if they were Supplier’s employees and (ii) any third party to whom Supplier permits access to Health Net Data or Health Net Confidential Information.

  

	 	(i)	Supplier shall not restrict or prevent (including by contract) any Subcontractor from entering into an agreement with Health Net to perform services directly for Health Net. 

 

	7.8	Supplier Personnel No Longer on Health Net Account 

 Subject to Section 7.4(e), in
the event any one of the Supplier Personnel in a Key Supplier Position leaves the Health Net account for any reason (e.g., termination, voluntary departure from Supplier, etc.), Supplier will use commercially reasonable efforts to notify
Health Net of such occurrence within seventy-two (72) hours. 

  

					
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	7.9	Training 

  

	 	(a)	Health Net Required Training. In addition to the training required by Schedule K (Regulatory Compliance Addendum), Supplier Personnel are required to take the then-current Health Net-provided training
(administered online via Health Net’s HR link). As of the Effective Date, the required Health Net training, for which Health Net will provide the content and materials at its own cost, includes: 

 

	 	(i)	HIPAA: An Overview; 

  

	 	(ii)	Business Code of Conduct at Health Net (Ethics); 

  

	 	(iii)	The Painful Price of Healthcare Fraud; 

  

	 	(iv)	Getting the Records Straight; 

  

	 	(v)	Health Net General Compliance; 

  

	 	(vi)	Medicare Part D: Fraud, Waste and Abuse (for all associates whose job functions cover or may cover Medicare Part D); and 

  

	 	(vii)	Other training courses related to the Functions that Health Net requires its employees or contractors to take. 

  

	 	(b)	Each Supplier Personnel shall complete the above training within sixty (60) days after being assigned to the Health Net account, and annually thereafter. 

 

	 	(c)	Health Net Customer Required Training. Supplier Personnel are also required to take any training that a customer of Health Net (e.g., LAUSD) would ordinarily require Health Net personnel to take if Health Net personnel
were performing the Services. 

  

	8.	HEALTH NET RESPONSIBILITIES 

  

	8.1	Appointment of Health Net Program Management Office (PMO) Personnel 

 Health Net will
designate an individual to serve as Health Net’s “Program Manager”, who will be Supplier’s principal point of contact for obtaining decisions, information, approvals and acceptances required from
Health Net. 
  

	8.2	Health Net Cooperation Duties 

  

	 	(a)	In support of Supplier’s performance of the Services and subject to Section 8.3, Health Net will perform the Functions expressly identified in this Agreement, including in each SOW, as retained Health Net
Functions and provide or make available to Supplier the Equipment, Software, and other resources specified in (i) for the Initial SOWs, Schedule O (Health Net Provided Resources), and (ii) each Future SOW, as applicable.

  

	 	(b)	Health Net will cooperate with Supplier, including by making available management decisions, information, approvals and acceptances, as reasonably requested by Supplier so that Supplier may accomplish its obligations
and responsibilities under this Agreement. 

  

					
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	8.3	Savings Clause 

 Health Net’s failure to perform its responsibilities set forth in
this Agreement (or cause them to be performed) will not constitute grounds for termination by Supplier except as provided in Section16.3 (Termination by Supplier). Supplier’s nonperformance of its obligations under this Agreement will be
excused if and to the extent (a) such Supplier nonperformance results from (i) the failure by Health Net (including failure by a Health Net contractor, agent or other party for which Health Net is responsible, but excluding Supplier) to
perform an express obligation of Health Net under this Agreement, (ii) the failure of a Health Net Provided Resource provided that such failure shall not be an excuse if it arises out of Supplier’s failure to perform its obligations to
manage and provide other Services with respect to such Health Net Provided Resource and the related third party from which Health Net procures such Health Net Provided Resource, and/or (iii) a breach by Health Net of its obligations under this
Agreement that prevents Supplier from performing in accordance with this Agreement, and (b) Supplier provides Health Net with reasonable notice of such nonperformance and uses Commercially Reasonable Efforts to perform notwithstanding Health
Net’s failure to perform or breach. If Supplier’s use of Commercially Reasonable Efforts to perform in such a circumstance would cause Supplier to incur Out-of-Pocket Expenses, Supplier may so notify Health Net. If it does, Supplier’s
obligation to continue its efforts to work around Health Net’s failure to perform will be subject to Health Net agreeing to reimburse Supplier for its Out-of-Pocket Expenses incurred in the course of such efforts. SUPPLIER ACKNOWLEDGES THAT
HEALTH NET WOULD NOT BE WILLING TO ENTER INTO THIS AGREEMENT WITHOUT ASSURANCE THAT THIS AGREEMENT MAY NOT BE TERMINATED BY SUPPLIER AND THAT SUPPLIER SHALL NOT HAVE THE RIGHT TO SUSPEND PERFORMANCE OF THE SERVICES EXCEPT, AND ONLY TO THE EXTENT,
EXPLICITLY PROVIDED HEREIN. 
  

	8.4	Minimum Revenue Commitment. 

 Schedule C (Charges) sets out the terms and
conditions of Health Net’s obligation to satisfy the Minimum Revenue Commitment. 
  

	9.	CHARGES 

 Schedule C (Charges) sets forth all the charges payable to Supplier for
performing the Services applicable to such SOW. Health Net will not be required to pay Supplier any amounts for or in connection with performing the Services and fulfilling Supplier’s obligations under this Agreement other than those amounts
expressly payable to Supplier under this Agreement. 
  

	9.1	Pass-Through Expenses 

  

	 	(a)	“Pass-Through Expenses” means third party charges that are to be both (i) paid by Health Net (either (A) directly to the third party or (B) to Supplier, which, in turn, pays the
third party) on an Out-of-Pocket Expenses basis, and (ii) administered by Supplier. Any Pass-Through Expenses shall be agreed upon in accordance with Section 19.4 of Schedule C (Charges). Supplier shall arrange for delivery by third
parties to Supplier of invoices for Pass-Through Expenses, and Supplier promptly shall review such invoices and provide Health Net with the original invoice together with a statement identifying which charges are proper and valid and should be paid
by Health Net. 

  

					
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	 	(b)	Supplier shall use Commercially Reasonable Efforts to minimize the amount of Pass-Through Expenses. With respect to services or materials paid for on a Pass-Through Expenses basis, Health Net reserves the right to:
(i) obtain such services or materials directly from a third party; (ii) designate the third party source for such services or materials; (iii) designate the particular services or materials (e.g., equipment make and model)
Supplier shall obtain; (iv) designate the terms for obtaining such services or materials (e.g., purchase or lease and lump sum payment or payment over time); (v) require Supplier to identify and consider multiple sources for such
services or materials or to conduct a competitive procurement; and (vi) review and approve the applicable Pass-Through Expenses before entering into a contract for particular services or materials. 

 

	9.2	Incidental Expenses 

 Supplier acknowledges that, except as may be otherwise provided in this Agreement,
expenses that Supplier expects to incur in performing the Services (including travel and lodging, document reproduction and shipping, and long-distance telephone) are included in Supplier’s Charges and rates set forth in this Agreement.
Accordingly, such Supplier expenses are not separately reimbursable by Health Net unless, on a case-by-case basis for unusual expenses, Health Net has agreed in advance and in writing to reimburse Supplier for the expense. 

 

	9.3	Taxes 

 The Parties’ respective responsibilities for taxes arising under or in connection with this
Agreement shall be as follows: 
  

	 	(a)	Each Party shall be responsible for any personal property taxes on property it owns or leases, for franchise and privilege taxes on its business, and for taxes based on its net income or gross receipts.

  

	 	(b)	Supplier shall be responsible for any sales, use, excise, value-added, services, consumption and other taxes and duties payable by Supplier on the goods or services used or consumed by Supplier in providing the Services
where the tax is imposed on Supplier’s acquisition or use of such goods or services and the amount of tax is measured by Supplier’s costs in acquiring such goods or services. 

 

	 	(c)	Health Net shall be responsible for any applicable sales, use, excise, value-added, services, consumption or other tax that is assessed on the provision of the Services as a whole, or on any particular Service by any
governmental or taxing authority within the United States; provided, however, that (i) Supplier invoices reflect on a current basis (and in any event before any such tax becomes due and payable) the amount of any such tax in each jurisdiction
and the taxable Services to which such tax relates, (ii) if Supplier fails to reflect on its invoice any such tax on a current basis, Supplier shall be financially responsible for any penalties and interest assessed by the taxing authority with
respect to such tax, and (iii) if Supplier fails to reflect any such tax on a Supplier invoice within twelve (12) months after the date that such tax is due and payable, Supplier shall be financially responsible for the full amount of such
tax, including any penalties and interest. 

  

	 	(d)	Supplier shall be responsible for any sales, use, excise, value-added, services, consumption or other tax that is assessed on the provision of the Services as a whole, or on any particular Service, by any governmental
or taxing authority outside the United States as of the Effective Date or during the Term, except (i) where the Parties agree in writing that a Supplier Affiliate located in a jurisdiction outside of the United States may invoice Health Net or
a Health Net Affiliate directly or (ii) where the Parties agree in writing that Supplier 

  

					
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 will provide centralized billing, wherein a Health Net Affiliate located in a jurisdiction
outside of the United States will receive Services from a Supplier Affiliate located in a jurisdiction outside of the United States and invoicing for such Services is between a Health Net Affiliate located in the United States and a Supplier
Affiliate located in the United States. 
  

	 	(e)	Supplier shall be responsible for any payments required to compensate Supplier Personnel for compensatory tax treatment resulting from Supplier Personnel traveling to perform services, subject to the remainder of this
paragraph. In the event that the assignment (or potential assignment) of particular Supplier Personnel to perform Services for Health Net has reached a point such that the continued assignment of such particular personnel is likely to trigger
compensatory tax treatment of the travel related expenses reimbursed to such particular Supplier Personnel, Supplier may inform Health Net in writing that Supplier is close to becoming subject to compensatory tax treatment as a result of such
assignment, and shall provide an estimate of the amount of such compensatory tax liability. If Supplier fails to so notify Health Net, Supplier shall remain responsible for any amounts resulting from compensatory tax treatment of such particular
Supplier Personnel. Following such notice by Supplier, Health Net may then elect by sending written notice to Supplier to be financially responsible for any payments required to compensate Supplier with respect to such particular Supplier Personnel
in an amount equal to the compensatory taxes assessed to such particular Supplier Personnel as the result of such assignment to the Health Net account. If Health Net does not so elect, Supplier shall remain responsible for any amounts resulting from
compensatory tax treatment of such particular Supplier Personnel, provided, however, Supplier may then relocate such Supplier Personnel to avoid such taxes, and the Parties shall cooperate to make other arrangements so that the Services will be
performed without interruption. 

  

	 	(f)	In the event that a sales, use, excise, value added, services, consumption or other tax is assessed on the provision of any of the Services, the Parties shall work together to segregate the payments under this Agreement
into three (3) payment streams: 

  

	 	(i)	those for taxable Services; 

  

	 	(ii)	those for which Supplier functions merely as a payment agent for Health Net in receiving goods, supplies, or services (including leasing and licensing arrangements); and 

 

	 	(iii)	those for other nontaxable Services. 

  

	 	(g)	The Parties agree to cooperate with each other to enable each to more accurately determine its own tax liability and to minimize such liability to the extent legally permissible, provided however, where the Parties have
made a joint assessment in writing as contemplated in this sentence and a taxing authority subsequently determines that a tax should have been collected and/or paid, the limitation in Section 9.3(c)(iii) will not apply. Supplier’s invoices
shall separately state the amounts of any taxes Supplier is collecting from Health Net, and Supplier shall remit such taxes to the appropriate authorities. Each Party shall provide and make available to the other any resale certificates, information
regarding out-of-state or out-of-country sales or use of equipment, materials or services, and other exemption certificates or information reasonably requested by the other Party. 

  

					
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	 	(h)	Supplier shall promptly notify Health Net of, and coordinate with Health Net the response to and settlement of, any claim for taxes asserted by applicable taxing authorities for which Health Net is responsible
hereunder, it being understood that with respect to any claim arising out of a form or return signed by a Party to this Agreement, such Party shall have the right to elect to control the response to and settlement of the claim, but the other Party
shall have all rights, at its sole cost and expense, to participate in the responses and settlements that are appropriate to its potential responsibilities or liabilities. If Health Net requests Supplier to challenge the imposition of any tax,
Supplier shall do so in a timely manner and Health Net shall reimburse Supplier for the reasonable legal fees and expenses it incurs. Health Net shall be entitled to any tax refunds or rebates granted to the extent such refunds or rebates are of
taxes that were paid by Health Net. 

  

	9.4	Estimating Model 

 Schedule J (Project Framework) sets forth the project
estimation model Supplier will use for the Non-BPaaS IT Services (the “PEM”). The Parties will baseline and assess the PEM annually to address accuracy and institute improvements in Q2 of each calendar year. 

 

	9.5	*** 

  

	 	(a)	***. 

  

	 	(b)	***. 

  

	 	(c)	***. 

  

	 	(d)	***. 

  

	10.	INVOICING AND PAYMENT 

  

	10.1	Invoicing 

  

	 	(a)	Supplier shall invoice Health Net for all amounts due under this Agreement on a monthly basis in arrears (i.e., Charges for Services delivered in August will be invoiced on the invoice delivered to Health Net in
September), or as otherwise agreed by the Parties in writing. Each invoice shall provide, for each Charge, information regarding the Services to which such Charge relate which is sufficient to enable Health Net to determine the contractual basis for
such Charge. Supplier shall include the calculations utilized to establish the Charges. 

  

	 	(b)	To the extent a credit may be due Health Net pursuant to this Agreement, Supplier shall provide Health Net with an appropriate credit against amounts then due and owing. If no further payments are due to Supplier,
Supplier shall pay such amounts to Health Net within *** days of the date of request for such credit by Health Net. 

  

	 	(c)	Supplier shall render a single consolidated invoice for each month’s Charges showing such details as reasonably specified by Health Net, including as necessary to satisfy Health Net’s internal accounting and
chargeback requirements (such as allocating Charges among Service components, locations and departments). The form of invoice shall be mutually agreed by the Parties during Transition and any changes to such form invoice during the Term must be
approved by Health Net. 

  

					
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	 	(d)	Supplier shall use good faith efforts to submit complete invoices that include all Charges incurred in the applicable month, and may include additional Charges on a later invoice, provided that in no event shall Charges
be billed more than *** days after the month during which the invoice for such Charges should have been provided to Health Net pursuant to Section 10.1(a). 

  

	10.2	Payment Due 

 Subject to the other provisions of this Section 10.2, invoices
provided under Section 10.1 and properly submitted to Health Net pursuant to this Agreement shall be paid by Health Net within *** days after receipt thereof. Any amount due under this Agreement for which a time for payment is not otherwise
specified shall be paid within *** days after receipt of a proper invoice for such amount. 
  

	10.3	Accountability 

 Supplier shall maintain complete and accurate records of and supporting
documentation for the amounts billable to and payments made by Health Net hereunder in accordance with generally accepted accounting principles applied on a consistent basis. Supplier agrees to provide Health Net with documentation and other
information with respect to each invoice as may be reasonably requested by Health Net to verify accuracy and compliance with the provisions of this Agreement. 
  

	10.4	Proration 

 Except as may be otherwise provided in this Agreement, periodic Charges under
this Agreement are to be computed on a calendar month basis, and shall be prorated for any partial month. 
  

	10.5	Refundable Items 

  

	 	(a)	Prepaid Amounts. Where Health Net has prepaid for a service or function for which Supplier is assuming Financial Responsibility under this Agreement, Supplier shall refund to Health Net, upon either Party
identifying the prepayment, that portion of such prepaid expense which is attributable to periods on and after the Effective Date. 

  

	 	(b)	Refunds and Credits. If Supplier should receive a refund, credit or other rebate for goods or services previously paid for by Health Net, Supplier shall promptly notify Health Net of such refund, credit or rebate
and shall promptly pay the full amount of such refund, credit or rebate, as the case may be, to Health Net. 

  

	10.6	Deductions 

 With respect to any amount to be paid by Health Net hereunder, Health Net
may deduct from such amount any amount that Supplier is obligated to pay Health Net hereunder. 
  

	10.7	Disputed Charges 

 Subject to Section10.6, Health Net shall pay undisputed Charges when
such payments are due under this Section 10.7. Health Net may withhold and/or set off payment of particular Charges that Health Net disputes in good faith, and may set off amounts due and owing to Health Net as credits against Charges payable
to Supplier under this Agreement. If any such disputed Charges have already been paid, Health Net may deduct such disputed Charges or amounts due from future 

  

					
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 amounts owed by Health Net to Supplier. If an invoiced amount is disputed in good faith by
Health Net, then Health Net shall provide written notification to Supplier of the dispute and the basis for such dispute, and the Parties shall utilize the procedures in Section 26.1 to resolve the issue. In the event that Charges cover both
disputed and undisputed items, then subject to the above in this Section 10.7, Health Net shall pay all undisputed items in accordance with this Agreement. If, after following the procedures in Section 26.1, it is determined that Health
Net should have paid all or a portion of the disputed amounts, (a) Supplier shall submit to Health Net an invoice for an amount equal to the amount of disputed charges that Health Net should have paid, and (b) Health Net will endeavor to
remit payment for such invoice as promptly as possible, but in no event more than *** days from receipt of such invoice. 
  

	11.	TRANSFER OR USE OF RESOURCES 

 This Section 11 sets forth the processes by which
certain resources used by Health Net prior to the Effective Date will be transferred or otherwise made available to Supplier for use in providing the Services. For avoidance of doubt, this Section 11 does not address Acquired Assets which are
being transferred by Health Net to Supplier pursuant to the APA. RIGHTS OF USE GRANTED BY HEALTH NET TO SUPPLIER UNDER THIS SECTION 11 ARE GRANTED ON AN ‘AS-IS, WHERE-IS’ BASIS, WITHOUT WARRANTIES OF ANY KIND. 

 

	11.1	Transfer of Resources 

 Schedule E (Transitioned Employees) sets forth the terms and conditions
governing the recruitment and transition of Health Net personnel to Supplier. If Supplier is obligated to make employment offers to any Health Net personnel in connection with Services to be provided by Supplier under this Agreement, such personnel
shall be the Affected Employees as defined in Schedule E (Transitioned Employees), and the terms of Schedule E (Transitioned Employees) shall govern. 
  

	11.2	Use of Health Net Resources 

  

	 	(a)	General. Health Net’s obligation to provide the Health Net Third Party Service Contracts, the Health Net Owned Software, the Health Net Licensed Software, the Health Net Owned Equipment and the Health Net
Leased Equipment pursuant to Sections 11.2(b), (c) and (d) below (collectively, “Health Net Provided Resources”) and Supplier’s right to use such Health Net Provided Resources, shall be subject to the terms of
Section 11.2(e) below. 

  

	 	(b)	Health Net Third Party Service Contracts. 

  

	 	(i)	The Health Net Third Party Service Contracts that are to be made available to Supplier for use in providing the Services are listed in Schedules O-5-1, O-5-1 and O-5-3 (Health Net Provided Resources). Health Net
(and each of its Affiliates) retains all of its right, title and interest in and to the referenced Health Net Third Party Service Contracts, subject to Supplier’s rights in this Agreement. 

 

	 	(ii)	As of the applicable SOW Effective Date, Health Net grants to Supplier, without assignment of any such Health Net Third Party Service Contract, but subject to the Parties obtaining any Required Consents pursuant to
Section 11.3 (Required Consents), the right to use the services provided to Health Net under such Health Net Third Party Service Contracts relevant to such SOW, if any, until such time as determined in accordance with
Section 11.2(e) below. 

  

					
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	 	(iii)	In the event Health Net or any Health Net Affiliate (e.g., Health Net of California, Inc.) enters into any third party contracts that are designated “Health Net Third Party Service Contracts” made
available to Supplier under this Section 11.2(a), Health Net and/or such Health Net Affiliate will file a list of them with the applicable Regulator. The filing by Health Net and/or such Health Net Affiliate is intended to demonstrate that the
availability of such contracts to Supplier will not prevent Health Net and/or such Health Net Affiliate from complying with the requirements of any applicable Law (e.g., the Knox-Keene Act of California). 

 

	 	(c)	Health Net Owned Software and Health Net Licensed Software. 

  

	 	(i)	For purposes of this Section 11, Health Net Owned Software includes Health Net proprietary configurations of third party Software other than the Configurations acquired by Supplier from Health Net pursuant to the
APA. 

  

	 	(ii)	The Health Net Owned Software and Health Net Licensed Software that are to be made available to Supplier for use in providing the Services, are listed in Schedules O-1 and O-2, respectively (Health Net Provided
Resources). Health Net (and each of its Affiliates) retains all of its right, title and interest in and to the referenced Health Net Owned Software and Health Net Licensed Software. 

 

	 	(iii)	As of the applicable SOW Effective Date, Health Net grants to Supplier until such time as determined in accordance with Section 11.2(e) below and except as provided in Section 5.1(a) of Schedule C
(Charges): 

  

	 	(A)	a fully paid-up, nonexclusive, worldwide license to Use the referenced Health Net Owned Software relevant to such SOW, if any, in both object and Source Code versions, and 

 

	 	(B)	subject to the Parties having obtained any Required Consents pursuant to Section 11.3 (Required Consents) with respect to the referenced Health Net Licensed Software, and without assignment of the license,
such rights as Health Net has (or later obtains) to use the referenced Health Net Licensed Software relevant to such SOW except as in object and, if permissible within the terms of the applicable Required Consent and if approved in writing by Health
Net, the right to modify and adapt the Health Net Licensed Software and access to the Source Code, 

 in each
case, via Citrix or other similar method of remote access. 
  

	 	(iv)	The rights granted in clause (ii) above shall be in effect until such time as determined in accordance with Section 11.2(e) below. 

 

	 	(d)	Health Net Owned Equipment and Health Net Leased Equipment. 

  

	 	(i)	The Health Net Owned Equipment and Health Net Leased Equipment that are to be made available to Supplier for use in providing the Services, are listed in Schedules O-3 and O-4 (Health Net Provided Resources).
Additionally terms relating to provision of desktop computers, laptops, cell phones and similar devices are set forth in and governed by Section 11.4(b). Health Net (and each of its Affiliates) retains all of its right, title and interest in
and to the referenced Health Net Owned Equipment and Health Net Leased Equipment. 

  

					
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	 	(ii)	As of the applicable SOW Effective Date, Health Net grants to Supplier: 

  

	 	(A)	a fully paid-up, nonexclusive, license to use the referenced Health Net Owned Equipment relevant to such SOW, and 

  

	 	(B)	subject to the Parties having obtained any Required Consents pursuant to Section 11.3 (Required Consents) with respect to the referenced Health Net Leased Equipment, and without assignment of the leases,
such rights as Health Net has (or later obtains) to use the referenced Health Net Leased Equipment relevant to such SOW. 

  

	 	(iii)	The rights granted in clause (ii) above shall be in effect until such time as determined in accordance with Section 11.2(e) below. After such time, Supplier will return such Equipment to Health Net in
substantially the same condition as it was when Supplier began use of it, subject to reasonable wear and tear. 

  

	 	(e)	Terms Regarding Supplier’s use of Health Net Provided Resources. The following shall apply to the Health Net Provided Resources: 

 

	 	(i)	Supplier shall utilize the Health Net Provided Resources solely to provide Services to Health Net (and other Service Recipients) under this Agreement. Supplier is not permitted to use the Health Net Provided Resources
for the benefit of any entity other than Health Net (and other Service Recipients under this Agreement) without the prior written consent of Health Net, which may be withheld in Health Net’s discretion. 

 

	 	(ii)	Supplier will comply with the duties and obligations imposed on Health Net by the Health Net Third Party Service Contracts, software licenses (and related maintenance, support and service agreements), and equipment
leases (and related maintenance and service agreements) related to the Health Net Provided Resources, as promptly as practicable after such Health Net Third Party Service Contracts and related agreements have been disclosed to Supplier (but in no
event later than thirty (30) days after such contracts and agreements have been provided to Supplier), provided that Health Net provides to Supplier any commercially reasonable support necessary from Health Net if available for Supplier to so
comply. Supplier shall not seek to revoke or modify the terms of any such agreement. Health Net may revoke or modify the terms of any such agreement, which revocation or modification may give rise to a Change, in which case the Change Control
Process will apply. 

  

	 	(iii)	Health Net shall make the Health Net Provided Resources available to Supplier commencing on the BPaaS Services Commencement Date and continuing through Phase 2, provided that (i) it is permitted under the existing
terms of any applicable third party agreements as of the Effective Date, and (ii) Supplier shall be responsible for providing Managed Third Party Contract Services (as defined in Schedule A (Cross Functional) with respect to the Health
Net Provided Resources after the BPaaS Services Commencement Date, even though Health Net is retaining (subject to Schedule C (Charges), including the Financial Responsibility Matrix attached as Schedule C-11 to Schedule C (Charges))
Financial Responsibility through Phase 2. After Phase 2, Health Net shall have no further obligation to provide such Health Net Provided Resources, subject to clause (iv) below. 

  

					
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	 	(iv)	Terms for making resources available beyond Phase 2. 

  

	 	(A)	If Supplier desires Health Net to continue to provide any of the Health Net Provided Resources after Phase 2, Supplier shall give written notice of such fact to Health Net as soon as reasonably possible, but not less
than ninety (90) days prior to the date by which Health Net would need to (i) notify the applicable contract counter-party in order to effect a renewal or extension of the affected contract beyond Phase 2, or (ii) in order to avoid
the payment of license, maintenance, support, service or other fees extending after Phase 2 if Supplier does not intend to utilize the applicable resource during such period after Phase 2 (a “Resource Extension Notice”).

  

	 	(B)	Provided that Health Net is permitted under the existing terms of any applicable third party agreements, Health Net shall make the Health Net Provided Resources identified in the Resource Extension Notice available
after Phase 2, provided that Supplier shall be financially responsible for any and all costs incurred by Health Net relating to such Health Net Provided Resources with respect to the period after Phase 2 (“Health Net Resources
Costs”), and Supplier shall reimburse Health Net for any and all such costs, such costs to include: 

  

	 	(1)	Any costs incurred by Health Net under any of the Health Net Provided Resources, including fees under the third party Software license fees and fees for maintenance, support and services agreements related to such
resources; 

  

	 	(2)	Any reasonable internal costs to maintain and support any of such resources; and 

  

	 	(3)	The reasonable internal administrative and personnel costs incurred by Health Net relating to any such resources. 

  

	 	(C)	Notwithstanding the foregoing, in no event shall (i) Health Net be obligated to make available the contracts identified in Schedule O-5-1 after Phase 2, and (ii) Health Net be obligated to make any Health Net
Provided Resource available to Supplier after the date that is two years after the end of Phase 2. 

  

	 	(D)	Health Net shall invoice Supplier for the Health Net Provided Resources Costs to be reimbursed by Supplier pursuant to this Section 11.2(e). Such invoices shall be paid by Supplier to Health Net within forty-five
(45) days after receipt thereof. 

  

	 	(E)	Section 5.1 of Schedule C (Charges) contains additional terms relating to the Health Net Provided Resources. 

  

					
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	 	(v)	Supplier will return any such Health Net Provide Resource to Health Net or, at Health Net’s election, destroy it and certify the destruction of all copies in Supplier’s (or any of its Subcontractor’s)
possession or control, at such time as Health Net is no longer obligated to provide such Health Net Provided Resource pursuant to this Section 11.2(e). 

  

	 	(vi)	In the event that Health Net makes any additional Health Net Provided Resources available after the Effective Date, any such additional item shall be subject to the applicable Section 11.2(b), (c) or
(d) above, as well as this Section 11.2(e). 

  

	 	(vii)	Supplier shall create a list of the dates by which Supplier must provide the Resource Extension Notice with respect to each Health Net Provided Resource in order to comply with the requirements of
Section 11.2(e)(iv)(A). Supplier shall provide such list to Health Net on or before the date that is forty-five (45) days after the BPaaS Services Commencement Date provided that with respect to any contract that is not provided to
Supplier as of the BPaaS Services Commencement Date, Supplier shall have an additional forty-five (45) days after being provided such contract to update the list with the date for such contract in order to be in compliance with
Section 11.2(e)(iv)(A). Any inaccuracies in such list shall not relieve Supplier of its obligations under this Section 11. 

  

	 	(f)	Health Net Facilities. 

  

	 	(i)	Subject to the Parties having obtained any Required Consents pursuant to Section 11.3, Health Net grants to Supplier the right, to access the Health Net Facilities, to the extent permitted by applicable lease
agreements, solely to perform the Services. Such space to be made available is described on Schedule O (Health Net Provided Resources). 

  

	 	(ii)	Such facilities shall be provided from the BPaaS Services Commencement Date until the end of Phase 2. If Supplier desires to occupy the Health Net facilities after Phase 2, Supplier shall pay Health Net for such space
in accordance with the following. Supplier shall provide written notice to Health Net that it desires to occupy such space after Phase 2 not less than six (6) months prior to the end of Phase 2. The Parties shall discuss and determine a fair
market rent for such space. 

  

	 	(iii)	Supplier will comply with the duties imposed on Health Net (or its Affiliate) by each lease for the Health Net Facilities, commencing ten (10) Business Days after such duties have been disclosed to Supplier in
writing. 

  

	 	(g)	Terms Applicable to Health Net Facilities, Generally. 

  

	 	(i)	The following provisions are applicable with respect to the Health Net Facilities: Health Net retains responsibility for management and maintenance of the building and property electrical systems, water, sewer, lights,
heating, ventilation and air conditioning (“HVAC”) systems, physical security services and general custodial/landscape services (including monitoring and maintaining the uninterruptible power supply
(“UPS”) system, air handlers and water chillers that are primary support for the raised-floor environment in Health Net Facilities). 

  

					
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	 	(ii)	Supplier is responsible for providing all other the facilities and facilities-related support it needs to provide the Services. 

  

	 	(iii)	Health Net will inform Supplier of any plans or determination to relocate the Health Net Facilities so that Supplier will have a reasonable amount of time to prepare for and implement such relocation as it affects
Supplier. 

  

	 	(iv)	Supplier’s use of the Health Net Facilities shall be for the sole and exclusive purpose of providing the Services and shall be subject to the terms set forth in this Section 11.2(f). Any other uses are subject
to the prior approval of Health Net in its discretion. Supplier’s use of Health Net Facilities does not constitute a leasehold or other property interest in favor of Supplier. 

 

	 	(v)	Supplier will use the Health Net Facilities in an efficient manner and in a manner that is coordinated and does not interfere with Health Net’s business operations. Supplier is responsible for any damage to Health
Net Facilities resulting from the negligent or intentional misconduct of Supplier (or its Subcontractors or other guests) or other failure to comply with its obligations under this Agreement respecting the Health Net Facilities. 

 

	 	(vi)	Supplier will keep the Health Net Facilities in good order, not commit or permit waste or damage to them or use them for any unlawful purpose or act. Supplier will comply with Health Net Policies and with applicable
leases made available to Supplier regarding access to and use of the Health Net Facilities, including procedures for the physical security of the Health Net Facilities. 

 

	 	(vii)	Supplier will permit Health Net and its agents and representatives to enter any portions of the Health Net Facilities occupied by Supplier Personnel. 

 

	 	(viii)	Supplier may not make improvements or changes involving structural, mechanical or electrical alterations to the Health Net Facilities without Health Net’s prior written approval. Any improvements to the Health Net
Facilities will become the property of Health Net. 

  

	 	(ix)	When Health Net Facilities are no longer required for performance of the Services, or in any event upon expiration or termination of this Agreement (or the applicable lease term, if shorter), Supplier will return them
to Health Net in substantially the same condition as when Supplier began use of them, subject to reasonable wear and tear. 

  

	11.3	Required Consents 

  

	 	(a)	Health Net, with the cooperation of Supplier, is responsible for obtaining Required Consents under any of the leases, contracts and licenses referred to in this Section 11 (Transfer or Use of Resources) (the
“Used Resources”). Health Net will work diligently to obtain such Required Consents as soon as practicable after: 

  

	 	(i)	the Effective Date with respect to the Used Resources known as of the Effective Date, or 

  

	 	(ii)	such later date as agreed by the Parties with respect to new Used Resources agreed to by the Parties after the Effective Date, if any. 

  

					
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	 	(b)	To the extent a Required Consent under this Section 11 has not been obtained prior to the Transfer Date of the applicable Health Net Personnel who have a role in obtaining a given Required Consent, then once such
Health Net Personnel are Transitioned Employees, Supplier will utilize such Transitioned Employee to obtain such Required Consents, provided that this shall not relieve Health Net from any legal obligation (including the obligations Health Net may
have to the third parties from which such Required Consents are sought) to obtain their consent to the transactions contemplated by this Agreement. 

  

	 	(c)	The Parties will equally bear any fees (such as transfer or upgrade fees) required to obtain a Required Consent relating to the Used Resources. Unless and until each such Required Consent has been obtained, to the
extent practical Supplier will determine and adopt, subject to Health Net’s prior written approval, such alternative approaches to provide the Services without the Required Consent. The Parties shall equally bear the costs to implement such
alternative approaches. 

  

	 	(d)	If either Party is not able to obtain any such Required Consent, or if it elects not to obtain a Required Consent because of the cost or other terms required to obtain such Required Consent, Health Net reserves the
right to remove from the scope of this Agreement any affected Services (or reduce the volume of any affected Services). If the failure to obtain the Required Consent has a material impact on Supplier’s ability to provide the remaining Services
or its Charges, Supplier may remove from the scope of this Agreement any affected Services (or reduce the volume of any affected Services). In either such event (i) the Charges shall be reduced using the charging methodologies provided in
Schedule C (Charges) and unit rates set forth in the applicable SOW, or otherwise in an equitable manner to the extent such unit rates and charging methodologies do not provide a means to determine what the reduction of Supplier’s
Charges should be, and (ii) Health Net shall have the right to rehire Transitioned Employees that are performing or will perform the Services removed from the scope of this Agreement. Health Net’s right in such case to remove or reduce
Services (and the corresponding adjustment to charges and right to rehire Transitioned Personnel) shall extend to other Services that relate to Services for which a Required Consent is not obtained if, in Health Net’s reasonable determination,
such other Services should be grouped together for operational, maintenance or other reasons. The removal or reduction of Services pursuant to this Section 11.3(d) will be subject to the Change Control Process and Schedule G
(Governance). 

  

	11.4	Health Net Resources Provided to Supplier Personnel Working On-site 

  

	 	(a)	“On-site Health Net Resources” means the reasonable office space, furniture, fixtures, telephones, office supplies, and other mutually agreed resources to be provided or made
available by Health Net (or its Affiliates) to Supplier Personnel assigned by mutual agreement of the Parties to work on-site at facilities of Health Net (or its Affiliates). 

 

	 	(b)	Except as otherwise provided in this Agreement, Health Net will provide to Supplier Personnel located and authorized to work on-site at Health Net Facilities the On-site Health Net Resources reasonably necessary for the
Transitioned Employees to continue to perform the Functions that they were providing prior to the Transfer Date; provided however, that: 

  

					
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	 	(i)	For those Transitioned Employees utilizing a Health Net-provided cell phone, Health Net will continue to provide such cell phones until the earlier of (A) the date the lease or contract for each phone expires or
terminates, or (B) the end of Phase 2, after which Supplier shall provide same; 

  

	 	(ii)	With respect to laptops and desktops, Health Net will provide such PCs for the Transitioned Employees until the earlier of (A) the date the lease on such PC expires or terminates, or (B) the end of Phase 2,
after which Supplier shall provide same. 

  

	 	(iii)	Health Net will not be responsible for providing any other portable computing or communications devices to Supplier Personnel. 

  

	 	(c)	Supplier shall comply and cause Supplier Personnel to comply with Health Net’s Policies regarding access to and use of the On-site Health Net Resources to Supplier, including procedures for the physical and logical
security. Health Net may conduct periodic compliance inspections and audits to confirm that Supplier’s use of the On-site Health Net Resources complies with the terms of this Agreement. 

 

	 	(d)	Supplier will use the On-site Health Net Resources in an efficient manner and for the sole purpose of providing the Services. Supplier will be responsible for damage to the On-site Health Net Resources caused by the
negligence or intentional misconduct of Supplier Personnel. When the On-site Health Net Resources are no longer required for performance of the Services, Supplier will return them to Health Net in substantially the same condition as they were in
when Supplier began use of them, subject to reasonable wear and tear. 

  

	11.5	Service Description Update 

  

	 	(a)	On or before the date that is forty-five (45) days after the Effective Date, Supplier shall provide a plan to Health Net describing Supplier’s proposed approach for conducting a true-up of the Services
descriptions to determine if there are any additional Functions that were being performed by the Affected Employees during the twelve (12) months prior to the Effective Date that are not described in the Initial SOWs. Such plan shall be subject
to Health Net’s review and approval. 

  

	 	(b)	Promptly after the BPaaS Services Commencement Date, Supplier shall implement the approved plan described in Section 11.5(a) above. Supplier shall create a list and description of any Functions that are not covered
in the Initial SOWs and provide same to Health Net on or before the date that is forty-five (45) days after the BPaaS Services Commencement Date. In assembling such list of omitted Functions, Supplier shall not exclude or delete any Function
identified by a Transitioned Employee in connection with such effort. The Initial SOWs shall be updated with any additional Functions and descriptions that the Parties agree were not described in the applicable Initial SOW. There shall be no
increase in the Charges as a result of the updating process described in this Section. 

  

					
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	12.	RESOURCE ACQUISITIONS DURING THE TERM 

  

	12.1	General Responsibility and Compatibility 

  

	 	(a)	Except for (i) any resources set forth in Schedule O (Health Net Provided Resources), for which Health Net has Financial Responsibility and (ii) items which are shown as Health Net Retained Expenses in
the Financial Responsibility Matrix attached as Schedule C-11 to Schedule C (Charges), Supplier is solely responsible (and has Financial Responsibility) for providing all Equipment, Software, connectivity, facilities, personnel, third party
services and other resources required to perform and render the Services in accordance with this Agreement, including modifications, upgrades, enhancements, additions and replacements of Equipment, Software, and other resources as necessary or
appropriate to render the Services in compliance with this Agreement. 

  

	 	(b)	Without limiting the generality of the foregoing, unless otherwise provided in Schedule O (Health Net Provided Resources), Supplier is also responsible (and has Financial Responsibility) for: 

 

	 	(i)	providing network connectivity between facilities necessary to provide the Services, including connectivity from Health Net Facilities or Health Net’s outsourcing vendor facilities to Supplier’s facilities,
onshore and offshore. The Parties shall work together to determine the bandwidth, access, security and other requirements for such network connectivity; 

  

	 	(ii)	acquiring additional third party services as necessary or appropriate to render the Services in compliance with this Agreement; 

  

	 	(iii)	providing personal computers for Supplier Personnel and any additional Equipment (including modifications, upgrades, enhancements, additions and replacements of Equipment) as necessary or appropriate to render the
Services in compliance with this Agreement, and the installation, operation, maintenance and refresh of such Equipment; and 

  

	 	(iv)	providing or acquiring all Software as necessary or appropriate to render the Services in compliance with this Agreement, including any office productivity Software for Supplier Personnel. 

 

	 	(c)	Supplier shall provide the Services using tools and processes that are compatible with those used by Health Net and its other service providers to provide other services within the Health Net environment. This includes
implementing and maintaining interfaces with Health Net and other service provider problem management, change control, and configuration management systems to the extent required to maintain such compatibility. 

 

	 	(d)	Notwithstanding anything to the contrary in Section 25.3, the Parties agree that Schedule O (Health Net Provided Resources) may be changed through the Change Control Process without the need for a formal
amendment to this Agreement. 

  

					
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	12.2	Software Used to Provide the Services 

  

	 	(a)	Upon Health Net’s request (made not more than twice per annum) Supplier will provide to Health Net a list of all Supplier Provided Software. Supplier Provided Software excludes any Health Net Software or third
party Software to be provided by Health Net for Supplier’s use under this Agreement. Each list of Supplier Provided Software required under this Section 12.2(a) will separately identify: 

 

	 	(i)	Supplier Software that is Commercially Available, 

  

	 	(ii)	Supplier Software that is Non-Commercially Available, 

  

	 	(iii)	Third Party Software that is Commercially Available, and 

  

	 	(iv)	Third Party Software that is Non-Commercially Available. 

  

	 	(b)	If, after the Effective Date, Supplier intends to use any Supplier Software or Third Party Software that would constitute Supplier Provided Software, Supplier may do so without obtaining Health Net’s prior written
consent (except as provided in Section 12.3(b)(ii)(B)(1)) provided that (i) Supplier’s implementation and use of such Software does not constitute a Change (and if it does, Supplier’s implementation and use of it will be subject to
the Change Control Process), and (ii) Supplier has all necessary rights and agrees to provide to Health Net at the end of the Term the applicable license rights set forth in Section 12.3 with respect to such Software. 

 

	 	(c)	Notwithstanding anything else in this Section 12.2 to the contrary, if Supplier makes available to Health Net, or otherwise makes receipt of the Services dependent upon, any Software and fails to follow the process
set forth in this Section 12.2, such use shall not limit Supplier’s obligations or Health Net’s rights set forth in Section 12.3 below. 

  

	 	(d)	Any Software and associated contracts acquired by Supplier for which Health Net is financially responsible shall be acquired in the name of Health Net unless Health Net otherwise agrees in writing. 

 

	12.3	Health Net Rights to Certain Software 

 The intent of this Section 12.3 is to
provide the means for Health Net to have the ability to access and Use, both during the Term and Disengagement Assistance Period and thereafter as Health Net may require as contemplated herein, all Supplier Provided Software, it being the mutual
intent of the Parties to provide Health Net a means to acquire licenses to whichever of the Supplier Provided Software that Health Net may desire to continue using after the Term and any Disengagement Assistance Period as outlined herein. 

 

	 	(a)	License During Term. 

  

	 	(i)	Supplier hereby grants to Health Net during the Term and any Disengagement Assistance Period, the right to use Software made available by Supplier to Health Net during the Term (including any updates and upgrades to
such Software provided by Supplier), solely for Health Net (and its Affiliates and Service Recipients) to receive and use the Services. 

  

					
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	 	(ii)	Supplier hereby grants to Health Net, its Affiliates and the Service Recipients during the Term and any Disengagement Assistance Period, the right to access and Use—appropriate to their designated roles for Health
Net and its Affiliates and consistent with Health Net’s and its Affiliates’ practices prior to the execution of this Agreement—the systems used by Supplier to provide the Services (and Health Net Data stored or processed in such
systems) solely for Health Net, its Affiliates and the Service Recipients to perform their designated roles for Health Net and its Affiliates as reasonably required to receive and use the Services and otherwise reasonably required to carry on Health
Net’s and its Affiliates business operations. By way of example and not limitation, Health Net’s rights include the right to access the systems used by Supplier to provide the Services in order to access Health Net Data, generate queries,
run reports and perform retained Functions. 

  

	 	(b)	Additional Licenses to Use Certain Software. 

 This Section 12.3(b) shall apply to
the Initial SOWs and any Future SOWs entered into by the Parties, provided that with respect to any Future SOW, the Parties may mutually agree in writing that this Section 12.3(b) shall not apply to such SOW, provided further that such
agreement shall require the written agreement of the Health Net Legal Department. 
  

	 	(i)	Supplier Software 

  

	 	(A)	Commercially Available Supplier Software 

  

	 	(1)	With respect to Supplier Provided Software that is Commercially Available Supplier Software, Supplier (on behalf of itself and those Supplier Affiliates that own any such Software) grants to Health Net and its
Affiliates (and for the sole purpose of providing services to Health Net, its Affiliates, Former Health Net Affiliates and Service Recipients, to Health Net’s and its Affiliates’ service providers), a license to Use such Software under the
then-current license terms made available by Supplier to commercial customers comparable to Health Net in terms of use of the Software, during all Disengagement Assistance Periods for any Service for which such Software is used, and continuing
thereafter, provided however that: 

  

	 	a.	if such then-current terms do not grant Health Net rights to Use such Software in the same manner and for the same purposes it was used under this Agreement, then such license shall be deemed to include such additional
rights of Use without additional charge; and 

  

	 	b.	if Health Net and Supplier have an existing license agreement applicable to such Software, the terms of such license agreement shall apply. 

The foregoing licenses shall be provided at the fees that are ordinarily charged by Supplier to licensees of such Software, for the period
after the applicable Disengagement Assistance Periods; provided, however, that if the fees that are ordinarily charged are for a perpetual license and Health Net desires to use such Software for only a limited time period after the applicable
Disengagement Assistance Periods, Health Net shall not be required to purchase a perpetual license for such Software (or pay the equivalent of a perpetual license fee). 

  

					
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	 	(2)	Supplier will offer to provide to Health Net, generally available Software Updates, maintenance, support and other services for such Supplier Software on Supplier’s then-current standard terms and conditions for
such services, including pricing not in excess of that customarily charged to Supplier’s other commercial customers comparable to Health Net in terms of use of the Software. If Health Net elects to receive such services, (a) Health Net
shall only be obligated to pay for such services to the extent applicable to the period after the applicable Disengagement Assistance Periods; and (b) the charges for such services will reflect that maintenance and support on such Software is
current (i.e., no “catch-up” or similar payments shall be required to be made by Health Net because maintenance and support may have lapsed – if maintenance and support has lapsed, Supplier shall pay charges necessary to bring
maintenance and support current). 

  

	 	(B)	Non-Commercially Available Supplier Software 

  

	 	(1)	Supplier (on behalf of itself and those Supplier Affiliates that own any Supplier Provided Software that is Non-Commercially Available Supplier Software) grants to Health Net and its Affiliates (and for the sole purpose
of providing services to Health Net, its Affiliates, Former Health Net Affiliates and Service Recipients, to Health Net’s and its Affiliates’ respective service providers), a worldwide, irrevocable, fully paid-up, royalty-free,
non-exclusive, non-transferable (except pursuant to a permitted assignment of the Agreement pursuant to Section 27.1) license to Use (solely to the extent such Use is reasonably necessary for use and receipt of the applicable Services being
disengaged or for Health Net, its Affiliates and their respective service providers to provide and deliver to Health Net, Health Net Affiliates, Former Health Net Affiliates and Service Recipients services that are substantially similar to the
Services being disengaged) Supplier Provided Software that is Non-Commercially Available Supplier Software (including technical interfaces, Documentation, artifacts, manuals and other materials useful in connection with the authorized Use of such
Software), during all Disengagement Assistance Periods for any Service for which such Software is used, and continuing through the date that is two (2) years after the last day of the Disengagement Assistance Period pertaining to the applicable
Services being disengaged. 

  

					
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	 	(2)	If Health Net requests, the Parties will mutually agree on applicable terms for Supplier’s maintenance and support of such Non-Commercially Available Supplier Software, and performance of software development
requested by Health Net relating to such Software, after such termination or expiration of the Agreement (in whole or in part) or termination of Services for which such Supplier Software was used; provided that: 

 

	 	a.	Health Net shall only be obligated to pay for such maintenance and support and development services for the period after the applicable Disengagement Assistance Periods; and 

 

	 	b.	If Health Net elects, such Software maintenance and support and development services shall be performed (i) under the AO Agreement, in which event the Parties shall negotiate in good faith an appropriate amendment
or work order to the AO Agreement, or (ii) on a time and materials basis, including using the professional service rates for applicable skill sets set forth in Schedule C (Charges). 

 

	 	c.	If Supplier fails to provide commercially reasonable maintenance and support and development services for such Non-Commercially Available Supplier Software at the charges described in this Section 12.3(b)(i)(B)(2)
, then within ten (10) days of Health Net’s request, Supplier shall provide Health Net and its designees access to the reasonably necessary Source Code for such Software in a Supplier-provided development environment during the period of
Health Net’s license to such Software described above, in order to enable Health Net and its designees to perform such maintenance and support and development work on such Software, subject to the license limitations set forth in Section
12.3(b)(ii)(B)(1). Supplier shall reasonably cooperate with Health Net and its designees in connection therewith to enable Health Net to realize the benefits of the license granted under Section 12.3(b)(i)(B)(1). 

 

	 	d.	If Supplier fails to provide the access and cooperation described in the preceding Section 12.3(b)(i)(B)(2)(c), then within ten (10) days of Health Net’s request Supplier shall provide the Source Code to
such Non Commercially Available Supplier Software for Use in accordance with the license granted in Section 12.3(b)(i)(B)(1). 

  

	(ii)	Third Party Software 

  

	 	(A)	Commercially Available Third Party Software. Supplier shall provide written notice to Health Net identifying any Supplier Provided Software that is Third Party Commercially Available Software as set forth in
Section 12.2(a) above. 

  

	 	(B)	Non-Commercially Available Third Party Software. 

  

					
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	 	(1)	Supplier shall not utilize any Non-Commercially Available Third Party Software that would constitute Supplier Provided Software without Health Net’s prior written consent, which consent Health Net may withhold in
its discretion. 

  

	 	(2)	Without limiting Health Net’s rights under this Section, no consent of Health Net shall be valid unless such consent outlines Health Net’s material rights to such Software during the Term and during any
Disengagement Assistance Periods and for the two years after the applicable Disengagement Assistance Period. Unless Health Net expressly (i) consents to other specifically outlined license rights in writing in which this Section
12.3(b)(ii)(B)(2) is cross referenced as being superseded, (ii) enters into a license agreement with the applicable third party under different terms or (iii) otherwise waives in such written consent the following requirements, such Health Net
material rights shall include the following: 

  

	 	a.	a world-wide, irrevocable, fully-paid up, royalty-free, non-exclusive license for Health Net and its Affiliates (and for the sole purpose of providing services to Health Net, its Affiliates, Former Health Net Affiliates
and Service Recipients, to Health Net’s and its Affiliates’ respective service providers) to Use such Non-Commercially Available Third Party Software (including Source Code, programmer interfaces, Documentation, artifacts, manuals and
other materials useful in connection with the Use of such Software), at no additional charge, during any Disengagement Assistance Periods for any Services for which such Software is used, and continuing through the date that is two (2) years
after the last day of the Disengagement Assistance Period with the latest end date, or such other license terms as Health Net may agree in writing to accept, and 

  

	 	b.	a commercially reasonable maintenance and support agreement for such Software from the licensor of such Third Party Software, provided that: 

 

	 	i.	if Health Net elects to receive such maintenance and support, Health Net will be responsible for charges under such maintenance and support agreement only with respect to the period after the end of the Disengagement
Assistance Period with the latest end date, and 

  

	 	ii.	the charges under such maintenance agreement shall reflect the fact that maintenance and support on such Software is current (i.e., no “catch-up” or similar payments shall be required to be made by Health Net
because maintenance and support may have lapsed during the Term or Disengagement Assistance Period). 

  

					
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	 	(C)	If Supplier fails to comply with its obligations under Section 12.3(b)(ii)(B)(1) or (2), such failure shall constitute a breach of this Agreement. In such event, by way of endeavoring to mitigate Health Net’s
damages resulting from the failure, Supplier shall use all Commercially Reasonable Efforts, at Supplier’s cost and expense to (i) promptly secure for Health Net a license comparable to a Deliverables License for the Non-Commercially Available
Third Party Software, or (ii) if this cannot be accomplished with Commercially Reasonable Efforts, replace the Non-Commercially Available Third Party Software without degrading the functionality or performance of the Services and bear any costs of
implementing the replacement Software, and secure for Health Net a license for such replacement Software as follows: (i) if such replacement Software is Non Commercially Available Third Party Software, then a license comparable to a
Deliverables License, and (ii) if such replacement Software is Commercially Available, then a license on the standard terms on which such Software is licensed to customers comparable to Health Net. 

 

	 	(c)	Relationship to License in Section 15 (IP Rights). Nothing set forth in this Section 12.3 shall limit Health Net’s rights under Section 15 (Intellectual Property Rights). 

 

	12.4	Colocation Facilities. 

  

	 	(a)	Prior to the Effective Date, Supplier entered into agreements (each a “Colocation Agreement”) to procure certain colocation space in a data center in Centennial, Colorado and a data center in
Chandler, Arizona. Supplier intends to exercise an option to procure additional colocation space under each of the Agreements for use in providing the Services to Health Net (“Health Net Colocation Space”). 

 

	 	(b)	Health Net shall have the option, at any time after it has requested Disengagement Assistance from Supplier and continuing through the date that is two (2) years after the last day of the Disengagement Assistance
Period pertaining to the applicable Services, to assume Supplier’s rights and obligations under the Colocation Agreements with respect to such Health Net Colocation Space only. Supplier represents and warrants that each of the providers of such
Health Net Colocation Space (“Colocation Providers”) has consented to such arrangement. 

  

	 	(c)	If Health Net elects to exercise such option, Health Net shall give written notice to Supplier. Supplier will assign the Colocation Agreement to Health Net or, if Health Net so elects, provide Health Net with reasonable
cooperation and support in Health Net’s efforts to procure a replacement agreement with the Colocation Provider for use of such Health Net Colocation Space. 

  

					
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	13.	TRANSITION 

  

	13.1	Overview 

  

	 	(a)	This Article 13 (Transition) addresses at a high level the transition of the Functions comprising the Services from Health Net to Supplier. Schedule Z (High-Level Transition Information) provides a consolidated
view of Transition across all of the Initial SOWs and, in addition, each of the Initial SOWs contains an exhibit describing the Transition approach and plans for the relevant Service Tower. 

 

	 	(b)	The Transition approaches, plans and schedules set forth in Schedule Z (High-Level Transition Information) and the Initial SOWs reflect the Parties’ preliminary understanding as to how the Transition will be
conducted, but they do not contain the necessary level of detail to serve as executable Transition plans. Promptly following the execution of this Agreement, Supplier will work diligently with Health Net’s team leads for each Service Tower to
develop and submit executable Transition plans containing the necessary level of operational detail, as set forth in Section 13.4(b). 

  

	 	(c)	The Transition will be carried out in sequential phases and discrete ‘waves’ encompassing different Functions and work streams. Some waves are independent from other waves, and some are dependent on the
progress and results of other waves. To help ensure that the Transition proceeds smoothly and with minimal disruption to Health Net’s business operations, the Parties will establish and include in the executable Transition plans appropriate
‘check-point gates’ intended to assess and validate the progress of Transition waves at logical points along the way, both to ensure that problems encountered during a Transition wave are resolved before dependent work proceeds and that
lessons learned from performance of Transition waves are documented and communicated to the Transition teams working on other waves in order to minimize the recurrence of problems during Transition. 

 

	13.2	“Transition” Defined 

  

	 	(a)	“Transition” means the process (and associated time period) of migrating performance of the Services from Health Net or from Health Net’s then-current service provider to Supplier,
completing any contemplated movement of services from onshore locations to alternate onshore locations, near shore locations and offshore locations (each as contemplated by the applicable Transition Documents), making any planned improvements to the
process and methods and infrastructure used to perform and deliver the Services that are intended to be made during the period of Transition, and causing any required knowledge transfer from Health Net personnel to Supplier Personnel.

  

	 	(b)	The Transitions for each of the Initial SOWs (each, an “Initial SOW Transition”) shall commence on the BPaaS Services Commencement Date, and continue through the date that Supplier has assumed
all responsibility with respect to the SOW Services covered by the Initial SOWs and completed the transition to the contemplated off-shore service delivery model. The Parties expectation is that Transition will occur over an approximately two
(2) year period after the BPaaS Services Commencement Date. 

  

	 	(c)	The Transition for each Future SOW (each, a “Future SOW Transition”) shall commence on the applicable SOW Effective Date, and continue through the date that Supplier has assumed all
responsibility with respect to the SOW Services covered by such Future SOW and completed the transition to the contemplated off-shore service delivery model (if any). 

 

	 	(d)	The Transition for the Initial SOWs includes the closing of the transaction contemplated by the APA. Health Net and Supplier shall close on such transaction in accordance with the terms of the APA. 

  

					
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	13.3	Transition Changes 

  

	 	(a)	Given the breadth, complexity and criticality of the Functions being outsourced by Health Net to Supplier under the Initial SOWs, a well-planned, orderly, well-executed Transition is critical to preventing damage to
Health Net, its Members, Providers, and employer Groups and to the continued, undisrupted operation of Health Net’s and its Affiliates businesses during the Term. Accordingly, it is agreed and understood that If Health Net determines in good
faith that the Transition, or any part of the Transition, poses a meaningful risk or hazard to Health Net’s business interests (a “Transition Risk”), Health Net may request a suspension of or alteration to the Transition
(each a “Transition Change”). 

  

	 	(b)	Upon Supplier receiving a Transition Change request from Health Net: 

  

	 	(i)	Notwithstanding anything else to the contrary in this Section 13.3, Supplier shall immediately suspend the Transition or those aspects of the Transition that Health Net requests be suspended; and 

 

	 	(ii)	the Parties’ respective Transition Management Offices shall immediately begin conferring to determine how to implement the Transition Change going forward (i.e., after any suspension) so as to eliminate the
Transition Risk in the least disruptive and least costly way, taking into account the risk to Health Net’s business and the financial impact on Supplier, but giving priority to minimizing the risk to Health Net’s business.

  

	 	(c)	If the Parties have not reached agreement as to the nature of the Transition Change to be made going forward or the manner in which it is to be made within a reasonable amount of time after Health Net’s sending the
notice of Transition Change to Supplier, the dispute shall immediately be escalated to the Executive Council. 

  

	 	(d)	If the Executive Council has not resolved the disagreement within a reasonable amount of time after referral of the disagreement to the Executive Council, Health Net’s Chief Executive Officer shall have the final
say on the nature and manner of the Transition Change, taking into account the risk to Health Net’s business and the financial impact on both Parties, but giving priority to minimizing the risk to Health Net’s business. In all events,
Health Net’s Chief Executive Officer must act reasonably and in good faith and shall choose a manner of Transition Change that, all else being equal, seeks to address the Transition Risk in a satisfactory way to Health Net while minimizing the
incremental financial burden on Supplier. 

  

	 	(e)	Supplier will bear financial responsibility for its cost impacts from the Transition Change if the Transition Risk giving rise to the Transition Change met the threshold of posing a meaningful risk or hazard to Health
Net’s routine business operations (an “Operational Transition Risk”), except to the extent that such Operational Transition Risk has resulted from the failure by Health Net (including failure by a Health Net contractor,
agent or other party for which Health Net is responsible, but excluding Supplier) to perform an express obligation of Health Net under this Agreement. The foregoing allocation of cost, if any, will be subject to Supplier following the procedures
outlined in Section 8.3 (Savings Clause). If not, Health Net will bear financial responsibility for Supplier’s cost impacts from the Transition Change. 

  

					
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	 	(f)	If the Executive Council cannot agree on whether (i) the risk threshold stated in Section 13.3(a) has been met, or (ii) Health Net was partially at fault in creating the Transition Risk and, if so, what
portion of Supplier’s cost impact is therefore equitably allocable to Health Net, then either Party may refer the disagreement for resolution to a third party subject matter expert (“Mediator”) for non-binding resolution. In order to
avoid conflicts of interests, the fees for such Mediator shall be paid for by both Parties equally. The selection of the Mediator shall be approved by at least three (3) members of the Executive Council. Both Parties shall cooperate fully with
the Mediator and provide any reasonably requested information as promptly as practicable. The Mediations shall be completed in not more than thirty (30) days. If either Party disagrees with the non-binding resolution(s) proposed by the
Mediator, , then such Party may refer the disagreement for resolution via litigation in accordance with Section 26.2 (Litigation); provided, however, that the existence of such disagreement (at any stage) and the mediation process
shall not constitute grounds for delaying or altering the Transition Change while the dispute is being resolved if so directed by Health Net. 

  

	 	(g)	Where possible, all Transition Changes shall be processed via the Change Control Process on an expedited basis, including as an Emergency Change when necessary under the circumstances. 

 

	13.4	Transition Documents 

  

	 	(a)	Each Transition shall be conducted in accordance with a written plan and documents (the “Transition Documents”) which shall include: (i) a description of the operations being
transitioned; (ii) a general description of the methods and procedures, personnel and organization Supplier will use to perform the Transition; (iii) a schedule of the Transition activities; (iv) a detailed description of the
respective roles and responsibilities of Health Net and Supplier; (v) such other information and planning as are necessary to conduct the Transition in accordance with the other terms in this Agreement. 

 

	 	(i)	A draft of the Transition Documents for the Initial SOWs Transition is attached to the Transition Manual for each SOW as Exhibit A-2 (Transition Description), Exhibit A-2-1 (Transition Project Plan) and
Exhibit A-2-2 (Transition Staffing Plan) and Schedule Z (High-Level Transition Information); and 

  

	 	(ii)	A draft of the Transition Documents for any Future SOW Transition shall be included as part of the applicable Future SOWs as contemplated by Schedule R (SOW Template). 

 

	 	(b)	Following the Effective Date with respect to the Initial SOW Transitions or the applicable SOW Effective Date for any Future SOW Transition, Supplier shall be responsible for revising and finalizing the applicable
Transition Documents, provided that: (i) Supplier shall cooperate and work closely with Health Net in finalizing such Transition Documents (including incorporating Health Net’s reasonable comments); and (B) all changes to such
Transition Documents shall be subject to the prior written approval by Health Net. 

  

					
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	13.5	Conduct of the Transition 

 Supplier will carry out and complete the Initial SOW
Transitions and any Future SOW Transition in accordance with the applicable Transition Documents, including its time schedule. Except as otherwise expressly provided in the applicable Transition Documents, Supplier’s responsibilities with
respect to each Transition include: 
  

	 	(a)	performing and managing the Transition and In-Flight Projects and activities; 

  

	 	(b)	establishing communications lines and network connections, and providing Equipment, Software, tapes, records and supplies, as made necessary by the Transition; 

 

	 	(c)	performing the Transition without interruption, and without disrupting Health Net’s business operations; 

  

	 	(d)	paying Supplier’s costs associated with the Transition, including communications circuit costs (both installation/de-installation and ongoing) except as otherwise expressly provided in this Agreement; and

  

	 	(e)	otherwise performing such migration tasks as are necessary to enable Supplier to complete the Transition and provide the Services. 

  

	13.6	Health Net Cooperation and Support 

 Health Net will cooperate with Supplier in the
conduct of each Transition and provide support as described in the applicable Transition Documents. 
  

	13.7	In Flight Projects 

 As part of the Transition, Supplier will also assume responsibility
for completing the projects listed or described in Schedule X (In-Flight and Accelerated Projects), which are in progress as of the SOW Effective Date or expected to commence promptly following the Effective Date (the
“In-Flight and Accelerated Projects”). 
  

	13.8	Completion of Transition Projects 

  

	 	(a)	Health Net reserves the right to monitor, test and otherwise observe and participate in each Transition. Supplier will notify Health Net without delay if any Health Net monitoring, testing or participation has caused
(or Supplier expects it to cause) a problem or delay in a particular Transition and work with Health Net to prevent or circumvent the problem or delay. 

  

	 	(b)	Health Net’s as-is operations will not be disabled until Supplier demonstrates to Health Net’s reasonable satisfaction that the affected processes and operations have been successfully migrated to Supplier and
are functioning properly. 

  

					
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	 	(c)	If any of the Transition activities are not completed on schedule and the delay is not due to the fault of Health Net (or its Affiliates, customers or other suppliers), Force Majeure, or a failure to secure required
Regulatory Consents, then for the period of delay: 

  

	 	(i)	if Supplier’s charges to Health Net are greater than they would have been if the delayed Transition activity had been completed on schedule, Health Net will receive a credit against Supplier’s monthly charges
in an amount equal to the difference between Supplier’s actual charges and what Supplier’s charges would have been if the delayed Transition activity had been completed on schedule; and 

 

	 	(ii)	Supplier will give Health Net an additional credit against Supplier’s monthly charges in an amount sufficient to reimburse Health Net for any excess or continuing costs incurred for personnel, third-party
equipment, Software and/or services that would not have been incurred if the delayed Transition activity had been completed on schedule. 

  

	 	(d)	Provided that a Transition is on schedule and that there are no problems with such Transition, Supplier may request the approval of Health Net to accelerate a wave of such Transition, provided that granting of such
approval shall be in Health Net’s reasonable discretion. 

  

	14.	DATA SECURITY AND PROTECTION 

  

	14.1	[Reserved.] 

  

	14.2	Health Net Data, Generally 

  

	 	(a)	As between the Parties, Health Net Data will be and remain the property of Health Net. Supplier may not use Health Net Data for any purpose other than to render the Services. No Health Net Data will be sold, assigned,
leased or otherwise disposed of to third parties or commercially exploited by or on behalf of Supplier (or any of its Subcontractors). Neither Supplier nor any of its Subcontractors may possess or assert any lien or other right against or to Health
Net Data. Without limiting the generality of the foregoing, (a) Supplier may only use Health Net Data as strictly necessary to render the Services and must restrict access to such information to Supplier Personnel on a strict need-to-know
basis, and (b) Supplier shall not download, copy, transmit or make available any Health Net Data to any third party (other than an Approved Subcontractor) except as expressly permitted by this Agreement. 

 

	 	(b)	At Health Net’s request at any time during the Term, Suppler shall provide Health Net with access to and/or copies of (in format reasonably requested by Health Net) any Health Net Data stored on Supplier systems or
otherwise under the control of Supplier. 

  

	14.3	Data Security 

  

	 	(a)	When present at Health Net Facilities or accessing Health Net systems or Health Net Data (whether such data is in Health Net’s systems of Supplier’s systems), Supplier will observe and comply with Health
Net’s Policies regarding data security procedures that have been communicated to Supplier. Prior to performing Services from any new service location (i.e., any service location other than those set forth in Schedule F (Supplier
Facilities)), Supplier shall complete a security questionnaire, which Health Net requires before Services are permitted to be provided from a new service location. If Health Net requests, Supplier shall provide Health Net with access to any new
service location for due diligence purposes. 

  

					
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	 	(b)	Supplier will establish and maintain reasonable safeguards designed to protect against the occurrence of any Security Breach, including by establishing and maintaining appropriate network and internet security
procedures, protocols, security gateways and firewalls with respect to Health Net Data. 

  

	 	(c)	Supplier shall comply with the security requirements and standards set forth in Schedule Q (Security Addendum), which represent the minimum security requirements and standards with which Supplier must comply.
Supplier shall also comply with: 

  

	 	(i)	All applicable Laws relating to privacy and information security, as they may evolve during the Term, including those establishing federal services requirements (such as the Federal Information Processing Requirements
and FIPS 140-2), the National Institute of Standards and Technology (NIST) and as may be required for Health Net to qualify for the safe harbor exemption for de-identified health information under the HIPAA Privacy Rule (45 CFR 164.502 (d));

  

	 	(i)	the Payment Card Industry Data Security Standards (promulgated by the PCI Data Security Standards Council) (“PCI DSS”); 

 

	 	(ii)	the applicable legal or regulatory requirements of the Exchange Agreement, to the extent provided to Supplier reasonably in advance of the need to implement any such requirements; and 

 

	 	(iii)	the legal or regulatory requirements, obligations or other terms with which Health Net must comply under any Regulatory Contract that are provided to Supplier reasonably in advance of the need to implement any such
requirements. 

  

	 	(d)	Supplier shall be responsible for implementing additional security measures as may be necessary to protect Health Net Data from any unauthorized access or use and to prevent any Security Breach in accordance with this
Agreement. 

  

	 	(e)	Supplier shall meet with Health Net not less frequently than once every six (6) months to review the continually evolving security threat environment and potential changes to the applicable security standards to
address the same. 

  

	 	(f)	No Health Net Data may be stored outside of the United States. No Health Net Data may be accessed from outside of the United States without Health Net’s prior written consent, which may be granted or withheld in
Health Net’s discretion. Supplier may access Health Net Data from those Supplier Facilities shown on Schedule F (Supplier Facilities), and Supplier may store Health Net Data at those on-shore Supplier Facilities shown on Schedule F
(Supplier Facilities), that are denoted as facilities from which Supplier may access and store (as applicable) Health Net Data. 

  

	 	(g)	Health Net will be provided with backup copies of Health Net Data from the Supplier upon written request. Supplier must store and transmit backup Health Net Data in accordance with Schedule Q (Security Addendum).
Supplier will document such safeguards in the Procedures Manual. 

  

					
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	 	(h)	Without limiting the generality of the foregoing: 

  

	 	(i)	Supplier’s information security policies shall provide for (A) regular assessment and re-assessment of the risks and vulnerabilities to the confidentiality, integrity, and availability of Health Net Data,
including electronic data, and systems acquired or maintained by Supplier and its agents and contractors, including (1) identification of internal and external threats that could result in a Security Breach, (2) assessment of the
likelihood and potential damage of such threats, taking into account the sensitivity of such data and systems, and (3) assessment of the sufficiency of policies, procedures, and information systems of Supplier and its agents and subcontractors,
and other arrangements in place, to control risks; (B) protection against such risks; and (C) establishment and monitoring of key risk indicators (KRIs). Supplier shall provide such policies, and conduct and report on the results of such
assessments to Health Net. 

  

	 	(ii)	Supplier shall (A) require all users to enter a user identification and password prior to gaining access to the information systems; (B) control and track the addition and deletion of users; (C) control
and track user access to areas and features of Supplier’s information systems, and (D) encrypt Health Net Data in accordance with Schedule Q (Security Addendum). 

 

	 	(iii)	Supplier Personnel will not attempt to access, or allow access to, any Health Net Data that they are not permitted to access under this Agreement. Without limiting any of Supplier’s other obligations in respect of
a Security Breach, including those set forth in Section 14.7, as soon as Supplier first becomes aware that unauthorized access to Health Net Data has been attained, (i) Supplier will report such unauthorized access to Health Net,
describing to the best of Supplier’s knowledge the Health Net Data that was accessed, and (ii) Supplier shall take all necessary measures to stop the access, prevent recurrences, and return to Health Net any copied or removed Health Net
Data. 

  

	 	(iv)	Except as provided in Section 21 (Confidentiality), Supplier shall (A) remove all Health Net Data from any media within the scope of the Services that is taken out of service; (B) destroy or securely
erase such media in accordance with Health Net Policies and otherwise in a manner designed to protect against Security Breaches; and (C) provide to Health Net, within five (5) business days after a receipt of a request from Health Net, a
notification of destruction, which may be provided via an automated solution that creates an auditable record. 

  

	14.4	Intrusion Detection/Interception 

 Supplier will provide Health Net and its
representatives with: 
  

	 	(a)	reasonable access to the alerts, logs and data feeds from Supplier’s and its Subcontractors’ network intrusion detection systems, host intrusion detection systems and anti-virus tools on assets at Health Net
Facilities or in data center(s) being used for the Services each to the extent used exclusively to provide Services to Health Net in order to enable Health Net to have adequate and timely access to system data regarding security incidents that have
a nexus to Health Net, including Security Breaches; 

  

	 	(b)	access to Supplier’s information security policies and Supplier’s procedures relating to intrusion detection and interception with respect to the Supplier systems used to provide the Services for the purpose
of examining and assessing those policies and procedures in accordance with Section 18 (Audits and Records); and 

  

					
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 (c) 
  

	 	(d)	the other requirements set forth in Schedule A (Services) or an SOW. 

  

	14.5	Litigation and Investigation Requests 

  

	 	(a)	Supplier recognizes that (i) Health Net may, from time to time, sue third parties, be sued by third parties, or have grounds to believe that one or more lawsuits will be filed for or against Health Net,
(ii) Health Net may be the subject of governmental, regulatory or similar investigations and requests or demands for information from third parties, and (iii) Health Net may conduct internal investigations at its own prerogative (including
investigations conducted by or on behalf of its Organization Effectiveness, Legal and/or Special Investigations business units). Upon any of the foregoing events occurring (for avoidance of doubt, these events do not include any legal proceeding
directly between Health Net and Supplier, or their respective Affiliates), Supplier hereby agrees to fully cooperate with Health Net and its legal counsel, and to create and implement a process sufficient to comply, in a timely manner, with any
requests from Health Net or its legal counsel to categorize, identify, view, preserve, extract, produce, filter, convert and and/or provide to Health Net or its designee (in the format reasonably requested by Health Net), any hard copy documents or
electronically stored information or data of any type that is associated with the Services, that results from or reflects the Services, or that evidences or memorializes Supplier’s efforts on behalf of Health Net pursuant to this Agreement
(hereinafter, the “Requested Information”). Requested Information may include: claims data, email data, home drive data, server data, common drive data, data stored in cloud repositories, data on smartphones or peripheral
devices, and data stored with any third-parties on Supplier’s behalf. Requested Information may include any type of reports or other information received, created or collected as part of the Services, all information created by or for Health
Net or Health Net’s employees, or at their request, and any information or “metadata,” associated with other types of Requested Information. Requested Information may include any type of information relating to the foregoing within
Supplier’s possession, custody or control, including information entrusted to its employees or third parties, or housed in any type of repository or media whatsoever, such as servers, systems, applications, discs, equipment, tapes, or other
locations. Supplier shall use best efforts to provide requested information in a timely manner to enable Health Net to meet regulatory and internal deadlines. 

  

	 	(b)	Supplier acknowledges and agrees that Supplier may, in some instances, be required to utilize or required to involve outside professionals to utilize forensic extraction methods and techniques to obtain Requested
Information without alteration, to set-up a new or use an existing non-production environment to retrieve and provide Requested Information, and if requested by Health Net, Supplier shall provide access to such environment or Requested Information
so that Health Net and/or its designee may access, view, download and extract the Requested Information, including reasonable access to third-party litigation support providers selected by Health Net to facilitate requests for Requested Information.
Supplier shall maintain and support an access method for allowing such access and extractions, as determined by Health Net (e.g., SFTP connections, remote access, on-site access). Supplier will use its best efforts to provide all Requested
Information within the time period specified by Health Net or its legal counsel, and, if such deadlines cannot be met, Supplier shall promptly notify Health Net of the reason and extent of any delay. 

  

					
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	 	(c)	Health Net shall direct any request under this Section 14.5 (Litigation and Investigation Requests) to the Supplier Account Executive. Upon Health Net’s request, Supplier shall promptly designate a Supplier
attorney to work with Health Net and who can facilitate any Health Net request under this Section. In the event that Health Net is the target of a governmental inquiry or investigation, Health Net shall retain all responsibility for directly
interacting with such governmental entity regarding such inquiry or investigation. Supplier shall comply with and follow all restrictions and requirements reasonably imposed by Health Net or its legal counsel to maintain the protections of the
attorney-client privilege and attorney work-product doctrine for all efforts and communications connected with requests and efforts made under this section 14.5. 

If requests for Requested Information do not comprise Services under this Agreement, and require additional time or resources to meet the
specifications of Health Net or its legal counsel, then such requests shall be responded to through the Change Control Process, but Health Net shall have the right to direct that any such request constitutes an Emergency Change under such process
requiring expedited handling and fulfillment. 
  

	14.6	Compliance with Data Privacy and Data Protection Laws, Regulations and Policies 

  

	 	(a)	In carrying out its activities under this Agreement, and without limiting Section 27.7 (Compliance with Laws), each Party will observe and comply with all applicable data privacy and data protection Laws. In
addition, when accessing or handling any Health Net Data that contains personal identifying information, Supplier will comply with Health Net Policies that have been disclosed to Supplier relating to the use and disclosure of such information.

  

	 	(b)	The Parties hereby reaffirm their agreement to the terms of the Business Associate Agreement between the Parties which is being executed on or about the Effective Date (“Business Associate
Agreement”). The Business Associate Agreement is hereby incorporated into this Agreement by reference and made a part of this Agreement. In the event of any conflict between the terms of this Section 14 (Data Security and
Protection), Section 21 (Confidentiality) and the terms and conditions of the Business Associate Agreement, the terms and conditions that are more protective of the Protected Health Information (as such term is defined in HIPAA) shall govern to
the extent of that conflict. 

  

	14.7	Security Breach. 

  

	 	(a)	If Supplier becomes aware of (or if Health Net notifies Supplier of) any Security Breach (even if such Security Breach arises out of events or items that are not in the possession of or operated by (or for) or under the
control of Supplier or a third party which receives Health Net Data (directly or indirectly) through Supplier, notwithstanding the limitations in the definition of Security Breach), Supplier shall: 

 

	 	(i)	notify Health Net’s Chief Information Security Officer (or his or her identified delegate) of such Security Breach in accordance with Section 14.3(f)(iii) and, thereafter, perform a root cause analysis
thereon, the results of which shall be provided to Health Net; 

  

					
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	 	(ii)	investigate such Security Breach and report its findings to Health Net, including providing updates of such investigation as they occur and promptly responding to requests for information from Health Net;

  

	 	(iii)	unless such investigation shows that a suspected or threatened Security Breach was unsuccessful, provide Health Net with a remediation plan, acceptable to Health Net in Health Net’s reasonable discretion, to
address the Security Breach and which is designed to prevent any further similar incidents; 

  

	 	(iv)	remediate such Security Breach in accordance with such approved plan; 

  

	 	(v)	after consulting with Health Net’s Chief Privacy Officer, conduct a forensic investigation to determine what systems, data and information have been affected by such event, and provide Health Net with daily updates
of the results of such investigation; 

  

	 	(vi)	cooperate with Health Net’s investigation of the Security Breach, including promptly providing any information that Supplier (or a Subcontractor) has with respect to the Security Breach; and 

 

	 	(vii)	at Health Net’s request, cooperate with any law enforcement or regulatory officials, credit reporting companies, and credit card associations investigating such Security Breach. 

 

	 	(b)	Where permitted by Law, Health Net shall, acting reasonably, make the final decision on notifying Health Net’s members, employees, suppliers and/or the general public of such Security Breach, and the implementation
of the remediation plan. 

  

	 	(c)	With respect to such Security Breach: 

  

	 	(i)	Except to the extent that Supplier is able to demonstrate that the Security Breach was caused by Health Net’s negligence, willful misconduct or breach of this Agreement, Supplier shall be responsible at its own
expense for performing the activities described in Section 14.7(a) and for all other costs and expenses incurred by Supplier (and its Subcontractors) in relation to the Security Breach; 

 

	 	(ii)	Supplier shall have Financial Responsibility for all costs and expenses incurred by Health Net (and Health Net’s Affiliates) in relation to the Security Breach, including Identity-Related Costs, except as provided
in Section 14.7(c)(iii) ; and 

  

	 	(iii)	To the extent the Security Breach arises out of Health Net Data that was compromised (“Compromised Data”) due to any Health Net-provided technologies, Software, or other assets prior to the time
that such Compromised Data was scheduled to be relocated to a Supplier-furnished data center as set forth in the Transition Documents for SOW#4 attached to the Transition Manual as Exhibit A-2 (Transition Description), Exhibit A-2-1(
Transition Project Plan), and Exhibit A-2-3 (Transition ITO Plan (Phase 2 Implementation)) (as such documents are updated by the Parties pursuant to Section 13.3 (Transition Documents) and Section 1 of Schedule Z
(Transition)), and provided the Security Breach was not attributable to (A) Supplier’s failure to adhere to the information, data and physical security practices and standards observed by Health Net and at 

  

					
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 the affected data center as of the BPaaS Services Commencement Date, or
(B) Supplier’s acts, omissions, negligence, willful misconduct, breach of this Agreement or failure to take reasonable actions or employ industry best practices to protect the Health Net Data, Health Net Software or systems in question,
then (x) Supplier shall not have Financial Responsibility for such Security Breach other than as provided in Section 14.7(c)(i), and (y) Supplier shall not have Financial Responsibility for remediating the Security Breach under
Section 14.7(a)(iv). 
  

	 	(d)	Supplier shall reimburse Health Net on demand for all costs and expenses described in Sections 24.2(f)(x) and 24.2(f)(xi) relating to any Security Breach. 

 

	14.8	Import/Export Controls 

  

	 	(a)	The Parties acknowledge that certain software and technical data exchanged pursuant to this Agreement may be subject to import/export controls under the Laws of the United States and other countries. Neither Party will
import, export or re-export any such items, any direct product of those items, or any technical data in violation of applicable import/export control Laws. 

  

	 	(b)	Each Party will be responsible for compliance with import/export control Laws with respect to any items it is deemed under such Laws to have imported or exported, including responsibility for preparing and filing all
required documentation and obtaining all licenses, permits and authorizations required for compliance. Each Party will cooperate with the other Party in that Party’s efforts to comply with applicable import/export control Laws.

  

	 	(c)	Supplier will include with copies of all Software provided to Supplier by Health Net’s U.S.-based personnel that Supplier will use outside of the United States documentation stating that “These commodities,
technology or software were exported from the United States in accordance with Export Administration Regulations. Diversion or re-export contrary to U.S. law is prohibited.” 

 

	14.9	Compliance with Gramm-Leach-Bliley 

  

	 	(a)	“GLB Act” means the Gramm-Leach-Bliley Act, 15 USC §6801 et. seq., and the implementing regulations and regulatory interpretations thereto, as amended from time to time.
Supplier acknowledges that Health Net is subject to Title V of the GLB Act, pursuant to which Health Net is required to obtain certain undertakings from Supplier with regard to the privacy, use and protection of nonpublic personal financial
information of Health Net’s (or of any Health Net Affiliate’s or Service Recipient’s) customers or prospective customers (“Health Net Non-public Data”). Therefore, notwithstanding anything to the contrary
contained in this Agreement and in addition to (and not in substitution for) Supplier’s other obligations hereunder, Supplier agrees that: 

  

	 	(b)	it will not disclose or use any Health Net Non-public Data except to the extent necessary to carry out its obligations under this Agreement and for no other purpose; 

 

	 	(i)	it will not disclose Health Net Non-public Data to any third party, including, without limitation, its third party service providers without the prior consent of Health Net and an agreement in writing from the third
party to use or disclose such Health Net Non-public Data only to the extent necessary to carry out Supplier obligations under this Agreement and for no other purposes; and 

  

					
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	 	(ii)	it will maintain, and will require all third parties approved under Section 7.7 (Subcontracting) to maintain, effective information security measures to protect Health Net Non-public Data from unauthorized
disclosure or use; and it will provide Health Net with information regarding such security measures upon the reasonable request of Health Net and promptly provide Health Net with information regarding any failure of such security measures or any
security breach related to Health Net Non-public Data. 

  

	 	(c)	The obligations set forth in this Section 14.9 (Compliance with Gramm-Leach-Bliley) will survive termination or expiration of this Agreement. For purposes of this Agreement, Health Net Non-public Data
includes the nonpublic personal information (as defined in 15 USC §6809(4)) received by Supplier in connection with the performance of its obligations hereunder, including (i) an individual’s name, address, e-mail address, IP address,
telephone number and/or social security number; (ii) the fact that an individual has a relationship with Health Net; and (iii) an individual’s account information. For the avoidance of doubt, Health Net Non-public Data does not
include (A) information collected from Health Net employees (in their capacity as employees, and not as Health Net’s customers) by Supplier for the purpose of administering and providing the Services, and (B) nonpublic information
collected from a source other than Health Net that has been obtained on a non-confidential basis and which is not subject to the GLB Act. 

  

	15.	INTELLECTUAL PROPERTY RIGHTS 

 This Article 15 sets forth the Parties’ respective
rights in Work Product and other materials provided or created pursuant to this Agreement. As between the Parties, the rights apply as set forth in this Article 15 whether the work in question is performed solely by Supplier Personnel or by Supplier
Personnel working jointly with others. 
  

	15.1	Certain IP-related Definitions 

  

	 	(a)	“Derivative Work” means a work of authorship or expressive creation (i) that includes more than a de-minimis amount of copyright-protected elements of a pre-existing work, or (ii) such
work is incapable of being used without the pre-existing work or in conjunction with the pre-existing work, including a work in which a pre-existing work has been modified, enhanced, recast, transformed, or adapted. 

 

	 	(b)	“Independent IP” of a party (including a third party) means any materials, methods, processes, and other forms of intellectual property that either (i) were created or acquired by or for the
party on or prior to the Effective Date, or (ii) are subsequently created or acquired by or for the party outside the scope of and independent from this Agreement, and (iii) any Derivative Works of either of the foregoing. Supplier
Independent IP includes the Acquired Seller Intellectual Property Rights as defined in the APA. 

  

	 	(c)	“New Work” means any Material produced by Supplier Personnel specifically for Health Net in the course of performing the Services that is not a Derivative Work. 

  

					
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	15.2	Independent IP, Generally 

  

	 	(a)	The Parties agree that: 

  

	 	(i)	As between the Parties, each Party will have and retain all ownership of all right, title and interest, including Intellectual Property Rights, in and to its Independent IP, and will be entitled to seek Intellectual
Property Rights protection for its Independent IP as it deems appropriate; 

  

	 	(ii)	a Party will not submit patent applications or otherwise seek to file for or obtain Intellectual Property Rights protection with respect to or based upon the other Party’s Independent IP without the other
Party’s prior written consent, which may be withheld at the other Party’s sole discretion; 

  

	 	(iii)	a Party will not be permitted to use the other Party’s Independent IP except as otherwise expressly provided in this Agreement or in any other written agreement between the Parties; 

 

	 	(iv)	EXCEPT AS OTHERWISE EXPRESSLY PROVIDED IN THIS AGREEMENT OR IN ANY OTHER WRITTEN AGREEMENT BETWEEN THE PARTIES, ANY RIGHTS OF USE OF A PARTY’S INDEPENDENT IP GRANTED IN THIS AGREEMENT ARE GRANTED ON AN ‘AS-IS,
WHERE-IS’ BASIS WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND; and 

  

	 	(v)	If Health Net provides any of its Independent IP to Supplier for use in rendering the Services, Health Net hereby grants to Supplier a nonexclusive, non-transferable, worldwide, fully paid-up right and license during
the Term and any Disengagement Period to Use such Independent IP solely to perform the Services, with the right to sublicense Approved Subcontractors to do the same on Supplier’s behalf, subject to any limitations or restrictions set forth in
agreements between Health Net (or its Affiliate) and third party licensors of the Health Independent IP that are disclosed in writing, in advance by Health Net to Supplier. Supplier may not Use Health Net’s Independent IP for the benefit of any
entities other than Health Net and Health Net’s Affiliates (and their respective Service Recipients under this Agreement) without the prior written consent of Health Net, which may be granted or withheld in Health Net’s discretion.

  

	15.3	Rights in Deliverables 

  

	 	(a)	“Deliverable” means any material that is produced by Supplier Personnel specifically for Health Net (or another Service Recipient) in the course of performing Services and is either
(i) listed or described in an SOW (or Work Order, Project plan or any other document signed or agreed to in writing by the Parties) as a Deliverable, or (ii) actually delivered or otherwise required to be delivered to Health Net (or
another Service Recipient) as an intended output of the Services. A Deliverable may be a one-off material resulting from performance of Project Services (e.g., a Software application) or, alternatively, a recurring form of material resulting
from performance of BPaaS Services (e.g., a document containing processed Health Net Data or a periodic operational or management report). 

  

	 	(b)	“Software Deliverable” means any Deliverable that is (or contains) Software. 

  

					
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	 	(c)	Except as otherwise expressly provided in a subsequent written agreement between the Parties, the Parties’ respective Intellectual Property Rights in Deliverables shall be as follows: 

 

	 	(i)	If the Deliverable is developed as part of an Accelerated Project, a BPaaS Roadmap Project a BPaaS Non-Discretionary Project, or any other type of Project under this Agreement that is not a BPaaS Discretionary Project,
Supplier will be the owner of the Deliverable, and Supplier hereby grants to Health Net, during the Term and any Disengagement Period, a nonexclusive, world-wide, fully paid-up, non-transferable (except as part of a permitted assignment pursuant to
Section 27.1 (Binding Nature and Assignment)) right and license for Health Net (or its Affiliate or another Service Recipient) to Use (or have Used on its behalf) the Deliverable solely in connection with Health Net’s (or its
Affiliate’s or such other Service Recipient’s) receipt and use of the BPaaS Services, subject to any additional limitations that may be set forth in a written agreement between the Parties. Health Net license rights with respect to
Software Deliverables owned by Supplier (including those developed as part of an Accelerated Project, a BPaaS Roadmap Project or a BPaaS Non-Discretionary Project) following the Term and any Disengagement Period shall be pursuant to the terms of
Section 12.3 (Health Net Rights to Use Certain Software) of this Agreement and Section 4 of the BPaaS Supplemental Terms and Conditions for BPaaS Services. 

 

	 	(ii)	If the Deliverable is developed as part of a BPaaS Discretionary Project and consists solely of New Work (or does not contain any Independent IP of Supplier or a third party who has licensed Independent IP to Supplier),
the Deliverable and all Intellectual Property Rights in and to the Deliverable will be owned by Health Net from the moment it is created, and the Deliverable will be deemed to be a ‘work made for hire’ for Health Net under applicable
copyright Laws. To the extent that title and ownership rights in the Deliverable may not originally vest in Health Net as contemplated herein, Supplier hereby irrevocably assigns, transfers and conveys to Health Net all such right, title and
interest without further consideration. Supplier agrees to execute such other documents or take such other actions as Health Net may reasonably request to file, record, perfect, and enforce Health Net’s Intellectual Property Rights in and to
the Deliverable, as set forth herein, including obtaining any necessary assignments, consents, or waivers from individual authors, creators, or inventors. 

  

	 	(iii)	 If the Deliverable is developed as part of a BPaaS Discretionary Project and does contain some Independent IP of Supplier, Supplier will be the owner
of the Deliverable (including any New Work incorporated into the Deliverable), and Supplier hereby grants to Health Net a nonexclusive, perpetual, irrevocable, fully paid-up, world-wide, transferable and sub-licensable (through multiple levels of
sub-licensees) right and license to Use (or have Used on its behalf) such Deliverable, including the Supplier Independent IP incorporated in such Deliverable, including for the creation and use of Derivative Works, without any further consideration
or duty of accounting to Supplier or any third party (a “Deliverables License”) provided, however, that if such Supplier Independent IP comprises Software, in no event shall such Supplier Independent IP be unbundled or
separated from the applicable Deliverable or used as a stand-alone product or development tool. In addition, unless and except as expressly provided in the proviso contained in the following sentence or as Health Net otherwise
expressly

  

					
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agrees in a written agreement with Supplier, Supplier shall be restricted to using such Deliverable solely to provide the Services under this Agreement (each such Deliverable, a
“Restricted Use Deliverable”). Health Net shall be obligated to compensate Supplier separately for providing ongoing maintenance and support services for any Restricted Use Deliverable, in a per annum amount equal to fifteen
percent (15%) of Supplier’s charges to Health Net for developing the Restricted Use Deliverable, or such other amount as may be agreed in writing between the Parties; provided, however, that Health Net shall have the right to
provide written notice to Supplier at any time that Health Net no longer requires that such Deliverable be a Restricted Use Deliverable, in which event Supplier shall thereafter provide maintenance and support for such Restricted Use Deliverable at
no additional charge to Health Net for the remainder of the Term and any Disengagement Period. 

  

	 	(d)	Any representations and warranties of Supplier that are applicable to a Deliverable shall apply equally to any Independent IP of Supplier or a third party incorporated into such Deliverable. 

 

	 	(e)	If the Deliverable is owned by Health Net or is a Restricted Use Deliverable, Supplier will mark the Deliverable with such proprietary rights and confidentiality legend(s) as Supplier may be reasonably instructed by
Health Net to use. 

  

	 	(f)	If Supplier desires to use any Deliverable that is owned by Health Net or is a Restricted Use Deliverable, or a Derivative Work of thereof, in connection with providing services to another customer, Supplier shall
notify Health Net of its proposal. If Health Net consents to Supplier’s proposed use of such Deliverable, Supplier may use such Deliverable to perform services for other customers in the manner and on the terms and conditions set forth in
Health Net’s written consent. 

  

	15.4	Incorporation of Third-Party Independent IP in a Deliverable 

  

	 	(a)	Supplier Personnel shall not incorporate any Independent IP of a third party into a Deliverable without first notifying Health Net of its nature and obtaining Health Net’s written consent to do so unless Supplier
has all necessary rights to grant Health Net a Deliverables License in and to such third party Independent IP as set forth herein. If Supplier does not have all such rights (or if Supplier is unwilling to grant Health Net a Deliverables License in
and to such Supplier Independent IP), then prior to incorporating the third party Independent IP into the Deliverable, Supplier shall enter into with Health Net, or procure for Health Net or assist Health Net in procuring, a license to Use the
incorporated third party Independent IP on terms that are acceptable to Health Net. 

  

	 	(b)	If Supplier incorporates any Independent IP of a third party into a Deliverable without first notifying Health Net of its nature and obtaining for Health Net, or confirming that Health Net has obtained, the necessary
rights of use as provided in Section 15.4(a), such failure shall constitute a breach of this Agreement. In such event, by way of endeavoring to mitigate Health Net’s damages resulting from the failure, Supplier shall, at Supplier’s
cost and expense: (i) use all Commercially Reasonable Efforts to promptly secure for Health Net a license comparable to a Deliverables License for the incorporated third party Independent IP, or (ii) if this cannot be accomplished on
commercially reasonable terms with Commercially Reasonable Efforts, replace or modify the Deliverable to remove the incorporated third party Independent IP without degrading the functionality or performance of the Deliverable and without adversely
affecting Supplier’s performance of the Services, and Supplier shall bear any costs of implementing the replaced or modified Deliverable. 

  

					
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	15.5	Work Products 

  

	 	(a)	“Work Product” means any material produced by Supplier Personnel in the course of performing the Services that is not a Deliverable. 

 

	 	(b)	Supplier will own all Intellectual Property Rights in and to all Work Products; provided, however, that if a Work Product contains any Health Net Data or other Health Net material, Health Net will retain all of its
Intellectual Property Rights in and to such Health Net material (and Derivative Works thereof) contained in the Work Product. Health Net hereby grants to Supplier a nonexclusive, non-transferable, worldwide, fully paid-up right and license during
the Term and any Disengagement Period to Use the subject Health Net materials solely to perform the Services, with the right to sublicense Approved Subcontractors to do the same on Supplier’s behalf. 

 

	 	(c)	If a Work Product is (or incorporates) Software, Health Net’s rights with respect to such Software shall be as set forth in Section 12.3 (Health Net Rights to Certain Software). 

 

	 	(d)	If a non-Software Work Product is necessary or useful for Health Net’s (or another Service Recipient’s) use of a Deliverable for its intended purpose or receipt and use of the Services, then, unless Health Net
agrees to enter and does enter into another form of license with Supplier with respect to the Work Product, Supplier hereby grants to Health Net, during the Term and any Disengagement Period, a nonexclusive, world-wide, fully paid-up,
non-transferable (except as part of a permitted assignment pursuant to Section 27.1 (Binding Nature and Assignment)) right and license for Health Net or another Service Recipient to Use (or have Used on its behalf) the Work Product as necessary
or useful for Health Net’s (or such other Service Recipient’s) use of the Deliverable or receipt and use of the Services. 

  

	15.6	Delivery of Deliverables and Other Materials 

 Upon expiration or termination of this Agreement or any
SOW or Services, to the extent Supplier has not already done so, Supplier will turn over to Health Net all Deliverables and other materials owned by Health Net or to which Health Net has been granted (or is to be granted) license rights pursuant to
this Agreement. 
  

	15.7	Use of Material Subject to Open Source Licenses 

 Without Health Net’s prior written approval, which
Health Net may grant or withhold in its sole discretion, no Deliverable will incorporate, link to or call upon any components subject to an Open Source License (including the GNU General Public License). The provisions of this Section 15.7 (Use
of Material Subject to Open Source Licenses) shall not apply to any Deliverable that forms part of the ABS Platform. 
  

	15.8	Intellectual Property Rights Agreements with Supplier Personnel 

 Supplier is responsible
for having in place with all Supplier Personnel (either directly or indirectly through their respective employers) such agreements respecting Intellectual Property Rights as are necessary for Supplier to fulfill its obligations under this
Section 15 (Intellectual Property Rights). 

  

					
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	15.9	Bankruptcy 

 All licenses and rights of Use granted under or pursuant to this Agreement
shall be deemed to be, for the purposes of Section 365(n) of the United States Bankruptcy Code (the “Bankruptcy Code”), licenses to rights in “intellectual property” as defined under the Bankruptcy Code.
Accordingly, the licensee of such rights shall retain and may fully exercise all of its rights and elections under the Bankruptcy Code. Upon the commencement of bankruptcy proceedings by or against either Party under the Bankruptcy Code, the other
Party shall be entitled to retain all of its license rights and Use rights granted under this Agreement. 
 15.10 Mental Impressions 

 

	 	(a)	“Mental Impressions” means general ideas, concepts, know-how and techniques relating to data processing and computer programming that are learned and retained in the unaided memory of a
Party’s and or any of its Affiliates’ personnel involved in performance of this Agreement who have had access to Confidential Information or materials of the other Party and its Affiliates without deliberately memorizing them for purposes
of reuse. 

  

	 	(b)	Each Party and its Affiliates may use the Mental Impressions of their personnel in their business activities provided that in doing so they do not disclose Confidential Information of the other Party in violation of
Section 21 (Confidentiality) or misappropriate or infringe the Intellectual Property Rights of the other Party, its Affiliates, or third parties who have licensed or provided materials to the other Party or its Affiliates. 

 

	16.	TERMINATION 

  

	16.1	Termination By Health Net 

  

	 	(a)	Termination for Cause. If Supplier (i) commits a material breach of this Agreement or any SOW and fails to cure such breach within thirty (30) days after receiving notice of the breach from Health Net,
or (ii) commits multiple breaches of this Agreement or any SOW, whether material or non-material, that collectively constitute a material breach of a material provision of this Agreement or any Related SOW(s), (iii) fails to close on the
transaction contemplated by the APA in breach thereof, or (iv) commits a material breach of its obligations under Section 3.6 of Schedule E (Transitioned Employees), then Health Net may, by giving written notice to Supplier,
terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part) for cause as of a date specified in the notice of termination. Any termination by Health Net shall not constitute an election of remedies and shall be without
prejudice as to Health Net’s other rights and remedies under this Agreement or at law or in equity. 

  

	 	(b)	Termination for Convenience. Health Net may terminate this Agreement (in whole or in part) or any SOW (in whole or in part) at any time for convenience (i.e., for any reason or no reason) by giving
Supplier at least three (3) months’ prior written notice specifying the terminated Services and designating the termination date. 

  

	 	(c)	Termination for Certain Service Level Failures. If (i) the amount of Service Level Credits (excluding those associated with Non-BPaaS IT Services) that Supplier is obligated to credit to Health Net equals
the entire BPaaS Amount at Risk for *** or more months in any rolling *** continuous month period, or (ii) the amount of Service Level Credits relating to the Non-BPaaS IT Services that Supplier is obligated to credit to Health Net equals the

  

					
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 entire Non-BPaaS Amount at Risk for *** or more months in any rolling *** continuous month
period, then Health Net may, by giving notice to Supplier, terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part), as of a date specified in the notice of termination. The foregoing rights to terminate shall not
be construed as precluding Health Net from claiming that any other Service Level Failure (or combination thereof) is a material breach of this Agreement and to exercise any available remedies in connection with such material breach. 

 

	 	(d)	Termination Following a Change of Control of Health Net. “Change of Control of Health Net” means an announcement by Health Net (i) that any other entity, person or “group”
(as such term is used in Section 13(d) of the Securities Exchange Act of 1934, as amended) will acquire Control, of all or substantially all of the assets or customers, of Health Net (or any parent company of Health Net), whether directly or
indirectly, in a single transaction or series of related transactions, or (ii) that Health Net (or any parent company of Health Net) will consolidate with, or be merged with or into, another entity, or will sell, assign, convey, transfer, lease
or otherwise dispose of all or substantially all of its assets or customers to another person(s) or entity(ies). At any time within one year after the effective date of the consummation of the transaction described in (i) or (ii) above,
Health Net may terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part) by giving Supplier at least ninety (90) days prior written notice specifying the terminated Services and designating the termination date.

  

	 	(e)	Termination Following a Change of Control of Supplier. A “Change of Control of Supplier” means an announcement by Supplier (A) that any other entity, person or “group” (as
such term is used in Section 13(d) of the Securities Exchange Act of 1934, as amended) that is a health plan, or offers a health plan to its customers, will acquire Control, of all or substantially all of the assets, of Supplier (or any parent
company of Supplier), whether directly or indirectly, in a single transaction or series of related transactions, or (B) that Supplier (or any parent company of Supplier) will consolidate with, or be merged with or into, another such entity, or
will sell, assign, convey, transfer, lease or otherwise dispose of all or substantially all of its assets to another such person(s) or entity(ies). At any time within *** after the effective date of the consummation of the transaction described in
subsections (i) or (ii) above, Health Net may terminate this Agreement (in whole) or in part (provided that such in part termination is limited to termination of all BPaaS Services or all Non-BPaaS IT Services) by giving Supplier at least
ninety (90) days’ prior written notice specifying the terminated Services and designating the termination date. 

  

	 	(f)	Termination in the Event of a Force Majeure. Health Net may terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part) as provided in Section 24.3 (Force Majeure).

  

	 	(g)	Termination Due to Change in Law. Health Net may terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part) by giving Supplier at least ninety (90) days’ prior written
notice specifying the terminated Services and designating the termination date if a Law enacted after the Effective Date (i) precludes or substantially restricts Health Net from using or receiving Services or (ii) substantially increases
Health Net’s cost of using or receiving Services. 

  

	 	(h)	[Reserved.] 

  

					
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	 	(i)	Termination Due To Adverse Changes in Supplier’s Financial Circumstances. If an Adverse Change in Supplier’s Financial Circumstances occurs then Health Net may terminate this Agreement by giving written
notice to Supplier designating the termination date. Supplier shall notify Health Net as soon as possible after becoming aware of an actual or likely Adverse Change in Supplier’s Financial Circumstances. Supplier shall (i) endeavor to
certify to Health Net at least annually, and (ii) otherwise certify within ten (10) days of a request by Health Net, that an Adverse Change in Supplier’s Financial Circumstances has not occurred as of the date of certification or, to
the best of Supplier’s knowledge, is not likely to occur within twenty (24) months after the date of certification. 

  

	 	(j)	Termination Relating to Customer Consents or Regulatory Approval. Health Net may terminate this Agreement (in whole or in part) or any SOW (in whole or in part), as provided in Section 4.3 (Regulatory and
Customer Approvals). 

  

	 	(k)	Termination if Supplier Becomes a Competitor of Health Net. If Supplier develops or acquires a business line or service offering that is a health plan or offers health plans to its customers and is competitive
with Health Net’s business, Health Net may terminate this Agreement (in whole or in part) or any SOW(s) (in whole or in part) by giving Supplier at least ninety (90) days’ prior written notice specifying the terminated Services and
designating the termination date; provided however, that this Section 16.1(k) shall not be considered to apply to Supplier’s provision of Services to a third party that competes with Health Net’s business. 

 

	 	(l)	Termination Relating to Supplier’s Liability Cap. If Supplier owes or has paid to Health Net damages in an amount greater than *** of the Liability Cap evidenced by one or more of the following:

  

	 	(i)	an agreement by Supplier that it owes Health Net such damages, 

  

	 	(ii)	a settlement agreed to by the Parties, or 

  

	 	(iii)	an order from a court of competent jurisdiction or an arbitration award, and Supplier does not agree to refresh the Liability Cap to its original amount (i.e., meaning that none of such damages incurred prior to the
date of Health Net’s request for Supplier to refresh the Liability Cap shall, after such refresh, be considered to apply against the refreshed Liability Cap) within thirty (30) days after a Health Net written request to Supplier to refresh
the Liability Cap, then Health Net may terminate this Agreement (in whole or in part) or any Related SOW(s) (in whole or in part) upon not less than thirty (30) days’ prior written notice to Supplier. 

 

	 	(m)	Termination Relating to Business Associate Agreement. Health Net may terminate this Agreement as provided in the Business Associate Agreement. 

 

	 	(n)	Pre-BPaaS Services Commencement Date Termination. Health Net shall have the right to terminate this Agreement prior to the BPaaS Services Commencement Date by sending written notice to Supplier and paying to
Supplier the Breakup Fee. 

  

					
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	16.2	Termination Related Payments. 

  

	 	(a)	Health Net and/or Supplier, as applicable, may exercise its rights to terminate under this Article 16 or Section 4.3(d)(iii) without charge, except that, subject to Section 16.2(a)(iii), on the effective date
of any termination under this Article 16 or Section 4.3, Health Net shall pay to Supplier: 

  

	 	(i)	the Break-Up Fee (and no other amounts) if the termination of the entire Agreement is prior to the BPaaS Services Commencement Date; or 

 

	 	(ii)	the following if the termination is on or after the BPaaS Services Commencement Date: 

  

	 	(A)	outstanding charges (if any) for all terminated Services completed in accordance with the Agreement through to the effective date of termination (including for work in progress); 

 

	 	(B)	the applicable termination fee calculated pursuant to Section 18 of Schedule C (Charges); and 

  

	 	(C)	any due and unpaid payments relating to the applicable Minimum Revenue Commitment fee through to the effective date of termination, calculated pursuant to Section 17 of Schedule C (Charges);

 provided that nothing set forth herein shall limit Health Net’s right to dispute Charges under Section 10.7. 

 

	 	(iii)	For any termination under Sections 16.1(a), 16.1(c), 16.1(l) or 16.1(m), 

  

	 	(A)	Health Net shall have the right to offset against the amounts owed under Section 16.2(a)(ii)(A), any damages that can be reasonably quantified as having been incurred by Health Net and arising directly out of the
event(s) giving rise to the termination; and 

  

	 	(B)	Health Net shall pay any remaining amounts owed to Supplier (if any) under Section 16.2(a) concurrently with the final resolution of Health Net’s underlying damage(s) claims, rather than on the effective date
of termination. 

  

	 	(b)	Nothing set forth in this Section 16.2 shall limit Health Net’s right to make a claim for damages or to exercise any other remedies available under this Agreement, at law or at in equity. 

 

	 	(c)	Termination Not Supported By Competent Authority. If a purported termination by Health Net under any of Sections 16.1(a) or 16.1(c) – 16.1(n) is found by a competent authority not to be a proper termination
under such section, then such termination will be deemed to be a termination for convenience by Health Net under Section 16.1(b). 

  

					
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	16.3	Termination By Supplier 

 If Health Net fails to pay Supplier when due material
undisputed charges totaling at least *** *** Charges under this Agreement, and fails to make such payment within sixty (60) days after the date Health Net receives notice of non-payment from Supplier, then Supplier may terminate this Agreement
by sending written notice to Health Net, in which event this Agreement shall terminate as of the date specified in the notice of termination. Following Supplier’s termination pursuant to this Section 16.3 (Termination By Supplier), Health
Net shall pay to Supplier all fees and charges set forth in Section 16.2(a)(ii). 
  

	16.4	Extension of Termination/Expiration Date 

 Health Net may extend the effective date of
any termination/expiration of this Agreement or a SOW one or more times as it elects in its discretion. However, the total of all such extensions for any single termination/expiration may not exceed one hundred eighty (180) days following the
effective date of termination/expiration in place immediately prior to the initial extension under this Section 16.4. If any extension notice provided to Supplier within thirty (30) days of the then-scheduled date of termination/expiration
would cause Supplier to incur Out-of-Pocket Expenses, Supplier may so notify Health Net. In that case, the extension will be subject to Health Net agreeing to reimburse Supplier for its Out-of-Pocket Expenses incurred as a result of the extension
notice being provided within thirty (30) days of the then-scheduled date of termination/expiration. If Supplier terminated pursuant to Section 16.3 (Termination By Supplier), then Health Net will pay for any such extension Services thirty
(30) days in advance based on projected usage, with the following month’s invoice showing a true up or true down to account for actuals. 
  

	16.5	Partial Termination 

  

	 	(a)	Partial Terminations by Health Net. With respect to any partial terminations described herein, included those set forth in this Article 16 or Section 4.3, Health Net may only terminate by Line of Business or
by Service Tower. All other purported partial terminations hereunder will be considered a reduction in Services unless otherwise agreed to by the Parties. 

  

	 	(b)	If this Agreement or any SOW is terminated in part: 

  

	 	(i)	the portions of this Agreement (or the applicable SOW) not terminated will continue in force according to the terms of this Agreement and the applicable SOW; 

 

	 	(ii)	if this Agreement (or the applicable SOW) does not otherwise specify the basis for determining Supplier’s charges for the continuing Services that are not terminated, the charges payable under this Agreement (or
the applicable SOW) will be equitably adjusted to reflect the Services that have been terminated, taking into account any increased per-unit charges for remaining Services; 

 

	 	(iii)	the amounts (if any) payable by Health Net pursuant to Section 16.2 in respect of such termination will be, where applicable, equitably adjusted to reflect the portion of the Services being terminated and any
changes in Supplier’s costs; and 

  

					
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	 	(iv)	the Agreement documents specifying the termination-related payments for which Health Net is responsible will be revised to reflect the amounts paid by Health Net pursuant to Section 16.2. 

 

	 	(c)	For clarity, Health Net’s reduction in volume of a particular Service (e.g., a reduction in the number of Claims or Members) shall not constitute a termination in part pursuant to Section 16.1 unless
Health Net provides written notice to Supplier terminating this Agreement in part or an SOW in part pursuant to Section 16.1. 

  

	16.6	Disengagement Assistance 

  

	 	(a)	General. 

  

	 	(i)	During each Disengagement Assistance Period, Supplier shall provide Disengagement Assistance to Health Net, or at Health Net’s request to Health Net’s designee. For the avoidance of doubt, there may be more
than one Disengagement Assistance Period for any Affected Services. 

  

	 	(ii)	The Parties further agree that: 

  

	 	(A)	Health Net’s request for (and Supplier’s provision of) Disengagement Assistance may be in the context of any reduction or removal of a portion of the Services (or volumes of Services) or Functions that is in
accordance with this Agreement or any SOW, although this Agreement or the applicable SOW is not itself expiring or being terminated; and 

  

	 	(B)	Disengagement Services provided by Supplier shall be subject to the other applicable provisions of this Agreement. 

  

	 	(b)	Except as may be permitted by Section 16.6(c), the quality of Services (including the Affected Services) provided by Supplier, and Supplier’s performance of the Services, will not be materially degraded during
the period Supplier is providing Disengagement Assistance. Supplier shall not (i) make any changes to the number of the Supplier Personnel providing the Services during the applicable Disengagement Assistance Period, or (ii) reassign any
Supplier Personnel away from performing Services under this Agreement during the applicable Disengagement Assistance Period, in each case except as otherwise permitted by this Agreement or set forth in any disengagement plan mutually agreed to by
the Parties. 

  

	 	(c)	Except to the extent permitted by this Section 16.6(c), Supplier shall provide Disengagement Assistance utilizing Supplier Personnel then being regularly utilized to provide the Services (“Existing
Supplier Personnel”). 

  

	 	(i)	If Supplier believes in good faith that providing Disengagement Assistance utilizing Existing Supplier Personnel will prevent Supplier from meeting the Service Levels or otherwise complying with other obligations under
this Agreement, Supplier shall provide written notice to such effect to Health Net, describing the circumstances in which the provision of such Disengagement Assistance by some or all Existing Supplier Personnel would prevent Supplier from meeting
Service Levels or comply with its obligations under this Agreement. 

  

					
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	 	(ii)	Upon receipt of such notice, Health Net may (in its sole discretion), elect to either: 

  

	 	(A)	Permit Supplier to utilize personnel in addition to the Existing Supplier Personnel to provide the Disengagement Assistance, or 

  

	 	(B)	Waive the Service Level Credits and any other remedy for failure to meet the applicable Service Levels and other affected obligations of Supplier, in which case Supplier shall only utilize the Existing Supplier
Personnel to provide the Disengagement Assistance, and shall nonetheless use good faith efforts to continue to meet the Service Levels and perform in accordance with its obligations under this Agreement. 

 

	 	(d)	Charges for Disengagement Assistance. Charges for Disengagement Services shall be as follows: 

  

	 	(i)	For Disengagement Assistance for which there is a predetermined charge in Schedule C (Charges) (e.g., a charge to maintain and support a server), such pre-determined charge in the applicable SOW shall
apply. 

  

	 	(ii)	For Disengagement Assistance for which (1) there are no predetermined charges in Schedule C (Charges) (i.e., for assistance that is not part of the routine Services) and (2) Supplier is permitted
under Section 16.6(c) to utilize (and does in fact utilize) personnel in addition to the Existing Supplier Personnel to provide such Disengagement Assistance, then the Services performed by such additional Supplier Personnel will be chargeable
on a time and material basis pursuant to Section 16.1(b) of Schedule C (Charges). 

  

	 	(iii)	If Supplier terminates for non-payment by Health Net under Section 16.3, Supplier shall have the right to request payment of the charges for the Disengagement Assistance monthly, in advance. 

 

	16.7	Survival 

 Any provision of this Agreement that contemplates or governs performance or
observance subsequent to termination or expiration of this Agreement will survive the expiration or termination of this Agreement for any reason, including the following Sections: 

 

	 	(a)	Article 2 (Definitions); 

  

	 	(b)	Article 10 (Invoicing and Payment); 

  

	 	(c)	Section 12.3 (Health Net Rights to Certain Software); 

  

	 	(d)	Article 15 (Intellectual Property Rights); 

  

	 	(e)	Section 16.6 (Disengagement Assistance); 

  

	 	(f)	Section 18.6 (Records Retention); 

  

	 	(g)	Section 19.4 (Deliverable); 

  

	 	(h)	Section 19.7 (Non-Infringement); 

  

					
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	 	(i)	Section 19.9 (Disabling Code); 

  

	 	(j)	Article 21 (Confidentiality); 

  

	 	(k)	Article 23 (Indemnification); 

  

	 	(l)	Article 24 (Liability); 

  

	 	(m)	Article 25 (Rules of Construction); 

  

	 	(n)	Section Sections 4 and 5 of Annex 1 (Supplemental Terms and Conditions for BPaaS Services); and 

  

	 	(o)	Software Escrow Agreement. 

  

	16.8	Bid Assistance 

  

	 	(a)	In the process of deciding whether to undertake or allow any cessation of Services, or any termination, expiration or renewal of this Agreement (or a SOW), in whole or in part, Health Net may consider or seek offers for
performance of services similar to the Services. As and when reasonably requested by Health Net for use in any such process, Supplier will provide to Health Net such information and other cooperation regarding performance of the Services as would be
reasonably necessary to enable Health Net to prepare a request for proposal relating to some or all of such services, and for a third party to conduct due diligence and prepare an informed, non-qualified offer for such services. 

 

	 	(b)	Without limiting the generality of Section 16.8(a), the types of information and level of cooperation to be provided by Supplier pursuant to this Section 16.8 will be no less than those initially provided by
Health Net to Supplier prior to the Effective Date, and shall include the following information which Health Net may distribute to third-party bidders in a request for proposal(s), request for information, specification, or any other solicitation
relating to the Services and as necessary to support any related due diligence activities: 

  

	 	(i)	General organization charts showing the overall structure of Supplier’s organization supporting Health Net, and a description of the roles and responsibilities of the various functions described in such
organization charts; 

  

	 	(ii)	General organization charts showing the overall structure of the organization supporting the Services and a description of the roles and responsibilities of the various Functions described in such organization charts;

  

	 	(iii)	The number of personnel at each location used to provide Services classified by job title, skill level, and experience; 

  

	 	(iv)	Generic descriptions of the functions and classifications of the personnel used to provide the Services; 

  

	 	(v)	New training materials, policies and procedures, work instructions, and other written Deliverables created as a result of the Services; 

  

					
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	 	(vi)	First order descriptions of Health Net’s IT infrastructure environment, including a listing of major infrastructure components and locations; 

 

	 	(vii)	Up-to-date Service Level performance histories, asset inventories (including Equipment and Software) with current book values, third party contracts, and (where possible) then-current work volumes and general
information relating to projects underway; and 

  

	 	(viii)	Detailed network topographies. 

  

	17.	GOVERNANCE AND MANAGEMENT 

  

	17.1	Contract Governance Structure and Processes 

  

	 	(a)	Supplier acknowledges that it is a key business requirement of Health Net that Supplier provide the Services in a consistent, integrated manner. Schedule G (Governance) describes the Contract Governance (as
defined therein) and the related framework and processes to manage the relationship between the Parties and Supplier’s performance under this Agreement. 

  

	 	(b)	Notwithstanding anything set forth in this Agreement to the contrary, any term in this Agreement that states that a matter shall be referred to or resolved in accordance with Schedule G (Governance) shall not affect
either Party’s right to escalate such matter to the dispute resolution provisions in Article 26. 

  

	17.2	Procedures Manual 

  

	 	(a)	The “Procedures Manual” is a document (or set of documents) to be prepared by Supplier describing how Supplier will perform and deliver the Services under this Agreement, the Equipment and
Software used, and the documentation (e.g., operations manuals, user guides, specifications) that provide further details of the activities. The Procedures Manual will: 

 

	 	(i)	describe the activities Supplier shall undertake in order to provide the Services, including those direction, supervision, monitoring, staffing, reporting, planning and oversight activities normally undertaken to
provide services of the type Supplier is to provide under this Agreement; 

  

	 	(ii)	include Supplier’s escalation procedures and the other standards and procedures of Supplier pertinent to Health Net’s interactions with Supplier in obtaining the Services; and 

 

	 	(iii)	include such other information as would be reasonably necessary to an Auditor when performing audits as permitted by this Agreement. 

The Procedures Manual shall describe the aforementioned information in sufficient detail so as to permit a reader to understand how the
Services are being provided. The table of contents for the Procedures Manual is set forth in Schedule S (Procedures Manual TOC) . 

  

					
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	 	(b)	Working in consultation with Health Net, Supplier will deliver to Health Net a detailed outline of the Procedures Manual describing the Services to be transitioned from Health Net to Supplier within ninety
(90) days after the Effective Date. Health Net may review the draft Procedures Manual to confirm that it is sufficiently comprehensive to enable Health Net to understand how the Services are being provided. In the event Health Net identifies
any deficiencies, Supplier will address such deficiencies and will finalize the Procedures Manual with respect to each wave, within one hundred eighty (180) days after the occurrence of such wave. The final Procedures Manual will be subject to
the approval of Health Net for the limited purposes described above. 

  

	 	(c)	The Procedures Manual will be considered an operational document, which Supplier shall revise and periodically update to reflect changes in the operations or procedures described in it. Updates of the Procedures Manual
will be provided to Health Net for review, comment and approval, which approval shall be for the limited purposes described in Section 17.2(b). 

  

	 	(d)	Supplier will perform the Services in accordance with the most recent Procedures Manual. In the event of a conflict between the provisions of this Agreement and the Procedures Manual, the provisions of this Agreement
will control. 

  

	 	(e)	Notwithstanding anything to the contrary in Article 15 (Intellectual Property Rights), Health Net and its Affiliates may retain and Use the Procedures Manual in their businesses and for their benefit both during the
Term and following the expiration or termination of this Agreement for any reason. Subject to appropriate non-disclosure agreements for the limited purpose of protecting any Independent IP of Supplier incorporated into the Procedures Manual, Health
Net and its Affiliates may permit any of their other service providers to use the Procedures Manual during and after the Term, but solely in connection with their provision of services for Health Net and its Affiliates. 

 

	17.3	Technology Plans 

 Supplier will update Health Net’s annual technology plan in
accordance with the provisions of this Section 17.3 (Technology Plan) (the “Technology Plan”). Each Technology Plan updated by Supplier will include a review and assessment of the immediately
preceding Technology Plan. The Technology Plan will consist of a three-year plan and an annual implementation plan as described below. 
  

	 	(a)	Contents of the Technology Plan. 

  

	 	(i)	The Technology Plan will include a comprehensive assessment and strategic analysis of Health Net’s then-current technology environments that are in-scope hereunder for the next three (3) years, including an
assessment of the appropriate direction for Health Net’s systems and services in light of Health Net’s business priorities and strategies and competitive market forces (to the extent such business information is available or provided to
Supplier). The Technology Plan will include a specific identification of proposed Software and Equipment strategies and direction, a cost projection, a costs-vs.-benefits analysis of any proposed Changes, a description of the types of personnel
skills and abilities needed to respond to any recommended Changes or upgrades in technology, a general plan and a projected time schedule for developing and achieving the recommendations made, and references to appropriate operating platforms that
support Service Level requirements, exploit industry trends in production capabilities and provide potential price-performance improvement opportunities. 

  

					
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	 	(ii)	As necessary to support the overall objectives and directions of the three (3)-year plan, the annual implementation plan will provide specific guidance as to the information services requirements, projects and plans for
the upcoming year, including details on operations, maintenance backlog and development activities. The annual implementation plan will include a summary review of Supplier’s performance of the Services in the year then concluding, and will
provide updates and revisions of the long-term plan as appropriate. Supplier will prepare an annual implementation plan for each year of the Term. 

  

	 	(b)	Process for Developing the Technology Plan. 

  

	 	(i)	As part of the process of preparing the annual implementation plan, (A) Health Net will inform Supplier of its strategic direction, (B) the Parties will mutually agree on the content of the Technology Plan,
and (C) the Parties will review the overall operation of this Agreement to ensure that the Services continue to be aligned with Health Net’s strategic business and IT requirements. 

 

	 	(ii)	Supplier will submit for Health Net’s review and approval a draft Technology Plan that reflects the content agreed to pursuant to Section 17.3(b)(i). Supplier will submit the final Technology Plan to Health
Net within fifteen (15) days after receiving Health Net’s comments on the draft. Supplier will submit the draft of the Technology Plan within nine (9) months after the Effective Date. 

The schedule for developing and delivering each Technology Plan will be coordinated to support Health Net’s annual business planning
cycle. Supplier will update the Technology Plan during the year as necessary to reflect changes to Health Net’s and its Affiliates’ businesses that materially affect the validity of the then-current Technology Plan. Supplier will recommend
modifications to the Technology Plan as it deems appropriate, and will revise the Technology Plan as requested or approved by Health Net. 
  

	17.4	Action Plans and Step In Rights 

  

	 	(a)	Triggers for an Action Plan. If Supplier fails to perform any material or critically important Function or material portion thereof for which it is responsible in accordance with the requirements of this
Agreement or the applicable SOW, Supplier shall perform a root cause analysis to determine the underlying cause of such failure to perform, and Health Net may request an action plan from Supplier (the “Action Plan”). If
Health Net requests an Action Plan, Supplier will prepare and deliver, at Supplier’s expense an Action Plan for Health Net’s review and approval within five (5) business days after receiving the request, unless a communication from a
Regulator requires an earlier date, in which case Supplier will use its best efforts to accelerate the production of the plan. 

  

	 	(b)	Contents of Action Plan. Each Action Plan must be submitted using a Health Net-provided corrective action plan template (or other Health Net-approved format). Each Action Plan must specify in detail reasonably
satisfactory to Health Net: 

  

	 	(i)	a description of the problem or problems (each, an “Underlying Problem”) or the process for identifying the Underlying Problem(s) that caused the failure that lead to Health Net’s request for an Action
Plan; 

  

					
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	 	(ii)	where remedy of the Underlying Problem is possible, the actions that will be implemented by Supplier to effect that remedy; 

  

	 	(iii)	the actions that will be implemented by Supplier to prevent the same or a substantially similar Underlying Problem from occurring in the future; 

 

	 	(iv)	a timeline for the implementation of the Action Plan; and 

  

	 	(v)	any other content that may reasonably be requested by Health Net. 

  

	 	(c)	Health Net’s Response to Draft Action Plan. 

  

	 	(i)	After receiving the draft Action Plan, Health Net may give Supplier notice that it approves the draft Action Plan or comment on the draft Action Plan, in which case Supplier must (i) at the reasonable request of
Health Net, meet at Supplier’s sole expense to discuss Health Net’s comments; and (ii) within two (2) Business Days (or such longer period as Health Net may set in writing) after the meeting, or receipt of Health Net’s
comments where no meeting is required by Health Net (unless as otherwise agreed by the Parties), prepare at Supplier’s sole expense a revised Action Plan addressing Health Net’s comments and submit it to Health Net for its approval.

  

	 	(ii)	This Section 17.4(c) applies to any proposed Action Plan until it has been approved by Health Net. 

  

	 	(d)	Implementation of Action Plan. Supplier will only implement an Action Plan if Health Net has approved it and in the form approved by Health Net. 

 

	 	(e)	Exercise of Step In Rights. 

  

	 	(i)	In the event: 

  

	 	(A)	Supplier fails to comply in a timely manner with Supplier’s obligations regarding the creation or implementation of an Action Plan, or 

 

	 	(B)	the implementation of the Action Plan does not and will not (within a reasonable period of time) result in the resolution of the Underlying Problem and the prevention of the same or a substantially similar Underlying
Problem from occurring in the future; or 

  

	 	(C)	an event (or multiple events) has occurred that Health Net reasonably believes could lead to the right for Health Net to terminate the Agreement (in whole or in part) or any SOW (in whole or in part), then

 Health Net may by giving written notice to Supplier have Health Net personnel and/or contractors retained by Health Network
along-side Supplier personnel to assist Supplier in resolving the Underlying Problem and preventing its recurrence (a “Step In”). Health Net’s Step In rights shall include the right to access the Health Net Colocation
Space and Supplier shall facilitate such access with the Colocation Providers. 

  

					
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	 	(ii)	If Health Net Steps In, Supplier must cooperate fully with Health Net and its personnel and will provide, at no additional charge to Health Net, all assistance reasonably required by Health Net as soon as possible,
including providing all reasonable access to Supplier Personnel and all relevant Equipment, premises and Software under Supplier’s control to facilitate the purpose of the Step In. 

 

	 	(iii)	Health Net’s right to Step In will end when Supplier demonstrates to Health Net’s reasonable satisfaction that Supplier has resolved the Underlying Problem and Supplier is capable of providing the affected
Service in accordance with the requirements of this Agreement and the affected SOW. 

  

	 	(iv)	Supplier must reimburse Health Net for its out-of-pocket expenses incurred by Health Net in the event Health Net exercises its right to Step In for up to *** months. 

 

	 	(v)	For the avoidance of doubt, Health Net’s election to Step In: 

  

	 	(A)	does not act to relieve Supplier of its obligations under this Agreement; and 

  

	 	(B)	shall not be construed as limiting any rights and remedies Health Net may have under this Agreement, or at law or equity, in connection with any Underlying Problem, the resulting failure(s) by Supplier to perform in
accordance with the Agreement. 

  

	17.5	Change Control 

  

	 	(a)	“Change” means any addition to, modification or removal of any aspect of the Services “Change Control Process” means the written procedure set forth in Schedule H
(Change Control Process) for considering, analyzing, approving and carrying out Changes, which is designed to ensure that only desirable Changes are made and that Changes made by or on behalf of Supplier are carried out in a controlled manner
with minimal disruption to the Services and Service Recipients’ business operations. 

  

	 	(b)	Except as otherwise expressly provided in Schedule A (Services) or in an SOW, Health Net has retained responsibility for establishing the standards (including security standards) and strategic direction of Health
Net (and its Affiliates) with respect to outsourcing. 

  

	 	(c)	The Parties agree that a Change might not require changes to the Charges. Supplier shall not be entitled to request an additional charge for a Change unless, and then only to the extent that, (i) such Change
(A) is either (1) not within the scope of the Services and is not otherwise Supplier’s financial responsibility under this Agreement or (2) even if it is within such scope or financial responsibility and except as otherwise
provided in Section 17.5(e), is a non-de minimus change requested by Health Net in the required manner or location of performance of the Services, and (B) would demonstrably increase Supplier’s costs to implement the Change or to
deliver the Services in accordance with such Change; and (ii) the additional charge requested by Supplier for such Change must be directly and reasonably related to the net additional costs incurred by Supplier arising out of the Change (after
taking into account any reductions to Supplier’s costs arising out of the Change). Supplier shall include in the applicable Change Order a proposal on how Charges for the affected Services will change. 

  

					
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	 	(d)	Supplier will not make any Changes, except in accordance with the Change Control Process and with Health Net’s prior written approval; provided, however, that Supplier operational changes that do not fall within
clauses (i), (ii) or (iii) and are not subject to other agreed restrictions shall not be subject to such approval. Health Net’s approval of any Change may be withheld in its discretion for any Change that may reasonably be expected to
do or result in any of the following in any non- de minimis way: (i) adversely affect the specifications, functionality, performance or resource efficiency of any Services; (ii) increase Health Net’s internal costs, Supplier’s
charges to Health Net under this Agreement or charges by other Health Net suppliers to Health Net; (iii) disrupt or adversely affect any of Health Net’s or its Affiliates’ business or operations; or (iv) discontinuing the use of
the ABS platform or claim edit system (ihealth) to provide the Services. If Supplier implements any Change without securing Health Net’s prior written approval via the Change Control Process, the Change will be deemed to be provided as part of
the Services at no additional charge. 

  

	 	(e)	With respect to any change in a Law or Health Net Policy (or any new Law or Health Net Policy) that either Party determines may require a potential Change to the Services: 

 

	 	(i)	The Parties will mutually discuss the potential Change to the Services, and based on such discussions, Supplier shall provide a proposed Change Order addressing such Change, to reflect how the Services would be modified
to be in compliance with such changed or new Law or Health Net Policy (as applicable). 

  

	 	(ii)	With respect to any Change resulting from (x) a change in or a new Law, or (y) a change in or a new Health Net Policy (but only to the extent such change in or new Health Net Policy was required in order to
comply with an existing Law or caused by a change in or a new Law): 

  

	 	(A)	Supplier shall use Commercially Reasonable Efforts to implement the Change sufficiently in advance of the effective date of compliance with such changed or new Law such that Health Net has a reasonable amount of time to
perform testing of any of Health Net’s equipment, systems, processes or other items that may be impacted by such Change; and 

  

	 	(B)	Supplier shall have financial responsibility for any such Change, except to the extent that Health Net is financially responsible as expressly set forth in Section 13 of Schedule C (Charges). 

 

	 	(f)	If an approved Change would result in: 

  

	 	(i)	New Services or a change to an existing SOW, then (unless otherwise agreed by Health Net to be documented in a Change Notice) the Change must be authorized via, as applicable, a Future SOW pursuant to Section 3.7
or an amendment or modification to an existing SOW made pursuant to Section 25.3 (Contract Amendments and Modifications) or documentation resulting from agreeing to such Change pursuant to the Change Control Procedure; or

  

	 	(ii)	A change to any other terms of this Agreement, the Change must be authorized via a contract amendment or modification made pursuant to Section 25.3 (Contract Amendments and Modifications). 

  

					
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	18.	AUDITS AND RECORDS 

  

	18.1	Audit Rights 

  

	 	(a)	Health Net and its agents, auditors (internal and external), Regulators, Health Net customers, provider groups and hospitals (and their respective auditors), and other representatives as Health Net may designate
(collectively, “Auditors”) will have the right to reasonably inspect, examine and audit those portions of the systems, records (including financial records), facilities, data, practices and procedures of Supplier and its
Subcontractors that are used in rendering the Services or pertain to the Services (collectively, “Audits”) for any of the following purposes: 

 

	 	(i)	to verify the accuracy of Supplier’s invoices; 

  

	 	(ii)	to verify the integrity of those elements of Health Net’s corporate control processes that are performed by Supplier, in order to permit Health Net’s management and independent auditors to make certifications
required by the securities or other Laws of any country; 

  

	 	(iii)	to verify the integrity of Health Net Data and Supplier’s compliance with the data privacy, data protection, confidentiality and security requirements of this Agreement; 

 

	 	(iv)	to examine Supplier’s performance of the Services and to verify Supplier’s compliance with this Agreement, including (to the extent applicable to the Services and to the charges therefore), performing audits
of: 

  

	 	(A)	practices and procedures; 

  

	 	(B)	systems, equipment, and Software; 

  

	 	(C)	general controls and security practices and procedures; 

  

	 	(D)	disaster recovery and back-up procedures; 

  

	 	(E)	the validity of Supplier’s charges, but Auditors shall not be given access to information concerning Supplier’s costs except in relation to the following: (1) charges billed on a time and materials basis
or using another form of ‘price x quantity’ charging model, (2) Supplier’s proposed charges for Changes, and (3) invoiced charges for reimbursement of Out-of-Pocket Expenses; 

 

	 	(F)	as necessary to enable Health Net to meet, or to confirm that Supplier is meeting, applicable regulatory and other legal requirements; and 

 

	 	(G)	Supplier’s methodology and approach for estimating the charges for Projects; 

  

	 	(v)	to satisfy the requirements of the Health Net audit committee and the requirements of Regulators (including with respect to the requirements of any corrective action plan); 

  

					
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	 	(vi)	to verify Health Net’s compliance with applicable Laws and Health Net’s agreements with customers and employer groups; 

  

	 	(vii)	to verify Supplier’s compliance with Section 9.5 (Most Favored Customer); and 

  

	 	(viii)	to perform mock Audits. 

  

	 	(b)	Health Net shall also have the right to retain a third party to perform Audits of Supplier’s Service Level measurements, calculations and reporting, and to confirm statistically valid random sampling.

  

	 	(c)	All Audits shall be subject to the following limitations: 

  

	 	(i)	Audits will be conducted during Business Hours and upon reasonable advance notice to Supplier except in the case of Audits by Regulators, emergency or security Audits and Audits investigating claims of illegal behavior;

  

	 	(ii)	Health Net and its Auditors will comply with Supplier’s reasonable security and confidentiality requirements, guidelines and other policies of Supplier when accessing facilities or other resources owned or
controlled by Supplier with respect to the Audit; 

  

	 	(iii)	Use of any third party auditor that is a Supplier Competitor, shall be subject to Supplier’s prior written approval, such approval not to be unreasonably withheld or delayed; 

 

	 	(iv)	Heath Net and its Auditor(s) must obtain Supplier’s written approval prior to utilizing tools or utilities within Supplier’s computer systems and network, and Supplier shall have the opportunity to thoroughly
test such tools prior to granting such approval, such approval not to be unreasonably withheld or delayed. 

  

	 	(d)	Supplier will cooperate with Health Net, its Regulators and its and their Auditors conducting Audits and provide such assistance as they reasonably require to carry out the Audits, including providing audit support as
contemplated in any SOWs and providing knowledgeable staff to assist them in conducting Audits. Furthermore, Supplier will comply with Health Net’s internal audit methodology, as it is provided to Supplier by Health Net. Subject to the
foregoing, Auditors will be provided reasonable access to systems or Supplier facilities used in the performance of the Services, provided that the Auditors will not have access to any data of any customer of Supplier other than Health Net.

  

	18.2	Supplier Audits 

  

	 	(a)	Supplier will conduct its own audits pertaining to the Services consistent with the audit practices of well-managed companies that perform services similar to the Services. Without limiting the generality of the
foregoing, Supplier will conduct the following audits upon Health Net’s request (provided that Health Net shall not request any audit more frequently than annually) at each Supplier Facility and obtain the appropriate compliance certification:

  

	 	(i)	a security (including physical security) audit; 

  

					
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	 	(ii)	an audit of privacy practices as related to the Services; 

  

	 	(iii)	a Statement on Standards for Attestation Engagements No. 16, Service Organization Control 2, Type 2 (“SSAE 16”) audit as defined by the American Institute of Certified Public Accountants (or
an equivalent ISAE 3402 Type 2 audit or an audit made pursuant to any other guidance that supersedes or replaces SSAE 16 SOC 1 and 2, Type 2). Supplier will provide copies of SSAE 16 or International Standard on Assurance Engagements 3402
(“ISAE 3402”) audit reports for the Services. Supplier will provide such audit reports for the Term of this Agreement. The Audits will be conducted in accordance with third party auditor’s control requirements and
industry standards or guidelines. Such audits will be performed on a service or facility basis and not on a customer specific basis; 

  

	 	(iv)	ISO 20000-1 audits (or similar audits based upon industry-recognized successor standards) to be performed by a reputable, independent third party auditor; 

 

	 	(v)	a corporate-wide ISO 9001:2008 audit (or similar audit based upon an industry-recognized successor standard); and 

  

	 	(vi)	an ISO 27001 audit; and 

  

	 	(vii)	such other audits in order to verify compliance with the provisions of the Sarbanes-Oxley Act of 2002, as such Act may be amended from time to time. 

(such audits referenced in this Section 18.2 collectively the “Required Supplier Audits”). Supplier’s SSAE
16/ISAE 3402 audits will cover the time period on an overlapping six (6) month basis of each calendar year. Each calendar year, one of Supplier’s SSAE 16/ISAE 3402 audits will cover a six (6) month period ending no later than two
(2) months prior to the end of such calendar year, and no earlier than three (3) months prior to the end of such calendar year, with the related SSAE 16/ISAE 3402 report provided to Health Net within three (3) months after the end
date of the period under audit. 
  

	 	(b)	If Supplier receives a qualified opinion resulting from a Supplier Audit, Supplier will promptly remediate the audited services and provide Health Net with a supplemental audit report removing the qualification.

  

	 	(c)	As requested by Health Net for a Required Supplier Audit as of a date that is specified by Health Net in such request and that is within the period in which such Required Supplier Audit remains valid, Supplier shall
provide Health Net with a “bring down” certification letter, signed by an appropriate Supplier employee, which certifies that such Required Supplier Audit remain materially accurate. 

 

	 	(d)	Supplier shall make available promptly to Health Net (i) the results of any review or audit conducted by or for Supplier or its Affiliates relating to Supplier’s operating practices or procedures, to the
extent relevant to the Services or Health Net, and (ii) summaries of business continuity test results to the extent relevant to the Services or Health Net, which shall include frequency of the testing, that which was tested, and a summary of
the outcome of those tests; and which shall be no less detailed than similar information that which Supplier provides to government or other customers similar to Health Net. In addition, Supplier will cause its account management team to maintain an
awareness of any material issues that relate to Health Net and that are discovered by Supplier or its auditors (including 

  

					
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 as part of any internal review or audit). If any such resulting review or audit report is
relevant to Health Net, its Affiliates or other Service Recipients, Supplier will provide a copy of the audit report to Health Net and its independent auditors for review and comment as soon as reasonably possible, and in any event within thirty
(30) days after completion of the audit report. Supplier will also provide information regarding its plans to correct, and will correct, any material errors or problems identified in the audit report. 

 

	18.3	Supplier’s Internal Controls 

  

	 	(a)	Supplier will develop and maintain internal control processes and controls that are designed to prevent and detect a material misstatement in financial information processed or generated by Supplier, as required to
achieve and maintain compliance with the provisions of the Sarbanes-Oxley Act of 2002, as such Act may be amended from time to time. 

  

	 	(b)	Supplier will permit Health Net access to Supplier’s processes and controls relevant to the Services and provide such documentation as reasonably requested by Health Net to the extent reasonably necessary for
Health Net to complete its internal control testing to satisfy the Sarbanes-Oxley Act of 2002. 

  

	18.4	Audit Follow-up 

  

	 	(a)	Following an Audit or examination, Health Net may conduct, or request its external Auditors or examiners to conduct, an exit conference with Supplier to obtain factual concurrence with issues identified in the review.
Supplier will make available promptly to Health Net the results of any review or audit conducted by Supplier and Supplier’s Affiliates (including by internal audit staff or external auditors), or by inspectors, Regulators or other
representatives, relating to Supplier’s operating practices and procedures to the extent relevant to the Services or Health Net. Supplier shall comply with Health Net’s internal audit methodology as Health Net makes it known to Supplier in
order resolve any issues that arise from the audit. 

  

	 	(b)	At Health Net’s request, Supplier will meet with Health Net to review each audit report promptly after the issuance thereof and to mutually agree upon the appropriate manner, if any, in which to respond to the
changes suggested by the audit report. Supplier and Health Net agree to develop operating procedures for the sharing of audit and regulatory findings and reports related to Supplier’s operating practices and procedures produced by auditors or
regulators of either Party. Supplier shall comply with Health Net’s internal audit methodology as Health Net makes it known to Supplier. 

  

	18.5	Confidentiality of Audits 

 All Audit results and disclosed records of Supplier’s
performance of the Services will be treated as Supplier Confidential Information (except to the extent they contain Health Net Confidential Information or fall within an exception in Section 21.1(b)) and shall not be used for any purpose except
to verify Supplier’s compliance with its obligations under this Agreement and except that such results and records may be disclosed to Regulators in accordance with Section 21.2(d). 

 

	18.6	Records Retention 

  

	 	(a)	In support of Health Net’s Audit rights, Supplier will keep and maintain (i) financial records relating to this Agreement in accordance with generally accepted accounting principles applied on a consistent
basis, (ii) records substantiating Supplier’s invoices, (iii) records pertaining to Supplier’s compliance with the Service Levels, including root cause analyses, and (iv) such other operational records pertaining to
performance of the Services as Supplier keeps in the ordinary course of its business. 

  

					
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	 	(b)	Supplier will retain such records and provide access to them upon request for Audits until the last to occur of the following: (i) ten (10) years after expiration or termination of this Agreement;
(ii) all pending matters relating to this Agreement (including disputes) are closed; and (iii) the information is no longer required to meet the Health Net Policy on records retention. Before destroying or otherwise disposing of such
records, Supplier will provide Health Net with sixty (60) days prior notice and offer Health Net the opportunity to recover the records or to request Supplier to deliver the records to Health Net, with Health Net paying Supplier’s
Out-of-Pocket Expenses. 

  

	 	(c)	Supplier will cause any Subcontractor of Supplier under this Agreement to make such Subcontractor’s books and records with respect to the Services available for inspection, examination and copying by the applicable
Regulator and to retain such books and records in accordance with applicable Laws (e.g., the California Knox-Keene Act requirements), which requirements shall be provided by Health Net to Supplier. In the event that Health Net or its
Affiliates receives any notice that a Regulator requires such access to a Subcontractor’s books and records, it will notify Supplier promptly to allow Supplier to notify the applicable Subcontractor, if not prohibited by Law. If Supplier or
Subcontractor requests that any information disclosed to Regulators be given confidential treatment by the Regulator, Health Net or the applicable Affiliate will make such request, will cooperate reasonably with Supplier in communicating with the
Regulator and will take all reasonable actions to obtain confidential treatment. 

  

	18.7	Financial Reports 

 At Health Net’s request, Supplier will provide to Health Net
copies of all publicly-available audited and unaudited financial statements of Supplier and its Controlling Affiliates. 
  

	18.8	Overcharges 

  

	 	(a)	If as a result of an audit or otherwise it is determined that Supplier has overcharged Health Net, Supplier shall credit Health Net’s account (or, at Health Net’s option, pay Health Net directly) an amount
equal to the overcharge plus interest at *** above the prime rate (as shown in The Wall Street Journal) calculated from the date the overcharge was paid by Health Net. 

 

	 	(b)	If an audit of the charges discloses that Supplier’s overcharges exceeded *** percent of the audited charges during the period audited, Supplier shall also reimburse Health Net for the reasonable cost of such
audit. 

  

	19.	REPRESENTATIONS, WARRANTIES AND COVENANTS OF SUPPLIER 

  

	19.1	Work Standards 

 Supplier covenants that the Services will be rendered with promptness
and diligence and be executed in a professional and workmanlike manner in accordance with the practices and standards observed by the leading companies in Supplier’s industry when performing similar services. Supplier covenants that it will use
adequate numbers of qualified Supplier Personnel with suitable training, education, experience and skill to perform the Services in accordance with timing and other requirements of this Agreement. 

  

					
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	19.2	Maintenance 

 Supplier represents, warrants and covenants that it will maintain the
Equipment and Software for which it has operational responsibility or Financial Responsibility so they operate in accordance with their specifications, including (i) maintaining Equipment in good operating condition, subject to normal wear and
tear; (ii) undertaking repairs and preventive maintenance on Equipment in accordance with the applicable Equipment manufacturer’s recommendations; and (iii) performing Software maintenance in accordance with the applicable Software
vendor’s documentation and recommendations. 
  

	19.3	Efficiency and Cost-Effectiveness 

 Supplier covenants that it will use Commercially
Reasonable Efforts to use efficiently the resources or services necessary to provide the Services. Supplier covenants that it will use Commercially Reasonable Efforts to perform the Services in a cost-effective manner consistent with the required
level of quality and performance. 
  

	19.4	Deliverable 

 Supplier represents, warrants and covenants that each Deliverable produced
by Supplier under this Agreement will not, during the Warranty Period, deviate in any material respect from the specifications and requirements for such Deliverable set forth or referred to in this Agreement (or a SOW, work order, service request,
project plan or similar document developed pursuant to this Agreement). If Health Net notifies Supplier of a breach of the foregoing warranty within the Warranty Period, Supplier will promptly correct and redeliver the affected Deliverable at no
additional charge to Health Net without delay. “Warranty Period” shall mean the period of time commencing on the date of delivery of the Deliverable to Health Net and continuing for ninety (90) days ; provided that with
respect to Deliverables that are modifications or enhancements or additions to the Technology Platform, the Warranty Period shall be the period of time commencing on the earlier to occur of (i) the date of delivery of such Deliverable to Health
Net, and (ii) use of such Deliverable to provide the Services, and continuing for the duration of the Term and all Disengagement Assistance Periods. 
  

	19.5	Documentation 

 Supplier represents, warrants and covenants that any Documentation
developed for Health Net by or on behalf of Supplier under this Agreement, except portions of the Documentation provided by Health Net, will (a) accurately and with reasonable comprehensiveness describe the operation, functionality and use of
the item described in such Documentation, and (b) for Application Software, accurately describe in terms understandable to a typical End User the functions and features of such item and the procedures for exercising such functions and features.

  

	19.6	Compatibility 

 Supplier represents, warrants and covenants that, during the Warranty
Period, Deliverables that are developed and that are intended to interact or otherwise work together as part of a functioning system, including with other technology components that exist at the time such Deliverables are created, will be compatible
and will properly inter-operate and work together as components of an integrated system. 

  

					
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	19.7	Non-Infringement 

  

	 	(a)	Subject to Section19.7(b), Supplier represents, warrants and covenants that: 

  

	 	(i)	Supplier will perform their responsibilities under this Agreement in a manner that does not infringe or constitute an infringement or misappropriation of any Intellectual Property Rights of any third party;

  

	 	(ii)	Supplier has all rights and licenses necessary to convey to Health Net (and to its Affiliates, where applicable) the ownership of or license rights to, as applicable, all Software, Work Product, Independent IP, and
other items provided to Health Net by or on behalf of Supplier; and 

  

	 	(iii)	no Software, Work Product, Independent IP, or other item used to provide the Services or otherwise provided to Health Net by or on behalf of Supplier, nor their use by Health Net or other Service Recipients in
accordance with the applicable Documentation (if any), will infringe or constitute an infringement or misappropriation of any Intellectual Property Right of any third party. 

 

	 	(b)	Supplier will not be considered in breach of the representations, warranties and covenants set forth in Section 19.7(a) to the extent (but only to the extent) that any claimed breach, infringement or
misappropriation (if true) would be attributable to any of the following: 

  

	 	(i)	Health Net’s modification of an item provided by or on behalf of Supplier unless the modification was expressly authorized, approved or made by Supplier; or 

 

	 	(ii)	Health Net’s combination, operation or use of an item provided by or on behalf of Supplier with other specific items not furnished by, through or at the specification of Supplier or its Subcontractors; provided,
however, that this exception will not be deemed to apply to the combination, operation or use of an item with other commercially available products that could reasonably have been anticipated by Supplier that Health Net would likely use in
combination with the item provided by or on behalf of Supplier (e.g., the combination, operation or use of application Software provided by Supplier with a commercially available computer and operating systems Software not provided by Supplier); or

  

	 	(iii)	Any aspect of Health Net’s Software, Documentation or data which existed prior to Supplier’s performance of Services provided the claimed breach, infringement or misappropriation (if true) would not be
attributable to any work performed by (or on behalf of) Supplier for Health Net or a Health Net Affiliate; or 

  

	 	(iv)	Claims relating to the ABS Platform in respect of which Health Net is obligated to indemnify Supplier under the APA; or 

  

	 	(v)	Any instruction, information, design or other materials furnished to Supplier hereunder by or on behalf of Health Net; or 

  

	 	(vi)	Health Net’s continuing the allegedly infringing activity after (A) being notified thereof, and (B) being provided with modifications that would have avoided the alleged infringement without adversely
affecting Health Net’s use of or the functionality of the applicable item or Health Net’s receipt of the Services. 

  

					
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	19.8	Viruses 

 “Virus” means (i) program code or programming
instruction(s) or set(s) of instructions intentionally designed to disrupt, disable, harm, interfere with or otherwise adversely affect computer programs, data files or operations; or (ii) other code typically described as a virus, Trojan
horse, worm, back door or other type of harmful code. Supplier covenants that Supplier Personnel will not knowingly introduce a Virus or allow a Virus to be introduced into Health Net’s or any other Service Recipient’s system or any system
used to provide the Services. In addition, Supplier will use Commercially Reasonable Efforts to prevent Supplier Personnel from unknowingly introducing a Virus or allowing a Virus to be introduced into Health Net’s or any other Service
Recipient’s system or any system used to provide the Services. If a Virus is found to have been introduced into Health Net’s or other Service Recipients’ systems or the systems used to provide the Services as a result of a breach of
the foregoing representation, warranty and covenant, Supplier will use Commercially Reasonable Efforts at no additional charge to assist Health Net in eradicating the Virus and reversing its effects and, if the Virus causes a loss of data or
operational efficiency, to assist Health Net in mitigating and reversing such losses. 
  

	19.9	Disabling Code 

 Supplier covenants that in the course of providing the Services it will
not intentionally insert into Software or any systems used to provide the Services any code that would have the effect of disabling or otherwise shutting down all or any portion of the Services. With respect to any disabling code that was already
part of Software or systems used to provide the Services, Supplier covenants that it will not intentionally invoke such disabling code or knowingly permit it to be invoked at any time without Health Net’s prior written consent. For purposes of
this covenant, programming errors will not be deemed disabling code to the extent Supplier can demonstrate that such errors were not made with the intention of disabling or otherwise shutting down all or any portion of Health Net’s or any other
Service Recipient’s systems or any system used to provide the Services. 
  

	19.10	Date and Currency Compliance 

 Supplier represents, warrants and covenants to Health Net
that the Services and any Deliverable provided by Supplier do and will, operate in a manner which prevents ambiguous or erroneous output with respect to all (a) date-related data and functions and (b) currency-related data and functions.

  

	19.11	Corporate Social Responsibility 

 Supplier represents, warrants and covenants to Health
Net that Supplier and Supplier Facilities comply, and during the Term will comply, with the following: 
  

	 	(a)	Supplier will not use forced or compulsory labor in any form, including prison, indentured, political, bonded or otherwise. 

  

	 	(b)	Supplier will not follow policies promoting or resulting in unacceptable worker treatment such as the exploitation of children, physical punishment, female abuse, involuntary servitude, or other forms of abuse.

  

	 	(c)	Supplier will not discriminate based on race, creed, gender, marital or maternity status, class or caste status, religious or political beliefs, age or sexual orientation. Supplier’s decisions related to hiring,
salary, benefits, advancement, termination or retirement will be based solely on the ability of an individual to do the job, Supplier’s business and technical requirements, and those of Supplier’s customers. 

  

					
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	 	(d)	Supplier’s management practices will recognize the dignity of the individual employee and the right to a work place free of harassment, abuse or corporal punishment, and will respect Supplier’s employees’
voluntary freedom of association. 

  

	 	(e)	Supplier will comply with all applicable Laws concerning the conditions of employment of its employees, including those relating to pay, benefits, and working conditions. 

 

	 	(f)	Supplier will maintain on file all documentation needed to demonstrate compliance with these standards and shall make these documents available for Health Net and its auditors with or without prior notice. Supplier will
publicize to its employees and enforce a non-retaliation policy that permits Supplier’s employees to speak with Health Net and Health Net’s auditors without fear of retaliation by Supplier or Supplier’s management. 

 

	19.12	Subcontractor Confidentiality and Data Protection 

 Supplier will ensure that each of
Supplier’s Subcontractors performing the Services will, prior to performing any Services, have executed an agreement satisfying the confidentiality and data protection obligations provided in this Agreement. 

 

	19.13	No Improper Inducements 

 Supplier represents, warrants and covenants to Health Net that
it has not violated any applicable Laws or any Health Net Policy regarding the offering of unlawful or improper inducements in connection with this Agreement. If at any time during the Term, Health Net determines that the foregoing representation,
warranty and covenant is inaccurate, then, in addition to any other rights Health Net may have at law or in equity, Health Net may terminate this Agreement for cause without affording Supplier an opportunity to cure. 

 

	19.14	Foreign Corrupt Practices Act 

  

	 	(a)	Supplier represents, warrants and covenants that it has not and will not offer, pay, promise to pay, or authorize the payment of any money, or offer, give, promise to give, or authorize the giving of anything of value
to a foreign official (as defined in the Foreign Corrupt Practices Act (P.L. 95-213), as amended), to any foreign political party or official thereof or any candidate for foreign political office, or to any person, while knowing or being aware of a
high probability that all or a portion of such money or thing of value will be offered, given or promised, directly or indirectly, to any foreign official, to any foreign political party or official thereof, or to any candidate for foreign political
office, for the purposes of: 

  

	 	(i)	influencing any act or decision of such foreign official, political party, party official, or candidate in his or its official capacity, including a decision to fail to perform his or its official functions; or

  

	 	(ii)	inducing such foreign official, political party, party official, or candidate to use his or its influence with the foreign government or instrumentality thereof to affect or influence any act or decision of such
government or instrumentality, in order to assist Health Net or Supplier in obtaining or retaining business for or with, or directing business to Health Net or Supplier. 

  

					
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	 	(b)	Supplier further represents, warrants and covenants that it will not violate the Foreign Corrupt Practices Act or any other applicable anti-corruption laws or regulations. Supplier agrees that if subsequent developments
after the Effective Date cause the representations, warranties, covenants and information reported herein to be no longer accurate or complete, Supplier will promptly furnish Health Net with a supplementary report detailing such change in
circumstances. 

  

	19.15	Claims Procedures, Appeals and External Review 

 Supplier shall ensure that its decisions
regarding hiring, compensation, termination, promotion, or other similar matters with respect to Supplier Personnel (such as a claims adjudicator, appeals processor, or medical expert) shall not be made based upon the likelihood or perceived
likelihood that the individual will support or tend to support the denial of benefits for Health Net members and/or customers. 
  

	19.16	ABS Platform 

 The representations, warranties, covenants and other provisions contained
in Sections 19.1-19.12 shall not apply to any part of the ABS Platform developed by or for Health Net (other than by Supplier) prior to the BPaaS Services Commencement Date. 
  

	20.	MUTUAL REPRESENTATIONS AND WARRANTIES; DISCLAIMER 

  

	20.1	Mutual Representations and Warranties 

 Each Party represents, warrants and covenants to
the other that: 
  

	 	(a)	It has the requisite corporate power and authority to enter into this Agreement and to carry out the transactions and activities contemplated by this Agreement; 

 

	 	(b)	The execution, delivery and performance of this Agreement and the consummation of the transactions contemplated by this Agreement have been duly authorized by the requisite corporate action on the part of such Party,
are a valid and binding obligation of such Party, and do not constitute a violation of any existing judgment, order or decree; 

  

	 	(c)	The execution, delivery and performance of this Agreement and the consummation of the transactions contemplated by this Agreement do not constitute a material default under any existing material contract by which it or
any of its material assets is bound, or an event that would, with notice or lapse of time or both, constitute such a default; and 

  

	 	(d)	There is no proceeding pending or, to the knowledge of the Party, threatened that challenges or could reasonably be expected to have a material adverse effect on this Agreement or the ability of the Party to perform and
fulfill its obligations under this Agreement. 

  

					
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	20.2	Disclaimer 

 OTHER THAN AS PROVIDED IN THIS AGREEMENT, THERE ARE NO EXPRESS WARRANTIES
AND THERE ARE NO IMPLIED WARRANTIES, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, ALL OF WHICH ARE EXPRESSLY DISCLAIMED EXCEPT WHERE REQUIRED BY LAW. 

 

	21.	CONFIDENTIALITY 

  

	21.1	“Confidential Information” Defined 

  

	 	(a)	“Confidential Information” of a Party means any non-public, commercially sensitive information (or materials) belonging to, concerning or in the possession or control of the Party or any of its
Affiliates (and, in the case of Health Net, any of the Service Recipients) (the “Furnishing Party”) that is furnished, disclosed or otherwise made available (directly or indirectly) to the other Party (the
“Receiving Party”) (or entities or persons acting on the other Party’s behalf) in connection with this Agreement and which is either marked or identified in writing as confidential, proprietary, secret or with another
designation sufficient to give notice of its sensitive nature, or is of a type that a reasonable person would recognize it to be confidential. In the case of Health Net, “Confidential Information” includes any
(i) information to which Supplier has access in Health Net Facilities or Health Net systems (or those of any Health Net Affiliates or Service Recipients) (ii) information belonging to or concerning Health Net, any Health Net Affiliates or
any of the Service Recipients in Supplier Facilities or systems used to provide the Services; (iii) Deliverables and information pertaining to them, (iv) Health Net Data, Health Net Owned Software, Health Net Licensed Software, and systems
access codes, (v) information concerning Health Net’s and/or its Affiliates’ and/or Service Recipients’ products, marketing strategies, financial affairs, employees, customers or suppliers, (vi) personal information and
Personally Identifiable Information of Health Net’s employees and members and any information protected under the Business Associate Agreement (including Protected Health Information), (vii) Proprietary Business Rules and (viii) all
data and information in any form derived from any of the foregoing, in each case regardless of whether or how any of the foregoing is marked. In the case of Supplier, “Confidential Information” includes any
(a) information regarding Supplier’s systems, marketing plans, Software, processes and controls, products and services, (b) Work Product (other than Deliverables) and Supplier’s Independent IP, and (c) any part of the
Required Information that is not Health Net Data, in each case regardless of whether or how any of the foregoing is marked. Any notes, memoranda, compilations, derivative works, data files or other materials prepared by or on behalf of the Receiving
Party that contain or otherwise reflect or refer to Confidential Information of the Furnishing Party will also be considered Confidential Information of the Furnishing Party. 

 

	 	(b)	 “Confidential Information” does not include any particular information (other than personal information, -Personally
Identifiable Information and Protected Health Information) that the Receiving Party can demonstrate: (i) was rightfully in the possession of, or was rightfully known by, the Receiving Party without an obligation to maintain its confidentiality
prior to receipt from the Furnishing Party; (ii) was or has become generally known to the public other than as a result of breach of this Agreement or a wrongful disclosure by the Receiving Party or any of its agents; (iii) after
disclosure to the Receiving Party, was received from a third party who, to the Receiving Party’s knowledge, had a 

  

					
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lawful right to disclose such information to the Receiving Party without any obligation to restrict its further use or disclosure; or (iv) was independently developed by the Receiving Party
without use of or reference to any Confidential Information of the Furnishing Party. 

  

	21.2	Obligations of Confidentiality 

  

	 	(a)	Each Party acknowledges that it may be furnished, receive or otherwise have access to Confidential Information of the other Party in connection with this Agreement. 

 

	 	(b)	The Receiving Party will not use, disclose or reproduce Confidential Information of the Furnishing Party except as reasonably required to accomplish the purposes and objectives of this Agreement. The Receiving Party
will not disclose the Confidential Information of the Furnishing Party to any person or appropriate it for the Receiving Party’s own use, or for any other person’s use or benefit, except as specifically permitted by this Agreement or
approved in writing by the Furnishing Party. 

  

	 	(c)	The Receiving Party will keep the Confidential Information of the Furnishing Party confidential and secure and will protect it from unauthorized use or disclosure by using at least the same degree of care as the
Receiving Party employs to avoid unauthorized use or disclosure of its own Confidential Information, but in no event less than reasonable care. 

  

	 	(d)	 As necessary to accomplish the purposes and objectives of this Agreement, the Receiving Party may disclose Confidential Information of the Furnishing
Party to any employee, officer, director, contractor, Service Recipient, agent or representative of the Receiving Party who is bound to the Receiving Party to protect the confidentiality of the information in a manner substantially equivalent to
that required of the Receiving Party under this Agreement. As necessary to accomplish the purposes and objectives of this Agreement, Health Net may also provide Confidential Information of Supplier to contractors (including outsourcing suppliers
that may replace Supplier under this Agreement) who provide services to Health Net, provided any such contractor and outsourcing supplier (but not their employees) (i) is bound to Health Net to use such Confidential Information for the sole
purpose of providing services to Health Net, and (ii) shall, prior to receipt of any Confidential Information, execute a non-disclosure agreement for Supplier substantially in the form set forth in Schedule N (the “Non-Disclosure
Agreement”), provided further that (A) Supplier has the right to make reasonable modifications to the form of Non-Disclosure Agreement, and (B) Supplier shall consider in good faith any changes to the form Non-Disclosure
Agreement reasonably requested by a contractor or outsourcing supplier and shall not unreasonably withhold agreement to any such changes. The Receiving Party may also disclose Confidential Information of the Furnishing Party to the Receiving
Party’s Auditors provided they are made aware of the Receiving Party’s obligations of confidentiality with respect to the Furnishing Party’s Confidential Information and such Auditors are obligated to maintain the confidentiality of
such Confidential Information on terms that are substantially equivalent to the terms of this Section 21 (Confidentiality). Health Net and its Affiliates may also disclose Supplier Confidential Information, including this Agreement and the
transactions contemplated by this Agreement, in any reports furnished, filed or required to be filed with the Securities and Exchange Commission (“SEC”) pursuant to the rules and regulations promulgated by the SEC, as well as
to the New York Stock Exchange and any other Regulator charged with the administration, oversight or enforcement of regulations applicable to any business conducted by Health Net or any of its Affiliates (collectively, the “SEC and
Regulatory Filing Requirements”). In the event that Health Net or its Affiliates intend to disclose 

  

					
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Supplier Confidential Information as permitted by the immediately preceding sentence it will, to the extent commercially practicable, notify Supplier prior to disclosing the information and
provide copies of the intended disclosure to allow Supplier to comment on such disclosures. If Supplier requests that Health Net or its Affiliates request confidential treatment of the Confidential Information by the SEC or other Regulator, Health
Net or the applicable Affiliate will make such request and will take all commercially reasonable actions to obtain confidential treatment. Notwithstanding the foregoing, Health Net shall maintain sole discretion regarding compliance with SEC and
Regulatory Filing Requirements. 

  

	 	(e)	If any unauthorized use, disclosure, loss of, or inability to account for any Confidential Information of the Furnishing Party occurs, the Receiving Party will promptly so notify the Furnishing Party and will cooperate
with the Furnishing Party and take such actions as may be necessary or reasonably requested by the Furnishing Party to minimize the violation and any damage resulting from it. 

 

	21.3	No Implied Rights 

 Each Party’s Confidential Information will remain the property
of that Party. Nothing contained in this Section 21 (Confidentiality) will be construed as obligating a Party to disclose its Confidential Information to the other Party, or as granting to or conferring on a Party, expressly or by implication,
any rights or license to the Confidential Information of the other Party. Any such obligation or grant will only be as provided by other provisions of this Agreement. 
  

	21.4	Compelled Disclosure 

 If the Receiving Party becomes legally compelled to disclose any
Confidential Information of the Furnishing Party in a manner not otherwise permitted by this Agreement, the Receiving Party will provide the Furnishing Party with prompt notice of the request so that the Furnishing Party may seek a protective order
or other appropriate remedy. If a protective order or similar order is not obtained by the date by which the Receiving Party must comply with the request, the Receiving Party may furnish that portion of the Confidential Information that, after
consulting with legal counsel, it determines it is legally required to furnish. The Receiving Party will exercise reasonable efforts to obtain assurances that confidential treatment will be accorded to the Confidential Information so disclosed. 

 

	21.5	Confidential Treatment of this Agreement 

 Each Party may disclose the existence and
general nature of this Agreement as permitted by Section 27.9 (Public Disclosures), but otherwise the terms and conditions of this Agreement will be considered the Confidential Information of each Party; provided however, that this Agreement may be
disclosed by either Party in connection with an actual or good-faith proposed merger, acquisition, divestiture or similar transaction, so long as such receiving entity first agrees in writing to obligations substantially similar to those described
in this Section 21 (Confidentiality). 
  

	21.6	Disclosure of Information Concerning Tax Treatment 

 Notwithstanding anything to the
contrary in this Section 21 (Confidentiality), each Party (and its Affiliates), and any person acting on their behalf, may disclose to any person or entity the “tax structure” and “tax treatment” (as such terms are defined
in the U.S. Internal Revenue Code and regulations under it) of the transactions effected by this Agreement and any materials provided to 

  

					
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that Party (or its Affiliates) describing or relating to such tax structure and tax treatment; provided, however, that this disclosure authorization will not be interpreted to
permit disclosure of (i) any materials or portions of materials that are not related to the transaction’s tax structure or tax treatment, or (ii) any materials or information that the Party (or its Affiliate(s)) must refrain from
disclosing to comply with applicable securities Laws. 
  

	21.7	Return or Destruction 

  

	 	(a)	As requested by the Furnishing Party during the Term, the Receiving Party will return or provide the Furnishing Party a copy of any designated Confidential Information of the Furnishing Party. When Confidential
Information of the Furnishing Party is no longer required for the Receiving Party’s performance under this Agreement, or in any event upon expiration or termination of this Agreement, the Receiving Party will return all materials that contain,
refer to, or relate to Confidential Information of the Furnishing Party or, at the Furnishing Party’s election, destroy them. In addition, Supplier shall, within sixty (60) days of the expiration or termination of this Agreement, delete
all of Health Net’s Confidential Information from its databases, servers, personal computers, web site and other electronic media that exist now or in the future. 

 

	 	(b)	The Receiving Party may, however, keep (i) any Confidential Information of the Furnishing Party that the Receiving Party has a license to continue using, (ii) in the files of its legal department or outside
counsel, for record purposes only, one copy of any material requested to be returned or destroyed, (iii) archival copies as may be necessary to comply with document retention laws and regulations applicable to such Party’s business
operations, and (iv) data that is necessary to be retained by Supplier in order to comply with Supplier’s back-up policies and procedures; provided that any electronic Confidential Information that is stored on routine back-up media for
the purpose of disaster recovery will be subject to destruction in due course. Additionally, the Receiving Party shall have no obligation to destroy any Confidential Information that is subject to a claim, dispute, lawsuit, or subpoena or in any
other circumstances in which such Party reasonably believes that destruction of such Confidential Information would be unethical or unlawful. Any Confidential Information of the Furnishing Party that is retained by the Receiving Party pursuant to
the foregoing shall continue to be subject to the confidentiality obligations of this Agreement. 

  

	 	(c)	At the Furnishing Party’s request, the Receiving Party will certify in writing to the Furnishing Party that it has returned or destroyed all copies of the Furnishing Party’s Confidential Information in the
possession or control of the Receiving Party’s or any of its Affiliates or contractors that are required to be returned or destroyed pursuant to this Section 21.7 (Return or Destruction). 

 

	21.8	Duration of Confidentiality Obligations 

 The Receiving Party’s obligations under
this Section 21 (Confidentiality) apply to Confidential Information of the Furnishing Party disclosed to the Receiving Party before or after the Effective Date and will continue during the Term and survive the expiration or termination of this
Agreement as follows: 
  

	 	(a)	The Receiving Party’s obligations under Section 21.7 (Return or Destruction) will continue in effect until fully performed; 

  

					
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	 	(b)	As to any portion of the Furnishing Party’s Confidential Information that constitutes a trade secret under applicable Law, the obligations will continue for as long as the information continues to constitute a
trade secret; 

  

	 	(c)	As to all other Confidential Information of the Furnishing Party, the obligations will survive for four (4) years after the Receiving Party’s fulfillment of its obligations under Section 21.7 (Return or
Destruction) with respect to the Confidential Information in question; and 

  

	 	(d)	With respect to personal information, Personally Identifiable Information and Protected Health Information, the obligations shall survive indefinitely. 

 

	22.	INSURANCE 

 Supplier represents that it has, as of the Effective Date, and agrees to
maintain in force throughout the Term at least the types and amounts of insurance coverage specified in Schedule I (Supplier Insurance). 
  

	23.	INDEMNIFICATION 

  

	23.1	Indemnification By Supplier 

 Supplier will at its expense indemnify, defend and hold
harmless Health Net and its Affiliates, and their respective officers, directors, customers, employees, agents, representatives, successors and assigns (collectively, “Health Net Indemnitees”) from and against
any and all Losses suffered or incurred by any of them arising from, in connection with, or based on any of the following, whenever made, except to the extent caused by Health Net or an Health Net Affiliate: 

 

	 	(a)	Any Indemnity Claim by, on behalf of or relating to any of the Affected Employees relating to Supplier’s employee selection, communications, recruitment or hiring process or a breach by Supplier of Schedule E
(Employee Transfer); 

  

	 	(b)	Any Indemnity Claim by, on behalf of or relating to any of the Transitioned Employees with respect to matters arising out of acts or omissions of Supplier occurring on or after the Transfer Date, excluding Indemnity
Claims for which Health Net is required to indemnify under Section 23.3(b); 

  

	 	(c)	Any Indemnity Claim (i) by a Subcontractor or by other Supplier Personnel, including claims by such personnel that Health Net is liable to such personnel for employee benefits or as the employer or joint employer
of such personnel, except to the extent, if any, that Health Net is required by this Agreement to indemnify Supplier in respect of the Indemnity Claim, or (ii) based upon the acts or omissions of any Subcontractor in performance of or relating
to the Services to the same extent as if Supplier had committed the act or omission; 

  

	 	(d)	Any Indemnity Claim arising out of Supplier’s breach of its obligations under Section 14 (Data Security and Protection) or Section 21 (Confidentiality) or the Business Associate Agreement;

  

	 	(e)	Any Indemnity Claim arising out of a Security Breach, except to the extent that such Security Breach was caused by Health Net’s negligence, willful misconduct or breach of this Agreement; 

  

					
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	 	(f)	Any Indemnity Claim arising out of Supplier’s breach of Section 19.7(a) (Non-Infringement); 

  

	 	(g)	Any Indemnity Claim arising out of Supplier’s breach of its obligations under Section 27.7 (Compliance with Laws) 

  

	 	(h)	Any Indemnity Claim for death or bodily injury, or the damage, loss or destruction of real or tangible personal property of any third party (including employees of Health Net or Supplier or their respective
subcontractors) brought against a Health Net Indemnitee alleged to have been caused by the tortious acts or omissions of Supplier, Supplier Personnel or anyone else for whose acts Supplier is responsible. However, Supplier will have a right of
contribution from Health Net with respect to the Indemnity Claim to the extent Health Net’s comparative negligence is responsible for causing the alleged injury or damage, loss or destruction; 

 

	 	(i)	Any Indemnity Claim with respect to Supplier’s use of any Health Net Provided Resources made available by Health Net to Supplier or Subcontractors pursuant to Section 11 to the extent the loss results from a
breach by Supplier or any Subcontractor of, or an act or omission of Supplier which creates liability for Health Net pursuant to (A) a Health Net Provided Resource or an agreement between Health Net and a third party relating to such Health Net
Provided Resources, or certain provisions thereof, which have been provided to Supplier in writing, including obligations to comply with requirements regarding numbers and types of licenses under any such agreements; (B) the terms of this
Agreement, including Supplier’s obligations with respect to Managed Third Party Contracts set forth in this Agreement, or (C) any other reasonable restrictions required by Health Net relating to the Health Net Provided Resources, which
restrictions are provided to Supplier in writing; 

  

	 	(j)	Any amounts, including taxes, interest, and penalties, assessed against Health Net which arise as a result of Supplier’s failure to comply with and perform its obligations under Section 9.3 (Taxes);

  

	 	(k)	Supplier’s (i) improper or wrongful termination of this Agreement or part thereof, or (ii) except to the extent any cessation of Services is expressly permitted under this Agreement, abandonment of any
work under this Agreement; 

  

	 	(l)	Any breach of any of Supplier’s representations or warranties set forth in Section 20 (Mutual Representations and Warranties), Section 19.8 (Disabling Code), or the second sentence of Section 19.7
(Viruses); 

  

	 	(m)	Any intentional misconduct or criminal misconduct by Supplier; and 

  

	 	(n)	Any Indemnity Claim arising out of occurrences Supplier is required to insure against under this Agreement, but only to the extent Supplier has failed to procure the insurance that Supplier is obligated to procure under
this Agreement. 

 Any act or omission of a Subcontractor shall be deemed to be an act or omission of Supplier for purposes of
determining Supplier’s indemnification obligations pursuant to this Section 23.1. 

  

					
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	23.2	Infringement Indemnity Claims 

 If any item used by Supplier to provide the Services or
provided by Supplier to Health Net or any Deliverable becomes, or in Supplier’s reasonable opinion is likely to become, the subject of an infringement or misappropriation Indemnity Claim, Supplier will, in addition to indemnifying Health Net
Indemnitees as provided in this Section 23 (Indemnification) and to the other rights Health Net may have under this Agreement, and at law or equity, at its expense: (i) promptly at Supplier’s expense secure the right to continue using
the item or Deliverable, or (ii) if this cannot be accomplished with Commercially Reasonable Efforts, then at Supplier’s expense, replace or modify the item or Deliverable to make it non-infringing or without misappropriation, while not
degrading performance, functionality, or quality, increasing Health Net costs, or disrupting Health Net’s business operations, or (iii) if neither of the foregoing can be accomplished by Supplier with Commercially Reasonable Efforts, and
only in such event, then upon at least one hundred eighty (180) days’ prior written notice to Health Net, (A) with respect to non-Deliverable items, Supplier may remove the item from use in performing the Services, in which case
Supplier’s Charges will be equitably adjusted to reflect such removal, and (B) in the case of Deliverable, Supplier may recall the Deliverables and shall refund to Health Net all Charges and fees paid by Health Net relating to such
Deliverable. If removal of the item from use in performing Services or recall of a Deliverable causes the loss or degradation of the Services or any portion of the Services that is material to Health Net or has a material impact on Health Net, such
loss, degradation or material impact will constitute a material breach of this Agreement by Supplier in respect of which Health Net may exercise its termination and other rights and remedies under this Agreement. This Section 23.2 (Infringement
Indemnity Claims) will not apply to any Indemnity Claim relating to the ABS Platform in respect of which Health Net is obligated to indemnify Supplier under the APA. 
  

	23.3	Indemnification By Health Net 

 Health Net will at its expense indemnify, defend and hold
harmless Supplier and its Affiliates and their respective officers, directors, employees, agents, representatives, successors and assigns (collectively, “Supplier Indemnitees”) from and against any and all Losses suffered or
incurred by any of them arising from, in connection with or based on any of the following, whenever made, except to the extent caused by Supplier or a Supplier Affiliate: Any Indemnity Claim by, on behalf of or relating to any of the Transitioned
Employees with respect to matters arising out of the acts or omissions of Health Net occurring prior to the Transfer Date, excluding Indemnity Claims for which Supplier is required to indemnify under Section 23.1(a); 

Any Indemnity Claim by, on behalf of or relating to any Supplier Personnel who is a Transitioned Employee and which arises out of Health
Net’s employee selection, communications, recruitment or hiring process relating to Health Net’s rehiring of such Transitioned Employees pursuant to the terms of this Agreement; 

Any Indemnity Claim arising out of Health Net’s breach of its obligations under Schedule E (Employee Transfer); 

Any Indemnity Claim arising out of (i) Health Net’s failure to observe or perform any duties or obligations to be observed or
performed prior to the Effective Date by Health Net under any of the Health Net Third Party Service Contracts or licenses for Health Net Licensed Software that are being made available for use by Supplier pursuant to Section 11.2(a); 

Any Indemnity Claim arising out of Health Net’s breach of its obligations under Section 21 (Confidentiality) or the Business
Associate Agreement; 

  

					
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Any Indemnity Claim arising out of Health Net’s breach of its obligations under Section 27.7 (Compliance with Laws), including a
failure to comply with Law by (1) any of the Transitioned Employees prior to their respective Transfer Date, or (2) any third party under any of the Health Net Third Party Service Contracts that are being made available for use by Supplier
pursuant to Section 11.2(a) (provided the Indemnity Claim did not arise due to the failure of Supplier to perform its management obligations under this Agreement with respect to such contracts); 

Any Indemnity Claim to the extent such claim alleges that (1) any Health Net Owned Software or Health Net Licensed Software that is being
made available for use by Supplier pursuant to Section 11.2(c), or (2) systems or other items made available to Supplier by Health Net under this Agreement, infringes or misappropriates any Intellectual Property Right of any third party,
provided however that this Section 23.3(g) does not apply to any such Indemnity Claim (x) that relates to any part of the ABS Platform or Configurations developed by or for Supplier, or (y) in which the alleged infringement or
misappropriation is attributable to the following: 
 Supplier’s modification of such Health Net Owned Software, Health Net Licensed
Software, or any such system or other item, unless the Indemnity Claim (if true) would be attributable to Health Net’s instructions, specifications or requirements; or 

Supplier’s combination, operation or use of such Health Net Owned Software, Health Net Licensed Software, or any such system or other item
with other Software, systems or items not provided by Health Net for use with such Health Net Developed Software, Health Net Provided Resource, or system or other item; or 

Supplier’s continuing the allegedly infringing activity after (A) being notified thereof, and (B) being provided with
modifications that would have avoided the alleged infringement without adversely affecting Supplier’s ability to provide the Services and a reasonable time to implement them for use. 

Any Indemnity Claim for death or bodily injury, or the damage, loss or destruction of real or tangible personal property of any third party
(including employees of Health Net or Supplier or their respective subcontractors) brought against a Supplier Indemnitee alleged to have been caused by the tortious acts or omissions of Health Net, Health Net personnel or anyone else for whose acts
Health Net is responsible. However, Health Net will have a right of contribution from Supplier with respect to the Indemnity Claim to the extent Supplier’s comparative negligence is responsible for causing the alleged injury or damage, loss or
destruction; 
 Any Indemnity Claim caused by Supplier’s proper compliance with any Health Net Policy or other requirement mandated by
Health Net; an Any Indemnity Claim based upon the gross negligence or willful misconduct of Health Net or any Health Net third party contractor (excluding Supplier, Supplier’s Affiliates and its subcontractors). 

  

					
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	23.4	Indemnification Procedures 

 The following procedures will apply to Indemnity Claims for
which a Party seeks to be indemnified pursuant to this Agreement: 
  

	 	(a)	Notice. 

  

	 	(i)	Promptly after an indemnitee receives notice of any Indemnity Claim for which it will seek indemnification pursuant to this Agreement, the indemnitee will notify the indemnitor of the Indemnity Claim in writing (an
“Indemnity Notice”). No failure to so notify the indemnitor will abrogate or diminish the indemnitor’s obligations under this Section 23 (Indemnification) if the indemnitor has or receives knowledge of the Indemnity
Claim by other means, or if the failure to notify does not materially prejudice its ability to defend the Indemnity Claim, or if the indemnitor does not have the right to defend the Indemnity Claim pursuant to Section 23.4(b)(ii). Within
fifteen (15) days after receiving an indemnitee’s Indemnity Notice of an Indemnity Claim, or otherwise obtaining knowledge of the Indemnity Claim, but no later than ten (10) days before the date on which any formal response to the
Indemnity Claim is due, the indemnitor will notify the indemnitee in writing (a “Notice of Election”) as to whether: 

  

	 	(A)	the indemnitor acknowledges its obligation to indemnify and hold the indemnitee harmless with respect to such Indemnity Claim, and 

  

	 	(B)	with respect to any such Indemnity Claim that is not an Identified Health Net Indemnity Claim (as defined below), the indemnitor elects to assume control of the defense and settlement of the Indemnity Claim.

  

	 	(ii)	Each Notice of Election shall be delivered to the indemnitee at the address set forth in Section 27.5 (Notices), as such address may be modified pursuant to such Section. 

 

	 	(b)	Procedure Following Indemnity Notice. 

  

	 	(i)	Procedure for Indemnity Claims that are not Identified Health Net Indemnity Claims. 

 With
respect to any Indemnity Claim that is not an Identified Health Net Indemnity Claim, if the indemnitor timely (i.e., in accordance with Section 23.4(a)) delivers a Notice of Election that both (1) acknowledges indemnitor’s
obligation to indemnify and hold the indemnitee harmless with respect to such Indemnity Claim, and (2) includes an express election to assume control of the defense and settlement of such Indemnity Claim, then: 

 

	 	(A)	the indemnitor will be entitled to have sole control over the defense and settlement of such Indemnity Claim; provided that the indemnitee shall have the right to approve: 

 

	 	(1)	the legal counsel selected by the indemnitor, and 

  

	 	(2)	in the indemnitee’s sole discretion, any settlement (or portion thereof) that is not a monetary settlement, including settlements involving injunctive relief; and 

 

	 	(B)	the indemnitor will not be required to reimburse the indemnitee for (1) any legal expenses incurred by the indemnitee in defending or settling such Indemnity Claim after the indemnitee’s receipt of such Notice
of Election unless reasonable and necessary (e.g., costs incurred prior to receipt of the Indemnitor’s Notice of Election), or (2) any amounts paid or payable by the indemnitee in settlement of such Indemnity Claim after the
indemnitee’s receipt of such Notice of Election if the settlement was agreed to without the written consent of the indemnitor. 

  

					
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	 	(ii)	Procedure for Identified Health Net Indemnity Claims. 

  

	 	(A)	An “Identified Health Net Indemnity Claim” means any of the following Indemnity Claims brought against Health Net with respect to which Health Net expressly elects to retain control of the
defense and settlement in its written Indemnity Notice to Supplier pursuant to Section 23.4(a) (or as soon as reasonably practicable thereafter so long as such notice is given by Health Net prior to receipt of Supplier’s Notice of Election
pursuant to Section 23.4(a)), and for which Health Net indicates in such Indemnity Notice that Health Net will seek indemnification from Supplier pursuant to this Agreement: 

 

	 	(1)	any Indemnity Claim brought by a governmental or regulatory entity (a “Public Indemnity Claim”); and 

  

	 	(2)	any Indemnity Claim brought by a private party that is based on the same events that also resulted in a Public Indemnity Claim being brought against Health Net, and where adjudication of the private party Indemnity
Claim or some part of it may result in collateral estoppel with respect to a material issue of the Public Indemnity Claim. 

  

	 	(B)	With respect to any Identified Health Net Indemnity Claim, if Supplier timely (i.e., in accordance with Section 23.4(a)) delivers a Notice of Election acknowledging its obligation to indemnify and hold Health Net
harmless with respect to such Identified Health Net Indemnity Claim, then: 

  

	 	(1)	Health Net will be entitled to have sole control over the defense and settlement of such Identified Health Net Indemnity Claim at the cost and expense of Supplier, including payment of any settlement, judgment or award
and the reasonable costs of defending or settling such Identified Health Net Indemnity Claim; provided that in the event of a settlement by Health Net, Supplier shall only be obligated to reimburse Health Net for reasonable amounts paid or payable
by Health Net in settlement of such Identified Health Net Indemnity Claim (the reasonableness of such amount determined by taking into consideration all of the facts and circumstances relating to such Identified Health Net Indemnity Claim, including
reputational risks to Health Net, the potential for the Identified Health Net Indemnity Claim to cause adverse impacts to Health Net’s business or operations, and costs incurred by Health Net as a result of or in connection with such Identified
Health Net Indemnity Claim); and 

  

					
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	 	(2)	Health Net shall keep Supplier informed regarding the status of and developments in any such Identified Health Net Indemnity Claim (subject to execution where appropriate of a mutually acceptable joint defense or common
interest agreement), shall invite and allow Supplier to be present at relevant discussions, negotiations and proceedings to the greatest extent practicable, and shall, in advance of settling any such Identified Health Net Indemnity Claim, meet and
confer with Supplier regarding the terms and conditions of such settlement with respect to which it intends to seek indemnification so as to give Supplier an opportunity to provide its input regarding such terms and conditions; and

  

	 	(3)	in the event that Health Net rejects any settlement offer with respect to an Identified Health Net Indemnity Claim (over Supplier’s written objection, assuming Health Net has complied with its obligations under
Section 23.4(b)(ii)(B)(2) above) and later settles such Identified Health Net Indemnity Claim for an amount exceeding any rejected settlement offer, or has a judgment entered against it with respect to such Identified Health Net Indemnity Claim
for an amount exceeding any rejected settlement offer, then Supplier will be responsible only for reimbursing Health Net for the lesser of (a) the lowest rejected settlement offer with respect to such Identified Health Net Indemnity Claim; or
(b) the reasonable amounts paid or payable by Health Net in settlement of such Identified Health Net Indemnity Claim, considering the factors described in Section 23.4(b)(ii)(B)(1) above; and 

 

	 	(4)	subject to the limitations described in Sections 23.4(b)(ii)(B)(1) and 23.4(b)(ii)(B)(3) above, Supplier will promptly reimburse Health Net upon demand for all Losses suffered or incurred by Health Net as a result of or
in connection with such Identified Health Net Indemnity Claim; and 

  

	 	(5)	in the event of a dispute between the Parties as to the reasonableness of the amount of a settlement that Health Net approves or the reasonableness of costs, including but not limited to attorneys’ fees, of
defending the Identified Health Net Indemnity Claim, (i) Supplier shall reimburse Health Net for that portion of the settlement or defense costs that it believes in good faith to be a reasonable amount, and (ii) the Parties agree to use
the arbitration process described in Section 23.4(e) below to resolve any dispute relating to the reasonableness of the difference between the actual amount of the settlement that Health Net approves or the defense costs that Health Net incurs
and the amount that Supplier reimbursed Health Net pursuant to item (i). 

  

	 	(c)	Procedure Where No Proper Notice of Election Is Delivered (Applicable to all Indemnity Claims including, for clarity, Identified Health Net Indemnity Claims). 

If the indemnitor does not deliver a timely (i.e., in accordance with Section 23.4(a)) Notice of Election that both
(i) acknowledges its obligation to indemnify and hold the indemnitee harmless with respect to the Indemnity Claim, and (ii) in the case of any Indemnity Claim 

  

					
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that is not an Identified Health Net Indemnity Claim, includes an express election by the indemnitor to assume control of the defense and settlement of the Indemnity Claim, then the indemnitee
may defend and/or settle the Indemnity Claim in such manner as it may deem appropriate at the cost and expense of the indemnitor, including payment of any settlement, judgment or award and the costs of defending or settling the Indemnity Claim. The
indemnitor will promptly reimburse the indemnitee upon demand for all Losses suffered or incurred by the indemnitee as a result of or in connection with the Indemnity Claim. 
  

	 	(d)	Cooperation regarding Indemnity Claims. The indemnitor and the indemnitee shall provide reasonable cooperation with one another in connection with the defense and resolution of any Indemnity Claim, provided that
any costs incurred by the indemnitee in connection with such cooperation shall be borne by the indemnitor, and shall be promptly reimbursed by the indemnitor upon demand from the indemnitee. 

 

	 	(e)	Arbitration of Disputed Settlement Amounts. 

  

	 	(i)	A dispute between the Parties as described in Section 23.4(b)(ii)(B)(5) above shall be finally settled by mandatory and binding arbitration administered by the American Arbitration Association
(“AAA”) in accordance with its then-effective Commercial Arbitration Rules (the “Rules”). One (1) arbitrator shall be appointed in accordance with the Rules. Either Party may initiate arbitration
by submitting a written request for arbitration to the AAA and the other Party, setting forth in reasonable detail the subject of the dispute and the relief requested. 

 

	 	(ii)	The arbitration shall be conducted in accordance with the Rules, provided that to the extent this Section 23.4(e) modifies, supplements or is inconsistent with the Rules, this Section 23.4(e) will govern. The
arbitrator shall have no power or authority to amend or disregard any provision of this Section 23.4(e) or any other provision of this Agreement. The arbitration hearing shall be commenced promptly and conducted expeditiously, with each Party
being allocated one-half of the time for the presentation of its case. 

  

	 	(iii)	Unless otherwise agreed by the Parties, arbitration hearings hereunder shall be held in Los Angeles, California. The language of the arbitration shall be English. Unless otherwise agreed by the Parties, an
arbitration hearing shall be conducted on consecutive days. The Parties will participate in the arbitration in good faith, and will share equally in the administrative costs of the arbitration; provided however, that each Party will pay its own
attorneys’ fees (subject to the next sentence). The arbitrator may, in his or her discretion, award the prevailing Party its attorneys’ fees and out-of-pocket expenses, including its share of the arbitration fees. 

 

	 	(iv)	Recognizing the express desire of the Parties for an expeditious means of dispute resolution, (A) each Party will, upon the written request of the other Party, promptly provide the other with copies of documents
relevant to the issues raised by the dispute, and (B) there will be no depositions. 

  

	 	(v)	The award shall be made within thirty (30) days of the filing of the notice of intention to arbitrate (demand), and the arbitrator shall agree to comply with this schedule before accepting appointment. However,
this time limit may be extended by agreement of the Parties or by the arbitrator if necessary. 

  

					
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	 	(vi)	The arbitration shall be conducted as follows: 

  

	 	(A)	Each Party shall submit to the arbitrator and exchange with each other not less than seven (7) days prior to the scheduled hearing date their last, best offers, along with a brief and documentation in support of
their offer. The arbitrator shall have the authority to limit the length of such submissions. 

  

	 	(B)	The arbitration hearing shall not exceed eight (8) hours and may be less if the arbitrator decides that less time is required. 

  

	 	(C)	The arbitrator shall be limited to awarding only one or the other of the two figures submitted. The arbitrator shall not have the option of deciding upon a resolution that reflects a compromise between (or is outside
of) the Parties’ respective proposed resolutions. For example, if the amount that Health Net demands from Supplier (above any amounts already reimbursed by Supplier pursuant to Section 23.4(b)(ii)(B)(5)(i) above) as its last, best offer is
$250,000, and Supplier has proposed to reimburse Health Net an additional $150,000 as its last, best offer, the arbitrator shall determine which of the two proposals (i.e., $250,000 or $150,000) is more appropriate and may not select an amount
somewhere between (or outside of) the two proposals. 

  

	 	(vii)	The arbitrator’s decision shall be final and binding on the Parties, and judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. 

 

	 	(viii)	The arbitrator is instructed that time is of the essence in the arbitration proceeding. 

  

	24.	LIABILITY 

  

	24.1	General Intent 

 Subject to the specific provisions of this Section 23.1
(Liability), it is the intent of the Parties that if a Party fails to perform its obligations in the manner required by this Agreement, that Party will be liable to the other Party for any damages suffered or incurred by the other Party as a result.

  

	24.2	Limitations of Liability 

  

	 	(a)	Consequential Damage Exclusion. Except as otherwise expressly provided below in this Section 24, in no event, whether in contract or in tort (including breach of warranty, negligence and strict liability in
tort or otherwise), will a Party be liable to the other Party under this Agreement for (1) indirect, incidental, consequential, exemplary, punitive or special damages of any kind or nature whatsoever, or (2) lost revenues, profits, savings
or business, even if such Party has been advised in advance of the possibility of such damages or such damages could have been reasonably foreseen by such Party. 

  

					
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	 	(b)	General Liability Cap. Except as otherwise expressly provided below in this Section 24, each Party’s total liability to the other under this Agreement, whether in contract or in tort (including breach
of warranty, negligence and strict liability in tort) will be limited, in the aggregate, to an amount equal to the greater of: 

  

	 	(i)	***; and 

  

	 	(ii)	the total charges paid or payable by Health Net to Supplier pursuant to this Agreement for proper performance of the Services for the twelve (12) months prior to the month in which the most recent event giving rise
to liability occurred, provided that if the event giving rise to liability occurs during the first twelve (12) months after the BPaaS Services Commencement Date, the liability cap under this clause (ii) will be an amount equal to twelve
(12) times the result obtained by dividing the total charges paid or payable under this Agreement from the BPaaS Services Commencement Date through the date on which such event occurred, by the number of months from the BPaaS Services
Commencement Date through such date***. 

 Service Level Credits and Deliverable Credits do not count against and do not reduce
the amounts available under the foregoing limitations. The limitations specified in this Section will survive and apply even if any limited remedy specified in this Agreement is found to have failed of its essential purpose. For purposes of this
Section, fees shall be deemed payable when accrued to the benefit of and legally collectable by Supplier. 
  

	 	(c)	Items to which the Liability Caps and Consequential Damages Exclusion do not apply. Sections 24.2(a) and 24.2(b) will not apply to any of the following: 

 

	 	(i)	damages arising out of the intentional or reckless misconduct or gross negligence of a Party; 

  

	 	(ii)	damages arising out of (A) the improper or wrongful termination of this Agreement by Supplier, or (B) abandonment of the Services by Supplier (except to the extent any such cessation of Services is expressly
permitted under this Agreement), or (C) Supplier’s refusal or failure to provide Disengagement Assistance as required by this Agreement; 

  

	 	(iii)	damages arising out of a Party’s breach of its obligations in Article 21 (Confidentiality), except with respect to Protected Health Information and Personally Identifiable Information (which are governed by
Section 24.2(d)(iii) below); 

  

	 	(iv)	damages arising out of a Party’s breach of its obligations to comply with applicable Laws as set forth in Section 27.7; 

  

	 	(v)	Claims and Losses that are the subject of indemnification pursuant to Sections 23.1 (Indemnification by Supplier) and 23.3 (Indemnification by Health Net), but not those indemnities described in
Section 24.2(d)(iv). 

  

	 	(d)	Liability Cap relating to PHI, PII and certain other items. Notwithstanding Sections 24.2(a), 24.2(b), and 24.2(e), each Party’s total liability to the other, including under this Agreement, whether in
contract or in tort (including breach of warranty, negligence and strict liability in tort) for all claims, liabilities and damages relating to or arising from the following, will be limited in the aggregate, to ***: 

 

	 	(i)	A Party’s breach of the Business Associate Agreement, including breaches related to Protected Health Information; 

  

					
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	 	(ii)	A Party’s breach of its obligations in Article 14 (Data Security And Protection) or damages attributable to Supplier’s breach of its obligations with respect to Health Net Data; 

 

	 	(iii)	a Party’s breach of its obligations in Article 21 (Confidentiality) relating to Protected Health Information or Personally Identifiable Information; 

 

	 	(iv)	Claims and Losses that are the subject of indemnification pursuant to Section 23.1(d) and 23.1(e) (Indemnification by Supplier) and 23.3(e) (Indemnification by Health Net); 

 

	 	(v)	a Party’s misappropriation or infringement of the other Party’s Intellectual Property Rights; and 

  

	 	(vi)	any other damages relating to Health Net Data or Personally Identifiable Information, or a Security Breach. 

For clarity, the exclusions of liability set forth in Section 24.2(a) will not apply to any of the damages described in this
Section 24.2(d). 
  

	 	(e)	Damages Subcap relating to TPUSA. Notwithstanding Section 24.2(b), Supplier’s total liability to Health Net arising out of the acts or omissions of TPUSA in its role as an Approved Subcontractor
providing Contact Center Services under this Agreement, whether in contract or in tort (including breach of warranty, negligence and strict liability in tort) will be limited, in the aggregate, to the greater of: 

 

	 	(i)	*** of the total charges paid or payable by Health Net to Supplier pursuant to this Agreement for proper performance of the Services for the twelve (12) months prior to the month in which the most recent event
based on TPUSA’s acts or omissions giving rise to liability occurred, provided that if the event giving rise to liability occurs during the first twelve (12) months after the BPaaS Services Commencement Date, the liability cap amount for
this clause (i) will be an amount equal to (A) *** of (B) twelve (12) times the result obtained by dividing (1) the total charges paid or payable under this Agreement from the BPaaS Services Commencement Date through the
date on which such event occurred, by (2) the number of months from the BPaaS Services Commencement Date through such date; and 

  

	 	(ii)	*** with respect to the following items: (a) damages arising out of the intentional or reckless misconduct or gross negligence of TPUSA, (b) damages arising out of TPUSA’s improper or wrongful termination
of Supplier’s subcontract agreement with TPUSA for the Contact Center Services, wrongful abandonment of the Services by TPUSA or TPUSA’s refusal or failure to provide disengagement assistance as required by Supplier’s subcontract
agreement with TPUSA, (c) TPUSA’s obligations under Sections 6.5 (Compliance with Law), Section 7 (Intellectual Property and Confidentiality) or Section 9 (Indemnity) of Supplier’s subcontract agreement with TPUSA for the
Contact Center Services. 

  

					
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Notwithstanding the foregoing, the cap set forth in this Section 24.2(e) shall not apply to the extent that the TPUSA-caused event giving
rise to liability is the result of Supplier’s failure to properly manage (i) TPUSA or (ii) the Services performed by TPUSA. For clarity, the exclusions set forth in Section 24.2(a) will not apply to any of the damages governed by
this Section 24.2(e) to the extent that they are also covered under Sections 24.2(c), 24.2(d) or 24.2(f). 
  

	 	(f)	Stipulated Direct Damages. Without limiting (1) each Party’s responsibility for direct damages under this Agreement, and (2) each Party’s right to claim other direct damages, the following items
shall be considered direct damages under this Agreement and are not prohibited by Section 24.2(a), to the extent they are reasonable: 

  

	 	(i)	Costs incurred by Health Net to correct or have corrected any errors or other deficiencies in the Services rendered by Supplier; 

  

	 	(ii)	Any portion of overpayments paid by Health Net to members due to errors of Supplier that remain unrecovered by Health Net ***; 

  

	 	(iii)	Amounts paid by Health Net for interest arising out of Supplier’s performance of the Services relating to examiner error ***; 

  

	 	(iv)	Amounts paid by Health Net for fines arising out of Supplier’s performance of the Services during each calendar year *** 

  

	 	(v)	Performance Guarantee Group Payment Amounts owed by Supplier to Health Net pursuant to Schedule B (Service Levels); 

  

	 	(vi)	Costs of recreating, restoring or reloading any of Health Net’s information lost or damaged as a result of a failure by Supplier to perform the Services at all or in accordance with this Agreement. Such recreation,
restoration and reloading costs shall include all activities and efforts that an IT group of a health insurance company may reasonably undertake to recreate, restore or reload such lost or damaged information, using efforts that are proportionate to
the importance to Health Net of the information to be recreated, restored or reloaded and the volume of such lost or damaged information; 

  

	 	(vii)	Costs of implementing a workaround in respect to a failure to perform the Services at all or in accordance with this Agreement; 

  

	 	(viii)	Costs and expenses incurred by Health Net to acquire and have performed substitute services conforming to this Agreement in place of any Services Supplier fails to provide at all or in accordance with this Agreement;

  

	 	(ix)	Straight time, overtime, or related expenses incurred by Health Net or its Affiliates, including wages and salaries of additional personnel, travel, expenses, telecommunication and similar charges, arising out of the
failure of Supplier to perform at all or in compliance with this Agreement; 

  

	 	(x)	Amounts required to be paid by Health Net under any Law or by any court or governmental or regulatory authority, or incurred by Health Net to create and implement any corrective actions plan, and to satisfy an order or
directive of a court or governmental or regulatory authority arising out of Supplier’s acts or omissions, and costs arising from settlements with such authorities, provided that interest and fines shall be governed by Sections 24.2(f)(iii) and
(iv) above; 

  

					
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	 	(xi)	Identity-Related Costs incurred by Health Net, except to the extent that Supplier is able to demonstrate that a Security Breach was caused by Health Net’s negligence, willful misconduct or breach of this Agreement,
and 

  

	 	(xii)	Damages arising out of a breach by Supplier of its obligations under Section 3.6 Schedule E (Transitioned Employees) with respect to the retention of Personnel Groups of Transitioned Personnel,

 provided, however, that nothing in this Section 24.2(f) shall limit Supplier’s obligations or liability under
Section 23.1 (Indemnification by Supplier) above. 
 Each Party shall pay to the other Party upon request of such other Party any
amount for which it is responsible under Sections 24.2(f)(ii). 24.2(f)(iii), 24.2(f)(iv), 24.2(f)(v) and 24.2(f)(xi) . 
  

	 	(g)	For clarity, the amounts spent by an indemnitor in defense of a Claim for which it is responsible under this Agreement shall not be counted for purposes of computing the amount of total damages that have been incurred
relative to the liability cap set forth in Section 24.2. 

  

	 	(h)	Each Party has a duty to mitigate the damages suffered by it for which the other Party is or may be liable. 

  

	24.3	Force Majeure 

  

	 	(a)	No Party will be liable for any default or delay in the performance of its obligations under this Agreement (i) if and to the extent such default or delay is caused, directly or indirectly, by fire, flood,
pestilence, earthquake, elements of nature or acts of God, riots, or civil disorders, (ii) provided the non-performing Party is without fault in causing such default or delay, and such default or delay could not have been prevented by
reasonable precautions and could not reasonably be circumvented by the non-performing Party through the use of alternate sources, workaround plans or other means (including with respect to Supplier by Supplier meeting its obligations for performing
disaster recovery and business continuity services as described in this Agreement) (each such event a “Force Majeure Event”). 

  

	 	(b)	In such event the non-performing Party will be excused from further performance or observance of the obligations so affected for as long as such circumstances prevail and such Party continues to use Commercially
Reasonable Efforts to recommence performance or observance without delay. Any Party so delayed in its performance will immediately notify the Party to whom performance is due by telephone (to be confirmed in writing within twenty-four
(24) hours of the inception of such delay) and describe at a reasonable level of detail the circumstances causing such delay. To the extent the provision of the Services or any part thereof is prevented or materially affected by a Force Majeure
Event, Health Net’s obligation to pay Charges hereunder shall accordingly be reduced by an equitable amount (which in the case of total suspension of the Services would be an amount equal to the total charges hereunder for the period of
suspension). 

  

					
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	 	(c)	If any event under Section 24.3(a) substantially prevents, hinders or delays performance of the Services, then Supplier shall use Commercially Reasonable Efforts to identify another Supplier location from which it
might provide the Services without interference from such event, and if Health Net requests, Supplier shall assist Health Net in identifying an alternate source that may be able to provide the Services to Health Net during the time of such Force
Majeure Event. If any event under Section 24.3(a) substantially prevents, hinders or delays performance of the Services necessary for the performance of functions reasonably identified by Health Net as critical for more than five
(5) consecutive business days, then at Health Net’s option: (i) Health Net may procure such Services from an alternate source, and in such event Supplier will reimburse Health Net for one-half of the difference between (A) the
amount Health Net is obligated to pay the alternate source for such services, and (B) the amount that Health Net would have paid Supplier for such Services under this Agreement, for a period not to exceed one hundred eighty (180) days;
(ii) Health Net may terminate any portion of this Agreement (including a SOW or a portion of a SOW) so affected without charge to Health Net or liability to Supplier and the Charges payable under this Agreement will be equitably adjusted to
reflect those terminated Services; or (iii) Health Net may terminate this Agreement, without charge to Health Net or liability to Supplier, as of a date specified by Health Net in a written notice of termination to Supplier. Supplier will not
have the right to any additional payments from Health Net for costs or expenses incurred by Supplier as a result of any Force Majeure Event. 

  

	 	(d)	A Force Majeure Event will not relieve Supplier of its obligations to implement successfully all of the Services relating to disaster recovery services that are included in this Agreement within the time period
described in this Agreement. 

  

	25.	RULES OF CONSTRUCTION 

  

	25.1	Entire Agreement 

 This Agreement – consisting of the signature page, these Terms
and Conditions and the attached Schedules and all SOWs and their attached Exhibits – constitutes the entire agreement between the Parties with respect to its subject matter and merges, integrates and supersedes all prior and contemporaneous
agreements and understandings between the Parties (including as described in Section 3.1(c), the Original BPO Agreement), whether written or oral, concerning its subject matter. For clarity, at such time as the Original BPO Agreement is
terminated as provided in Section 3.1(c), Health Net will not owe any penalties, termination fees, wind-down charges, or similar fees or charges in connection with such termination. 

 

	25.2	Contracting Parties; No Third Party Beneficiaries 

 This Agreement is entered into solely
between, and may be enforced only by, Health Net and Supplier. This Agreement does not create any legally enforceable rights in third parties, including suppliers, subcontractors and customers of a Party, except as provided in this paragraph and
Section 23 (Indemnification). 
  

	25.3	Contract Amendments and Modifications 

 Any terms and conditions varying from this
Agreement on any order or written notification from either Party will not be effective or binding on the other Party. This Agreement may be amended or modified solely in a writing signed by an authorized representative of each Party. 

  

					
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	25.4	Governing Law 

 This Agreement and performance under it shall be governed by and
construed in accordance with the laws of the state of California without regard to its choice of law principles. 
  

	25.5	Relationship of the Parties 

 Supplier, in furnishing the Services, is acting as an
independent contractor. Supplier has the sole right and obligation to supervise, manage, contract, direct, procure, perform or cause to be performed, all work to be performed by Supplier under this Agreement. Supplier is not an agent or partner of
Health Net and has no authority to represent or bind Health Net as to any matters, except as expressly authorized in this Agreement. This Agreement establishes a nonexclusive relationship between the Parties. 

 

	25.6	Consents and Approvals 

 Where approval, acceptance, consent or similar action by either
Party is required under this Agreement, such action will not be unreasonably delayed, conditioned or withheld unless this Agreement expressly provides that it is in the discretion of the Party. No approval or consent given by a Party under this
Agreement will relieve the other Party from responsibility for complying with the requirements of this Agreement, nor will it be construed as a waiver of any rights under this Agreement (except to the extent, if any, expressly provided in such
approval or consent). Each Party will, at the request of the other Party, perform those actions, including executing additional documents and instruments, reasonably necessary to give full effect to this Agreement. 

 

	25.7	Waiver 

 No failure or delay by a Party in exercising any right, power or remedy will
operate as a waiver of that right, power or remedy, and no waiver will be effective unless it is in writing and signed by an authorized representative of the waiving Party. If a Party waives any right, power or remedy, the waiver will not waive any
successive or other right, power or remedy that Party may have. 
  

	25.8	Remedies Cumulative 

 Except as otherwise expressly provided in this Agreement, all
remedies provided in this Agreement are cumulative and in addition to and not in lieu of any other remedies available to a Party under this Agreement, at law, or in equity. 
  

	25.9	References 

  

	 	(a)	The section headings and the table of contents used in this Agreement are for convenience of reference only and will not enter into the interpretation of this Agreement. 

 

	 	(b)	Unless otherwise indicated, section references are to sections of the document in which the reference is contained. For example, section references in these Terms and Conditions are to sections of the Terms and
Conditions and, likewise, section references in a Schedule to this Agreement are to sections of that Schedule. 

  

	 	(c)	References to numbered (or lettered) sections of this Agreement also refer to and include all subsections of the referenced section. 

  

					
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	 	(d)	Unless otherwise indicated, references to Schedules to this Agreement also refer to and include all sub-Schedules to the referenced Schedule. 

 

	25.10	Rules of Interpretation 

  

	 	(a)	Unless the context requires otherwise, (i) “including” (and any of its derivative forms) means including but not limited to, (ii) “may” means has the right, but
not the obligation to do something and “may not” means does not have the right to do something, (iii) “will” and “shall” are expressions of command, not merely expressions
of future intent or expectation, (iv) “written” or “in writing” is used for emphasis in certain circumstances, but that will not derogate from the general application of the notice requirements
set forth in Section 27.5 (Notices) in those and other circumstances, (v) use of the singular imports the plural and vice versa, and (vi) use of a specific gender imports the other gender(s). 

 

	 	(b)	References in this Agreement to “hours”, “days”, or “years” that do not specifically refer to Business
Hours, Business Days or Contract Years are references to clock hours, calendar days, or calendar years, respectively, unless otherwise provided. 

  

	25.11	Order of Precedence 

  

	 	(a)	If there is any conflict between this Agreement and any document incorporated by reference into this Agreement, the Parties shall attempt to read any such conflicting provisions consistently, however, in the event such
a consistent reading cannot be accomplished, the order of precedence will be as follows: (i) the Terms and Conditions and any amendments thereto, (ii) the Schedules, (iii) the Initial SOWs and the Transition Manual (it being the
intent of the Parties that such documents shall be give equal priority), (iv) other attachments to this Agreement, and (v) other documents incorporated by reference. 

 

	 	(b)	If there is any conflict between any Future SOW and the other terms of this Agreement, the Parties shall attempt to read any such conflicting provisions consistently, however, in the event such a consistent reading
cannot be accomplished, such Future SOW will take precedence over such other terms of this Agreement with respect to such Future SOW only if and to the extent the requirements of Section 3.7(a)(ii)(A) are satisfied. If such requirements are not
satisfied, then the other terms of this Agreement shall govern. 

  

	25.12	Severability 

 If any provision of this Agreement conflicts with the Law under which this
Agreement is to be construed or if any provision of this Agreement is held invalid, illegal, or otherwise unenforceable by a competent authority, such provision will, if possible, be deemed to be restated to reflect as nearly as possible the
original intentions of the Parties in accordance with applicable Law. In any event, the remainder of this Agreement will remain in full force and effect. 
  

	25.13	Counterparts 

 This Agreement may be executed in several counterparts and by facsimile or
PDF signature, all of which taken together constitute a single agreement between the Parties. Each signed counter-part, including a signed counterpart reproduced by reliable means (including facsimile and PDF), will be considered as legally
effective as an original signature. 

  

					
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	25.14	Reading Down 

 If a provision of this Agreement is reasonably capable of an
interpretation which would make that provision valid, lawful and enforceable and an alternative interpretation that would make it unenforceable, illegal, invalid or void then, so far as is possible, that provision will be interpreted or construed to
be limited and read down to the extent necessary to make it valid and enforceable. 
  

	26.	DISPUTE RESOLUTION 

 Any dispute between the Parties arising out of or relating to this
Agreement, including with respect to the interpretation of any provision of this Agreement or with respect to performance by Supplier or Health Net, will be resolved as provided in this Section 26 (Dispute Resolution). 

 

	26.1	Informal Dispute Resolution 

  

	 	(a)	Subject to Section 26.1(b), the Parties initially will attempt to resolve any dispute arising out of or relating to this Agreement informally in accordance with the following: 

 

	 	(i)	Within ten (10) days after a Party receives notice of a dispute from the other Party (“Dispute Date”), it will designate a senior representative (i.e., a person whose rank within the
company is superior to, in the case of Supplier, the Client Partner, and in the case of Health Net, the Health Net Program Manager) who does not devote substantially all of his time to performance under this Agreement, who will offer to meet with
the designated senior representative of the other Party for the purpose of attempting to resolve the dispute amicably. 

  

	 	(ii)	The appointed representatives will meet promptly to discuss the dispute and attempt to resolve it without the necessity of any formal proceeding. They will meet as often as the Parties deem necessary in order that each
Party may be fully advised of the other’s position. During the course of discussion, all reasonable requests made by one Party to the other for non-privileged information reasonably related to the matters in dispute will be honored promptly.

  

	 	(iii)	The specific format for the discussions will be left to the discretion of the appointed representatives. 

  

	 	(b)	Formal dispute resolution may be commenced by a Party upon the first to occur of any of the following: 

  

	 	(i)	the appointed representatives conclude in good faith that amicable resolution of the dispute through continued negotiation does not appear likely; 

 

	 	(ii)	thirty-five (35) days have passed from the Dispute Date (this period will be deemed to run notwithstanding any claim that the process described in this Section 26.1 (Informal Dispute Resolution) was not
followed or completed); or 

  

	 	(iii)	commencement of formal dispute resolution is deemed appropriate by a Party to avoid the expiration of an applicable limitations period or to preserve a superior position with respect to other creditors, or a Party makes
a good faith determination, including as provided in Section 26.4 (Equitable Remedies), that a breach of this Agreement by the other Party is such that a temporary restraining order or other injunctive or conservatory relief is necessary.

  

					
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	 	(c)	All timeframes specified in this Section 26.1 are not-to-exceed durations. In the event of disputes related to compliance with Laws, Health Net may request (and Supplier shall use all best efforts to comply with)
shorter timeframes as needed in order for Health Net to respond to any Regulator or regulatory deadlines. 

  

	26.2	Litigation 

 For all litigation which may arise with respect this Agreement, the Parties
irrevocably and unconditionally submit (a) to the exclusive jurisdiction and venue (and waive any claim of forum non conveniens and any objections as to laying of venue) of the United States District Court for the Central District
of California, or (b) if such court does not have subject matter jurisdiction, to the Superior Court of the State of California, Los Angeles County in connection with any action, suit or proceeding arising out of or relating to this Agreement.
The Parties further consent to the jurisdiction of any state court located within a district that encompasses assets of a Party against which a judgment has been rendered for the enforcement of such judgment or award against the assets of such
Party. 
  

	26.3	Continued Performance 

 Each Party agrees (a) to continue performing its obligations
under this Agreement while a dispute is being resolved except (and then only) to the extent performance is prevented by the other Party or the issue in dispute precludes performance, and (b) not to take any action that intentionally obstructs,
delays, or reduces in any way the performance of such obligations. For the avoidance of doubt, a good faith dispute regarding invoiced charges and Health Net’s withholding payment of disputed charges as permitted under this Agreement will not
be considered to prevent Supplier from performing the Services or preclude performance by Supplier, nor will this Section 26.3 be interpreted to limit either Party’s right to terminate this Agreement (in whole or in part) or any SOW (in
whole or in part) as provided in Section 16 (Termination). 
  

	26.4	Equitable Remedies 

 Each Party acknowledges that a breach of any of its obligations
under the Sections of this Agreement listed below, or its infringement or misappropriation of any Intellectual Property Rights of the other Party, may irreparably harm the other Party in a way that could not be adequately compensated by money
damages. In such a circumstance, the aggrieved Party may (in addition to all other remedies and rights) proceed directly to court notwithstanding the other provisions of this Section 26 (Dispute Resolution). If a court of competent jurisdiction
should find that a Party has breached (or attempted or threatened to breach) any such obligations, such Party agrees that without posting bond or proving damages and without any additional findings of irreparable injury or other conditions to
injunctive relief, it will not oppose the entry of an appropriate order compelling its performance of such obligations and restraining it from any further breaches (or attempted or threatened breaches) of such obligations. The following Sections are
subject to this paragraph: 
  

	 	(a)	Section 14 (Data Security and Protection); 

  

	 	(b)	Section 15 (Intellectual Property Rights); 

  

					
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	 	(c)	Section 16 (Termination); 

  

	 	(d)	Section 21 (Confidentiality); 

  

	 	(e)	Section 23 (Indemnification); 

  

	 	(f)	Section 27.7; and 

  

	 	(g)	Schedule E (Transitioned Employees). 

  

	26.5	Waiver of Jury Trial 

 THE PARTIES HEREBY UNCONDITIONALLY WAIVE THEIR RESPECTIVE RIGHTS
TO A JURY TRIAL OF ANY CLAIM OR CAUSE OF ACTION ARISING DIRECTLY OR INDIRECTLY OUT OF, RELATED TO, OR IN ANY WAY CONNECTED WITH, THE PERFORMANCE OR BREACH OF THIS AGREEMENT, OR THE RELATIONSHIP THAT IS BEING ESTABLISHED BETWEEN THEM. THE SCOPE OF
THIS WAIVER IS INTENDED TO BE ALL ENCOMPASSING OF ANY AND ALL DISPUTES THAT MAY BE FILED IN ANY COURT OR OTHER TRIBUNAL (INCLUDING, WITHOUT LIMITATION, CONTRACT CLAIMS, TORT CLAIMS, BREACH OF DUTY CLAIMS, AND ALL OTHER COMMON LAW AND STATUTORY
CLAIMS). THIS WAIVER IS IRREVOCABLE, MEANING THAT IT MAY NOT BE MODIFIED EITHER ORALLY OR IN WRITING, AND THE WAIVER SHALL APPLY TO ANY SUBSEQUENT AMENDMENTS, RENEWALS, SUPPLEMENTS OR MODIFICATIONS TO THIS AGREEMENT, AND RELATED DOCUMENTS, OR TO ANY
OTHER DOCUMENTS OR AGREEMENTS RELATING TO THIS TRANSACTION OR ANY RELATED TRANSACTION. IN THE EVENT OF LITIGATION, THIS AGREEMENT MAY BE FILED AS A CONSENT TO A TRIAL BY THE COURT. 

 

	26.6	Disclaimer of Uniform Computer Information Transactions Act 

 TO THE MAXIMUM EXTENT
PERMITTED UNDER APPLICABLE LAW, THE PARTIES DISCLAIM AND NONE OF THIS AGREEMENT SHALL BE SUBJECT TO THE UNIFORM COMPUTER INFORMATION TRANSACTIONS ACT (“UCITA”) (PREPARED BY THE NATIONAL CONFERENCE OF COMMISSIONERS ON UNIFORM
STATE LAWS) AS CURRENTLY ENACTED OR AS MAY BE ENACTED, CODIFIED OR AMENDED FROM TIME TO TIME BY ANY JURISDICTION. TO THE EXTANT THAT ANY ASPECT OF THIS AGREEMENT OR ANY LICENSE GRANTED UNDER THIS AGREEMENT IS UNCLEAR OR DISPUTED BY THE PARTIES AND
UCITA, IF APPLIED, WOULD CLARIFY SUCH LICENSE OR RESOLVE SUCH DISPUTE, THE PARTIES AGREE TO CLARIFY SUCH LICENSE OR RESOLVE SUCH DISPUTE INDEPENDENTLY OF UCITA BY APPLYING THE INTENT OF THE PARTIES AT THE TIME THAT THEY ENTERED THIS AGREEMENT. 

 

	27.	GENERAL 

  

	27.1	Binding Nature and Assignment 

 This Agreement is binding on the Parties and their
respective successors and permitted assigns. Supplier acknowledges that the Services are personal in nature and that, as a result, Supplier may not assign this Agreement or delegate (except to Subcontractors as permitted in Section 7.7 its
rights or obligations under this Agreement, whether by operation of law or otherwise, without the 

  

					
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prior written consent of Health Net (which may be conditioned upon Health Net (or the applicable Health Net Affiliate or Health Net lines of business) providing prior notification to, and
receiving approval from, applicable Regulator(s) and customers). Health Net may not assign this Agreement or delegate its rights or obligations under this Agreement without the prior written consent of Supplier except to a Health Net Affiliate or to
the successor in a merger or reorganization of Health Net or an entity that acquires Control of Health Net or acquires all or substantially all of Health Net’s business or assets. Any attempted assignment in violation of this Section 27.1
will be void and will constitute a material breach of this Agreement by the Party attempting the assignment. A Party assigning this Agreement or delegating its rights or obligations under this Agreement must provide prompt notice of the assignment
or delegation to the other Party after its effective date, subject to the prior regulatory approval set out above. 
  

	27.2	Ethics Hotline 

 Supplier agrees to report any violation of Law (including HIPAA and the
FCPA) committed by Supplier, its employees or subcontractors in the performance of the Services to Health Net’s Ethics Hotline at (888) 866-1366 or Health Net’s Ethics Officer at Health Net’s address for Notices. 

 

	27.3	Nondiscrimination 

  

	 	(a)	Neither Party shall discriminate against any Beneficiary in the provision of Services hereunder, whether on the basis of the Beneficiary’s coverage under a Benefit Program, age, sex, marital status, sexual
orientation, race, color, religion, ancestry, national origin, disability, handicap, health status, source of payment, utilization of medical or mental health services or supplies, or other unlawful basis including, without limitation, the filing by
such Beneficiary of any complaint, grievance or legal action against Supplier, Health Net, or a Health Net Affiliate. Supplier agrees to make reasonable accommodations for Beneficiaries with disabilities or handicaps, including but not limited to,
providing auxiliary aids and services to Beneficiaries at Supplier’s expense, as required by law. 

  

	 	(b)	This Agreement is subject to the affirmative action and nondiscrimination requirements of Executive Order 11246 as amended, Section 503 of the Rehabilitation Act of 1973, and Section 402 of the Vietnam Era
Veterans’ Readjustment Assistance Act of 1974, and with all rules, regulations, pertaining thereto, which are incorporated herein by specific reference. 

  

	 	(c)	Supplier and its subcontractors shall abide by the requirements of 41 CFR 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or
disability, and require affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans and individuals with disabilities. 

 

	27.4	Beneficiary Hold Harmless 

 Supplier will (a) not hold any Beneficiary liable for
fees that are the responsibility of Health Net or a Health Net Affiliate; and (b) ensure that Supplier’s subcontractors will not hold any Beneficiary liable for fees that are the responsibility of Health Net or a Health Net Affiliate. 

  

					
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	27.5	Notices 

  

	 	(a)	All notices, requests, demands and determinations under this Agreement (other than routine operational communications), shall be in writing and shall be deemed duly given (i) when delivered by hand, (ii) on
the designated day of delivery after being timely given to an express overnight courier with a reliable system for tracking delivery, (iii) six (6) days after the day of mailing, when mailed by United States mail, registered or certified
mail, return receipt requested and postage prepaid, and addressed as follows: 

  

	 	(i)	In the case of Health Net: 

 Health Net, Inc. 

21650 Oxnard Street 
 Woodland
Hills, CA 91367 
 Attn: Vendor Management Officer 

With a copy to: 
 Health Net,
Inc. 
 21650 Oxnard Street 

Woodland Hills, CA 91367 
 Attn:
General Counsel 
  

	 	(ii)	In the case of Supplier: 

 Cognizant Technology Solutions US Corporation 

500 Frank W. Burr Blvd. 

Teaneck, New Jersey 07666 

Attn: General Counsel 
  

	 	(b)	A Party may from time to time change its address or designee for notification purposes by giving the other prior written notice of the new address or designee and the date upon which it will become effective.

  

	27.6	Non-solicitation of Employees 

  

	 	(a)	Except as provided in Schedule E (Employee Transfer), Supplier will not solicit or seek to procure the employment of any Health Net personnel, either directly or indirectly (other than by general advertising not
specifically targeted at Health Net’s employees) until after the date on which any such Health Net personnel is terminated by Health Net, or three (3) months after any such Health Net Personnel voluntarily ceases to be employed by Health
Net, without the prior written consent of Health Net (which consent is deemed given as of the Effective Date for the Affected Employees). 

  

	 	(b)	Except as provided in Schedule L (Disengagement Assistance), Health Net will not solicit or seek to procure the employment of any Supplier Personnel, either directly or indirectly (other than by general
advertising not specifically targeted at Supplier’s employees) until after the date on which any such Supplier Personnel is terminated by Supplier, or three (3) months after any such Supplier personnel voluntarily ceases to be employed by
Supplier, without the prior written consent of Supplier. 

  

					
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	27.7	Compliance with Laws 

  

	 	(a)	Supplier’s Obligations. 

  

	 	(i)	Supplier agrees at its cost and expense (x) to comply with its obligations under the Regulatory Compliance Addendum attached hereto as Schedule K (Regulatory Compliance Addendum), and (y) obtain all
necessary approvals, licenses, and permits required by Law, and to comply with all Laws, in each case as applicable to: 

  

	 	(A)	its business (or that of any of its Affiliates); 

  

	 	(B)	the performance of any of its obligations under this Agreement; 

  

	 	(C)	the Services that Supplier is obligated to provide under this Agreement, including as such obligations may evolve pursuant to this Agreement, including Services provided with respect to any jurisdiction in which Health
Net does business; or 

  

	 	(D)	its obligations under Sections 14.3, 14.6, 14.8, and 14.9. 

  

	 	(ii)	If Supplier is charged with failing to comply with any such Laws, it shall promptly notify Health Net of the charges in writing. 

  

	 	(iii)	Supplier shall identify, track and report any failure by Supplier to comply with Laws or failure (or suspected failure) to comply with the Compliance Services set forth in Section 3.5 of Schedule A (Cross
Functional Services). Such report shall be made to Health Net with five (5) days of Supplier’s learning of same. 

  

	 	(iv)	Health Net, not Supplier, shall be responsible (as provided in Section 27.7(b)(iii)(ii) below) for discovering, identifying, and notifying Supplier of new Laws and changes in Laws applicable to Health Net’s
own business and operations that are applicable to the Services but would not otherwise be applicable to Supplier. Upon receiving notification of a new Law or change in Law applicable to the Services, Supplier shall prepare for Health Net’s
approval draft policies concerning compliance with the new Law or change in Law. Health Net shall review and the following portions of policies submitted by Supplier: policy statement, policy purpose, scope/limitations, references and definitions
(“Reviewed Policy Provisions”), but Supplier shall be responsible for any other portions of such policies. Supplier shall comply with all such Reviewed Policy Provisions approved by Health Net. Supplier shall alone be responsible for the
development and implementation of operational procedures to facilitate Supplier’s compliance with such policies. 

  

	 	(b)	Health Net’s Obligations. 

  

	 	(i)	Health Net agrees at its cost and expense (x) to comply with its obligations under the Regulatory Compliance Addendum attached hereto as Schedule K (Regulatory Compliance Addendum), and (y) obtain all
necessary approvals, licenses and permits required by Law, and to comply with all Laws, in each case as applicable to: 

  

	 	(A)	its business (or that of any of its Affiliates); 

  

					
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	 	(B)	the performance of any of its obligations under this Agreement; or 

  

	 	(C)	its obligations under Sections 14.6 and 14.8. 

  

	 	(ii)	If Health Net is charged with failing to comply with any such Laws it shall promptly notify Supplier of the charges in writing. 

  

	 	(iii)	As between Health Net and Supplier, Health Net shall be responsible for discovering, identifying, and notifying Supplier of new Laws and changes in Laws applicable to Health Net’s own business and operations that
are applicable to the Services but would not otherwise be applicable to Supplier. 

  

	 	(c)	If there is a Law with which Supplier is obligated to comply pursuant to Section 27.7(a) and Health Net is obligated to comply pursuant to Section 27.7(b), each Party shall have the financial responsibility
for its own compliance with such Law. 

  

	 	(d)	When either Party receives notice of a change in Law applicable to the Services or the other Party’s activities pursuant to this Agreement, such Party will promptly provide notice to the other Party.

  

	 	(e)	For the avoidance of doubt, nothing contained in this Agreement shall require either Party to act in any illegal manner. 

  

	27.8	Covenant of Good Faith 

 Each Party, in its respective dealings with the other Party
under or in connection with this Agreement, will act reasonably and in good faith. 
  

	27.9	Public Disclosures 

 Neither Party shall make any media releases, public announcements or
public disclosures relating to this Agreement or the subject matter of this Agreement, including promotional or marketing material, but not including disclosures to the extent required to meet legal or regulatory requirements beyond the reasonable
control of the disclosing Party without the prior written consent of the other Party. 
  

	27.10	Service Marks 

 Supplier will not, without Health Net’s consent, use the name,
service marks or trademarks of Health Net in any advertising or promotional materials prepared by or on behalf of Supplier. 
  

	27.11	Guaranty 

 Supplier shall cause the Guaranty Agreement, attached as Schedule V
(Guaranty), to be executed by Cognizant Technology Solutions Corporation and delivered to Health Net concurrently with the execution of this Agreement. Failure to do so will constitute a material breach of this Agreement by Supplier. 

  

					
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	27.12	Mutually Negotiated 

 No rule of construction will apply in the interpretation of this
Agreement to the disadvantage of one Party on the basis that such Party put forward or drafted this Agreement or any provision of this Agreement. 

  

					
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IN WITNESS WHEREOF, Health Net and Supplier have each caused this Agreement to be signed and delivered by its duly authorized officer,
all as of the date first set forth above. 
  

									
	Health Net, Inc.				Cognizant Healthcare Services, LLC
					
	By:		/s/ James E. Woys				By:		/s/ Steven Schwartz
	Print Name:		James E. Woys				Print Name:		Steven Schwartz
	Title:		EVP, COO & CFO				Title:		Executive Vice President Chief Legal and
	Date:		 						Corporate Affairs Officer
							Date:		 

  

					
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SCHEDULE A 
 CROSS
FUNCTIONAL SERVICES 

  

					
	Schedule A		 		Health Net / Supplier Confidential

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 SCHEDULE A 

CROSS FUNCIONAL SERVICES 

Table of Contents 
  

									
	 1
		INTRODUCTION		 	1	  
			1.1		General		 	1	  
			1.2		Solution		 	1	  
			1.3		Hours of Coverage		 	i	  
			1.4		Definitions		 	2	  
			1.5		Changes		 	3	  
			
	 2
		RESPONSIBLE PARTY		 	4	  
			
	 3
		CROSS-FUNCTIONAL SERVICES		 	4	  
			3.1		Business Continuity & Disaster Recovery Services		 	5	  
			3.2		Training Services		 	8	  
			3.3		Documentation		 	9	  
			3.4		ERM Services		 	10	  
			3.5		Regulatory Compliance Adherence Services		 	10	  
			3.6		Innovation Services		 	11	  
			3.7		Root Cause Analysis Services		 	13	  
			3.8		Managed Third Party Contract Services		 	13	  
			3.9		Reporting and Analytics Services		 	16	  
			3.10		User Acceptance Testing Services		 	17	  
			3.11		Return Mail Processing Services		 	18	  
			3.12		Inventory Management Services		 	18	  
			3.13		Collection of Funds Services		 	19	  
			3.14		Issue and Error Resolution Services		 	19	  
			3.15		Integration Services		 	19	  
			3.16		Translation Services		 	20	  
			
	 4
		EMBEDDED PROCESSES		 	20	  
			4.1		General		 	20	  
			4.2		Embedded Processes		 	20	  

  

					
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 SCHEDULE A 

CROSS FUNCTIONAL SERVICES 
  

	1	INTRODUCTION 

  

	1.1	General 

  

	 	(a)	This Schedule A (Cross Functional Services) describes, among other things, those Cross Functional Services and Embedded Processes to be performed and delivered by Supplier, which are applicable to all of the
Services performed by Supplier under this Agreement. 

  

	 	(b)	The Services are required for Health Net’s business operations in the United States, including its territories. 

  

	 	(c)	References to specific resources (e.g., tools, systems) in this Schedule A (Cross Functional Services), any SOW, or elsewhere in the Agreement that are used by Supplier in performing the Services shall be deemed
to include successor or replacement resources. 

  

	 	(d)	Supplier shall manage and perform the Services in a tightly integrated manner (with appropriate consideration given at all times to the impact of change to all Services). 

 

	 	(e)	Supplier shall provide such information as may be reasonably requested by Health Net from time to time to support Health Net’s investigation into potential violations of Health Net’s policies and procedures.

  

	 	(f)	All communications and documentation will be in English unless otherwise specified in the Agreement. 

  

	 	(g)	Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is
no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and
evolutions of the Cross Functional Services during the term of the Agreement. 

  

	1.2	Solution 

 Schedule A-1 (Cross Functional Solution) describes how Supplier will
perform and deliver the Services in a manner that meets the requirements of the Agreement (the “Cross Functional Solution”). Except where explicitly noted otherwise, Schedule A-1 (Cross Functional Solution) is intended
to describe the future “To-Be” service delivery environment and processes and tools to be implemented and used by Supplier in performing the Services. Supplier’s performance of the Services will be in accordance with the Solution. The
Solution may not modify or change the scope of Services to be provided under, or any other terms or conditions of, this Agreement. 
  

	1.3	Hours of Coverage 

 The hours of coverage for each of the Services are set forth in
Schedule A-1 (Cross Functional Solution). Supplier will at minimum mirror the regular operating hours adhered to by the Health 

  

					
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Net personnel performing the Cross Functional Services as of the Effective Date. Supplier acknowledges and agrees that performance of the Cross Functional Services will regularly require Supplier
Personnel to perform additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Cross Functional Services. 

Supplier will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of operations is within the scope of the Cross Functional Services. 

Within the regular hours of operations set forth in Schedule A-1 (Cross Functional Solution), Supplier will have staff work according to
defined shift schedules. However, Supplier will make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to meet regulatory requirements, Compliance and Service
Level metrics and other requirements of the Agreement. 
  

	1.4	Definitions 

 Capitalized terms not defined in this Schedule A (Cross Functional
Services) shall have the meanings given them in Schedule W (Glossary) or elsewhere in this Agreement. 
  

	 	(a)	“Channels” means various forms of communication including phone, chat, email, text, and SMS. 

  

	 	(b)	“Health Net Departments” means Claims, Membership, Configuration, Correspondence, Customer Contact Center, and Appeals & Grievances. 

 

	 	(c)	“Health Net Investigations” means any effort that Health Net (including the Health Net Compliance Department, Vendor Oversight, or any other department) undertakes to obtain information necessary
to perform an internal audit or monitoring process, obtain information necessary to respond to regulators or other external entities, or otherwise ensure compliance with business and regulatory requirements. 

 

	 	(d)	“Member” means a person who is properly enrolled in and eligible to receive covered services under a Health Net benefit program at the time covered services are rendered. 

 

	 	(e)	“Plan” means a health insurance plan offered by Health Net. 

  

	 	(f)	“Provider” means a facility, physician, physician organization, independent practice association, health care provider, supplier, or other organization that may provide covered services.

  

	 	(g)	“Ramp Up” means the period of time from when an associate completes process training to the time when the agent starts meeting the required quality SLAs and 100% productivity standards.

  

	 	(h)	“Regions” means (i) Arizona, (ii) California, and (iii) Oregon/Washington. 

  

	 	(i)	“RTO” means recovery time objective. 

  

	 	(j)	“Supplier Facilities” means those locations set forth in Schedule F (Supplier Facilities). 

  

					
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	 	(k)	“Tower(s)” means the set of Services described in each Statement of Work. 

  

	 	(l)	“Transition Management Office” or “TMO” means the Supplier resources dedicated to managing the Transition as further described in the Transition Manual. 

 

	1.5	Changes 

 Material additions to, deletions from, or other changes in the Services
described in this Schedule A (Cross Functional Services) are subject to the Change Control Process. 

  

					
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	2	RESPONSIBLE PARTY 

  

											
	 Process /

Function ID
	  	 Process/Function Name / Description
	  	Line of
Business	  	Region	  	Resp. Party
	  	  	  	  	Supplier	  	HN
	 CF1
	  	Business Continuity & Disaster Recovery Services	  	All	  	All	  	X	  	
	 CF2
	  	Training Services	  	All	  	All	  	X	  	
	 CF3
	  	Documentation	  	All	  	All	  	X	  	
	 CF4
	  	ERM Services	  	All	  	All	  	X	  	
	 CF5
	  	Regulatory Compliance Adherence	  	All	  	All	  	X	  	
	 CF6
	  	Innovation	  	All	  	All	  	X	  	
	 CF7
	  	Root Cause Analysis	  	All	  	All	  	X	  	
	 CF8
	  	Managed Third Party Contract Service	  	All	  	All	  	X	  	
	 CF9
	  	Reporting and Analytics	  	All	  	All	  	X	  	
	 CF10
	  	User Acceptance Testing	  	All	  	All	  	X	  	
	 CF11
	  	Return Mail Processing	  	All	  	All	  	X	  	
	 CF12
	  	Inventory Management	  	All	  	All	  	X	  	
	 CF13
	  	Collection of Funds	  	All	  	All	  	X	  	
	 CF14
	  	Issue/Error Resolution	  	All	  	All	  	X	  	
	 CF15
	  	Integration Services	  	All	  	All	  	X	  	
	 CF16
	  	Translation Services	  	All	  	All	  	X	  	

  

	3	CROSS-FUNCTIONAL SERVICES 

 Supplier shall provide the following cross-functional services (the
“Cross Functional Services”) as part of the Services and any other Services the Parties may agree to add to the scope of this Agreement. In the event that Health Net terminates the provision of any part of the Services
pursuant to this Agreement, Supplier shall continue to provide the Cross Functional Services set forth in this Section 3 as such Cross Functional Services relate to the remaining Services. 

  

					
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	3.1	Business Continuity & Disaster Recovery Services 

  

	 	(a)	“Business Continuity and Disaster Recovery Services” are (i) the Functions associated with planning, documenting, implementing, maintaining and periodically testing a mutually agreed-upon
business continuity plan that ensures that the Services are sustained at a suitable and appropriate level during any business disruption, disaster or Force Majeure event (the “Business Continuity Plan”), and (ii) the IT
Continuity and Business Recovery Services set forth in Schedule A-3 (IT Continuity and Business Recovery Services). 

  

	 	(b)	Supplier will assume responsibility for performing Business Continuity and Disaster Recovery Services for each Service as of the BPaaS Services Commencement Date. Supplier will adopt Health Net’s then existing
business continuity plan for all operations that remain at Health Net Facilities following the BPaaS Services Commencement Date. Supplier will develop a Business Continuity Plan and Disaster Recovery Plan for all Services to be performed at Supplier
Facilities (i) prior to the BPaaS Service Commencement Date or (ii) for Services transitioned after the BPaaS Services Commencement Date, prior to the date that such Service is transitioned from a Health Net Facility to a Supplier
Facility. No later than eighteen (18) months following the BPaaS Services Commencement Date, Supplier will fully implement a tested Business Continuity Plan for the Services in compliance with all enhanced requirements set forth in this
Agreement. 

  

	 	(c)	Supplier will ensure during the Transition and during steady state that at all times the Services comply with Health Net’s disaster recovery policies and business requirements (and changes thereto), including any
applicable regulatory requirements, to the extent such plans, policies, requirements and regulations apply to the Services. Supplier will store the Business Continuity Plans in readily accessible locations for access in the event of a disaster.

  

	 	(d)	Among other things, the Business Continuity Plan shall: 

  

	 	(i)	Contain a brief description of processes and procedures used to recover the Services, and associated time frames for the recovery of such Services, including a prioritized listing of Services, subject to Health
Net’s input, review and approval; 

  

	 	(ii)	Contain notification procedures to alert Health Net of Service disruptions including off-hour and weekend coverage; and 

  

	 	(iii)	Describe Supplier’s and Health Net respective recovery responsibilities. 

  

	 	(e)	The Parties will alert each other of any deficiencies discovered in the Business Continuity Plan that would adversely affect Health Net or the provision of Services. 

 

	 	(f)	With cooperation and approval from Health Net, Supplier shall review and update, the Business Continuity Plan at a minimum on an annual basis or as otherwise warranted by (i) business or technical changes (or
both), (ii) requirements of applicable Laws, and (iii) otherwise as necessary to maintain compatibility with Health Net’s overall business continuity plan. Supplier will receive business direction and requirements from Health Net and
must receive authorization from Health Net to make significant changes to the strategic and/or tactical direction of Health Net’s overall business continuity plan. 

  

					
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	 	(g)	As part of the Business Continuity and Disaster Recovery Services, Supplier will: 

  

	 	(i)	assess and define functional, performance, availability, maintainability and disaster recovery needs and the security requirements to meet user, regulatory, client and company policy requirements; and 

 

	 	(ii)	propose functional, performance, availability, maintainability and disaster recovery requirements and establish standards (e.g., support processes and procedures). 

 

	 	(h)	As part of the Business Continuity and Disaster Recovery Services, Supplier will: 

  

	 	(i)	provide training and support to Health Net technical and business unit employees for the necessary technical and non-technical (process oriented) changes that would become necessary and executed during emergencies and
business disruption events affecting the Services; and 

  

	 	(ii)	perform education and awareness training related to the Business Continuity Plan for all Supplier Personnel. 

  

	 	(i)	As part of the Business Continuity and Disaster Recovery Services Supplier will, at a minimum: 

  

	 	(i)	Perform the Business Continuity and Disaster Recovery Services in accordance with ISO 22301 (or any replacement standard during the Term that is mutually agreed upon by Supplier and Health Net) and any additional
standards and procedures mutually agreed upon by Supplier and Health Net; 

  

	 	(ii)	Include the capabilities to transition back from the disaster recovery site to Supplier Facilities of the affected services and restoration of Services at the affected site upon cessation of the disaster;

  

	 	(iii)	Include the capabilities to allow the same Supplier Personnel assigned to perform the Services to continue providing the Services in the event of a disaster; 

 

	 	(iv)	Upon cessation of the disaster, implement the activities necessary to restore the affected Services at the affected locations with the capabilities to meet the RTO and other turnaround times set forth in the Business
Continuity Plan; 

  

	 	(j)	Test Supplier’s disaster recovery and business continuity plans (including the Business Continuity Plan), as warranted by (i) business or technical changes (or both), (ii) Health Net requirements as
defined in this Schedule A (Cross Functional Services) or requirements of applicable Laws, and (iii) otherwise as necessary to maintain compatibility with Health Net’s overall business continuity plan. Supplier will receive business
direction and requirements from Health Net and must receive authorization from Health Net to make significant changes to the strategic and/or tactical direction of Health Net’s overall business continuity plan, procedures and capabilities with
respect to each Supplier Facility and those related to or affecting the Services. 

  

					
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	 	(k)	Interface Supplier’s disaster recovery and business continuity plans, procedures and capabilities with, and provide support and assistance to Health Net in connection with Health Net’s annual testing of,
Health Net’s disaster recovery and business continuity plans, processes and procedures. Supplier will permit Health Net and its auditors to audit the Business Continuity Plans on an annual basis. 

 

	 	(l)	In the event of a disaster, Supplier shall provide the Services and other business continuity Functions in accordance with the Business Continuity Plan. Supplier’s Functions shall include the following:

  

	 	(i)	Providing a single 24 hour per day, 365 day per year (24/365) point-of-contact with at least two (2) alternative back-up points-of-contact with 24/365 availability for business continuity related
communications and activities; 

  

	 	(ii)	Paying all travel and living expenses incurred by Supplier Personnel in the performance of Supplier’s responsibilities described in this Section 3.1 for Supplier’s facilities offshore; and

  

	 	(iii)	Meet service levels established in the approved BCP/DR Plan related to mission critical processes required during the disaster event, with relief during the phase of Transition from any penalties (financial or
otherwise) that occur as a result of documented deficiencies in the existing Health Net business continuity and disaster recovery testing reports related to services and supporting technology that are adopted by Supplier prior to development,
approval, and testing of the Supplier’s Business Continuity Plan, and with relief from consequences (financial impact or otherwise) outside of Supplier control and within scope of services provided by third parties contracted directly to Health
Net. 

  

	 	(m)	In the event of a disaster, Supplier shall not give priority to the recovery of other Supplier clients’ processes with recovery time objectives that exceed Health Net’s recovery time objectives for recovery of
affected Equipment, Software, Services and data related to the Services deemed mission critical in the Business Continuity and Disaster Recovery Plan. 

  

	 	(n)	In addition to the Functions described in Section 3.1(b) through 3.1(m) above, the Business Continuity & Disaster Recovery Services include the following activities: 

 

	 	(i)	Develop, subject to Health Net’s approval, the Business Continuity Plan in accordance with the requirements of this Section 3.1; 

 

	 	(ii)	Conduct gap analyses of potential faults in meeting the RTO, in applications or processes used to perform the Services; 

  

	 	(iii)	Propose to Health Net updates to Health Net’s overall disaster recovery and business continuity plans and to the Business Continuity Plan, as needed to reflect changes in the Services, the technical environment, or
requirements of applicable Laws; 

  

	 	(iv)	Conduct tests of the Business Continuity Plan related to the Services; 

  

					
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	 	(v)	Participate, as requested by Health Net, in Health Net’s disaster recovery and business continuity tests that will enable Health Net to test compatibility of their applications and processes with the recovery
center environment; 

  

	 	(vi)	Participate, as requested by Health Net, in Health Net’s disaster recovery and business continuity testing (or, in the event of a disaster, disaster recovery and business continuity execution) for Health Net
customers and business partners, including by coordinating with third parties as such third parties relate to the Services; 

  

	 	(vii)	Integrate Supplier’s disaster recovery and business continuity plans, procedures and capabilities with Health Net’s disaster recovery and business continuity plans, processes and procedures; 

 

	 	(viii)	Review and approval by Health Net of Supplier’s disaster recovery and business continuity plans, test plans and testing results; 

 

	 	(ix)	Participate with Health Net in the Joint Steering Committee and test team meetings for disaster recovery and business continuity; 

  

	 	(x)	Communicate to Health Net proposed disaster recovery and business continuity plan changes, including changes in the Business Continuity Plan, due to any technical or business changes; 

 

	 	(xi)	Identify and inform Health Net of opportunities (if any) for improvement of effectiveness and efficiencies in disaster recovery and business continuity functions; 

 

	 	(xii)	Review and recommend opportunities for improvement of effectiveness and efficiencies in disaster recovery and business continuity functions; 

 

	 	(xiii)	Communicate to Health Net disaster recovery and business continuity goals and initiatives, related to Supplier Services for the following year; and 

 

	 	(xiv)	Report to Health Net, quarterly, all business continuity and disaster recovery activities as outlined in ISO 22301. 

  

	3.2	Training Services 

 “Training Services” are those Functions
associated with the curriculum development, planning, scheduling and delivery of trainings in compliance with Laws for all Supplier Personnel performing the Services in the Claims, Membership, Appeals & Grievances, and Contact Center,
including the following activities: 
  

	 	(a)	Develop training curriculum needed to deliver the Services including training scenarios and knowledge checks; 

  

	 	(b)	Develop training, including computer based training that comply with regulatory requirements; 

  

	 	(c)	Provide training and oversight for External Employer Group Auditors; 

  

					
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	 	(d)	Maintain training calendar and inventory; 

  

	 	(e)	Provide training reports to various parties including but not limited to Health Net Management, Health Net areas, Compliance, and Regulators; 

 

	 	(f)	Document training attendance, course completion and other training related details; 

  

	 	(g)	Manage and maintain intake process and system for new and adjusted training requests; 

  

	 	(h)	Regular review of training technology, methodologies, courses, and approach; 

  

	 	(i)	Perform needs assessment and training validation for any new training requests; 

  

	 	(j)	Review audit findings and make recommendations to business areas for policy and procedure creation/updates, additional training, process automation tools, and/or process change/improvement; 

 

	 	(k)	Provide regulatory training support including but not limited to ad hoc training requests and reporting; and 

  

	 	(l)	Certify training staff. 

 Any Training Associates who perform any Training Services associated
with the Offshore Restricted Entities listed in Section 3.1 of Schedule Y (Offshore Prohibitions and Restrictions) shall remain on-shore. 
  

	3.3	Documentation 

 “Documentation Services” means those Functions
associated with maintaining, archiving, offsite storage, retrieval, and destruction of documentation as related to the Services in hard copy and/or electronic form, including the following activities: 

 

	 	(a)	Recommending documentation requirements, location, and formats; 

  

	 	(b)	Reviewing and approving documentation requirements, location and formats as appropriate; 

  

	 	(c)	Maintaining, retrieving and archiving documentation in agreed format in support of the Services; 

  

	 	(d)	Identifying documentation for archival per Health Net retention policies and coordinating with Health Net to prepare documents for delivery to offsite storage; 

 

	 	(e)	Providing to Health Net any documentation as required in response to regulatory requirements, Health Net Investigations, and/or inquiries; 

 

	 	(f)	Providing additional information as requested to support Health Net documentation requirements and Health Net proposal efforts; 

  

	 	(g)	Enabling Health Net direct electronic access to documentation retained in accordance with the documentation requirements; 

  

					
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	 	(h)	Following Health Net’s policies and processes for destruction of records, including acquiring Health Net approval prior to any document destruction; 

 

	 	(i)	Storing business continuity documentation separate from standard retention documents; 

  

	 	(j)	Complying with Health Net’s Records Information Management (RIM policies, processes and procedures related to the retention, archive and destruction of documents (including any documents containing Confidential
Information), and the ability to retain information in compliance with laws, legal and regulatory obligations and disaster recovery requirements; 

  

	 	(k)	Maintaining documentation per legal hold requirements per regulatory and Health Net policies; and 

  

	 	(l)	Marking and handling documentation in accordance with Health Net’s Data Classification Policies and Procedures. 

  

	3.4	ERM Services 

 “Enterprise Risk Management Services” or
“ERM Services” are those Functions associated with a formalized process to identify, assess, mitigate, monitor and report on risks, consistent with the Health Net ERM Guide and related processes/policies (“ERM
Framework”), to the proper performance and fulfillment of the Solution and all Services performed by Supplier. Any such risks, assessment, mitigation and monitoring activity are reported to Health Net for its evaluation, monitoring and
reporting requirements. In addition, ERM Services require Supplier to develop, implement, and manage solutions to mitigate the impact of existing and emerging risks. 

ERM Services shall be overseen by a single accountable individual within Supplier’s organization. Supplier shall conduct a risk assessment
no less than twice a year that is consistent with and which supports the ERM Framework and report on the results of such risk assessments to Health Net along with Supplier’s plans to monitor and mitigate any identified risks. Health Net will
retain the final decision making authority of whether any suggested risks actually make the formal list and what risks can be closed and removed. 
  

	3.5	Regulatory Compliance Adherence Services 

 As a basic principle, Health Net must retain
ownership of the compliance functions associated with the Services. For avoidance of doubt, Health Net will own and fully retain responsibility for (i) maintaining relationships with Regulators and policy makers as it relates to Health
Net’s business, (ii) interpreting new or modified Laws with which Health Net is responsible for complying pursuant to Section 27.7 (Compliance with Laws) of the Terms and Conditions; and (iii) drafting and submitting
responses to regulator Communications. 
 “Regulatory Compliance Adherence Services” are the Functions necessary to
manage compliance of the Services, including managing the compliance of all related downstream entities and entities with delegated Functions, in accordance with Law. The Regulatory Compliance Adherence Services include the following activities:

  

	 	(a)	As requested by Health Net to comply with Law, provide information related to the Services to enable Health Net to respond to directives, complaints, requests for information or other communications from Regulators
(e.g., CMS Memo, Annual call letters) (collectively, “Regulator Communications”); 

  

					
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	 	(b)	Provide data to Health Net related to any in-scope Functions including audit activities and participate in data validation activities; 

 

	 	(c)	Develop and distribute content for, and monitor evidence of completion of, compliance training for Supplier Personnel; 

  

	 	(d)	Monitor Cognizant’s compliance with Laws with which Cognizant is responsible for complying pursuant to Section 27.7 (Compliance with Laws) of the Terms and Conditions; 

 

	 	(e)	Identify, track, report, and escalate issues of non-compliance (or suspected non-compliance) to Health Net within required timeframes; 

 

	 	(f)	Implement, monitor and report on normal course of business controls; 

  

	 	(g)	Notify downstream entities of compliance requirements, monitor downstream entity compliance, and report to Health Net on the compliance of downstream entities; 

 

	 	(h)	Respond to data requests to support active Health Net Investigations; and 

  

	 	(i)	Comply with due dates and turnaround times as specified by Health Net Legal and Regulatory Affairs. 

  

	3.6	Innovation Services 

  

	 	(a)	“Innovation” means the development, discovery and/or application of new ideas, techniques, methods, processes or technology related to the Services that improve outcomes – be they financial
or experiential – for Health Net’s Members, Providers, Shareholders or other Stakeholders. “Innovation Services” are the Functions the Supplier will provide to ensure Innovation of the Services (including as
required for Supplier to continuously evolve and improve the Services as required by Section 3.3 (Evolution of the Services) of the Terms and Conditions and Section 5.4 (Continuous Improvement) of Schedule B
(Service Levels) and that Health Net receives the benefits from Supplier’s continuous Innovation. 

  

	 	(b)	As part of the Innovation Services and subject to 3.7(h), Supplier shall develop, implement, manage and maintain a set of processes, procedures and tools through which Supplier will continually monitor and improve its
service delivery methods using industry recognized best practices. Supplier will identify weaknesses and opportunities for Innovation and improvement in its service delivery methods and systematically implement those Innovations and improvements.

  

	 	(c)	By the end of Transition and annually thereafter Supplier will provide to Health Net an Innovation Plan. Health Net will provide input to the Innovation Plan as it is developed and updated. Each Innovation Plan will
include: 

  

	 	(i)	An identification of general and industry specific business, medical (e.g., related to medical trends regarding claims and authorizations), and technical trends and forecasts that inform both the Supplier and Health Net
of new opportunities that could be used to improve financial or experiential outcomes; 

  

					
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	 	(ii)	An annual benchmark conducted by Supplier comparing itself against the Supplier Competitors listed in Schedule M (Supplier Competitors). The underlying purpose of the benchmark will be for Health Net to
understand market capabilities and to stay current with market advancements; 

  

	 	(iii)	The business challenges facing the Health Care Industry and Heath Net relative to Health Net’s stated business goals and objectives; 

 

	 	(iv)	Specific new, disruptive technological or scientific advances and their expected timeframes for practical (e.g., economically feasible) application of future advances within the context of Health Net’s business and
the Services; 

  

	 	(v)	Reporting on the current STARs, HEDIS and NCQA rating for the Services over the previous year and a plan for improving each rating during the upcoming year; 

 

	 	(vi)	For STARS, identifying goals for the upcoming year for each measure, initiatives to achieve the goals, and correlating metrics to track progress and inform that goals are on track; and 

 

	 	(vii)	A rolling two year forecast identifying specific improvements in techniques, methods, processes or technologies that Supplier will implement to deliver ongoing Innovation within the scope of the Services and a list of
prioritized recommendations as to how Health Net could take advantage of opportunities to innovate in areas related to the Services. 

  

	 	(d)	Health Net and Supplier will utilize the Governance structure to ensure the Innovation Plan is completed timely, with Health Net participation as part of the Technology/Services Meetings, and that Supplier is executing
upon the Innovation Plan. Supplier will provide quarterly reports to Health Net on Supplier’s Innovation activities in support of the Innovation Plan. 

  

	 	(e)	In addition to the annual Innovation Plan, Supplier shall: 

  

	 	(i)	Continuously monitor industry trends, including through independent research, and document and report on products and services with potential use for Health Net on a quarterly basis. 

 

	 	(ii)	Participate, as requested by Health Net, in technical and business planning sessions. 

  

	 	(f)	Without limiting Supplier’s obligation under Section 3.7(c), annually Health Net may conduct an assessment of (i) Supplier’s Solution, (ii) Supplier’s Service delivery environment, and
(iii) the processes, procedures, software, systems and tools Supplier uses to perform the Services, that compares Supplier against Supplier’s competitors and other entities (including other health insurance companies) performing similar
services. The results of the assessment will be used to determine whether Supplier’s Service offering and performance remain on pace with industry best practices and developments. At Health Net’s discretion, an assessment under this
Section 3.7(f) may be conducted by 

  

					
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 Health Net or an independent industry-recognized service provider designated by Health Net
(“Assessor”). Supplier agrees to cooperate with the Assessor, including, as appropriate, promptly making available knowledgeable personnel and pertinent documents and records, and providing the Assessor with access to
relevant facilities, software, systems and tools used to perform the Services. At the conclusion of the assessment process the Assessor will issue a report of its findings and conclusions to Health Net. The Assessor’s findings will be used to
inform the annual Innovation Plan (described in Section 3.7(c) above). 
  

	 	(g)	The assessment performed in accordance with Section 3.7(f) and Health Net’s assessment of Supplier’s execution of Innovation Services and the value of the Innovation Services will be included in the
Stakeholder Satisfaction Survey. 

  

	 	(h)	Health Net is not obligated to implement any recommendations by Supplier. Supplier does not need to seek Health Net approval for implementation of Innovation activities except as expressly required by this Agreement,
including those subject to Change Control. 

  

	3.7	Root Cause Analysis Services 

 Supplier will develop, implement, and maintain a process
to coordinate root cause analysis activities required to diagnose, analyze, recommend, take corrective measures across the Services, and provide reports on root cause analyses (“Root Cause Analysis Services”). Supplier will
staff the Root Cause Analysis Services with appropriate roles in order to see Root Causes Analysis activities to conclusion. In addition to root cause analyses related to the operations, Supplier will perform all root cause analyses required by
Health Net regulators (and within the timeframes specified by Health Net regulators) that relate to the Services. These Root Cause Analysis Services shall also include the Functions associated with Problem Identification and Resolution performed as
part of the IT Services set forth in SOW #4 (IT Services). 
  

	3.8	Managed Third Party Contract Services 

 “Managed Third Party
Contract” means a contract in the name of Health Net or a Health Net Affiliate used in support of the Services or complimentary to the Services (including those Managed Third Party Contracts set forth in Schedule O (Health Net
Provided Resources) and those third party contracts identified through Exhibit A of SOW #4 (IT Services). 
 “Managed
Third Party Contract Services” means the Functions associated with managing the Managed Third Party Contracts in place as of the Effective Date and entered into by Health Net after the Effective Date . Health Net shall have the right to
add additional Managed Third Party Contracts by sending written notice to Supplier. 
 Supplier shall provide the Managed Third Party
Contract Services with respect to the Managed Third Party Contracts, including the following activities: 
  

	 	(a)	Performing commercial Functions including: 

  

	 	(i)	Understanding contractual commitments in the Managed Third Party Contracts. 

  

	 	(ii)	Serving as primary point of contact with Health Net for interpretation and modification of contracts with third party suppliers. 

  

					
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	 	(iii)	Authorizing scope changes, project work and obtaining and documenting all requisite approvals to establish an appropriate audit trail, within Health Net guidelines for Managed Third Party Contracts. Any such scope
changes as well as exceptions to Health Net guidelines will require Health Net’s prior written approval before any work is performed. If no guidelines are established for a specific Managed Third Party Contract, Supplier will consult with
Health Net regarding any such scope change. 

  

	 	(iv)	Revising Managed Third Party Contracts to reflect changes in scope, new services, service levels and other conditions upon prior approval by Health Net, including those related to formal change requests.

  

	 	(v)	Performing general administrative tasks associated with Managed Third Contracts, including maintaining records and documentation related to Managed Third Contracts, recording decisions in contract files.

  

	 	(vi)	Maintaining Health Net-provided copies of all Managed Third Party Contracts (or a Health Net-provided summary of the pertinent information contained in each Managed Third Party Contract), including such contracts that
expire during the Term, in a secure, online location accessible to designated individuals at both Health Net and Supplier. 

  

	 	(vii)	Monitoring license usage and maintaining compliance with the terms of third party licenses (ie., the number of licenses and scope of licenses) and including performing the Functions set forth in subtask 2.7.4
(Configuration and Asset Management) of SOW #4 (IT Services) Exhibit A-1-1 (Process Definitions). 

  

	 	(viii)	Escalating and resolving issues and disputes related to the Managed Third Party Contracts, and referring matters to Health Net legal where appropriate. 

 

	 	(ix)	Overseeing the performance of Managed Third Party Contracts, striving to (i) maximize the operational and financial performance of such contracts (from Health Net’s perspective) and (ii) minimize risk to
Health Net from the performance of such contracts. Supplier’s responsibilities include: 

  

	 	(A)	Monitoring Managed Third Party Contract performance with respect to all material contractual requirements directly related to the provision of products or services and tracking and reporting on service levels or similar
performance metrics included in the applicable contract; 

  

	 	(B)	Coordinating work performed under the Managed Third Party Contracts between Supplier and Supplier’s Subcontractor(s); 

  

	 	(C)	Validating assessments, calculations, and if Health Net elects to receive credits related to service level failures, the timely payment of such credits and other similar types of credits and rebates under Managed Third
Party Contracts; provided, however, that execution and escalation on service level failures, or application of credits and rebates, will be in cooperation with Health Net; 

  

					
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	 	(D)	Monitoring the compliance with any service levels contained in the applicable Managed Third Party Contract; Notifying Health Net of material failure to perform in accordance with the provisions of its Managed Third
Party Contract; 

  

	 	(E)	Notifying Health Net promptly if (i) there are performance failures or other issues regarding contractual responsibilities related to any Managed Third Party Contract, or (ii) there are issues with a Managed
Third Party Contract adversely affecting the Services or Health Net (or its Affiliates), 

  

	 	(F)	Evaluating and recommending retention, modification, or termination of a Managed Third Party Contract based on the performance or cost benefits to Health Net as tracked by Supplier; and 

 

	 	(G)	Monitoring Managed Third Party Contract adherence to compliance activities, including auditing and training. 

  

	 	(x)	Providing assistance with Managed Third Party Contract negotiations as required. 

  

	 	(b)	Performing financial contract management Functions including: 

  

	 	(i)	Managing contract and order pricing; 

  

	 	(ii)	Reviewing third party supplier invoices to confirm validity and accuracy; 

  

	 	(iii)	Assigning applicable financial coding or other coding; 

  

	 	(iv)	Managing invoice discrepancies and disputes; and 

  

	 	(v)	Submitting processed invoices for payment. 

  

	 	(c)	Performing contract order management Functions including: 

  

	 	(i)	Maintaining third party supplier catalogs; 

  

	 	(ii)	Obtaining/placing orders for goods and services; 

  

	 	(iii)	Tracking and managing orders; 

  

	 	(iv)	Advising applicable process owners of problems with orders; 

  

	 	(v)	Managing receipt and acceptance/rejection (and return) of delivered goods and services; and 

  

	 	(vi)	Notifying the applicable financial management function of accepted and rejected deliveries. 

  

					
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	3.9	Reporting and Analytics Services 

 “Reporting and Analytics
Services” means those Functions associated with producing management reports, operational and performance indicators, and information in a form that will allow Health Net to focus on business outcomes leveraging market capabilities. The
Reporting and Analytics Services include all forms of reporting and analytics including web analytics. The objective of this service is to provide the Parties with real time access to information that will enable optimal performance of the Services
and continuous improvement. The Reporting and Analytics Services employ advanced techniques to derive risks, opportunities and insights from the information to support Health Net’s business and strategic decision making. The Reporting and
Analytics Services include: 
  

	 	(a)	Continuing to provide the same reporting and analytics capabilities that exist as of the BPaaS Services Commencement Date; 

  

	 	(b)	Identifying applicable sources of data or information and enabling Health Net real time access to all such sources; 

  

	 	(c)	Providing Health Net with real time performance monitoring (in read only access) that is no less robust than that which Health Net provides as of the Effective Date; 

 

	 	(d)	Extracting and collating data; 

  

	 	(e)	Reporting on outcome based metrics related to the Services; 

  

	 	(f)	Reporting on end to end function level metrics; 

  

	 	(g)	Analyzing data and summarizing findings related to a specific business issue or problem; 

  

	 	(h)	Developing applicable modeling methodologies to assess specific business issues or problems; 

  

	 	(i)	Performing trend analysis and modeling; 

  

	 	(j)	Using results of analyses to assist Health Net to develop business strategies and solutions; and 

  

	 	(k)	Responding to and fulfilling regulatory, ongoing, and ad hoc requests for reports from regulators or other business areas. 

  

					
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 In addition to the Monthly Performance Report defined in Schedule G-3 (Management
Reporting) the Reporting and Analytics Services include creating and providing Health Net with access to a dashboard that reflects on Supplier’s performance with respect to each of the Service Levels (including Compliance Measures)
(“Dashboard”). Supplier shall provide the initial version of the Dashboard as defined in Schedule R (Critical Deliverables). Information on the Dashboard shall be updated on a daily basis. The Dashboard (including the
type of information provided, format, and layout of the Dashboard) shall be subject to the prior written approval of Health Net. Supplier shall make such changes to the Dashboard as Health Net requests, including requests made during the Term after
the initial approval of the Dashboard. The Dashboard shall include the following: 
  

	 	(i)	Interactive capability that will permit Health Net to drill down on metrics; 

  

	 	(ii)	Ability to create custom views; 

  

	 	(iii)	Ability to extract reports; 

  

	 	(iv)	Messaging capability to question results; 

  

	 	(v)	Corrective Action Plan (CAP) for any Service Level that has been missed. 

 The Reporting and
Analytics Services detailed in this Section 3.10 do not limit Supplier’s reporting obligations specified elsewhere in this Agreement including in Schedule G. 
  

	3.10	User Acceptance Testing Services 

 “Testing Services” mean the
Functions associated with coordinating testing activities related to the Services, including user acceptance testing (e.g., support for Health Net’s testing in connection with a system release), with Health Net users including the following
activities: 
  

	 	(a)	Coordinating User Acceptance Testing with Health Net users; 

  

	 	(b)	Developing valid business requirements for test script development by retained departments; 

  

	 	(c)	Coordinating access to test environments for Health Net testers; 

  

	 	(d)	Supporting data preparation needs within the test environments, i.e. system support for entry of BPaaS area of data needed for test script execution; 

 

	 	(e)	Preparing required documentation artifacts related to user acceptance testing, including appropriate redactions; 

  

	 	(f)	Reporting of test results and tracking and resolution of issues and defects; 

  

	 	(g)	Coordinating with third parties on file exchanges or other inputs/outputs; 

  

	 	(h)	Overseeing user acceptance testing; 

  

					
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	 	(i)	Coordinating with system releases, including on-site presence during release ‘go-live’ dates when necessary; and 

  

	 	(j)	Support of system rollouts. 

  

	3.11	Return Mail Processing Services 

 “Return Mail Processing” are
the Functions associated with processing and correcting correspondence (including notification letters, checks, EOBs) that were returned to Health Net by the post office and routed to Cognizant from Health Net’s mail intake Function, including
the following activities: 
  

	 	(a)	Receiving and processing all mail onshore after physical receipt of returned mail from Health Net’s mail intake Function; 

  

	 	(b)	Handling and processing return mail and corrections to names and addresses consistent with Health Net department’s policies and procedures; 

 

	 	(c)	Researching and correcting the address and name that was utilized for the original mailing; 

  

	 	(d)	Where possible/permitted, updating the applicable System(s) with the correct mailing information; 

  

	 	(e)	For all returned mail related to contracted Providers, forwarding all findings to the Provider Network Department (PNM) for review; 

  

	 	(f)	For Medicare, researching the change of address, updating the Beneficiary record, and perform all other Functions required by Health Net and Laws for the following categories of returned mail: 

 

	 	(i)	All returned Beneficiary materials that were originally generated and sent by Supplier in accordance with this Agreement; 

  

	 	(ii)	Returned Beneficiary materials not originally generated and mailed by Supplier by accepting and processing address update files from Caremark ` and sending the CMS required Beneficiary letter reminding Caremark to
contact SSA to update their address; and 

  

	3.12	Inventory Management Services 

 “Inventory Management” are the
Functions associated with creating and maintaining a daily accurate accounting of all inventories and transactions, reporting to Health Net production and inventory numbers (including aged claim statistics), and attending meetings to discuss
volumes, issues, and other operational topics, including the following activities: 
  

	 	(a)	Performing inventory control and management; 

  

	 	(b)	Creating and maintaining a daily accurate accounting of transactional inventories, including enrollments and other eligibility related transactions received, “in process” (i.e. transactions received, but not
considered “complete” in the core system.) and transactions completed and inventory aging statistics; 

  

					
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	 	(c)	Utilizing daily inventory management reports to control and maintain inventory within compliance and business service levels; 

  

	 	(d)	Making all daily and cumulative monthly inventory management reports available to Health Net; and 

  

	 	(e)	Providing access to daily inventory reports / systems and cumulative monthly inventory management reports to Health Net. 

  

	3.13	Collection of Funds Services 

 “Collection of Funds Services”
means the Functions associated with collecting, depositing, and processing of all monies collected by Supplier personnel for or on behalf of Health Net on a daily basis into the applicable Health Net bank account. Such amounts shall not at any time
be deposited in or held in any other account of Supplier or any of its other customers. All funds shall at all times be the sole property of Health Net or the applicable Health Net Affiliate. All monies in the Health Net bank account(s) shall not be
subject to any lien, charge, security interest, right of offset or setoff or any other rights or encumbrances due to any act or omission of Supplier. As standard practice, all funds should be directed to be deposited to an approved Health Net bank
account, however, if such funds are misdirected or received by Supplier then Supplier shall follow the Collection of Funds Services outlined in this Section 3.14. 
  

	3.14	Issue and Error Resolution Services 

 “Issue and Error
Resolution” means the Functions associated with resolving all issues related to the Services that are identified by Supplier’s Quality Assurance Services set forth in Statement of Work #5 (Quality Assurance Services), Health
Net’s internal audit, customer complaints, any errors identified by regulators, or in Section 3.8 above, or any other Health Net or Supplier quality assurance activities, including the following: 

 

	 	(a)	Reviewing requests to correct errors; 

  

	 	(b)	Correcting all errors in the applicable Systems; and 

  

	 	(c)	Timely reporting to Health Net on the Issue and Error Resolution. 

 These Issue and Error
Resolution Services shall also include the Functions associated with Problem Identification and Resolution performed as part of the IT Services set forth in SOW #4 (IT Services). 

 

	3.15	Integration Services 

 “Integration Services” mean the Functions
associated with integrating third party services into the Health Net Technology Platform including creating new EDI interfaces and third party pricer feeds, subject to Schedule H (Change Control). Changes to existing third party interfaces or
the addition of new interfaces will not result in additional Charges to Health Net unless a particular change or addition to the third party interfaces meets the Material Change threshold set forth in Section 8 (Material Changes) of
Schedule C (Charges). 

  

					
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	3.16	Translation Services 

 “Translation Services” mean the Functions
associated with coordinating for the translation of written and verbal communications in accordance with Health Net Policies, including the following activities: 
  

	 	(a)	Overseeing all translation needs across towers and in accordance with any Service specific translation requirements set forth in each Statement of Work; 

 

	 	(b)	Receiving requests from Members, Providers or Lines of Business for translation of a written or verbal communication; 

  

	 	(c)	Prior to using a Health Net approved third party translator, determining if translated materials already exist; 

  

	 	(d)	Determining if a translation request is in compliance with Health Net Policy and regulatory requirements; 

  

	 	(e)	Escalating any requests that fall outside of Health Net Policy or regulatory requirements; 

  

	 	(f)	Contacting one of Health Net’s approved third party translators to have the translation request fulfilled; and 

  

	 	(g)	Managing the budget, billing and allocation cost of third party translation services allocation across each tower. 

  

	4	EMBEDDED PROCESSES 

  

	4.1	General 

 To the extent Supplier is responsible for performing a particular Function
(either as identified in Section 3 of this Schedule A (Cross Functional Services) or in any SOW, then Supplier is responsible not only for performing the indicated Function, but also for providing the resources necessary to perform such
Function and any other Functions and responsibilities described in this Section 4.1 as they may relate to such Function (the “Embedded Processes”). 

 

	4.2	Embedded Processes 

 The Embedded Processes include: 

 

	 	(a)	Developing the procedures underlying the Function, subject to and in compliance with Health Net regulatory requirements and in alignment with Health Net Policies as defined in Schedule P (Policies) and the requirements
of this Agreement so as to enable the Services to function cohesively and in a coordinated manner; 

  

	 	(b)	Performing the activities comprising the Function in accordance with Health Net Policies as defined in Schedule P (Policies) and the requirements of this Agreement; 

 

	 	(c)	Except as provided in Schedule O (Health Net Provided Resources), providing and maintaining the necessary non-human resources (e.g., hardware, property, plant, supplies, software, tools, infrastructure) and human
resources (including to provide training) to perform the Function; 

  

					
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	 	(d)	Retaining all financial, operational and administrative responsibility for the Function, including the resources necessary for its performance; 

 

	 	(e)	Performing the required activities necessary to manage the Function, including (i) supervising and reporting, including reporting to other personnel within the Function, (ii) measuring and reporting on the
performance of the Function (or parts thereof) to other Health Net, its Affiliates, other Service Recipients or anyone else requested by Health Net, and (iii) developing and distributing operational reporting related to the Function, including
any reporting related to the Service Levels; 

  

	 	(f)	Managing documents and data (including data acquisition, data entry, data recording and data distribution) related to the Function; 

  

	 	(g)	Coordinating with Health Net business units as necessary to perform the Services; 

  

	 	(h)	Performing “self audits” of the Function, including testing the (i) accuracy, reliability and quality of work, (ii) compliance with approved policies and procedures, and (iii) performance and
correction of any issues identified during such audits and reporting of self audit results; 

  

	 	(i)	Participating in internal and external audits; 

  

	 	(j)	Engineering the Function, including performing those actions necessary to maintain or improve the underlying activities based on (i) then-current best practices, and (ii) how it is intended to interact with
other activities performed by Supplier or by Health Net; Notifying Health Net as required of output or other findings or information developed or learned through the Function, including notifying Health Net of the readiness for activities to be
performed by Health Net that are necessary to either complete or progress a Function being performed by Supplier; 

  

	 	(k)	Responding to queries and requests concerning activities associated with the performance of the Function, including making the applicable subject matter experts, documentation and other relevant content available as
necessary to be responsive; 

  

	 	(l)	Handling all aspects of incidents and problems relevant to the Functions, including (i) receiving notification of and resolving incidents and problems, (ii) providing Health Net with updated information
regarding the status of such incidents and problems and the associated resolution efforts, (iii) escalating incidents and problems that cannot be resolved, and (iv) responding to requests from Health Net; 

 

	 	(m)	Interacting and coordinating as needed with Health Net, including (i) integrating the Function with the activities of Health Net such that the overall delivery of services is optimized (i.e., not sub-optimized
within the confines of the Function), and (ii) monitoring the activities performed by Health Net to mitigate negative impact on the Function; 

  

	 	(n)	Researching and planning for new products, open enrollment (Commercial), AEP (Medicare), and Duals including by (i) participating in Health Net information gathering initiatives (i.e., by providing access to former
Health Net Personnel rebadged as part of this Agreement), (ii) assisting with the development of requirements definitions, and (iii) supporting the analysis and testing of new products; 

  

					
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	 	(o)	Supporting Health Net’s sales and marketing processes including responding to prospective or existing Customer requests for proposals (RFPs), providing access to Supplier Facilities and Supplier Personnel as part
of any prospective or existing Customer requests, and providing Health Net with all information concerning the Services or delivery of the Services as (i) reasonably requested by the prospective or existing Customer, (ii) required by
Health Net for the purpose of responding to an RFP, or (iii) necessary to support the Health Net sales and marketing process (e.g., sales pitches) 

  

	 	(p)	Providing advice and guidance on the Function to Health Net (e.g., best practices, operational issues, impact from other activities) so as to enable Health Net to optimize the linkages of its activities with the
Function being performed by Supplier; Adhering to the applicable documentation standards; and 

  

	 	(q)	Providing information to support any Health Net Investigations (including Health Net’s special investigation unit) or threatened, pending or commenced litigation against Health Net related to the Services.

  

					
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 SCHEDULE A-1 

CROSS-FUNCTIONAL SERVICES SOLUTION DOCUMENT 

  

					
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 SCHEDULE A-1 

CROSS-FUNCTIONAL SERVICES SOLUTION DOCUMENT 

TABLE OF CONTENTS 
  

							
	 1.
		INTRODUCTION		 	1	  
	 2.
		BUSINESS CONTINUITY & DISASTER RECOVERY SERVICES		 	2	  
	 3.
		TRAINING SERVICES		 	3	  
	 4.
		DOCUMENTATION SERVICES		 	6	  
	 5.
		ENTERPRISE RISK MANAGEMENT SERVICES		 	9	  
	 6.
		REGULATORY COMPLIANCE ADHERENCE SERVICES		 	13	  
	 7.
		INNOVATION SERVICES		 	20	  
	 8.
		ROOT CAUSE ANALYSIS SERVICES		 	22	  
	 9.
		MANAGED THIRD PARTY CONTRACT SERVICES		 	25	  
	 10.
		REPORTING AND ANALYTICS SERVICES		 	30	  
	 11.
		USER ACCEPTANCE TESTING		 	32	  
	 12.
		RETURN MAIL PROCESSING SERVICES		 	34	  
	 13.
		INVENTORY MANAGEMENT SERVICES		 	36	  
	 14.
		COLLECTION OF FUNDS SERVICES		 	37	  
	 15.
		ISSUE AND ERROR RESOLUTION AND REPORTING SERVICES		 	38	  
	 16.
		INTEGRATION SERVICES		 	40	  
	 17.
		TRANSLATION SERVICES		 	42	  

  

					
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SCHEDULE A-1 

CROSS-FUNCTIONAL SERVICES 

SOLUTION DOCUMENT 
  

	1.	INTRODUCTION 

 Health Net has engaged Supplier to deliver End-to-End Services in an
outcome based service, delivery model for multiple Health Net lines of business. The initial LOBs to be supported are Individual, Commercial, Medicaid, Medicare and Duals with the potential for additional LOBs during the Term. Each LOB will be
supported by the Services (as set forth in Exhibit A of each SOW) combined and enabled through a transforming market relevant Application Platform and Infrastructure. Supplier will deliver these services under this Agreement. 

The Cross-Functional Services are as specified in Schedule A (Cross Functional Services). This Schedule A-1 (Cross Functional
Services Solution Description) describes Supplier’s solution and approach for delivery of the Cross Functional Services. 
 The
Cross-Functional Solution includes capabilities for the following Services: 
  

	 	•	 	Business Continuity and Disaster Recovery Services, 

  

	 	•	 	Training Services, 

  

	 	•	 	Documentation Services, 

  

	 	•	 	Enterprise Risk Management Services, 

  

	 	•	 	Regulatory Compliance Adherence Services, 

  

	 	•	 	Innovation Services, 

  

	 	•	 	Root Cause Analysis Services, 

  

	 	•	 	Managed Third Party Management Services, 

  

	 	•	 	Reporting and Analytics Services, 

  

	 	•	 	User Acceptance Testing Services, 

  

	 	•	 	Return Mail Processing Services, 

  

	 	•	 	Inventory Management Services, 

  

	 	•	 	Collection of Funds Services, 

  

	 	•	 	Issue and Error Resolution Services, 

  

	 	•	 	Integration Services, 

  

	 	•	 	Translation Services. 

  

					
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Cross Functional Services performed by Health Net as of the Effective Date provide a level of capability referred to as the “As-Is”
capability. The Cross Functional Services will be evolved from the As-Is capability to an improved way of delivering the Services referred to as the “To-Be” as a result of certain Transition and Transformation activities set forth in the
Transition Manual. This Schedule A-1 (Cross Functional Services Solution Description) describes Supplier’s To-Be approach for performing the Cross Functional Services. Specific processes and procedures for executing the Cross Functional
Services will be documented and maintained as part of the Procedures Manual. 
  

	2.	BUSINESS CONTINUITY & DISASTER RECOVERY SERVICES 

 Business Continuity Planning
(BCP) and Disaster Recovery (DR) Services are a Cross Functional Service as the function involves a solution that spans all towers and impacts Services defined across all SOWs. The following Schedules contain information related to the requirements,
solution and approach, and transition for the BCP and DR Services: 
  

	 	•	 	Schedule A (Cross Functional Services): Contains requirements for BCP/DR Services 

  

	 	•	 	Schedule A-1-1 (Business Continuity and Disaster Recovery Solution) 

  

	 	•	 	Schedule A-4 (Supplemental Business Continuity and Disaster Recovery Requirements) 

  

	 	•	 	Schedule Q (Security Requirements) 

 Refer to Schedule A-1-1 (Business Continuity and
Disaster Recovery Solution) for the solution and approach to meet the requirements outlined in Schedule A (Cross Functional Services), Schedule Q (Security Requirements) and A-4 (Supplemental Business Continuity and Disaster
Recovery Requirements). 

  

					
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	3.	TRAINING SERVICES 

 The Training Services includes functions associated with curriculum
development, planning, scheduling and delivery of training to staff performing delivery of the Services. Training is linked to improving performance, developing new skills, adherence to regulatory/compliance regulation. 

 

	3.1	Overall Approach 

 Supplier will follow industry standard human resource practices to
manage service related Training Services as performed for the Services. 
 The Training Model will be set up as shown in the diagram below:

  
 

 
  

	 	(a)	Skill Gap Assessment: 

  

	 	•	 	All resources will be mapped to the skills for their level and the next level for their role, 

  

	 	•	 	Supplier will perform personnel competencies verification, 

  

	 	•	 	The results will reflect, by resource, the gap in skill for the resource’s current job level and the next level, 

  

	 	•	 	Supplier will review the audit findings for gaps in training material or policy and procedure and update accordingly, 

  

	 	•	 	Supplier will also assess the gaps in the Supplier training staff capabilities. 

  

	 	(b)	Develop training material: 

  

	 	•	 	Training requirements will be divided into process and soft skills, 

  

	 	•	 	For domain training, Healthcare Boot Camp Training will be used to induct new team members for Healthcare specific processes, 

  

					
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	 	•	 	For process training, the desktop procedures created by operation teams will be reviewed to ensure they are as per defined procedures & formats and all new changes & updates are being documented,

  

	 	•	 	Training curriculum and material to bridge the gap for the current level and ‘up-skilling’ will be identified for every resource including on Regulatory, Compliance, HIPAA Privacy and Security related aspects,

  

	 	•	 	Training curriculum and material will be created for gaps identified in audits, 

  

	 	•	 	Other than process training, gaps in soft skills, e.g., communication, leadership, etc. will be addressed by customizing the standard Supplier training programs. 

 

	 	(c)	Training delivery: 

  

	 	•	 	Training sessions will be organized for resources that have on boarded or per their individual training plan, 

  

	 	•	 	The Policies and Procedures will be used in the initial and refresher training sessions and will also be used to serve as reference material for resources on the job, 

 

	 	•	 	Training calendar will be created and updated related to process training and soft skills development, 

  

	 	•	 	Training staff will be trained using internal and external resources, 

  

	 	•	 	Training reports will be published to include attendance, course completion, etc., 

  

	 	•	 	Training will be provided on researching, responding to, tracking and reporting privacy related incidents. 

  

	 	(d)	Training Effectiveness: 

  

	 	•	 	New Supplier Personnel supporting the Services will undergo and successfully complete the boot camp training, 

  

	 	•	 	Training technology, methodologies, courses, content and approach will be reviewed and updated on a regular basis, 

  

	 	•	 	Testing of associates that have undergone training will be conducted to ensure that associates have learned and can apply what they have learned, 

 

	 	•	 	Supplier will measure the impact of training on service level performance, productivity improvements, etc. 

  

	3.2	Delivery Location 

 During Phase 2, Supplier will deliver the Cross Functional Training
Services primarily from Woodland Hills, Rancho Cordova and San Rafael. During Transition, Supplier will gradually build training teams in India and Manila to coincide with the movement of staff to offshore locations. It is the intent to have
trainers co-located with the staff for ongoing training to deliver the Services as well as onboarding of new staff. Prior to Phase 3 the Supplier will move any remaining Training Services from Health Net facilities to Supplier service delivery
location. 

  

					
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	3.3	Staffing Considerations 

 Supplier will staff Training Services with a dedicated team
while leveraging SME’s from each Tower as needed. 
  

	3.4	Hours of Coverage 

  

					
	 Training Services
		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided necessary to meet Schedule A (Cross- Functional Services)
requirements.

  

	3.5	Tools 

 The Learning Management System (LMS), or equivalent, as provided by Health Net.

  

	3.6	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
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	4.	DOCUMENTATION SERVICES 

 Documentation Services includes functions associated with the
life cycle management of documents, specifically the cataloguing, archiving, retrieval, and destruction of paper and electronic documents, in adherence with Health Net’s Record Information Management (RIM) procedures. 

 

	4.1	Overall Approach 

 During execution of the Services, Supplier will classify documents
according to the procedures outlined in Health Net’s RIM process as outlined as follows: 
  

	 	•	 	Supplier will also identify documents that are to be archived and retained, 

  

	 	•	 	For paper documents, Supplier will coordinate with Health Net staff to catalog and package documents for offsite storage using Health Net’s Managed Third Party Contract with Iron Mountain or other vendor designated
by Health Net, 

  

	 	•	 	Retrieval will be accomplished via the Iron Mountain Connect service/tool, or equivalent provided by Health Net, 

  

	 	•	 	For electronic documentation. Supplier will retain document files per RIM procedures. Archival and destruction will be accomplished via coordination and approval steps with and by Health Net, 

 

	 	•	 	The Supplier will archive Documentation consistent with RIM Procedures as well as submit request for authorization to destroy documents to the Heath Net Document Manager and execute accordingly. 

 

	4.2	Delivery Process and Methods 

 The Cross Functional Document Services will provide
coordination across Towers and consistency of delivery as relating to the Services. 
 Supplier’s Solution will include: 

 

	 	•	 	Classifying documents adhering to Health Net RIM policy, 

  

	 	•	 	Identifying retention period for specific hard copy and electronic documents, 

  

	 	•	 	Identifying documents to be archived periodically to offsite storage location, 

  

	 	•	 	Coordinating with Health Net staff to catalog and package documents for shipment to offsite storage location, 

  

	 	•	 	Utilizing automated tools to retrieve documents, as needed to support the Services, from offsite storage, 

  

	 	•	 	Identifying documents or electronic information to be destroyed per retention policies and coordinating with Health Net to obtain proper approvals prior to destruction, 

 

	 	•	 	Adhering to Health Net policies related to legal hold and records management, 

  

					
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	 	•	 	Notifying of any process changes to Documentation coordinators across the Towers, 

  

	 	•	 	Destroying documents and / or electronic information as authorized by Health Net, 

  

	 	•	 	Escalating issues or inconsistencies identified by Health Net and / or the Supplier for correction, 

  

	 	•	 	Developing detailed procedures for producing, catalogue management, storing, retention, retrieval and deletion of the documents as part of the Procedures Manual, 

 

	 	•	 	Ensuring the document management process is consistently deployed across all towers, 

  

	 	•	 	Ensuring that user rights are defined in the desktop procedure and will conduct audits to ensure compliance, 

  

	 	•	 	Conducting training on regular intervals for all resources working on document management tool and processes to ensure that the staff is adequately trained on procedures and policies, 

 

	 	•	 	Updating procedures regularly (at least annually) or as needed to incorporate any changes, 

  

	 	•	 	Auditing the document management process to ensure adherence to applicable policies. 

 Health
Net Responsibilities will include: 
  

	 	•	 	Reviewing and approving the detailed procedure created by Supplier for document management in the Procedures Manual as defined in Schedule R (Critical Deliverables), 

 

	 	•	 	Providing the third party service for physical shipment and retrieval of documents to and from offsite storage location, 

  

	 	•	 	Providing the automated document management tool to be utilized by Supplier and Health Net for retrieval of archived documents, 

  

	 	•	 	Providing the retention policy to the Supplier. 

  

	4.3	Delivery Location 

 Supplier will deliver the Cross Functional Document Services from all
locations where hard copy and electronic documents are created and maintained, including the Woodland Hills, Rancho Cordova, and other facilities put into operation during the Term. Supplier will leverage Health Net’s offsite storage locations.
Prior to Phase 3, the Supplier will move personnel performing Cross Functional Documentation Services from Health Net facilities to a Supplier Service Delivery Center near the Health Net Woodland Hills location. 

 

	4.4	Staffing Considerations 

  

	 	•	 	Supplier will identify a Document Manager to be the centralized contact to coordinate document management services across towers. Supplier anticipates this to be a part time role in addition to other responsibilities
within the centralized team. 

  

	 	•	 	In addition, Supplier will identify an individual within each tower who will be responsible to coordinate document archival for their service area and to function as a single point of contact for the centralized
Document Manager as well as for Health Net for their service area. This document management responsibility within the tower will be a part time role in addition to their other responsibilities to deliver Services within the tower. 

  

					
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	4.5	Hours of Coverage 

  

					
	 Documentation Services
		08:00 am to 5:00 pm		Ad-hoc after hour support will be provided necessary to meet Schedule A (Cross-
Functional Services) requirements.

  

	4.6	Tools 

 Iron Mountain Connect, or equivalent tool as provided by Health Net for catalog
and retrieval of documents in offsite storage. 
  

	4.7	Reliance and/or Constraints Associated with Third Parties 

  

	 	•	 	Iron Mountain Connect, or equivalent tool as provided by Health Net for catalog and retrieval of documents in offsite storage, 

  

	 	•	 	Managed Third Party Contract with Iron Mountain, or equivalent as provided by Health Net, 

  

	 	•	 	Reliance on Health Net-provided vendor who handles intake of paper claims with responsibility for Documentation Services as it relates to the paper documents. 

  

					
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	5.	ENTERPRISE RISK MANAGEMENT SERVICES 

 In support of Health Net’s Enterprise Risk
Management team (ERM), Supplier will work with Health Net’s Enterprise Risk Officer to identify existing and emerging risks to the fulfillment of the Services. Supplier will support the process to address risks that have been raised via a
variety of channels, including identification of risks by Health Net’s team, Supplier Risk Officer, and Supplier teams within the towers who are responsible for delivery of the Services. Supplier will support risk assessments, and take
necessary steps to monitor, report, re-assess, and mitigate identified risks. 
  

	5.1	Overall Approach 

 Supplier will support Health Net’s Enterprise Risk Management
program, including applicable policies and procedures. Health Net’s risk framework will be used to define how Supplier will conduct and document risk assessments and mitigation strategies in coordination with Health Net. The framework will also
be utilized to mitigate and monitor existing and emerging risks and to report such exposures, as well as mitigation plans, for visibility to appropriate stakeholders, owners, and executive leadership. 

 
 

 

  

					
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	5.2	Delivery Process and Methods 

 Risk assessment processes will be established and adhered
consistently across the towers and coordinated through a centralized Supplier function. The Supplier Risk Officer will: 
  

	 	•	 	Be the single point of contact for the Health Net Risk Officer as well as a leader providing oversight and direction for internal Supplier teams who are integral to the process. 

 

	 	•	 	Work with Supplier teams to identify current and emerging risks identified during performance of the Services. 

  

	 	•	 	Collect and collate risks as identified by Supplier and provides material risk to the Health Net Enterprise Risk Officer as input to the Enterprise Risk Management process. 

 

	 	•	 	Supports the entire life cycle of each material risk, including identification of emerging drivers of risks, maintenance of the risks inventory, assignment of owners responsible for creating and executing mitigation
plans, monitoring and status reporting on mitigation activities, and ensuring proper focus to ensure risks are actively mitigated to the fullest extent possible. 

Supplier will leverage the inherent relationship that exists between the Issues and Error Resolution Services, Root Cause Analysis
(“RCA”) and Enterprise Risk Management to provide a robust solution to risk management: 
  

	 	•	 	Where a tower level issue is determined to be material enough to cause an Enterprise risk, an RCA and corrective action plan will become part of the risk description and the mitigation strategy, 

 

	 	•	 	Where Issues and Errors are identified by either the Quality Assurance Process or the Audit Process and are material enough to cause an Enterprise risk an RCA performed will be performed and a corrective action plan
will be developed. 

 Supplier will work with Health Net to both manage the mitigation of the risks identified by Health Net as
well as the agreed material risks raised by the Supplier. 
 Supplier will include the following in its Solution: 

 

	 	•	 	Adopting Health Net’s Enterprise Risk Management framework to ensure that risks are being properly identified, assessed, monitored and reported at an enterprise level, 

 

	 	•	 	Mitigating and managing the risk exposures as part of the day to day operational processes at the tower level, 

  

	 	•	 	Identifying events (an important realistic threat that exploits a significant applicable vulnerability) with a potential negative impact on the goals or operations of the enterprise, including events that are market
driven, regulatory, financial, legal, technological, involving third parties and operational aspects, 

  

	 	•	 	Assessing on a recurring basis the likelihood and impact of identified risks, using qualitative and quantitative methods. The likelihood and impact associated with inherent and residual risk should be determined
individually, by risk category including by not limited to operational, technology applications, infrastructure, third party contracts associated with the delivery of all Services, 

  

					
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	 	•	 	Developing and maintaining a risk mitigation process designed to ensure that cost-effective controls mitigate exposure to risks on a continuing basis. The risk mitigation process should identify risk strategies such as
avoidance, reduction, determine associated responsibilities; and consider Health Net’s tolerance levels for material risks, 

  

	 	•	 	Prioritizing and planning the control activities at all levels to implement the risk mitigation strategies, including mitigation goals and responsibility for execution, 

 

	 	•	 	Evaluating Third Party Managed Services deemed material in nature for enterprise risks, financial viability, technical currency, and marketplace reputation and reliance for Health Net’s consideration in the overall
Risk Inventory, 

  

	 	•	 	Establishing operational risk management committees with representation from delivery head, tower leads and resources across all delivery locations, 

 

	 	•	 	Defining a governance model to ensure the committees meet on periodic intervals to serve as a forum to track, report and rectify potential risk concerns and manage any risk, 

 

	 	•	 	Monitoring execution of the plans, and report on any deviations to senior management; and 

  

	 	•	 	Participating in Health Net’s Risk Management Committee and/or Task/Force if requested by Health Net. 

Health Net will engage the Supplier in the Enterprise Risk Management program to both manage the mitigation of the risks identified by Health
Net as well as the agreed material risks raised by the Supplier. 
 Heath Net will have the following responsibilities: 

 

	 	•	 	Providing an opportunity to the Supplier leadership team to have an representation in the risk committee and operation risk review forum, 

 

	 	•	 	Providing support and resolution as needed to execute mitigation plans where there are dependencies with Health Net retained responsibilities under the Agreement. 

 

	5.3	Delivery Location 

 Enterprise Risk Management services will be supported by individuals
across all facilities in all delivery locations. The Enterprise Risk Officer will be onshore, with an offshore counterpart located in India. Prior to Phase 3, the Supplier will move personnel performing Cross Functional ERM Services from Health Net
facilities to a Supplier Service Delivery Center. 
  

	5.4	Staffing Considerations 

 Supplier will staff a Supplier Risk Officer who will be
dedicated in a full time capacity to perform the duties outlined in this section. In addition, there will be a Risk Lead identified in each tower who will function in a part time capacity as the single point of contact for the Supplier Risk Officer
for their respective tower. 

  

					
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	 	•	 	The Risk Leads support all aspects of ERM services at the tower level including aggregation, identification, assessment, impact determination, mitigation strategies and plans, monitoring of status, and reporting risk
information as appropriate. 

  

	 	•	 	The Risk Leads have responsibility to manage risks specific to their tower – as well as the responsibility for enterprise level risks impacting their tower. Supplier SMEs and other resources also support the entire
risk lifecycle as it relates to their assigned responsibility to execute the Services. 

  

	5.5	Hours of Coverage 

  

					
	 Enterprise Risk

Management Services
		08:00 am to 5:00 pm		Ad-hoc /after hour support will be provided necessary to meet Schedule A (Cross-
Functional Services) requirements.

  

	5.6	Tools 

  

	 	•	 	Enterprise Risk Inventory as owned and maintained by Health Net 

  

	 	•	 	Tower level Risk Inventory as owned and maintained by Supplier 

  

	5.7	Reliance and/or Constraints Associated with Third Parties 

  

	 	•	 	None. 

  

					
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	6.	REGULATORY COMPLIANCE ADHERENCE SERVICES 

 Supplier will build a quality and effective
Compliance Program to support the Services which is based upon industry best practices, benchmarks, and Supplier’s extensive background and familiarity with health care regulations and the foundational work and example set by Health Net. The
Compliance Program is an essential tool for promoting regulatory compliance for operations and ethical conduct, and which enforces the detection, prevention, and resolution of non-compliant and illegal conduct, including fraud, waste or abuse. The
core elements of the Regulatory Compliance Adherence Services will include the following seven essential elements: 
  

	 	•	 	Conducting Internal Auditing and Monitoring, 

  

	 	•	 	Implementing written policies, procedures and standards of conduct, 

  

	 	•	 	Responding promptly to detected offenses and developing Corrective Action Plans, 

  

	 	•	 	Developing effective lines of communication, 

  

	 	•	 	Conducting effective training and education, 

  

	 	•	 	Enforcing Standards through well-publicized disciplinary guidelines, 

  

	 	•	 	Designating Compliance Officer and Compliance Committee. 

  

	6.1	Overall Approach 

 Supplier will assign a Compliance Officer to oversee and manage the
Supplier Compliance Program for Services provided under this Agreement. The Supplier Compliance Officer will manage and oversee all aspects of Compliance for delivery of the Services. The Supplier Compliance Officer will report, in a timely fashion
and in conformance with timeframes established by Health Net, incidents of suspected or identified noncompliance to Health Net’s Compliance Officer. 

Supplier’s Compliance Officer will provide information as required by Health Net’s Compliance Officer to ensure that Health
Net’s Boards of Directors are appropriately apprised of compliance issues and risks. Supplier will develop a comprehensive Compliance Plan that will be a written document describing the specific manner in which the Compliance Program elements
will meet the standards for all lines of business. Specific procedures to execute the functions required of the Compliance Plan 
 will be
documented as part of the Procedures Manual. 
 Supplier’s Compliance Plan will be reviewed and revised at least annually and align with
Health Net’s compliance plans for each line of business. If there are changes in regulatory requirements or changes to Health Net and Supplier business processes, the Compliance Plan will be modified throughout the year to reflect current Laws
and business practices serving as the means of documentation of record and approach to be in compliance. The Compliance Plan will also include ongoing risk assessment and issue event response procedures so the program will respond in near real time
to regulatory issues that arise, and have the capability to deploy appropriate resources where and when needed. The Compliance Plan will include processes for assessing the effectiveness of the Compliance Program, through the use of effective,
two-way communications self-audit, feedback mechanisms, and reporting metrics. 

  

					
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 Supplier will be accountable and have responsibility for ensuring compliance of all Services
as of the BPaaS Services Commencement Date. Health Net will be the responsible party for performing the final interpretation of Compliance rules as they impact BPaaS operations and will provide specific requirements to Supplier’s services teams
to implement within the BPaaS scope. During Phase 1, Supplier will support Health Net’s compliance activities and become familiar with Health Net’s compliance processes. Supplier will build controls or leverage existing controls in all
operational areas to maintain compliance with all applicable Laws as well as compliance expectations and requirements as determined by the Health Net Compliance Officer. 

Supplier will provide operational dashboards and alerts to Health Net management. The Supplier’s Compliance Officer will work to align
development plans necessary to address the Changes Laws and directives as interpreted by Health Net. 
 Supplier will actively engage and
maintain effective lines of communications with Health Net’s Compliance Office and ensure information needed by Health Net compliance, legal and regulatory staff to provide information and support responding to any regulator requests is
provided within the requested time periods to Health Net. Supplier will support all audits from state and federal agencies or their designees, as well as internal and external audits. 

The Supplier acknowledges and recognizes that Health Net is responsible for ensuring Health Net compliance with applicable Law and Regulations.
As such, Health Net will be responsible for interpreting new and modified Laws regarding the impact on performance of the Services. Health Net will also provide specific requirements regarding these Laws and the Supplier will implement within the
scope of Services consistent with Health Net’s interpretation and requirements. Health Net will continue to have direct responsibility for interacting with State and Federal Regulators. Supplier will participate in such meetings at the request
of Health Net. 
 Supplier will incorporate and adopt, whenever possible, Health Net’s Compliance Framework including Health Net’s
Code of Business Conduct and Ethics and all other applicable policies and procedures. Supplier will support the basic tenet of that framework such that leadership of each tower understands and takes accountability for the implementation and
adherence to these standards, procedures and Laws in addition to working collaboratively with the Suppliers Compliance Officer to meet the requirements outlined through the Agreement. 

The Supplier Compliance Officer will coordinate activities at an enterprise level, engaging responsible parties within the towers to achieve,
monitor, and maintain compliance. In addition, the Supplier intends to adopt Health Net’s Medicare Compliance Plan and various associated compliance policies and procedures. 

 

	6.2	Delivery Process and Methods 

 Supplier will create a Compliance Office within the
organizational structure that will be responsible for the following essential services: 
  

	 	•	 	Developing Compliance policies and procedures, 

  

	 	•	 	Monitoring to ensure guidelines and standards are being followed, 

  

	 	•	 	Initiating and manage compliance projects, 

  

	 	•	 	Reporting on status of compliance activities, 

  

					
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	 	•	 	Self-identification (self-reporting and self-audits) and the subsequent implementation of corrective actions, 

  

	 	•	 	Participation on compliance committee. 

 The Compliance Office will take direction from Health
Net’s Compliance Office on the interpretation and impact on the Services or Health Net’s departments of new Laws or changes to existing, state, and federal regulations. In addition, under Health Net’s direction the Compliance Office
will participate in external audits and interact with regulators from the DMHC, CMS, DMHCS, HHS, etc., or their designee. 
 The Compliance
Office, led by the Supplier Compliance Officer, will manage compliance related aspects for the ongoing performance of the Services. The Compliance Office will develop or adopt policies and procedures and audits to ensure that all Supplier areas are
following the guidelines and standards documented and established by Health Net. This will include the following activities: 
  

	 	•	 	Implementing written policies, procedures and standards of conduct related to Health Net’s interpretation of Laws into Policy supported by Procedures, 

 

	 	•	 	Conducting Compliance education and training to the in-scope resources thereby enabling them to understand and conduct their duties consistent with Laws and Regulations, 

 

	 	•	 	Providing for effective communication with Supplier Personnel related to Health Net’s interpretations and policy decisions, 

  

	 	•	 	Enforcing Standards through well-publicized disciplinary guidelines linked to education and training, monitoring and audit functions. 

The Supplier will monitor Services to oversee and measure that Compliance guidelines and standards are being followed. From time to time,
Regulatory Agencies or other interested parties may request reports or responses to their inquiries from Supplier. Such requests will need to be managed by the Suppliers Compliance Office under the direction of Health Net’s Compliance Office.

 Health Net’s Compliance Office will be the overall responsible party in responding to Regulatory requests with direct support from
the Supplier Compliance Officer and Tower Leads ensuring that the associated supporting documentation are accurate and available on a timely basis. As directed by Health Net, the Suppliers Compliance Office will respond to requests and create
reports for regulators or other third parties such as but not limited to the following: 
  

	 	•	 	Notice of Non-Compliance, Corrective Action Plans, or mitigation requests from any Regulatory agency (CMS, DMHC, DCHS, DOI), 

  

	 	•	 	Complaints filed with any of the Regulatory agencies, 

  

	 	•	 	Complaints related to sales and marketing issues, 

  

	 	•	 	Secret Shopper issues and findings identified by CMS, 

  

	 	•	 	Clarification of risks as identified in the OIG work plan, 

  

	 	•	 	Audit findings from any Regulatory agency (CMS, DMHC, DHCS, DOI), 

  

					
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	 	•	 	Member “touch points” such as Appeals & Grievances, Claims, Member Services, 

  

	 	•	 	Corrective Action Plan follow-up. 

 The Compliance Office will participate in responding to
Regulatory requests and ensuring that the associated supporting documentation are accurate and available on a timely basis. The Compliance Office may also be periodically required to respond to requests and create reports for Employer Groups or
other third parties. 
 Because it is essential that the Compliance Office is continuously updated about pending changes in Compliance
standards or metrics, the office will participate in CMS’s annual Call Letter, receive CMS bulletins directly, compliance (HHS + CMS) webinars, conferences, and in-person hearings. For avoidance of doubt, the Compliance Office will not
(i) represent Health Net in any way in any of these activities (e.g., indicating that Supplier is participating in a meeting or conference call on behalf of Supplier, and, (ii) act on any changes in Compliance standards or metrics without
direction from Health Net. Health Net’s Compliance Office has the sole responsibility for final determination of the interpretation of any regulatory requirement. 

The initiation and management of compliance projects is necessary to meet Health Net’s interpretation of Law and Regulations. The
Supplier’s Compliance Officer will provide Health Net with project plans and status reports about the progress of all regulatory projects. The actual management of those projects will be performed by Supplier teams under the responsibility of
the Supplier’s Compliance Officer. Supplier’s Compliance Officer will keep Health Net abreast of the currents progress of these projects. 

The Supplier will monitor and audit critical elements of a Compliance Program while each year Health Net’s Compliance Officer determines
which Compliance-related elements will be used to develop the metrics for evaluating performance against regulatory standards. Supplier operational teams on behalf of Health Net will perform these monitoring and auditing activities including the
necessary reporting. 
 The Supplier will provide reports and information that allows Health Net to identify areas that may require
corrective action in order for the Health Net to achieve compliance with specific regulatory requirements. 
 The Supplier operational teams
will perform audits and reporting with subsequent implementation of corrective actions to enable Health Net’s overall Compliance. The Supplier’s Compliance Office will lead the overall program and follow up to ensure that corrective
actions plans to address identified risks are effectively implemented (including enforcing disciplinary actions where necessary). 
 The
Supplier will provide education and training for its personnel necessary related to Compliance 
 Laws and Health Net Policies. 

The Supplier Compliance Officer will attend the appropriate Health Net compliance committees to respond to questions or provide details on
audits or corrective action plans. 
  

	6.3	Supplier Compliance Standards 

 Supplier associates will be trained upon on-boarding and
annual re-certifying on Code of Conduct and Ethics. Specific Supplier employee related job training & certifications will include the following: 
  

	 	•	 	OIG and GSA Background checks prior to employment and monthly thereafter for all Medicare and Medicaid associates, 

  

					
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	 	•	 	Health Net required compliance training (as revised and updated during the Term) including: 

  

	 	•	 	Mandatory for all Supplier Personnel and must be completed within 30 days of the date the Supplier Personnel is assigned to the Health net account and annually thereafter: 

 

	 	•	 	Health Net General Compliance Program (within 30 days of the date the Supplier Personnel is assigned) 

  

	 	•	 	HIPAA Basic Privacy and Security 

  

	 	•	 	The following training programs are mandatory for all Supplier Personnel and must be completed within 60 days of the Effective Date or the date the Supplier Personnel is assigned to the Health Net account and annually
thereafter: 

  

	 	•	 	The Painful price of Health Care and Pharmaceutical Fraud (within 60 days of hire), 

  

	 	•	 	Health Net Code of Business Conduct and Ethics, 

  

	 	•	 	Record Information Management Training (previously Getting the Records Straight), 

  

	 	•	 	Access provided to all Supplier Personnel to a Supplier 24X7 Hotline to report Compliance / Ethics issues. 

  

	6.4	HIPAA Compliance 

 Supplier associates will also be trained on HIPAA regulations,
including enterprise responsibilities related to HIPAA and individual responsibilities. Compliance training will include the following: 
  

	 	•	 	HIPAA Privacy and Security 

  

	 	•	 	Supplier security policies map to PHI mandates, 

  

	 	•	 	Administrative: Policy and Procedures necessary to detect, contain and correct security violations, Privacy Officer for Compliance, training modules & Contingency plans, 

 

	 	•	 	Physical: Workstation rules and standard configuration settings, Control on usage of portable devices, 

  

	 	•	 	Technical: Data encryption, Access Controls and Internal Audits. 

  

	6.5	Supplier’s Corporate Compliance Audits 

 Supplier is familiar with Regulatory
mandates, compliance and auditing. The following are examples of Supplier’s current standards as of the Effective Date: 
  

	 	•	 	SAS 70 / SSAE 16 Audit, 

  

	 	•	 	SOX & Security Audit, 

  

	 	•	 	ISO Surveillance. 

  

					
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 Supplier resources will conduct training courses as required at a corporate level by the
Supplier organization, including, but not limited to, HIPAA Training, Acceptable Use Policy, and Code of Conduct, in addition to the required Health Net required training courses. 

 

	6.6	Self-Reporting 

 Supplier will utilize the Cognizant Corporate Compliance Hot Line and
associated policies and procedures, which articulates its commitment to comply with all applicable laws and regulations. Any material items will be reported to Health Net immediately. 

As a policy, Supplier culture and workplace environment is based on individual integrity, ethical behavior and non-retaliation of reported
incidents or breaches by employees. 
  

	6.7	Delivery Location 

  

	 	•	 	During Phase 2, the Supplier Compliance Officer will be located in Rancho Cordova and Woodland Hills to facilitate establishment of the Supplier Compliance Program. During Phase 3, specific members of the Compliance
Office may be co-located with service delivery teams where it is determined to be preferable. 

  

	 	•	 	Close proximity is needed between the Health Net Compliance Office, the Supplier Compliance Office, and the Supplier delivery staff located both onshore and offshore who have compliance responsibilities. Members of the
Compliance Office will be strategically placed to ensure optimum coordination by embedding Compliance team members offshore when appropriate. 

  

	6.8	Staffing Considerations 

  

	 	•	 	The design of the Supplier Compliance organization is intended to mirror the Health Net Compliance Office in terms of alignment of responsibility to specific roles and individuals. 

 

	 	•	 	Counterparts within the respective organizations will facilitate the coordination between the two Compliance organizations and help them to work in tandem. 

 

	 	•	 	Supplier will hire a full time Compliance Officer as the counterpart to Health Net’s Compliance Officer. The Supplier Compliance Office will include the following full time positions: 

 

	 	•	 	Compliance Officer, 

  

	 	•	 	Compliance Lead – Medicare, 

  

	 	•	 	Compliance Specialist – Medicare (2), 

  

	 	•	 	Compliance Lead – Medicaid, 

  

	 	•	 	Compliance Specialist – Medicaid (1), 

  

	 	•	 	Compliance Lead – Commercial, 

  

	 	•	 	Compliance Specialist – Commercial (2). 

  

					
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	 	•	 	In addition to the full time Compliance Office, Supplier will identify a Business Compliance Consultant (BCC) within each tower who will be the primary point of contact for the Compliance Leads for coordination and
execution of compliance functions performed at the tower level. 

  

	 	•	 	Additional members will be added to the compliance office during Transition and over the Term as needed to successfully execute the Compliance Program. 

 

	6.9	Hours of Coverage 

  

					
	Regulatory Compliance Adherence Services		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided necessary to meet Schedule A (Cross- Functional Services) requirements.

  

	 	•	 	Supplier Compliance Ethics and Fraud and Abuse Hot-Lines will be available 24 by 7. 

  

	6.10	Tools 

 Tools currently used by the functional teams in support of Compliance will
continue to be utilized. 
  

	6.11	Reliance and/or Constraints Associated with Third Parties 

 While there are third parties
engaged in keeping the Services compliant (Optum, for example), there are no specific third party reliance or constraints as it pertains to the management of Regulatory Compliance Adherence Services. 

  

					
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	7.	INNOVATION SERVICES 

 The intent of the Innovation Services is to provide guidance for
the Road Map and operational transformation of Services compared to the marketplace resulting in market relevant and commercially viable products / services. 
  

	7.1	Overall Approach 

 In addition to continuous improvement to the Services the Supplier
will develop and annually update an Innovation Plan that will be the basis for material improvements to the Services over the Term. 

Development of the Innovation Plan will involve an assessment of market trends, challenges, and capabilities in the market space, including
market advancements, changing and evolving legislative drivers, competitive capabilities, as well as existing and emerging opportunities. The Innovation Plan will include benchmarks within the industry that can be used to measure efficiency and
maturity of the Services. 
 The Innovation Plan will include targeted improvements, priorities, and recommendations that can be evaluated
for inclusion in: 
  

	 	•	 	The Road Map and/or, 

  

	 	•	 	Discretionary projects, 

  

	 	•	 	Non-Discretionary projects 

 with the goal of capitalizing on opportunities to continually
mature and innovate the Services. 
  

	7.2	Delivery Process and Methods 

 Supplier will assess the marketplace using a scoring
system to rate the capability and maturity of the Services as compared to existing capabilities of competitors within the marketplace as well as emerging capabilities and needs within the industry. 

The market place assessment will be evaluated against current capabilities as well as with the Road Map, Discretionary and Non-Discretionary
project to determine material gaps that exist and the extent to which they are bridged by adopting the recommendations documented in the Innovation Plan. Supplier will engage Health Net in the development and evaluation of the Innovation Plan in
order to align priorities and particular areas of interest as input to the plan. 
 Innovation Services will include the following
activities: 
  

	 	•	 	Monitoring and improving service delivery methods and identify weaknesses and opportunities for evolution and improvement to the service delivery methods while systematically implement those innovations,

  

	 	•	 	Monitoring industry trends, including through independent research, and document and report on products and services with potential application for Health Net on a quarterly basis, 

 

	 	•	 	Developing an innovation plan that will be reviewed annually to include: 

  

					
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	 	•	 	Identifying general and industry specific business, technical and medical trends and forecasts that inform both the Supplier and Health Net of new opportunities that could be used to improve medical, financial or
experiential outcomes; 

  

	 	•	 	Identifying business challenges facing the Health Care Industry and Heath Net relative to Health Net’s stated business goals and objectives; 

 

	 	•	 	Categorizing disruptive technological or scientific advances and their expected timeframes for practical (e.g., economically feasible) application of future advances within the context of Health Net’s business and
the Services; 

  

	 	•	 	Reporting on the current STARs, HEDIS and NCQA rating for the Services over the previous year and a plan for improving each rating during the upcoming year; 

 

	 	•	 	Identifying STARS goals for the upcoming year for each measure, initiatives to achieve the goals, and correlating metrics to track progress and inform that goals are on track; and 

 

	 	•	 	Maintaining a rolling two year forecast outlining specific improvements in techniques, methods, processes or technologies that Supplier will implement to deliver ongoing Innovation within the scope of the Services and a
list of prioritized recommendations as to how Health Net could take advantage of opportunities to innovate in areas related to the Services. 

  

	7.3	Delivery Location 

 Innovation Services will be supported by individuals across all
facilities in all delivery locations. During Phase 2, the Innovation Lead will be onshore, with a counterparts in each tower in corresponding location of service delivery for each tower. Prior to Phase 3, the Supplier will move any remaining
Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 
  

	7.4	Staffing Considerations 

 The Innovation Lead will be a part time role with support from
SMEs at the tower level. 
  

	7.5	Hours of Coverage 

  

					
	Innovation Services		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided necessary to meet Schedule A (Cross- Functional Services) requirements.

  

	7.6	Tools 

 None. 
  

	7.7	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
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	8.	ROOT CAUSE ANALYSIS SERVICES 

 Supplier’s solution will use a Root Cause Analysis
(RCA) process that will ensure the resolution of issues designated for inclusion in the RCA including the identification and correction of root cause associated with any systemic issues until they are fully resolved while preventing reoccurrence.

  

	8.1	Overall Approach 

 The intent of the Root Cause Analysis Services is to thoroughly
resolve issues through identification and resolution of root causes and to proactively identify systemic issues before they adversely impact delivery or outcomes of the Services. Issues that are candidates for Root Cause Analysis may come from many
different sources, including issues identified during the course of delivery of the Services, issues logged in the Issue/Error Resolution process, issues identified through regulatory and audit processes, and many other sources. 

Supplier will perform Root Cause Analysis (RCA) using a process that includes diagnosing, analyzing, recommending, and taking corrective
measures across the Services. It is essential that RCA be performed across towers (i.e., not in a silo approach) to be effective. Supplier will maintain a centralized team that will monitor the Root Causes Analysis activities to conclusion. 

The Root Cause Analysis solution will ensure improvement in efficiency and effectiveness by proactively identifying potential problems before
these become trends and analyzing root causes of incidents once sources of the problem is uncovered. Supplier will perform an in-depth and formal RCA for critical issues and escalated issues or incidents. 

 

	8.2	Process and Delivery Methods 

 Root Cause Analysis will be performed using industry
standard practices. Supplier will conduct weekly Cross Functional meetings with representatives across the towers to review identified issues, identify and analyze root cause, and discuss progress towards resolution of root cause. Supplier will
participate in meetings related to RCA with Health Net as needed to address RCA across the enterprise as needed. 
 Meetings will increase in
frequency as needed, including daily and multiple times each day during peak periods. During these meetings, call drivers will be analyzed, identifying systemic issues in upstream processes. 

Supplier will establish a centralized RCA function to manage and oversee activities across the towers. 

The Supplier Solution includes the following: 
  

	 	•	 	Collecting issues from multiple sources, including proactive search for issues that are candidates for Root Cause Analysis, 

  

	 	•	 	Maintaining catalog of issues requiring Root Cause Analysis, 

  

	 	•	 	Identifying owners responsible for RCA for each issue, 

  

	 	•	 	Developing solution / corrective action, 

  

	 	•	 	Monitoring status from identification to resolution, 

  

	 	•	 	Documenting and reporting issues and root cause for compliance related issues within required timeframes. 

  

					
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 Supplier will periodically meet with Health Net to refine the process and monitor progress.
As required by Health Net, Supplier will include representatives from other areas of Health Net (e.g., Provider Network Management Department). 

Specific procedures to perform the Root Cause Analysis function will be documented in the Procedures Manual. Identifying and categorizing all
issues that need RCA including the following activities: 
  

	 	•	 	Assessing the impact of the incident, 

  

	 	•	 	Gathering data and other information required for the RCA, 

  

	 	•	 	Performing RCA for all identified issues, 

  

	 	•	 	Creating a corrective action plan to address and resolve the root cause while working to prevent recurrence of the incident, 

  

	 	•	 	Providing RCA status reporting including action items, 

  

	 	•	 	Performing root cause analysis as required by Health Net regulators in the required time frames, 

  

	 	•	 	Monitoring and report on success of RCA solutions implemented, 

  

	 	•	 	Analyzing incidents and RCA to identify trends, 

  

	 	•	 	Analyzing trending to proactively identify, diagnose and correct recurring problems, and performance degradation and identify associated consequences, 

 

	 	•	 	Tracking, diagnose and report recurring incidents, problems and failures, and performance degradation, 

  

	 	•	 	Leveraging trending analysis methods and techniques to eliminate issues before they become problems. 

  

	8.3	Delivery Location 

 The centralized function of Root Cause Analysis Services will be
performed primarily from Woodland Hills and Rancho Cordova. Additional support will be provided from all delivery teams across all towers that reside in all delivery locations both onshore and offshore. Prior to Phase 3, the Supplier will move any
remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 
  

	8.4	Staffing Considerations 

 The Supplier will establish a dedicated Project Management
Office (PMO) that will include staff responsible to manage the Root Cause Analysis Services across the towers. The PMO will include full time dedicated resources that will include Root Cause Analysis as one of their responsibilities. 

  

					
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 Resources within each tower will be engaged as it relates to Root Cause Analysis impacting
their specific tower. 
  

	8.5	Hours of Coverage 

  

					
	 Root Cause Analysis

Services
		08:00 am to 5:00 pm		
Ad-hoc /after hour support will be provided necessary to meet Schedule
A (Cross-
 Functional Services) requirements.

  

	8.6	Tools 

 Existing Dashboards (i.e., Excel Spreadsheets) will continue to be used with
plans to improve and mature the capability with a more robust tool during Transition. Focus of improvement in the area will include more direct point of capture of issues such that there is more data captured that can be used for identification of
commonalities and root cause. 
  

	8.7	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
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	9.	MANAGED THIRD PARTY CONTRACT SERVICES 

 As of the BPaaS Services Commencement Date,
Supplier will manage Managed Third Party Contracts on behalf of Health Net as set forth in Section 3.8 (Managed Third Party Management Services) of Schedule A (Cross Functional Services). 

 

	9.1	Overall Approach 

 The portfolio of Managed Third Party Contracts is as set forth in
Schedule A and will be segmented into either BPaaS scope with the intent to re-contract before Phase 3 (where applicable) or Non-BPaaS. Whether Supplier will subsequently re-contract directly with vendor will be guided by the terms as outlined in
Schedule O (Health Net Provided Resources). Some contracts that are extremely large such as IBM and AT&T will be managed by a dedicated team and have specific financial objectives associated with oversight and optimization as called out
in Schedule C (Charges). Managed Third Party Contracts is subject to the terms relating to the Use of Health Net Resources as outlined in Section 11.2(d) of the Terms and Conditions. 

Managed Third Party Contracts will be managed by Supplier beginning on the Services Commencement Date. Any third party contracts that are
procured by the Supplier prior to the Service Commencement Date will be managed from the effective date of that agreement. Contracts that are shared across BPaaS and non-BPaaS will either be split or agreed with Health Net to remain in the
appropriate category for management as a combined entity with the intent of greater cost savings and management efficiency. The remaining Non-BPaaS managed contracts will be under the governance and control of Health Net. Supplier will help Health
Net look for opportunities to optimize and reduce costs. 
 Supplier will manage third party services to help ensure BPaaS SLAs will be met.
Supplier will focus on establishing a relationship with Health Net and bilateral responsibilities with qualified third-party service providers and monitoring the service delivery to verify and ensure adherence to SLAs, and underpinning contracts.
This will be achieved by identifying and categorizing services, identifying and mitigating risk and monitoring and measuring performance 
  

	9.2	Process and Delivery Methods 

 The Managed Third Party Contract management team will
liaise and communicate directly with technical and subject matter expertise in the Health Net retained organization and also report to the commercial and service integration team from a portfolio management and cost standpoint. 

For the BPaaS portfolio, each contract will be evaluated and recommendations will be made to Health Net based upon review of the results. When
applicable as outlined in Schedule O (Health Net Provided Resources), Supplier will determine if a contract already exists with Supplier that could be leveraged and, if not, look to negotiate appropriate terms and conditions for the Supplier
to contract for the services directly. 
 Supplier may choose to use the same or similar solution as Health Net is currently using or in some
cases may consider replace the technology or service component with something different but comparable allowing Health Net to terminate current services. 

Depending on the category of third party services, different expertise and tools will be leveraged. There will be a central contract repository
which will be the database for each contract to be managed by Supplier. While Supplier continues to manage the Managed Third Party Contracts, the original 

  

					
	Schedule A-1		A-1-25		Health Net / Cognizant Confidential

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 Health Net contracts will be maintained by Health Net. Linked to this database will be other
Supplier interactions which may be pertinent to the review process. Copies of all contracts and notes on key terms, conditions and licensing will be linked to the database. 

Reporting will be created that forecasts, at the individual or portfolio level depending on agreed, “Hard Cap” or gain sharing
agreements actual costs vs. baseline costs and performance. Compliance reports will be created to document license usage and to ensure no third party contracts are in violation of stated licensing requirements or guidelines. 

Managed Third Party Management Services activities for both BPaaS and Non-BPaaS Health Net Contracts include: 

 

	 	•	 	Identification of all suppliers services, and categorizes them according to supplier type, significance and criticality. Maintain formal documentation of technical and organizational relationships covering the roles and
responsibilities, goals, expected deliverables, performance track record of past and current issues, escalations, and resolutions, 

  

	 	•	 	Performance monitoring to ensure compliance with contract terms and conditions, SLAs, 

  

	 	•	 	Recommendations and resolution of issues related to non-compliance, 

  

	 	•	 	Monitoring license usage and maintaining compliance with the terms of third party licenses as defined in subtask 2.7.4 (Configuration and Asset Management) of SOW#4 Exhibit A-1-1 (Process Definitions),

  

	 	•	 	Tracking and managing orders, third-party catalog management throughout Phase 2 and Phase 3 for any remaining contracts that remain with Health Net, 

 

	 	•	 	Monitoring performance to ensure compliance with contract terms and conditions as well as SLAs, 

  

	 	•	 	Managing financial obligations such as reviewing invoices for discrepancies, submitting processed invoices for payment, resolution of billing and invoices disputes, etc., 

 

	 	•	 	Identifying and managing fee reductions and incentives, based on performance information and Agreement terms, 

  

	 	•	 	Managing risks through mitigation to ensure services are delivered securely, efficiently and effectively meeting Health Net SLAs. Identify and mitigate risks relating to suppliers’ ability to continue effective
service delivery in a secure and efficient manner on a continual basis, 

  

	 	•	 	Escalating to Health Net known risks and areas of non-compliance, 

  

	 	•	 	Ensuring that contracts conform to universal business standards in accordance with legal and regulatory requirements, 

  

	 	•	 	Monitoring service delivery to ensure that the supplier is meeting current business requirements and continuing to adhere to the contract agreements and SLAs, and that performance is competitive with alternative
suppliers and market conditions. 

  

					
	Schedule A-1		A-1-26		Health Net / Cognizant Confidential

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 Health Net retains final decision making authority for any contracts that are managed on
their behalf until such time they are procured by the supplier and the corresponding service is terminated by Health Net and the provider. 
  

	9.3	Delivery Location 

 The centralized function of Managed Third Party Management Services
will be performed primarily from Woodland Hills and Rancho Cordova. Additional delivery and execution support will be provided from all delivery teams across all towers that reside in all delivery locations both onshore and offshore. Prior to Phase
3, the Supplier will move any remaining Third Managed Party Management Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 

 

	9.4	Staffing Considerations 

 For contracts managed by Supplier, Supplier will designate a
Contract Manager as a single point of contact for Managed Third Party Contract Management Services. Contract Manager would be responsible for leading and owning the day-to-day decisions related to contract administration and negotiations pertaining
to the services as identified and set forth in the Agreement. He/she will coordinate the contract negotiations/renegotiations to accommodate scope Changes, Changes to business requirements as identified by Health Net, and the management of Contract
Change requests. 
 For contracts managed by Supplier, Individual portfolio leads will handle the specific negotiations and optimization of
services based on the segmentation of the overall inventory of suppliers. These portfolio teams will report directly to the Contract Manager and PMO. During Phase 1, the team will be established and the dedicated portfolio leads will have team
members who will each manage a section of the in scope contracts with objectives to review, optimize and close terms and conditions as defined. Each portfolio lead will leverage the virtual support of the following resources: 

 

	 	•	 	Legal support for review and compliance, 

  

	 	•	 	Alliance support services for major partners where applicable, 

  

	 	•	 	Sourcing specialists to optimize buying power and cross client leverage, 

  

	 	•	 	Technical Subject Matter Experts to review accuracy, 

  

	 	•	 	Technical program management to measure and forecast pricing and outcomes, 

  

	 	•	 	Product management across scope of services. 

 Supplier and Health Net Contract Management and
Contract portfolio teams will work closely with procurement and legal counsel from both sides and follow Change Control procedures as outlined in Schedule H (Change Control Process) to: 

 

	 	•	 	Create, negotiate and incorporate amendments into the Agreement, 

  

	 	•	 	Coordinate the Agreement negotiations/renegotiations to accommodate scope changes or changes to business requirements per the contract change management process. Any such scope changes as well as exceptions to Health
Net guidelines will require Health Net’s prior written approval before any work is performed, 

  

	 	•	 	Obtaining and documenting all requisite approvals to establish an appropriate audit trail, within Health Net guidelines for Managed Third Party Agreements. 

  

					
	Schedule A-1		A-1-27		Health Net / Cognizant Confidential

 Final 
  

 Managed Third Party Contract activities include: 

 

	 	•	 	Identification of all suppliers services, and categorizes them according to supplier type, significance and criticality. Maintain formal documentation of technical and organizational relationships covering the roles and
responsibilities, goals, expected deliverables, performance track record of past and current issues, escalations, and resolutions, 

  

	 	•	 	Leading and facilitating contract agreement activities from agreement signing through transition and ongoing operations (e.g., Interface for contractual change implementation), 

 

	 	•	 	Performance monitoring to ensure compliance with contract terms and conditions, SLAs, 

  

	 	•	 	Recommendations and resolution of issues related to non-compliance, 

  

	 	•	 	Monitoring license usage and maintaining compliance with the terms of third party licenses as defined in subtask 2.7.4 (Configuration and Asset Management) of SOW#4 Exhibit A-1-1 (Process Definitions),

  

	 	•	 	Tracking and managing orders, third-party catalog management throughout Phase 2 and Phase 3, 

  

	 	•	 	Monitoring performance to ensure compliance with contract terms and conditions as well as SLAs, 

  

	 	•	 	Managing financial obligations such as reviewing invoices for discrepancies, submitting processed invoices for payment, resolution of billing and invoices disputes, etc., 

 

	 	•	 	Identifying and managing fee reductions and incentives, based on performance information and Agreement terms, 

  

	 	•	 	Managing risks through mitigation to ensure services are delivered securely, efficiently and effectively meeting Health Net SLAs. Identify and mitigate risks relating to suppliers’ ability to continue effective
service delivery in a secure and efficient manner on a continual basis, 

  

	 	•	 	Escalating to Health Net known risks and areas of non-compliance, 

  

	 	•	 	Ensuring that contracts conform to universal business standards in accordance with legal and regulatory requirements, 

  

	 	•	 	Monitoring service delivery to ensure that the supplier is meeting current business requirements and continuing to adhere to the contract agreements and SLAs, and that performance is competitive with alternative
suppliers and market conditions. 

  

	9.5	Hours of Coverage 

  

					
	 Managed Third Party

Management Services
		08:00 am to 5:00 pm		
Ad-hoc /after hour support will be provided

necessary to meet Schedule A (Cross-

Functional Services) requirements.

  

					
	Schedule A-1		A-1-28		Health Net / Cognizant Confidential

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	9.6	Tools 

 To be developed 

 

	9.7	Reliance and/or Constraints Associated with Third Parties 

 As defined by each Third
Party Agreement. 

  

					
	Schedule A-1		A-1-29		Health Net / Cognizant Confidential

 Final 
  

	10.	REPORTING AND ANALYTICS SERVICES 

 Supplier will provide Health Net with data, tools and
reports; operational and performance indicators; and other information deemed necessary by Health Net in order for Health Net to assess its business and Supplier service performance. 

 

	10.1	Overall Approach 

 Supplier will approach Reporting and Analytics in three stages. Stage
1 will continue the current capabilities and tools that Health Net leverages today with the intent of producing the same information as of the Service Commencement Date. Stage 2 will focus on the requirements gathering and design of a Service
Performance Reporting capability. Stage 3 will commence 6 months post the implementation of the Stage 2 and will focus on the requirements gathering and design of performance analytics for the Services and SLA associated with the Agreement. The
market analysis research, solution/capability analysis, and resulting recommendations specific to Health Net will be documented for inclusion in the Innovation Plan. Stage 2 and Stage 3 are key input to the Innovation Plan and will feed directly
into the improvement plans and Innovation Services process outlined in Schedule A-1 (Cross Functional Services Solution Description). 
  

	10.2	Process and Delivery Methods 

 Supplier will use tools and methods available as of the
BPaaS Service Commencement Date to: 
  

	 	•	 	Continuing with same reporting format as at the time of execution of the Agreement. Any changes to the content and format must be pre-approved by Health Net, 

 

	 	•	 	Providing reports based on ad-hoc and on-going requests, 

  

	 	•	 	Analyzing the data to identify trends and potential risks. The output of this exercise will be added to the monthly and quarterly management reports, 

 

	 	•	 	Leveraging the performance reports and the results of the trend analysis to assist Health Net develop business strategies and solutions. 

As part of Stage 2, the Supplier will implement a Service Reporting tool that enables the Supplier to create reporting and dashboards for
performance, joint situational awareness and governance meetings and end to end service delivery management. 
 Supplier will also provide
other inputs to Stage 2 (reporting) and Stage 3 (analytics) as input to the Innovation Plan providing comparison with market peers and industry trends as input to market and Industry capabilities related to performance reporting for like services in
the marketplace. 
  

	10.3	Delivery Location 

 Supplier will deliver the Cross Functional Reporting and Analytics
Services initially from Woodland Hills and/or Rancho Cordova facilities as determined by the Supplier. Phase 3 the Supplier will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near
Health Net’s headquarters. 
  

	10.4	Staffing Considerations 

 The Supplier will establish a Reporting and Analytics team that
will work across all towers to perform Reporting and Analytic Services. SMEs from individual towers will support these efforts as needed. 

  

					
	Schedule A-1		A-1-30		Health Net / Cognizant Confidential

 Final 
  

	10.5	Hours of Coverage 

  

					
	 Reporting and Analytics

Services
		08:00 am to 5:00 pm		 Ad-hoc / after hour support will be provided 

necessary to meet Schedule A (Cross- 

Functional Services) requirements.

  

	10.6	Tools 

 To be determined during performance of the Services. 

 

	10.7	Reliance and/or Constraints Associated with Third Parties 

 To be determined during
performance of the Services. 

  

					
	Schedule A-1		A-1-31		Health Net / Cognizant Confidential

 Final 
  

	11.	USER ACCEPTANCE TESTING 

  

	11.1	Overall Approach 

 Cross Functional User Acceptance Testing includes those functions
associated with planning, coordinating, and executing testing activities related to the Services with appropriate members of the Health Net retained organization. User Acceptance Testing methods and procedures are outlined in Schedule J (Project
Framework). 
  

	11.2	Processes and Delivery Methods 

 Supplier will coordinate and manage Cross Functional UAT
Services for new and modified functionality as part of the system life cycle prior to the release into the production environment. 
 During
the requirements gathering phase, UAT Coordinators and Business Analysts within the Supplier organization will perform the following functions: 
  

	 	•	 	Determining the scope of testing that will be required, 

  

	 	•	 	Identifying who within the retained organization will be involved in the testing phase for the set of requirements, 

  

	 	•	 	Coordinating with the testers in the retained organization as they develop their own test cases to be executed during the testing phase of the project, 

 

	 	•	 	Determining what needs to be in the UAT environment for the specific testing effort, including surround and core systems. 

During the build phase, UAT Coordinators and Business Analysts within the Supplier organization will perform the following functions: 

 

	 	•	 	Coordinating and managing the that test scripts are written, 

  

	 	•	 	Identifying synergies that can be achieved across a particular release, 

  

	 	•	 	Coordinating access administration to the testing systems, 

  

	 	•	 	Providing training for the testers in the business area, 

  

	 	•	 	Overseeing the preparation and loading of test data into the environments in the proper sequence so it is available when ready to test, 

 

	 	•	 	Establishing a sequenced plan for data loads and batch cycles to support testing efforts, 

  

	 	•	 	Overseeing and managing testing completion per plan, 

  

	 	•	 	Prioritizing defect resolution to enable testing progress, 

  

	 	•	 	Updating dashboards for reporting progress of UAT, 

  

	 	•	 	Managing and coordinate “go-live” phase activities including: 

  

					
	Schedule A-1		A-1-32		Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Performing testing immediately prior to the release to confirm there are no defects being staged into production, 

  

	 	•	 	Monitoring system functionality and performance onsite during cutover to the new release (typically during off hours), 

  

	 	•	 	Ensuring successful cutover into production, 

  

	 	•	 	Environment planning, including when the test environments can be decommissioned. 

  

	11.3	Delivery Location 

 Supplier staff performing the coordination directly with testers in
the retained organization will be co-located with the Health Net staff in on shore locations during Phase 2. Specific functions related to UAT planning, data loads, and the like may be performed in India and Manila. Prior to Phase 3, the Supplier
will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 
  

	11.4	Staffing Considerations 

 Supplier will have a dedicated team for Cross Functional User
Acceptance Testing Services coordinating all User Acceptance Testing. 
  

	11.5	Hours of Coverage 

  

					
	 User Acceptance Testing

Services
		08:00 am to 5:00 pm		 Ad-hoc / after hour support will be provided

necessary to meet Schedule A (Cross-

Functional Services) requirements.

  

	11.6	Tools 

 Testing Dashboard currently being used by Health Net. 

 

	11.7	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
	Schedule A-1		A-1-33		Health Net / Cognizant Confidential

 Final 
  

	12.	RETURN MAIL PROCESSING SERVICES 

  

	12.1	Overall Approach 

 As of the BPaaS Services Commencement Date, Health Net will deliver
the return mail to centralized locations within Supplier departments and Supplier Personnel will receive the return mail from Health Net and perform the Return Mail Processing Services. Detailed Process and Procedures to execute Return Mail
Processing Services will be included in the Procedures Manual. 
  

	12.2	Delivery Process and Methods 

 Supplier will process the Return Mail Services based upon
the type of return mail and the action required that would enable the mail to be re-delivered to the recipient. Steps will also be taken to ensure records are updated properly for any future mailings and correspondence. Where possible the new
address information, if known (and permitted by regulators), will be updated in the system of record for the Member, thus raising the potential for successful delivery. 

During the Term, Supplier may introduce improvements to the Return Mail Processing Services to enable portions of this Service to be performed
offshore (subject to all Health Net offshoring restrictions). As part of Supplier’s Solution for the Return Mail Processing Services, the physical handling of return mail will remain onshore. 

 

	12.3	Delivery Location 

 Supplier will deliver the Cross Functional Return Mail Services from
the Woodland Hills and/or the Rancho Cordova facilities in accordance with the location of return mail receipt by Health Net. If deemed to generate savings and/or efficiencies into the process, capabilities may be added offshore. In all cases,
applicable data privacy and protection steps will be added to the process prior to an offshore movement. Prior to Phase 3, the Supplier will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery
location near Health Net’s headquarters. 
  

	12.4	Staffing Considerations 

 Supplier will identify a specific point of contact for Return
Mail Processing and distribution. The staffing of the Cross Functional Return Mail Processing and Document Services will be a combined part time role and flex with the amount of volume of return mail received for processing. 

 

	12.5	Hours of Coverage 

  

					
	 Return Mail Processing

Services
		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided
				necessary to meet Schedule A (Cross-
				Functional Services) requirements.

  

	12.6	Tools 

 Member Name and Address Information via Systems Support. 

  

					
	Schedule A-1		A-1-34		Health Net / Cognizant Confidential

 Final 
  

	12.7	Reliance and/or Constraints Associated with Third Parties 

 Reliance on Health
Net-provided vendor who receives mail from the post office and delivers to Supplier staff within the Departments. 

  

					
	Schedule A-1		A-1-35		Health Net / Cognizant Confidential

 Final 
  

	13.	INVENTORY MANAGEMENT SERVICES 

 Supplier’s approach to Inventory Management will
include reporting to Health Net production and inventory numbers and attending meetings to discuss volumes, issues, and other operational topics to maintain work inventories within target levels. 

 

	13.1	Overall Approach 

 Inventory Management levels will be monitored and managed within the
threshold tolerance levels to meet Service Levels. 
  

	 	•	 	During Phase 2, Supplier will upgrade the current reporting system and integrate it into the management reporting approach outlined in Schedule G-3 (Management Reports). 

 

	 	•	 	As an example of the approach, Supplier will create and maintain a daily accurate accounting for all inventories including transactions received, “in process” (i.e., transactions received, but not considered
“complete” in the core system) and transactions completed to arrive at the production and inventories number. Based on the established process the Supplier will create an action plan when the inventory is outside of the established
thresholds to get back to established target inventory levels. 

 Supplier will use the daily inventory management reports to
control and maintain inventory within compliance and business service levels. Supplier will report the daily and cumulative monthly inventory management reports to Health Net. 

 

	13.2	Delivery Location 

 Supplier will deliver the Inventory Management Services across
delivery location in US, India and Manila. Prior to Phase 3, the Supplier will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 

 

	13.3	Staffing Considerations 

 Existing operational team across delivery locations in US,
India and Manila will be leveraged for staffing with the Cross Functional Reporting and Analytics Services. The centralized PMO will establish process and procedure to ensure consistency across towers. 

 

	13.4	Hours of Coverage 

  

					
	 Inventory Management

Services
		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided
				necessary to meet Schedule A (Cross-
				Functional Services) requirements.

  

	13.5	Tools 

 Current Reporting Tools used by Health Net (EIS, Omni/Prime, Macess, Excel
Workbooks). 
  

	13.6	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
	Schedule A-1		A-1-36		Health Net / Cognizant Confidential

 Final 
  

	14.	COLLECTION OF FUNDS SERVICES 

 Supplier will perform “Collection of funds”
associated with collecting and depositing all monies for or on behalf of Health Net as envisioned in Schedule A (Cross Functional Services). 
  

	14.1	Overall Approach 

 Supplier will manage the Collection of Funds consistent with each of
the Services in all the in-scope Towers. Supplier will redirect such funds to the appropriate lock box in a timely manner when funds are received outside of the standard process. 

 

	14.2	Delivery Process and Methods 

 Supplier will collect the checks/funds that are received
at any facility at any time. Supplier will log the funds, package them for mailing and deposit and will direct them to the appropriate lock box via the United States Postal Service. 

As part of the monthly operating meetings, the log and total funds received will be reviewed with Health Net. For monthly funds received that
are in excess of thresholds set and adjusted for seasonality, a Root Cause Analysis will be executed and the results including recommendations and implementation plans for corrections, where appropriate, provided in the following month’s
report. 
  

	14.3	Delivery Location 

 Supplier will deliver the Cross Functional Collection of Funds
Services from any location where such funds are received. Prior to Phase 3, the Supplier will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 

 

	14.4	Staffing Considerations 

 Supplier will staff the Cross Functional Collection of Funds
Services on a part time basis as part of the Services being performed by the Supplier. 
  

	14.5	Hours of Coverage 

  

					
	 Collection of Funds

Services
		08:00 am to 5:00 pm		Ad-hoc / after hour support will be provided
				necessary to meet Schedule A (Cross-
				Functional Services) requirements.

  

	14.6	Tools 

 Collection of Funds log. 

 

	14.7	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
	Schedule A-1		A-1-37		Health Net / Cognizant Confidential

 Final 
  

	15.	ISSUE AND ERROR RESOLUTION AND REPORTING SERVICES 

  

	15.1	Overall Approach 

 Cross Functional Issue and Error Resolution and Reporting Services is
the specific function that logs, tracks and manages issues and errors identified as part of the internal audit, Compliance and QA functions. This Cross Functional Service is the management of the inventory of Issues and Errors that are identified to
be resolved and managed to closure with the Towers as part of closing out the QA action items and Compliance and internal audit report findings. The intent of the Issue and Error Reporting Services is to provide an enterprise view of the material
issues and errors that exist in the towers and timely manage them to closure while protecting against recurrence. 
  

	15.2	Processes and Delivery Methods 

 Supplier will receive the Issues and Errors from Health
Net in its scheduled weekly meetings or as a result of audit findings. Supplier will work with the internal audit, Compliance and QA processes to manage the inventory of Issues and Errors to closure and assess the month inventory to determine if
there are any repeating patterns and material items that are candidates for inclusion in the Enterprise Risk Management Inventory or warrant the conducting of a Root Cause Analysis and corrective action plan. Supplier will ensure that Health
Net’s business and supplier delivery teams are meeting periodically to define and discuss Issues and Errors, identify owners, develop solutions/corrective action, including an assessment of the adequacy of current system and process controls,
track and resolve issues. As required, Supplier will also include representatives from provider networks, pharmacy networks and other towers in the meetings. 

In addition to this, Supplier will also manage all SOX/IPC requirements relative to its solution and Issues and Errors impacting these
requirements. 
 Root Cause Analysis will be performed if the Issues or Errors are systemic and can be prevented in the future. Supplier will
use the lessons learned to create a risk and mitigation plan to contain such Issues and Errors in the future if these are deemed material in nature. Data will be mined to help uncover Issues and Errors that will ultimately lead to process
improvements and cost savings. Supplier will identify systemic issues along the process flow, especially upstream. All compliance related issues 

will be escalated following Health Net guidelines. Higher priority will be assigned to recurring Issues and Errors. 

Supplier will automate the data collection and synthesis process. Efforts will also be made to collect observations from resources on the
ground to better understand the Issues or Errors. 
  

	15.3	Delivery Location 

 The centralized function of Issue and Error Resolution and Reporting
Services will be performed primarily from Woodland Hills and Rancho Cordova. Additional support will be provided from all delivery teams across all towers that reside in all delivery locations both onshore and offshore. Prior to Phase 3, the
Supplier will move any remaining Innovation Services personnel from Health Net facilities to Supplier service delivery location near Health Net’s headquarters. 
  

	15.4	Staffing Considerations 

 Supplier will establish a dedicated Project Management Office
(PMO) that will include staff responsible to manage the Issue and Error Resolution and Reporting Services across the towers. The PMO will include full time dedicated resources whose responsibilities will include Issue and Error Resolution and
Reporting. Resources within each tower will be engaged as it relates to Issue and Error Resolution and Reporting impacting their specific tower. 

  

					
	Schedule A-1		A-1-38		Health Net / Cognizant Confidential

 Final 
  

	15.5	Hours of Coverage 

  

					
	 Issues and Error

Resolution Services
		08:00 am to 5:00 pm		 Ad-hoc / after hour support will be provided

necessary to meet Schedule A (Cross-

Functional Services) requirements.

  

	15.6	Tools 

 Issue and Error Log. 

 

	15.7	Reliance and/or Constraints Associated with Third Parties 

 None. 

  

					
	Schedule A-1		A-1-39		Health Net / Cognizant Confidential

 Final 
  

	16.	INTEGRATION SERVICES 

  

	16.1	Overall Approach 

 Supplier will support interfaces that integrate third party products
and services as of the Effective Date. Subject to Change Control, Supplier will additionally support modifications to existing interfaces as well as support for new interfaces as needed to support the Services and as requested by Health Net.
Supplier will coordinate directly with third parties as necessary to support the Integration Services. 
 Integration Services categories are
anticipated to be: 
  

	 	•	 	Electronic Data interface (EDI) scheduled at regular intervals, it will be used to send and receive data from third party vendors and will be scheduled at regular intervals. Such interfaces will use proprietary
framework, 

  

	 	•	 	Third-party integration in real time (Burgess, for example) typically used for claims processing or pricing, 

  

	 	•	 	Integration aligned to processing, (iHealth, for example). 

  

	16.2	Processes and Delivery Methods 

 Integration Services will be evaluated on a case-by-case
basis and managed as part of the Third Party Management Services to evaluate the overall effort of integration as well as the long term maintenance and support of the integration. In conjunction with the towers, the Cross Functional Integration
Services will manage the overall inventory of external interfaces as well as coordinating the evaluation of the services being integrated. 

This process will be highly integrated with the Services in SOW 4 (IT Services) to provide oversight and coordination for an holistic
view of integration across the enterprise. 
  

	16.3	Delivery Location 

 Supplier will deliver the Cross Functional Integration Services from
the locations where Services are performed within the towers. 
  

	16.4	Staffing Considerations 

 Supplier will staff the Cross Functional Integration Services
on a part time basis as necessary to perform the Services. 
  

	16.5	Hours of Coverage 

  

					
	 Integration Services
		08:00 am to  5:00 pm		Ad-hoc / after hour support will be provided
				necessary to meet Schedule A (Cross-
				Functional Services) requirements.

  

	16.6	Tools 

 Integration Services Inventory. 

  

					
	Schedule A-1		A-1-40		Health Net / Cognizant Confidential

 Final 
  

	16.7	Reliance and/or Constraints Associated with Third Parties 

 As identified by each
Integration Services as part of this process. 

  

					
	Schedule A-1		A-1-41		Health Net / Cognizant Confidential

 Final 
  

	17.	TRANSLATION SERVICES 

 “Translation Services” includes functions
associated with voice translation as well as the translation of documents to multiple languages as required by policy and Health Net contracted agreements. 
  

	17.1	Overall Approach 

 The Supplier will perform Translation Services related to three types
of communications: (i) voice translations (within the Contact Center Tower or other Towers), (ii) document/written translations (across all Towers), and (iii) translation support for a member at a Provider’s location (i.e., such
member requests as handled via the Contact Center Tower). 
 The Supplier will coordinate this Cross Functional Service using Health
Net’s current third party translation service providers using Health Net’s current process and allocation approach. Supplier will comply with Health Net’s list of approved languages by line of business for translation. The Supplier
will have a centralized point of contact to facilitate/manage the coordination of translation services. Each tower will maintain policies and a budget to cover the Translation Services with the approved vendor(s). 

 

	17.2	Delivery Process and Methods 

 The Cross Functional Translation Services will provide
coordination across Towers and consistency of delivery related to the translation required at the tower level. 
 Supplier responsibilities
include: 
  

	 	•	 	Maintenance of the “Translation Source of Truth,” containing: 

  

	 	•	 	Health Net’s approved list of languages by line of business for translation 

  

	 	•	 	Regulation rule and section 

  

	 	•	 	Regulation verbatim 

  

	 	•	 	Compliance/SME contact 

  

	 	•	 	List of vital documents by LOB 

  

	 	•	 	Model disclaimer language 

  

	 	•	 	List of interpreter service resources to which members can be referred for translations not handled by Health Net (i.e., for non-approved translations) 

 

	 	•	 	Documentation of procedures to execute Translation Services in the Procedures Manual that are consistent with the “Translation Source of Truth” to include the following: 

 

	 	•	 	A list of required documents / languages that are proactively translated year over year and made available to business areas 

  

	 	•	 	Processes for the handling of translation requests that fall outside of departmental policy 

  

	 	•	 	Escalation process when input or decision is needed from Health Net and the Supplier’s Compliance Officer 

  

					
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	 	•	 	Process for notifications sent to downstream departments whose materials may be impacted 

  

	 	•	 	Process to measure operational results at established checkpoints (i.e., quarterly or annually as needed) 

  

	 	•	 	Process to review and allocate cost of third party translation services across each tower as needed by Health Net to support internal charge back needs 

 

	 	•	 	Update procedures on recurring schedule and as needed to incorporate changes in policy and/or Health Net contractual commitments, 

  

	 	•	 	Ensure continuity of service for any modification to policy and procedures, including: 

  

	 	•	 	Pilot revised policy and procedures with a selected Tower 

  

	 	•	 	Review results with Tower Leads to determine the refinements and to confirm any modifications continue to meet Regulatory and Compliance guidelines as well as Health Net’s requirements 

 

	 	•	 	Deploy updated charge back approach, providing Health Net with the appropriate charges based upon usage for Translation Services 

  

	 	•	 	Conduct training on regular intervals for all resources working on Translation Services to ensure that the staff is adequately trained on procedures and policies, 

 

	 	•	 	Manage the third party translation service providers on behalf of Health Net as part of Third Party Managed Services until such time as the Supplier can transition the contract agreement directly with Supplier.

  

					
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 The graphic below illustrates the high-level process of handling requests for the translation
of documents and providing approvals at the tower level. 
  
 

 
  

	17.3	Delivery Location 

  

	 	•	 	The centralized function of Translation Services will be performed primarily from Woodland Hills and Rancho Cordova. Prior to Phase 3, the Supplier will move supplier personnel from Health Net facilities to Supplier
service delivery location near Health Net headquarters. 

  

	17.4	Staffing Considerations 

  

	 	•	 	Supplier will identify a single point of contact to coordinate Translation Services across towers. Supplier anticipates this to be a part time role in addition to other responsibilities within the centralized team.

  

	 	•	 	In addition, Supplier will identify an individual within each tower who will be responsible to coordinate Translation Services for their service area and to function as a single point of contact within the tower. This
Translation services responsibility within the tower will be a part time role in addition to their other responsibilities to deliver Services within the tower. 

  

					
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	17.5	Hours of Coverage 

  

					
	Translation Services		08:00 am to 5:00 pm		 Ad-hoc / after hour support will be provided

necessary to meet Schedule A (Cross-

Functional Services) requirements.

  

	17.6	Tools 

 To be determined. 

 

	17.7	Reliance and/or Constraints Associated with Third Parties 

 Managed Third Party Services
Contract with Health Net’s Translation Service Providers as provided by Health Net. 

  

					
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SCHEDULE A-1-1 
 HEALTH
NET 
 BUSINESS CONTINUITY PLAN/DISASTER RECOVERY 

  

					
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TABLE OF CONTENTS 
  

					
	 1. EXECUTIVE SUMMARY
		 	1	  
		
	 2. SCOPE
		 	1	  
		
	 3. ORGANIZATION STRUCTURE OF BCP
		 	2	  
		
	 3.1 Roles and Responsibilities
		 	3	  
		
	 3.2 Business Process Services (BPS) Specific BCP Chart
		 	5	  
		
	 4. DISASTER RECOVERY PRE-PLANNING PROCESS
		 	6	  
		
	 4.1 Disaster Recovery Assessment
		 	6	  
		
	 4.2 Disaster Recovery Design
		 	7	  
		
	 4.3 Disaster Recovery Implementation
		 	7	  
		
	 4.4 Disaster Recovery Test
		 	8	  
		
	 4.5 Disaster Recovery Test Completion
		 	8	  
		
	 4.6 Disaster Recovery Approach
		 	9	  
		
	 5. BUSINESS CONTINUITY PLANNING PROCESS
		 	10	  
		
	 5.1 Business Impact Analysis
		 	10	  
		
	 5.2 Criticality of Application Description
		 	10	  
		
	 5.3 Criticality of Business Process Services Description
		 	11	  
		
	 5.4 BCP Triggers
		 	11	  
		
	 6. BUSINESS CONTINUITY POLICIES FOR HEALTH NET
		 	12	  
		
	 6.1 Intra-city/Inter-City Alternate Sites
		 	12	  
		
	 6.2 Policies for Network and Systems Support
		 	13	  
		
	 6.3 Policies for Business Critical Functions
		 	13	  
		
	 6.4 Policies for Administration (Supplier facilities only)
		 	13	  
		
	 6.5 Policies for Human Resources (Supplier resources only)
		 	14	  
		
	 7. DISASTER RECOVERY STRATEGY FOR HEALTH NET
		 	14	  
		
	 7.1 Infrastructure (ITO) Strategy
		 	14	  

  

					
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	 7.2 Business Process Services (BPS) Strategy
		 	15	  
		
	 8. BUSINESS RESUMPTION PROCESS
		 	16	  
		
	 8.1 Infrastructure Set-Up or Recovery
		 	16	  
		
	 8.2 Business Functions/Projects Recovery
		 	16	  
		
	 9. BCP TESTING PROCESS
		 	16	  
		
	 9.1 Purpose
		 	16	  
		
	 9.2 BCP Test Plan
		 	17	  
		
	 9.3 BCP Test Periodicity
		 	17	  
		
	 9.4 BCP Test Reports
		 	17	  
		
	 10. BCP REVIEW AND MAINTENANCE
		 	18	  
		
	 11. PROCESS FOR INCLUDING A NEW SERVICE IN BCP
		 	18	  
		
	 12. ESCALATION AND COMMUNICATION PROCEDURES
		 	18	  
		
	 SCHEDULE A-1-1-2
		 	1	  
		
	 SCHEDULE A-1-1-2
		 	1	  
		
	 SCHEDULE A-1-1-3
		 	1	  

  

					
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SCHEDULE A-1-1 
 HEALTH
NET BUSINESS CONTINUITY PLAN/DISASTER RECOVERY 
  

	1.	EXECUTIVE SUMMARY 

 The Business Continuity Plan (“BCP”) is
designed to ensure that the business operations of Health Net are not affected by the occurrence of a disaster or in case of an emergency situation. The BCP ensures commitment of Supplier towards delivering the highest quality solutions and making
sure that the services offered to Health Net are protected in the event where any of our service locations becomes inoperable, or any other issues require us to move the work elsewhere. The BCP reiterates our commitment to deliver the highest
quality solution using the Global Delivery Model, and protecting Health Net from service continuity risks. Our business continuity plans are based on the need to protect professional staff, computing infrastructure, and intellectual property in
order to help Health Net remain in business through any contingency; that includes provisions to ensure the mobility of professional skills along with fully redundant communications backbones and computing infrastructures. 

The plan presents the actions and procedures necessary to recover from an adverse event. When totally implemented, the plan is designed to
establish availability of employees to carry out the designated assignments, data center processing, network communications and all business unit functions within desired timeframes from identified recovery sites as per the plan. It is aimed at
achieving the following during any disaster struck. 
  

	 	•	 	Minimizing potential economic/business loss 

  

	 	•	 	Reducing the probability of occurrence 

  

	 	•	 	Reducing disruptions to operations 

  

	 	•	 	Providing an orderly recovery 

  

	 	•	 	Ensuring the safety of personnel 

  

	 	•	 	Minimizing legal liability 

  

	 	•	 	Adhere to regulatory and legal requirements 

  

	2.	SCOPE 

 This document covers the overall Supplier’s Health Net business continuity
strategy that would form the base for the business continuity procedures for each of the following functions; 
  

	 	•	 	BPaaS 

  

	 	•	 	Non BPaaS 

  

	 	•	 	ITIS 

  

					
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	3.	ORGANIZATION STRUCTURE OF BCP 

  
 

 

  

					
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	3.1	Roles and Responsibilities 

  

			
	 Supplier Role
		 Responsibilities

		
	Steering Committee (C-Level’s, Business and IT Leaders)		 •    Review the detailed disaster recovery plan & Execution

•    Declare a disaster based on the agreed communication plan between Health Net and
Supplier
 •    Provide direction on prioritizing the list of projects applications/Systems
and services to be recovered during a disaster.
 •    Ensure effective communication
across all associates/customers involved
 •    Review the critical processes for
restoration in case of a disaster
 •    Health Net and Supplier groups will be part of
this role

			
	BCP Manager		 •    Coordinate the development and maintenance of the Corporate BCP
manual by the BCP committee
 •    Coordinate the development and maintenance of the center
level BCP procedures manual at each center.
 •    Coordinate the development and
maintenance of the BCP plan
 •    Manage and direct the business continuity activities
across the organization
 •    Ensure that the plan is updated on a regular basis

•    Drive the recovery process during disaster/emergency situations

•    Monitor the organization wide, center level and project specific BCP testing process

•    Ensure these are in compliance with the documented process

•    Ensure that the Corporate BCP manual is available across multiple locations

•    Health Net and Supplier groups will be part of this role

•    Ensure that all the Center Level BCP team members have the latest copy of their
respective Center Level BCP Procedures manual
 •    Ensure that such manuals are also
stored in a different site.
 •    Coordinate BCP awareness activities across the
organization

			
	BCP Committee – (Comprise of Functional Head from IT/IT IS/BPS Team)		 •    Develop and maintain the Corporate BCP Manual on a regular basis
Develop and maintain the BCP plan on a regular basis.
 •    Ensure that the plan is tested
at least annually.
 •    Ensure that the BCP objectives are in line with the business
requirements
 •    Identify & review the critical processes for restoration in case of
a disaster
 •    Prioritize the list of projects applications/Systems and services to be
recovered during a disaster
 •    Ensure effective communication across all
associates/customers involved
 •    Review the detailed disaster recovery report prepared
by the Center Specific BCP Team members on completion of recovery process

  

					
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	 Supplier Role
		 Responsibilities

	Center Specific BCP Coordinators		 •    Identify and nominate the Center specific BCP/DR team with
representation from various functional units
 •    Manage and direct the business
continuity activities within the center
 •    Coordinate with center specific functions
for the preparation and test execution of BCP/DR
 •    Manage the recovery process within
the center during disaster/emergency situations
 •    Initiate/approve the recovery plan
for the center and inform the Center Specific BCP/DR Team to action
 •    Ensure periodic
status updates are communicated to the BCP Manager/BCP Committee
 •    Prepare a disaster
recovery report on completion of recovery process and submit the report to BCP Committee

			
	Center Specific BCP Team		 •    Provide feedbacks to BCP Committee and Center Specific BCP
coordinators, regarding development and maintenance of the BCP plan on a regular basis

•    Identify and nominate the Center specific BCP Disaster Recovery team with representation
from various functional units
 •    Identify the critical processes for restoration in
case of a disaster
 •    Ensure effective communication across all associates/customers
involved
 •    Instruct the Disaster Recovery Team to carry out the recovery process at
the time of disaster
 •    Inform concerned Functional to activate their Function Specific
BCP
 •    Review and publish a detailed disaster recovery report on completion of recovery
process to Center Specific BCP Coordinator
 •    Ensure periodic status updates are
communicated to the Center specific BCP Coordinator

			
	 Disaster Recovery
 Team
		 •    Assess damage

•    Analyze the impact on business

•    Clearly relate damage assessment to business continuity of organization

•    Identify and isolate damaged assets

•    Assess the reusability of damaged assets

•    Understand economics of repair versus replacement

•    Implement the recovery process as per the plan

•    Periodically update the Center Specific BCP Team on the status of recovery process.

•    Coordinate with vendors/contractors for the recovery process.

•    Carry out the business resumption

			
	Functional Leads – Center Specific		 •    Will be part of Center Specific BCP Team

•    Develop current and viable plan for business continuity

•    Identify and nominate the BCP team for the respective functional units

  

					
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	 Supplier Role
		 Responsibilities

			 •    Coordinate with the Corporate BCP Coordinator for maintenance of
the plan
 •    Identify and list out all critical functions and time frame for restoration
of the services in case of a disaster
 •    Ensure that proper Escalation and
Communication process is in place and it is updated regularly
 •    Manage BCP activities
within the function
 •    Monitor the implementation of the functional level plans during
disaster/emergency situations
 •    Monitor the implementation of the tests as per the
plan and schedule
 •    Prepare a unit specific disaster recovery report on completion of
recovery process

  

	3.2	Business Process Services (BPS) Specific BCP Chart 

 The chart below depicts how a BCP
will be defined at each BPS Function level like Contact Center, Membership, etc. This covers all locations for a given Business Function from BCP perspective. 
  

 

  

					
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	4.	DISASTER RECOVERY PRE-PLANNING PROCESS 

 Supplier provides comprehensive DR services and
would execute the DR process in accordance with ITIL V3 Service Continuity Management (SCM) and perform the activities by leveraging the existing knowledge base and frameworks of Supplier. 

Supplier has built capabilities to provide end-to-end DR services which include the following: 

 

	 	•	 	Conducting Risk Assessment 

  

	 	•	 	Conducting Business Impact Analysis 

  

	 	•	 	Categorizing resources into various criticality levels 

  

	 	•	 	Designing Disaster Recovery solutions for resources under various categories of criticality 

  

	 	•	 	Implementing the DR solutions 

  

	 	•	 	Management and maintenance of the DR Program 

  

	 	•	 	DR Audit / Assessment 

 The below sections describes the various stages of Supplier’s DR
preparedness; 
  
 

 
  

	4.1	Disaster Recovery Assessment 

 This is the most important stage of the Supplier’s DR
preparedness. This stage focusses on creation of the DR plan in conjunction with all the involved stakeholders. This stage also focusses on the creation of crisis management plan and exhaustive list of activities to be executed with proper schedule.

  

					
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Activities: 
  

	 	•	 	Analyze and Propose infrastructure layer including network, storage, servers, virtualization, operating system etc. and create an as-is map of infrastructure to be later used as an input in the DR design phase

  

	 	•	 	Analyze current platform including database servers, application servers, Email, Citrix etc. and create an as-is map of the current platform to be used later as an input to the DR design phase 

 

	 	•	 	Analyze current application integrations, dependencies and batch jobs and create a map, to create a Service Recovery Order (SRO) document 

 

	 	•	 	Analyze current support and operational processes and identify potential process gaps in both implementation and support of the DR solution. 

 

	 	•	 	Analyze end user connectivity methodology to identify dependencies and ensure transparent recovery for end users 

  

	4.2	Disaster Recovery Design 

 This stage focusses on the designing of an effecting DR
solution for Health Net. Supplier will interview stake-holders to gain and be up to date on the DR requirements and design, update the end state DR solution for Health Net. 

Activities: 
  

	 	•	 	Prepare High Level DR Solution Architecture depicting key technology components that constitute the solution. The Solution Architecture will also include the technical requirements that align to the business
requirements specified in the DR Strategy as well as technology constraints, dependencies and risks. 

  

	 	•	 	Prepare detailed design for each infrastructure and platform layer including Network, Storage, Servers, virtualization, and support infrastructure stressing the role played by the respective layer in enabling the DR
solution. 

  

	 	•	 	Prepare detailed application specific Disaster Recovery documents in collaboration with application subject-matter-experts with references to the infrastructure and platform recovery designs that are prerequisites for
the application recovery. 

  

	 	•	 	Prepare Service Recovery Order (SRO) document derived from the BIA document and the application integration document. 

  

	4.3	Disaster Recovery Implementation 

 This stage focusses on the implementation of the DR
design stage. 

  

					
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Activities: 
  

	 	•	 	Prepare a High Level implementation plan and schedule based on inputs from the application /infrastructure Architect and detailed design. The plan should include high level resource requirements from the required cross
functional teams. 

  

	 	•	 	Prepare detailed Implementation Plans and checklists for implementing the requisite Infrastructure and support platforms at the DR facility 

 

	 	•	 	Prepare a detailed vendor management plan for coordinating between various vendors that are required to implement the solution 

  

	 	•	 	Implement requisite support infrastructure (e.g. patching, monitoring) at the DR site. 

  

	 	•	 	Implement DR solution at the DR Facility and the requisite components at the Primary site in coordination with the colocation vendors and network service providers 

 

	 	•	 	Prepare updated support process documents for handover 

  

	4.4	Disaster Recovery Test 

 In this stage the test cases are executed to ensure full
functionality of all devices and network are working as expected. This test will be done in isolated environment, production environment will not be disturbed during this testing. All the databases are tested for consistency of data. Supplier and
Health Net will sign off on the post test result. In case of adverse DR test, Supplier team will ensure the normal operation of resources through primary site and shall do a root cause analysis of the causes of failure. The same will be shared with
the Health Net and another DR testing for the failed test cases would be scheduled as per the plan (at least annually). 
 Activities:

  

	 	•	 	Prepare DR Test Strategy aligned to the High Level DR strategy and consequentially the business requirements of disaster recovery 

  

	 	•	 	Prepare Test schedule in alignment to the Implementation schedule 

  

	 	•	 	Prepare detailed application level DR test plans derived from regression test plans of the application. 

  

	 	•	 	Prepare user acceptance plan for business sign-off for the DR test 

  

	 	•	 	Execute and Verify Test plans 

  

	4.5	Disaster Recovery Test Completion 

 This is the stage where the communication of
successful/unsuccessful completion of the DR test is shared with various stakeholders with the key learnings. The documentations which need to be submitted in this stage are: 
  

	 	•	 	Revised DR plan 

  

	 	•	 	DR Execution run book 

  

	 	•	 	Post test results 

  

					
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	4.6	Disaster Recovery Approach 

 Supplier will follow the methodology defined—DR
Assessment, Desgin, Implementation, Test , Operations. This is an iterative process to include changing business needs. Currently Supplier proposes the below DR architecture which will be validated and updated during the DR Assessment phase. The
timeline of DR Design will be aligned to ITO Phase 2 timelines, as there is a wave based migration approach for applications to Supplier DC and DR solution will be designed based on the application criticality, RPO & RTO. 

Target DR Architecture 

Below diagram illustrates the DR sites (secondary datacenter) and the involved architecture for the Supplier approach: 

 
 

 

  

					
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Supplier approach to Health Net DR is to exceed their current DR capabilities by means of below mentioned methodologies 

 

	 	•	 	Will have dedicated Hardware for ABS HP Integrity and Alpha servers 

  

	 	•	 	Will have dedicated AIX and Solaris hardware to support applications utilizing these system types by using LPAR/LDOM 

  

	 	•	 	Will have dedicated VM for windows and LINUX needs, but will take advantage of VMware and have zero resources applied to them until need for a DR or DR test 

 

	 	•	 	Will have dedicated Storage pool for DR, that will have HUR (Hitachi Universal Replicator) replication with Centennial (Supplier primary datacenter) for production 

 

	 	•	 	Development environment may be used for Cold Stand by needs 

  

	5.	BUSINESS CONTINUITY PLANNING PROCESS 

  

	5.1	Business Impact Analysis 

 The Business Continuity Planning Process shall be based on the
ISO 22301 standard. A Business Impact Analysis or BIA estimates the possible consequences of a sudden, unplanned, severe interruption for any reason and determines the priority of the recovery of processes and supporting technical and non-technical
supporting components within the recovery time demands set forth in the BIA. 
 The purpose of Business Impact Analysis is to 

 

	 	(a)	Identify all applications and its criticality 

  

	 	(b)	Based on criticality, set the priority for recovery of services (tier’s in this case) 

  

	 	(c)	Establish an estimate of the maximum tolerable downtime for each service offering 

  

	 	(d)	Determine the type of fallback arrangements required in case of a disaster 

  

	 	(e)	Determine the priorities and processes for recovery of critical business processes 

 The list of
all applications and its criticality has been given in Schedule A-1-1-3. 
  

	5.2	Criticality of Application Description 

 The applications have been classified into one
of the three Tiers based on the criticality of the applications disruption 
  

	 	(a)	Tier 1 

 Any application disruption that would stop the business or function would be
categorized as “Tier 1”. 
  

	 	(b)	Tier 2 

  

					
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Any application disruption that would affect the business or function but still the bare minimum activities can be carried out would be
categorized as “Tier 2”. 
  

	 	(c)	Tier 3 

 Any application disruption that would cause some inconveniences to the business or
function would be categorized as “Tier 3”. 
  

	5.3	Criticality of Business Process Services Description 

 The services have been classified
into one of the four based on the criticality of the services disruption. They are Vital, Essential, Necessary and Desirable. 
  

	 	(a)	Vital 

 Vital services are defined under Tier 1 services, any disruption in service that would
stop the business or function would be categorized as “Vital”. The RTOs for Vital services are as defined in the Terms and Conditions. 
  

	 	(b)	Essential 

 Essential services are defined under Tier 2 services, the criticality would be
classified as “Essential” if the service affects business but still the bare minimum activities can be carried out. The RTOs for Essential services are as defined in the Terms and Conditions. 

 

	 	(c)	Necessary 

 Necessary services are defined under Tier 3 services,
“Necessary” services are the ones, which, if not available causes some inconveniences to the business or deliverable. The RTOs for Necessary services are as defined in MSA . 

 

	 	(d)	Desirable 

 Desirable services are defined under Tier 3 services, all
“Desirable” services will fall into the category of cosmetic services where the downtime will not affect business in anyway. The RTOs for Desirable services are as defined in MSA . 

 

	5.4	BCP Triggers 

 A Disaster can happen for many reasons. Some of them are listed below;

  

	 	•	 	Primary Data/Network Center is impacted 

  

	 	•	 	Network Connectivity Failure (LAN, WAN, Internet, MPLS, etc.) 

  

	 	•	 	Network Device Failure (Firewall, Router, Switch etc.) 

  

	 	•	 	Application Failure (Active Directory, Exchange, Project File Share etc.) 

  

	 	•	 	All Tier 1 and Tier 2 applications stop functioning 

  

	 	•	 	Multiple locations are impacted and Business cannot carry out critical functions 

  

					
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	 	•	 	Social unrest 

  

	 	•	 	Flood 

  

	 	•	 	Transport disruption 

  

	 	•	 	Extreme Weather 

  

	 	•	 	Fire 

  

	 	•	 	Power blackout 

  

	 	•	 	Seismic Events (Earthquake, Tsunami) 

  

	 	•	 	Pandemic Outbreak (In a situation of 25% - 50% of Absenteeism) 

  

	 	•	 	Terrorist Attack 

 BCP would be activated when any one of the events occur as mentioned above
which would cause a serious impact to business services. The escalation process mentioned in Section 12 would be followed to control the situation, initiate recovery process and communicate as necessary. 

 

	6.	BUSINESS CONTINUITY POLICIES FOR HEALTH NET 

  

	 	•	 	The BCP Coordinator would invoke the BCP process in consultation with the BCP committee 

  

	 	•	 	It is the responsibility of the BCP Committee to ensure that adequate spare resources are made available at the backup sites as mentioned in the functional procedures 

 

	 	•	 	It is mandatory for all BCP team members to maintain two copies of business continuity procedures for their respective functions in an easily accessible and secure location 

 

	 	•	 	The BCP shall be reviewed and updated at least once a year or according to Health Net’s schedule if any major changes take place 

 

	 	•	 	The BCP shall be updated whenever major additions, upgrades, deletions take place to the underlying hardware, network environment, office infrastructure or key personnel 

 

	 	•	 	Any changes to the BCP needs to be notified to the entire BCP team and all the existing hardcopies should be withdrawn and replaced with the updated BCP 

 

	 	•	 	The BCP testing process for critical services referenced in SOW#4 (IT Services) Exhibit B (IT Service Levels) would be done once a year. All the functional tower units shall maintain BCP pertaining to their functions.

  

	6.1	Intra-city/Inter-City Alternate Sites 

 Refer Schedule F (Supplier Facilities) for
details around; 
  

	 	(a)	Infrastructure Sites 

  

					
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	 	(b)	Service Delivery Sites 

  

	 	(c)	Application Delivery Sites 

  

	 	(d)	Business Process Services Sites 

  

	6.2	Policies for Network and Systems Support 

 This will be updated after the due diligence
phase 
  

	6.3	Policies for Business Critical Functions 

  

	 	•	 	All applications identified by their tiers will have to be up and running as per defined RTO and RPO guidelines per Schedule A-1-1-2. 

 

	 	•	 	The application teams should coordinate with the concerned functional tower unit and identify the business continuity plans for the critical services 

 

	 	•	 	Use multi-location delivery organization such that in the event of a complete facility-level outage at any of the one location, *** of the business remains unaffected on account of being in a different city

  

	 	•	 	For all critical processes performed at the primary site, Supplier will create a minimum of *** BCP capacity by cross training resources with similar skills and expertise at alternate locations. 

 

	6.4	Policies for Administration (Supplier facilities only) 

  

	 	•	 	All the facilities shall have adequate fire detection and prevention equipment tested annually 

  

	 	•	 	All electrical fittings shall be adequately maintained for efficient functioning 

  

	 	•	 	All confidential and sensitive documents shall be stored in fire proof cabinets in secured locations 

  

	 	•	 	All facilities will be guarded round the clock by trained security personnel or by security equipment 

  

	 	•	 	There will be well defined evacuation procedures available in all the facilities 

  

	 	•	 	All facilities with multiple floors will have floor coordinators as lead personnel at times of fire, flood or similar exigencies 

  

	 	•	 	All the data centers will have adequate backups for air conditioners 

  

	 	•	 	Since power is a very vital service, we will ensure that redundant/backup UPS be available in all the facilities UPS and Generators will be tested monthly 

 

	 	•	 	It is mandatory to have a standby generator in all the facilities 

  

	 	•	 	It is mandatory to have enough fuel for generators and agreement with the vendor for fuel supply in case of extended disaster 

  

					
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	6.5	Policies for Human Resources (Supplier resources only) 

  

	 	•	 	In case of a disaster HR should ensure that all the associates are safe. It should also set up a helpdesk to communicate to the associates regarding the disaster. 

 

	 	•	 	It should have tie ups with travel agencies for making travel arrangements in short notice and leverage Supplier Travel Desks across delivery locations as necessary to meet the travel needs when associates need to be
transported to secondary delivery centers during a business continuity scenario. 

  

	7.	DISASTER RECOVERY STRATEGY FOR HEALTH NET 

 Supplier has a robust and proven BCP that
ensures that services offered to Health Net are protected in the event where any of our service locations becomes inoperable, or any other issues require us to move the work elsewhere. The BCP reiterates our commitment to delivering the highest
quality solution using the Global Delivery Model and protecting Health Net from service continuity risks. Our business continuity plans are based on the need to protect professional staff, computing infrastructure and intellectual property in order
to help Health Net remain in business through any contingency; that includes provisions to ensure the mobility of professional skills along with fully redundant communications backbones and computing infrastructures. 

 

	7.1	Infrastructure (ITO) Strategy 

 As part of the BCP Plan, Supplier will provide a fallback
strategy to manage disruptions affecting delivery locations. The fallback strategy that we will deploy for Health Net is given below: 
  

 

  

					
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Supplier has a multi-site presence in each location as well as a multi-location presence so that each site / location acts as a fall—back
to the other with respect to infrastructure. 
 In India, the delivery centers Coimbatore and Bangalore will be fallback locations for each
other. Systems for HA/DR includes Power, WAN—Connectivity Inter-City and Health Net locations, Internet Connectivity, Metro Ethernet—Connectivity to multiple facilities within the city. Supplier will strategically plan Onsite team presence
to effectively respond to disruptions and meet their recovery objectives. Both the Offshore delivery centers are geographically separated by two hundred (200) miles (of reach). 

Onsite support for both Federal and commercial will be delivered from Health Net office at Rancho Cordova and AeroJet, for example, will be
fall back locations for each other based on Health Net’s approval and availability of office space. 
 Bangalore and Coimbatore are the
two offshore delivery locations identified for Health Net. Both the offshore locations have Health Net skilled resources working on various technologies. In case of BCP/DR situation both locations will cover each other respectively. 

At Manila, Cebu is a service desk ready location and operations can start immediately once BCP/DR is invoked and has all the required resources
and skills for service desk function. 
 Supplier has flexi resources at their delivery centers worldwide. These can be deployed quickly
during the BCP/DR situation. All these resources are technically skilled covering wide spectrum of technologies including niche skills 
  

	7.2	Business Process Services (BPS) Strategy 

 The BPS strategy involves the restoration of
normal business operations after an unexpected event which has disrupted all or part of the business process. From a Business perspective, this is the most critical phase of the whole BCP. 

The BPS strategy will either follow directly the Infrastructure recovery phase or will be directly initiated after a serious emergency incident
affecting normal business operations depending upon the disaster impact. 
 Supplier’s BCP approach is be based on the RTO and RPO
(refer Schedule A-1-1-2) and 
 Application Criticality (refer Schedule A-1-1-3). 

When implemented, the BCP/DR plan will establish availability of employees, and workspace with the required technology and network access to
carry out the designated assignments, within the proposed recovery plan and time frames 
 Supplier’s multi location delivery
organization provides a first level of BCP/ DR of about fifty percent (50%), wherever the in-scope processes provide minimal scale and scope to have operations to be distributed equally in two different cities. For such processes, in the event of a
complete facility-level outage at any of the one location, fifty percent (50%) of the business remains unaffected on account of being in a different city. 

After completion of Phase 2, processes that are transactional in nature (excludes roles like Business Analysts, Business System Analyst and
Project Management) and delivered from a single location, For all critical processes performed at the primary site, Supplier will create a 

  

					
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minimum of twenty-five percent (25%) BCP capacity by cross training resources with similar skills and expertise at alternate locations The
actual availability of the seats during an outage will also be determined by the severity of the event, and the actual BCP/ DR plan prepared during the start of the engagement will fully cover these aspects 

During the transition planning phase Supplier will identify critical processes within the critical Business Functions which will be prioritized
over other processes, subject to a cap of the maximum available BCP capacity in the back up location. 
 Please refer to Schedule F
(Supplier Facilities) for identified critical Business Functions by Delivery locations. 
  

	8.	BUSINESS RESUMPTION PROCESS 

 Once the disaster recovery has taken place the business
continues in the alternate site. However, it should be noted that the business should resume from the home site since the alternate site is for a disaster elapsed period only. The alternative site will be available / utilized until the move to the
home site is completed. 
 For returning back to home site, the following should be planned to ensure the business operations are not
disturbed: 
  

	8.1	Infrastructure Set-Up or Recovery 

 For Health Net ITO outage, the infrastructure
recovery will be executed per the RTO, RPO guidelines defined in Schedule A-1-1-2. Regular updates will be provided to
Health Net and its impacted Business Functions until the business functions are restored. 
 For Supplier location specific infrastructure
outage, Supplier’s corporate BCP plan will be executed for restoration. 
  

	8.2	Business Functions/Projects Recovery 

 It will be the responsibility of functional tower
units to take care of migration of their units into the home site(s) as part of the business resumption process. They will be supporting the projects move into the home site by coordinating with respective project managers. 

The order of business services that need to be restored will be per the tier guidelines defined in Schedule A-1-1-3. 

 

	9.	BCP TESTING PROCESS 

  

	9.1	Purpose 

 It is essential that the BCP process be tested annually in order to ensure the
following to 
  

	 	•	 	Ensure all critical activities outlined in the plan are functioning to combat any disaster 

  

	 	•	 	Measure the effectiveness of the Business Continuity Process 

  

	 	•	 	Verify compatibility of backup facilities 

  

					
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	 	•	 	Ensure the adequacy of team procedures 

  

	 	•	 	Identify deficiencies in procedures 

  

	 	•	 	Team members training and awareness 

  

	 	•	 	Provide mechanism for maintaining/updating the plan 

  

	 	•	 	Address the needs of any additional resources 

  

	 	•	 	Assess the preparedness for handling any disaster 

  

	9.2	BCP Test Plan 

 BCP Test Plan needs to be established for all critical Business
Functions. These test plans may contain one or more of the following; 
  

	 	•	 	Structured Walkthroughs (Review of test plan) 

  

	 	•	 	Life exercises/Simulations 

  

	 	•	 	Periodic off-site recovery tests/Parallel (Done once a year currently at Health Net) 

  

	9.3	BCP Test Periodicity 

 The services categorized under Tier 1 category that might have an
impact on the business need to be tested at least once in year. If there is a deviation from this process it should be documented and approved by Health Net. 
  

	9.4	BCP Test Reports 

 Upon completion of the BCP testing process a detailed test report
should be presented to BCP committee and Health Net. This report should include the following 
  

	 	•	 	Type of test conducted 

  

	 	•	 	Test Scenario 

  

	 	•	 	Desired Result 

  

	 	•	 	Actual Result 

  

	 	•	 	Acceptable recovery time 

  

	 	•	 	Actual Time taken for recovery 

  

	 	•	 	Problems faced, if any 

  

	 	•	 	Corrective measures with anticipated corrective dates 

  

					
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	10.	BCP REVIEW AND MAINTENANCE 

 To ensure that the BCP is current and effective, the BCP
policy and procedures should be reviewed and updated as defined in Schedule A (Cross Functional Services). The responsibility for review of Health Net BCP Manual shall lie with the BCP Coordinator and the BCP Committee. 

 

	11.	PROCESS FOR INCLUDING A NEW SERVICE IN BCP 

 The following process needs to be followed
for including a new service as part of BCP; 
  

	 	•	 	Risk assessment should be done for the service 

  

	 	•	 	It should be categorized in Schedule A-1-1-3 based on criticality 

  

	 	•	 	An alternate plan should be developed to mitigate the risk and it should be included as part of the BCP 

  

	 	•	 	The BCP test plan should be updated to reflect this change 

  

	12.	ESCALATION AND COMMUNICATION PROCEDURES 

 This section would cover the communication and
escalation process to be followed for any disaster. The escalation process would be based on the disaster categorization and criticality of the services affected. 

If a disaster has been declared by an authorized Health Net Executive, the following shall be identified immediately 

 

	 	•	 	Details of disaster 

  

	 	•	 	Impact of the disaster 

  

	 	•	 	Identify relevant existing recovery procedure and plan 

  

	 	•	 	If it is a new disaster scenario, prepare recovery plan/procedure 

  

	 	•	 	Time estimate for recovery 

 The Center Specific BCP Coordinator would trigger the recovery
process and also inform the BCP Manager and BCP Committee. 
 The Center Specific BCP Team would intimate the Disaster Recovery Team to
report immediately. 
 The Disaster Recovery Team shall immediately initiate the recovery procedure. 

If any Business/IT Functions are affected, the concerned head will be intimated by the Center Specific BCP team to take necessary action and
invoke Function specific BCP. 
 The BCP Manager would invoke the Communication process for intimating the Steering committee. 

  

					
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The Center Specific BCP Team and the BCP Committee would be updated on the status of the recovery process by the disaster recovery team every
hour or on completion of each phase whichever is earlier. 
 The Administration and HR group would set up a temporary helpdesk for intimating
the concerned people about the disaster. 

  

					
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SCHEDULE A-1-1-2 

DEFINITION OF BCP TERMS 
  

	1.1	Recovery Time Objective (RTO) 

 Elapsed Time from the time when a disaster is declared
until IT infrastructure and data recovered and project can resume operations. 
  

	1.2	Recovery Point Objective (RPO) 

 In the event of an outage, the point in time to which
systems and data must be recovered. (E.g. end of previous day’s processing) determined by the responsible business unit(s). RPOs are often used as the basis for the development of backup strategies, and as a determinant of the amount of data
that may need to be recreated after the systems or functions have been recovered 
  

	1.3	Recovery Time Objective (RTO) 

 The targeted duration of time and a service level within
which a business process must be restored after a disaster (or disruption) in order to avoid unacceptable consequences associated with a break in business continuity. 

  

					
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SCHEDULE A-1-1-2 
 RTO,
RPO BY APPLICATION CATEGORY 
 RTO and RPO for all Health Net applications by categories are detailed below: 

 

					
	 Sl. No.
		 Application category
		 RPO and RTO Details

			Tier-1		As Per Schedule A- 4
					
			Tier-2		As Per Schedule A- 4
					
			Tier-3		As Per Schedule A- 4
					

  

					
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SCHEDULE A-1-1-3 
 HEALTH
NET APPLICATIONS AND ITS CRITICALITY 
 Table below shows the list of Tier 1, 2 & 3 applications for Commercial, Federal and
Corporate applications. This information is provided by Health Net and will be updated during the assessment and based on the Critical SLA commitments between Health Net and Supplier. 

 

							
	 Application category
		 Commercial Application
		 Federal Application
		 Corp Application

							
							
							

 *** 

  

					
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SCHEDULE A-2 
 [RESERVED]

  

					
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SCHEDULE A-3 
 FUTURE SOW
TEMPLATE 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE GENERAL TERMS AND CONDITIONS] 

  

					
	Schedule A-3		 		Health Net / Cognizant Confidential

 MSA Schedule A-4 

SCHEDULE A-4 
 IT
CONTINUITY AND DISASTER RECOVERY SERVICES 
 *** 

[Represents 8 pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed
separately with the Securities and Exchange Commission] 

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SCHEDULE B 
 SERVICE
LEVELS 

  

					
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SCHEDULE B 
 SERVICE
LEVELS 
 TABLE OF CONTENTS 
  

					
	 1. INTRODUCTION
		 	1	  
		
	 2. DEFINITIONS
		 	1	  
		
	 2.1    Certain Definitions
		 	1	  
		
	 2.2    Other Terms
		 	4	  
		
	 3. MEASUREMENT, REPORTING AND SUPPORTING INFORMATION
		 	4	  
		
	 3.1    Measurement Period and Times
		 	4	  
		
	 3.2    Measurement Process and Tools
		 	4	  
		
	 3.3    Reporting and Supporting Information
		 	5	  
		
	 4. SERVICE LEVEL METHODOLOGY
		 	6	  
		
	 4.1    General
		 	6	  
		
	 4.2    Service Level Codes/Setting of Initial Operational Service Levels
		 	7	  
		
	 4.3    Failure to Perform
		 	8	  
		
	 4.4    Excused Critical Service Level Failures
		 	10	  
		
	 4.5    Operational Service Level Credits and Compliance Service Level Credits
		 	10	  
		
	 4.6    Performance Guarantee Group Payment Amounts
		 	13	  
		
	 4.7    Stakeholder Satisfaction Survey Credits
		 	13	  
		
	 4.8    Weighting Factors; Amounts at Risk
		 	13	  
		
	 5. MODIFICATIONS AND IMPROVEMENTS TO SERVICE LEVELS
		 	15	  
		
	 5.1    Deletions of Service Levels
		 	15	  
		
	 5.2    New Operational Service Levels
		 	15	  
		
	 5.3    New Compliance Service Levels and Compliance Measures and Changes to Existing Compliance Service Levels and
Compliance Measures
		 	16	  
		
	 5.4    New Performance Guarantee Group Service Levels and Changes to Existing PGG Service Levels
		 	16	  
		
	 5.5    Continuous Improvement
		 	17	  
		
	 5.6    Quarterly Meeting to Adjust Service Levels
		 	18	  
		
	 6. STAKEHOLDER SATISFACTION SURVEY
		 	18	  
		
	 7. OTHER TERMS
		 	19	  
		
	 7.1    Changes to Service Levels via Change Control
		 	19	  
		
	 7.2    Comparable Critical Service Levels and Performance Guarantee Group Service Levels
		 	19	  
		
	 7.3    Incentive Opportunity
		 	19	  

  

					
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TABLE OF SCHEDULES 
  

			
	 Schedule B-1:
		Certain Service Levels
		
	 Schedule B-2:
		Compliance Service Level Metrics
		
	 Schedule B-2-1:
		Compliance Measures
		
	 Schedule B-2-2:
		Payment of Fines that Cover Critical Compliance Service Level Failures
		
	 Schedule B-3:
		Performance Guarantee Group Service Level Metrics
		
	 Schedule B-3-1:
		Standards for New or Modified Performance Guarantee Group Service Levels
		
	 Schedule B-4:
		Stakeholder Satisfaction Survey

  

					
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SCHEDULE B 
 SERVICE
LEVELS 
  

	1.	INTRODUCTION 

 This Schedule B (“Schedule B”) sets forth the
Service Levels that Supplier is required to meet or exceed in performing certain of the Services during the Term. This Schedule also describes (a) the methodology for calculating Performance Payments that will be provided to Health Net by Supplier
in the event of any Critical Service Level Failure, and (b) the process the Parties will follow to add, modify or delete Service Levels during the Term. 
  

	2.	DEFINITIONS 

  

	2.1	Certain Definitions 

  

	 	(a)	“BPaaS Amount at Risk” means ***percent (***%) of the aggregate monthly charges payable by Health Net under this Agreement (excluding (i) Charges applicable to Non- BPaaS IT Services which
are described in Section 2.1(o)(iii), but for Phase 2 only, shall be ***percent (***%) of the monthly Phase 2 Fixed Fee, (ii) for Phase 2 only, an amount equal to $*** to reflect the adjustment made to reflect the limit of liability
applicable to the AO Agreement as described in Section 24.2(b)(ii) of the Terms and Conditions, and (iii) Pass-Through Expenses). 

  

	 	(b)	“BPaaS Pool Percentage Available for Allocation” means *** (***) percentage points. 

  

	 	(c)	“Business Days” mean Monday through Friday (except holidays on which the offices of Health Net, as applicable, are not open for regular business). For purposes of measuring performance against
Service Levels, each Business Day shall start at the occurrence of the event to be measured by the Service Level and end the same time of day the following Business Day (e.g., a task that requires a one (1) Business Day turnaround time and
starts on 3:00 p.m. local time on Monday must be finished by 3:00 p.m. local time on Tuesday, provided that both Monday and Tuesday are Business Days). 

  

	 	(d)	“Compliance Measures” means the quantitative measures set forth in Schedule B-2-1 (Compliance Measures), as they may be modified or supplemented in accordance with Section 5.3.
Compliance Measures are grouped together to form Compliance Service Levels, as set forth in Schedule B-2 (Compliance Service Level Metrics). 

  

	 	(e)	“Compliance Measure Failure” means a failure by Supplier to perform in accordance with any Compliance Measure (i.e. Yellow or Red performance) or to properly measure or report on the performance
of any Compliance Measure. 

  

	 	(f)	“Compliance Service Level” means a Service Level set forth in Schedule B-2 (Compliance Service Level Metrics). Each Compliance Service Level consists of a grouping of Compliance Measures.

  

	 	(g)	“Compliance Service Level Credit” has the meaning given in Section 4.3(b)(ii). 

  

	 	(h)	“Compliance Service Level Failure” means a Service Level Failure (i.e. Yellow or Red performance) with regard to any Compliance Service Level. 

  

					
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	 	(i)	“Critical Compliance Service Level Failure” means a Critical Service Level Failure with regard to a Compliance Service Level that is a Critical Service Level. 

 

	 	(j)	“Critical Operational Service Level Failure” means a Critical Service Level Failure with regard to an Operational Service Level that is a Critical Service Level. 

 

	 	(k)	“Critical Service Level” means collectively (i) an Operational Service Level, Compliance Service Level or Stakeholder Satisfaction Survey Service Level designated as a Critical Service Level
in Schedule B-1 (Certain Service Levels), B-2 (Compliance Service Level Metrics) or B-3 (Performance Guarantee Group Service Level Metrics), or Exhibit B-1 to each SOW, in each case as may be modified by Health Net in accordance
with Sections 4.8, 5 and 6, and (ii) any Performance Guarantee Group Service Level. 

  

	 	(l)	“Critical Service Level Failure” means a Service Level Failure with regard to any Critical Service Level. 

  

	 	(m)	“Critical Stakeholder Satisfaction Survey Service Level Failure” means a Critical Service Level Failure with regard to the Stakeholder Satisfaction Survey Service Level that is a Critical Service
Level. 

  

	 	(n)	“Measurement Period” means, for any Service Level, the period of time during the Term, during which Supplier’s actual performance of the relevant Services is to be measured against the
corresponding Service Level. The Measurement Period for each Service Level is described in Section 3.1. 

  

	 	(o)	“Non-BPaaS Amount at Risk” means ***percent (***%) of the aggregate monthly Charges payable by Health Net under this Agreement (excluding Pass-Through Expenses) with respect to Non-BPaaS IT
Services. The following rules shall be used in computing the Non-BPaaS Amount at Risk: 

  

	 	(i)	During Phase 1, the monthly Non-BPaaS Amount at Risk shall be $ *** ($***); 

  

	 	(ii)	During Phase 2, the monthly Non-BPaaS Amount at Risk shall equal ***percent (***%) of the amount that is ***percent (***%) of the monthly Phase 2 Fixed Fee. 

 

	 	(iii)	During Phase 3, the Charges applicable to Non-BPaaS IT Services that are to be used to calculate the Non-BPaaS Amount at Risk (and excluded from the calculation of the BPaaS Amount at Risk) shall equal all amounts
payable under Sections 10, 12 and 13 of Schedule C (Charges) and any other Charges payable for Services provided under SOW #4 (IT Services). 

  

	 	(p)	“Non-BPaaS Pool Percentage Available for Allocation” means *** (***) percentage points. 

  

	 	(q)	“Non-BPaaS IT Service Levels” shall mean (i) the Service Levels set forth in Exhibit B- 1 of SOW #4 (IT Services) and (ii) the Security Service Levels set forth on Schedule B-1
(Certain Service Levels), which Security Service Levels shall also be deemed to be BPaaS Service Levels, as further described herein. 

  

					
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	 	(r)	“Operational Service Level” means a Service Level set forth in Schedule B-1 (Certain Service Levels) or in Exhibit B-1 to each SOW, as they may be modified or supplemented in accordance
with Section 5.2. 

  

	 	(s)	“Operational Service Level Credit” has the meaning given in Section 4.3(b)(i). 

  

	 	(t)	“Performance Payments” shall mean collectively Operational Service Level Credits, Compliance Service Level Credits, Performance Guarantee Group Payment Amounts, and Stakeholder Satisfaction
Survey Credits. 

  

	 	(u)	“Performance Guarantee Group” means an entity with which Health Net has contracted to meet specific service levels, either as of the Effective Date or at any point during the Term.

  

	 	(v)	“Performance Guarantee Group Payment Amount” has the meaning given in Section 4.3(b)(iii). 

  

	 	(w)	“Performance Guarantee Group Service Level” means a Service Level set forth in Schedule B-3 (Performance Guarantee Group Service Level Metrics), as they may be modified or supplemented in
accordance with Section 5.4. 

  

	 	(x)	“Performance Guarantee Group Service Level Failure” means a Service Level Failure with regard to any Performance Guarantee Group Service Level. 

 

	 	(y)	“Security Service Level” means the Service Levels set forth on Schedule B-1 (Certain Service Levels), excluding the Stakeholder’s Satisfaction Survey Service Level.

  

	 	(z)	“Service Levels” means a performance standard for certain Services, which are set forth in Schedules B, B-1, B-2, B-3 and Exhibit B-1 to each SOW. Service Levels include Operational Service
Levels, Compliance Service Levels, Performance Guarantee Group Service Levels, and the Stakeholder Satisfaction Survey Service Level. 

  

	 	(aa)	“Service Level Credit” shall mean any Performance Payment, excluding the Performance Guarantee Group Payment Amounts. 

 

	 	(bb)	“Service Level Failure” means, with regard to any Service Level (including Operational Service Levels, Compliance Service Levels, Performance Guarantee Group Service Levels, and the Stakeholder
Satisfaction Survey Service Level), a failure by Supplier to either (i) perform at the level that meets the corresponding Service Level during any particular Measurement Period, or (ii) properly measure and report on the performance for
any Service Level. 

  

	 	(cc)	“Stakeholder Satisfaction Survey Credit” has the meaning given in Section 4.3(b)(iv). 

  

	 	(dd)	“Stakeholder Satisfaction Survey Service Level” means the Service Level set forth in Section 6. 

  

	 	(ee)	“Weighting Factor” means the portion of the BPaaS Pool Percentage Available for Allocation or Non-BPaaS Pool Percentage Available for Allocation (as applicable) that Health Net has allocated with
respect to a Critical Service Level. The initial Weighting Factor for each of the Critical Service Levels shall be established via written notice(s) provided by Health Net to Supplier not later than January 15, 2015, and in each case shall be
subject to modification pursuant to Section 4.8(e). 

  

					
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	2.2	Other Terms 

 Other terms used in this Schedule B (Service Levels) (including any
Schedule to this Schedule B) are either defined in the context in which they are used or are defined elsewhere in this Agreement, and in each case shall have the meanings there indicated. 

 

	3.	MEASUREMENT, REPORTING AND SUPPORTING INFORMATION 

  

	3.1	Measurement Period and Times 

  

	 	(a)	The Measurement Period for the Stakeholder Satisfaction Survey Service Level shall be on a quarterly basis. 

  

	 	(b)	For all other Service Levels, the Measurement Period shall be monthly unless otherwise set forth in Schedules B, B-1, B-2, B-3 or Exhibit B-1 to each SOW. 

 

	 	(c)	Except as otherwise expressly indicated in this Schedule B, all references to “hour” or “hours” shall mean clock hours and all reference to “day”
or “days” shall mean calendar days, unless otherwise stated as Business Days. 

  

	3.2	Measurement Process and Tools 

  

	 	(a)	With respect to Service Levels for which there is no measurement tool shown on Schedules B-1, B-2-1 or B-3 or Exhibit B-1 to any SOW, Supplier shall develop and implement measurement and monitoring tools, processes and
methodologies (collectively “Measuring Items”) required to measure such Service Levels not later than ninety 90) days prior to the BPaaS Services Commencement Date. Supplier shall also use Commercially Reasonable Efforts to
develop and implement to the extent feasible Measuring Items that will measure each Service Level in an automated fashion such that Supplier’s actual performance with respect to the Service Levels shall be determined using system generated
data, so that such Measuring Items are in place not later than the BPaaS Services Commencement Date. The Measuring Items described in this Section and for any modified or new Service Levels added after the Effective Date shall be subject to Health
Net’s prior written approval. 

  

	 	(b)	Supplier shall measure Supplier’s performance with respect to each Service Level using the corresponding Measuring Items identified for such Service Level in Schedules B, B- 1, B-2, B-2-1 or B-3, or Exhibit B-1 to
each SOW, as applicable, or as specified elsewhere in this Section 3.2. 

  

	 	(i)	Supplier shall provide and utilize (and have operational, administrative and financial responsibility for) the necessary Measuring Items required to measure and report Supplier’s performance of the Services against
the applicable Service Levels set forth in this Agreement. Such Measuring Items shall (A) permit measurement and daily reporting of compliance with the Service Levels, (B) permit reporting at a level of detail sufficient to verify
compliance with the Service Levels, and (C) will be subject to verification and review by Health Net. Supplier shall provide Health Net with access to such Measuring Items at all times, without the need for Health Net to specifically request
such access in advance. 

  

					
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	 	(ii)	If, after the Effective Date (with respect to Service Levels for which there is a measurement tool set forth in Schedule B-1, B-2-1 or B-3 or Exhibit B-1 to any SOW), or after the date that the Measuring Item has been
approved by Health Net pursuant to Section 3.2(a), Supplier desires to use a different Measuring Item for any Service Level, Supplier shall provide written notice to Health Net proposing: 

 

	 	(A)	the alternative Measuring Item; and 

  

	 	(B)	any reasonable adjustments to the Service Levels that are necessary to account for any increased or decreased sensitivity that will likely result from use of the alternative Measuring Item. 

Supplier may utilize such alternative Measuring Item only to the extent Supplier demonstrates to Health Net’s reasonable satisfaction (as
evidenced by Health Net’s approval in writing) that such tool is capable of measuring and reporting the applicable Service Levels in the same manner or functionally equivalent manner as the Measuring Item being replaced and meets all of the
requirements for Measuring Items set forth in this Schedule B (Service Levels). 
  

	 	(iii)	If any Service Level specifies that it will be measured based on a sampling of an overall population, the applicable Service Level shall be measured as follows: 

 

	 	(A)	During each Measurement Period, Supplier shall audit a statistically valid, dollar and product stratified, sampling of the applicable unit of measure in order to determine Supplier’s performance with respect to
each Service Level. 

  

	 	(B)	Supplier shall calculate its performance against each of the Service Levels based on the results of each such audit and Supplier shall track the results of each audit in an applicable database. 

 

	 	(c)	Notwithstanding Sections 3.2(a), 3.2(b) or 3.3, Health Net shall have the right, by sending written notice to Supplier, to assume responsibility for the development and implementation of Measuring Items required to
measure any Service Level, and/or to measure such Service Level. 

  

	3.3	Reporting and Supporting Information 

  

	 	(a)	Supplier shall deliver the Monthly Performance Report to Health Net in accordance with Section 4.2(b)(i) of Schedule G (Governance). 

 

	 	(b)	Upon Health Net’s request, Supplier shall provide to Health Net detailed supporting information (including available raw performance data) relating to Supplier’s performance relative to the Service Levels.
Such information shall at a minimum include all information that is as necessary for Health Net to verify the accuracy of Supplier’s Service Level measurements and reporting, and other supporting information as reasonably requested by Health
Net. 

  

					
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	 	(c)	Supplier shall make the reporting and supporting information described in this Section 3.3, available to Health Net both (i) in machine-readable form suitable for use on a personal computer; and (ii) via
a secure website. 

  

	4.	SERVICE LEVEL METHODOLOGY 

  

	4.1	General 

  

	 	(a)	Commencing on the BPaaS Services Commencement Date, Supplier shall meet or exceed each of the Service Levels set forth in Schedules B, B-1, B-2, B-2-1 and B-3, and Exhibit B-1 to each of the SOWs (as the same may be
amended and supplemented pursuant to this Schedule B), subject to Section 4.1(b) below. Notwithstanding the prior sentence, the Parties agree that (i) for those Service Levels that are designated as a Code “C”
Service Level on an Exhibit B-1 as described in Section 4.2(c) below, Supplier shall commence meeting or exceeding each of such Service Levels promptly after the completion of the baselining process described in Section 4.2(c) below, and
(ii) Supplier shall commence meeting or exceeding the Non-BPaaS IT Service Levels at such time that Supplier has assumed responsibility for performing any Non-BPaaS IT Services to which such Non-BPaaS IT Service Levels relate, which the Parties
acknowledge will be on a rolling basis commencing in Phase 1 and in accordance with the applicable transition plans. 

  

	 	(b)	Notwithstanding Section 4.1(a) above, with respect to any Compliance Measure for which the average level of performance by Health Net during the six months prior to the BPaaS Services Commencement Date is
“Red” or “Yellow”, if (1) Supplier fails to meet such Compliance Measure during any of the first six (6) months after the BPaaS Services Commencement Date (the “Grace
Period”), and (2) such Compliance Measure is not within the scope of services provide by Supplier under the Original BPO Agreement, such performance of the Compliance Measure shall be excluded from the calculation of whether
Supplier has met the Compliance Service Level of which such Compliance Measure is a part; provided, however, that: 

  

	 	(i)	if Supplier’s performance with respect to such Compliance Measure during each of the months during the Grace Period does not meet or exceed Health Net’s average performance with respect to such Compliance
Measure during the six months prior to the BPaaS Services Commencement Date, then such data shall be included in the calculation of whether Supplier met the Compliance Service Level of which the Compliance Measure is included, and 

 

	 	(ii)	Supplier’s performance after the Grace Period with respect to such Compliance Measures shall be counted. 

  

	 	(c)	Service Levels constitute one means, but not the exclusive means, of measuring Supplier’s performance of its commitment under Section 5.4 of the Terms and Conditions. If a Service Level includes multiple
conditions or components (e.g., components (a), (b) and(c)), then Supplier’s performance must satisfy each and every condition or component (i.e., components (a), (b) and (c)) to achieve the corresponding Service Level.

  

					
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	 	(d)	In the event that a single incident causes more than one failure to meet a Critical Service Level (excluding the Stakeholder Satisfaction Service Level), then (i) if the incident causes more than one Critical
Service Level Failure (excluding those relating to Non- BPaaS IT Service Levels), Health Net shall be entitled to each of such credits, and (ii) if the incident causes more than one Critical Service Level Failure relating to the Non- BPaaS IT
Service Levels, Health Net shall have the right to select the credit or payment that it wishes to receive, but shall not be entitled to all of such credits and payments arising from the multiple Critical Service Level Failures associated with the
Non-BPaaS IT Service Levels. In the event that a single incident causes a Critical Service Level Failure of BPaaS Service Levels and Non-BPaaS IT Service Levels, Health Net shall be entitled to all of such BPaaS Service Level credits and Health Net
may select which of the Non-BPaaS IT Service Level credits that it elects to receive. For purposes of this Section, with respect to any Security Service Level, if Health Net has allocated Weighting Factor points from the BPaaS Pool Percentage
Available for Allocation and/or the Non- BPaaS Pool Percentage Available for Allocation, the credits from the BPaaS Pool Percentage Available for Allocation shall be treated as BPaaS Service Level Credits and the credits from the Non- BPaaS Pool
Percentage Available for Allocation will be treated as Non-BPaaS IT Service Level credits, in accordance with the above. 

  

	 	(e)	If any portion of the Services are to be provided from a business continuity recovery environment, the Service Levels shall continue to apply; except to the extent a disaster occurring at a Health Net facility prevents
Supplier from meeting such Service Levels. 

  

	4.2	Service Level Codes/Setting of Initial Operational Service Levels 

 For each of the
Operational Service Levels set forth in Schedules B-1 (Certain Service Levels) and Exhibit B-1 to each SOW, a corresponding code has been designated in the ““Code”” column of the applicable table, as follows:

  

	 	(a)	Code ““A””—For each Service Level metric for which “”A”” is designated as the applicable code, then as of the BPaaS Services Commencement Date,
the Service Level shall be the Service Level set forth on the applicable Schedule or Exhibit (“Code A”). 

  

	 	(b)	Code ““B””—For each Service Level metric for which ““B”” is designated as the applicable code, the Service Level which shall be in effect on the
BPaaS Services Commencement Date shall be established based on the following process (“Code B”): 

  

	 	(i)	The Service Level metric will be established based on Health Net’s performance of the Services during the last six (6) months of 2014 (the ““Code B Baselining Period””).

  

	 	(ii)	Immediately following the Code B Baselining Period, the Service Level for such Code B Service Level will be promptly established and shall be effective on the BPaaS Services Commencement Date. Such metric shall be the
arithmetic mean of the baselined data collected during the Code B Baselining Period. 

  

	 	(iii)	Notwithstanding the above, if the baselined data demonstrates performance that is unsatisfactory to Health Net, then (A) Health Net may rely on the continuous improvement provision set forth in Section 5.5 to
improve the Service Level, or (B) upon Health Net’s request, Supplier will promptly develop a plan to improve performance and the Parties will meet to establish a mutually agreeable Service Level. The implementation of the plan to improve
the Service Level shall be done pursuant to the Change Control Process. 

  

					
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	 	(c)	Code ““C””—For each Service Level metric for which ““C”” is designated as the applicable code, the Service Level which shall be in effect on the
BPaaS Services Commencement Date (or thereafter if necessary to gather additional data as described below) shall be established based on the following process (“Code C”): 

 

	 	(i)	The Service Level metric will be established based on Health Net’s performance of the Services commencing at such time as Health Net is able to start measurement of the Service Level, and continuing for six
(6) months (the ““Code C Baselining Period””). Under this approach, the Code C Baselining Period will be six (6) months, and may be comprised of performance based on any of the possible scenarios:

  

	 	(A)	Health Net’s performance only (for example if Health Net begins measuring the Service Level in September 2014 and ends in February 2015, thereby resulting in six (6) months of measurement), or

  

	 	(B)	a combination of Health Net and Supplier performance (for example, if Health Net begins measuring the Service Level in October 2014, and the BPaaS Commencement Date is March 1, 2015, thereby resulting in five
(5) months of measurement under Health Net’s performance of the Services and one (1) month of Supplier’s performance of the Services), or 

  

	 	(C)	all under Supplier (for example if Health Net is not able to start measurement prior to the BPaaS Services Commencement Date, in which event Supplier shall commence measurement upon the BPaaS Services Commencement Date,
unless Health Net requests otherwise). 

  

	 	(ii)	Immediately following the Code C Baselining Period, the Service Level for such Code C Service Level will be promptly established and shall be effective as of the completion of the Code C Baselining Period (or as soon
thereafter as Health Net requests). Such metric shall be the arithmetic mean of the baselined data collected during the Code B Baselining Period. 

  

	 	(iii)	Notwithstanding the above, if the baselined data demonstrates performance that is unsatisfactory to Health Net, then (A) Health Net may rely on the continuous improvement provision set forth in Section 5.5 to
improve the Service Level, or (B) upon Health Net’s request, Supplier will promptly develop a plan to improve performance and the Parties will meet to establish a mutually agreeable Service Level. The implementation of the plan to improve
the Service Level shall be done pursuant to the Change Control Process. 

  

	 	(d)	Supplier shall use all Commercially Reasonable Efforts to achieve the highest possible Service Levels during any portion of the foregoing Baselining Periods which measure Supplier’s performance of the Services.

  

	4.3	Failure to Perform 

  

	 	(a)	 For each Service Level Failure and Compliance Measure Failure, Supplier shall (i) investigate, assemble and preserve pertinent information with
respect to, and report on the causes of, the problem, including performing a root cause analysis of the problem; (ii) 

  

					
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advise Health Net, as and to the extent requested by Health Net, of the status of remedial efforts being undertaken with respect to such problem; (iii) minimize the impact of and correct the
problem and begin meeting the Service Level; and (iv) take appropriate preventive measures so that the problem does not recur. 

  

	 	(b)	Supplier recognizes that a Critical Service Level Failure may have a material adverse impact on the business and operations of Health Net and that the damages from a Critical Service Level Failure are not susceptible to
precise determination. Accordingly, unless otherwise excused pursuant to Section 4.4: 

  

	 	(i)	In the event of a Critical Operational Service Level Failure, Supplier shall pay to Health Net a credit calculated pursuant to Section 4.5 (“Operational Service Level Credit”); and

  

	 	(ii)	In the event of a Critical Compliance Service Level Failure , Supplier shall pay to Health Net a credit calculated pursuant to Section 4.5 (“Compliance Service Level Credit”);
and 

  

	 	(iii)	In the event of a Performance Group Guarantee Service Level Failure, then Supplier shall pay to Health Net an amount calculated pursuant to Section 4.6 (“Performance Guarantee Group Payment
Amount”); and 

  

	 	(iv)	In the event of a Critical Stakeholder Satisfaction Survey Service Level Failures, Supplier shall pay to Health Net a credit calculated pursuant to Section 4.7 (“Stakeholder Satisfaction Survey
Credit”). 

  

	 	(c)	For the avoidance of doubt, in the event that Supplier is obligated to grant to Health Net any Operational Service Level Credit, Compliance Service Level Credit, Performance Guarantee Group Payment Amount, or
Stakeholder Satisfaction Survey Credit, the obligation for Supplier to pay such credits and amounts are separate and independent obligations of Supplier. 

  

	 	(d)	Performance Payments will not be construed as a penalty or as liquidated damages for a Critical Service Level Failure and, accordingly, they will not be deemed to constitute Health Net’s remedy, exclusive or
otherwise, for any actual damages caused by a Critical Service Level Failure. Performance Payments will be in addition to any other monetary and non-monetary remedies available to Health Net under this Agreement, at law, or in equity with respect to
a Critical Service Level Failure or the events that result in a Critical Service Level Failure, including Health Net’s right to either before or after receiving any particular Performance Payment, make a claim for damages against Supplier
arising out of the Critical Service Level Failure; provided, however, that if Health Net had previously received any Performance Payment as a result of such failure, then the amount of damages then recoverable by Health Net shall equal (i) the
total amount of damages then recoverable under this Agreement and incurred by Health Net with respect to such failure, without consideration of whether any Performance Payment resulting from such failure had been provided to Health Net; less
(ii) any Performance Payment previously provided to Health Net resulting from such failure. 

  

	 	(e)	This Section 4.3 shall not limit Health Net’s rights with respect to the events upon which Health Net may rely as a basis for Health Net’s termination of this Agreement. 

  

					
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	4.4	Excused Critical Service Level Failures 

  

	 	(a)	If Supplier fails to meet a Service Level and establishes within two (2) months after such failure that each of the following criteria are satisfied: 

 

	 	(i)	the root cause of Supplier’s failure to meet such Service Level was caused by: 

  

	 	(A)	the failure of Health Net, Health Net’s Affiliates or Health Net’s third party contractors or agents (other than Supplier or Supplier’s subcontractors) to perform an express obligation of Health Net under
this Agreement; provided that upon becoming aware of such failure, Supplier provided Health Net with reasonable notice of such failure and used Commercially Reasonable Efforts to perform and achieve the Service Level notwithstanding the occurrence
and impact of such actions, or 

  

	 	(B)	a Force Majeure Event under Section 24.3 of the Terms and Conditions; provided that Supplier fulfilled the obligations set forth in Section 24.3(b) of the Terms and Conditions 

(each an “Excusable Critical Service Level Failure Event”); 

 

	 	(ii)	Supplier would have achieved such Service Level but for such Excusable Critical Service Level Failure Event; and 

  

	 	(iii)	Supplier is without material fault in causing such Excusable Critical Service Level Failure Event, 

then Supplier shall not be obligated to pay the Service Level Credit for any resulting Critical Service Level Failure, and Supplier shall
otherwise be excused from achieving such Service Level for as long as such Excusable Critical Service Level Failure Event continues and Supplier continues to use Commercially Reasonable Efforts to prevent, overcome, and mitigate the adverse effects
of such Excusable Critical Service Level Failure Event to the extent required to achieve the applicable Service Level. 
  

	 	(b)	Supplier shall not be excused from a failure to achieve a Service Level other than under this Section 4.4, or as expressly provided elsewhere in this Agreement. 

 

	4.5	Operational Service Level Credits and Compliance Service Level Credits 

  

	 	(a)	Calculation. For each Critical Operational Service Level Failure and Critical Compliance Service Level Failure, the applicable Service Level Credits referenced in Sections 4.3(b)(i) and 4.3(b)(ii) above shall be
calculated in accordance with the following formula: 

 Service Level Credit = A x B x C 

Where: 
 A = the applicable
Weighting Factor; 
 B = (i) the BPaaS Amount at Risk for such calendar month for all Service Levels except the Non-BPaaS IT Service
Levels, or (ii) the Non-BPaaS Amount at Risk for Non-PBaaS 

  

					
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IT Service Levels (as applicable), provided that if there is a Critical Operational Service Level Failure relating to a Security Service Level,
the credit shall be calculated in accordance with Section 4.5(c) below; and 
 C = 

 

	 	(i)	For a Critical Operational Service Level Failure, C = 1. 

  

	 	(ii)	For a Critical Compliance Service Level Failure, C = the percentage determined using the table below. 

  

											
	 	  	Percentage of Total Number of Compliance
Measures in a Compliance Service Level
for which there is a Compliance
Measure
Failure (Yellow or Red)
	 Level of Performance
	  	 	*	** 	 		  		  	
	 Green
	  				 		  		  	
	 Yellow
	  				 		  		  	
	 Red
	  				 		  		  	

  

	 	(A)	The levels of performance to meet the Green, Yellow and Red thresholds are set forth on Exhibit B-2-1 (Compliance Measures). 

  

	 	(B)	Performance at a Yellow or Red level shall constitute a Compliance Measure Failure. 

  

	 	(C)	There must be more than one Compliance Measure Failure in order for there to be Critical Compliance Service Level Failure which results in a Service Level Credit owed by Supplier to Health Net. 

 

	 	(D)	At the end of each month, the Service Level Credits shall be calculated against the actual number of Red and Yellow failures separately and then summed up to determine the total Service Level Credit from such Compliance
Service Level. 

  

	 	(1)	For example – Assume the results of a Compliance Service Level are: *** of the measures are Yellow and *** of the measures are Red. 

 

	 	(2)	Then C = *** = 35%. 

  

	 	(E)	A Compliance Measure that is measured on a quarterly basis will be measured and counted using the above approach for the month in which such quarterly measure is measured. 

  

					
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	 	(F)	If a Regulator changes the threshold level at which it enforces its regulatory requirements or Health Net receives a different interpretation from the Regulator regarding the threshold that will be enforced, Health Net
shall have the right to change the Green, Yellow and Red thresholds based on such Regulatory input. Health Net shall also have the right to add such Red/Yellow/Green thresholds for new compliance measures added per Section 5.3.

  

	(b)	*** 

  

	(c)	***Notification; Payment of Credits. 

  

	 	(i)	For each Critical Operational Service Level Failure and Critical Compliance Service Level Failure, Supplier shall report such failure to Health Net pursuant to Section 3. Supplier shall also report on each
Compliance Measure Failure pursuant to Section 3. Such report will, at a minimum, (A) identify such Critical Service Level Failure and Compliance Measure Failure, and (B) calculate the amount of the corresponding Service Level Credit,
calculated pursuant to Section 4.5(a). 

  

	 	(ii)	Supplier shall credit any such Service Level Credits earned in a month against the subsequent month’s Charges. 

  

	(d)	***. 

  

	(e)	***Security Service Level Service Level Credits 

  

	 	(i)	The Parties agree that Health Net may allocate Weighting Factor points to the Security Service Levels from the BPaaS Pool Percentage Available for Allocation and from the Non-BPaaS Pool Percentage Available for
Allocation. Service Level Credits relating to the Security Service Levels referenced in Section 4.3(b)(i) shall be calculated in accordance with the following: 

Service Level Credit = ((A x B) + (C x D)) 

Where: 
 A = the applicable
Weighting Factor from the BPaaS Pool Percentage Available for Allocation; 
 B = the BPaaS Amount at Risk for such calendar month; 

C = the applicable Weighting Factor from the Non-BPaaS Pool Percentage Available for Allocation; and 

D = the Non-BPaaS Amount at Risk for such calendar month. 

  

					
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	4.6	*** 

  

	4.7	Stakeholder Satisfaction Survey Credits 

  

	 	(a)	Calculation. For each Critical Stakeholder Satisfaction Survey Service Level Failure, the applicable Stakeholder Satisfaction Survey Credit referenced in Section 4.3(b)(iv) above shall be equal to

 Stakeholder Satisfaction Survey Credit = ((A x B) + (C x D)) x E 

Where: 
 A = the applicable
Weighting Factor from the BPaaS Pool Percentage Available for Allocation; 
 B = the sum of the BPaaS Amounts at Risk for each calendar
month during the period measured by the Stakeholder Satisfaction Survey; and 
 C = the applicable Weighting Factor from the Non-BPaaS Pool
Percentage Available for Allocation; 
 D = the sum of the Non-BPaaS Amounts at Risk for each calendar month during the period measured by
the Stakeholder Satisfaction Survey; and 
 E = ***% if Supplier’s score is ***, and ***% if Supplier’s score is less than ***.

  

	 	(b)	Notification; Payment of Credits. 

  

	 	(i)	For each Critical Stakeholder Satisfaction Survey Service Level Failure, Health Net shall report such failure to Supplier pursuant to Section 3. Such report will, at a minimum, (A) identify such Critical
Stakeholder Satisfaction Survey Service Level Failure, and (B) set forth the amount of the corresponding Stakeholder Satisfaction Survey Credit, calculated pursuant to Section 4.7(a). 

 

	 	(ii)	Supplier shall credit any such Stakeholder Satisfaction Survey Credit earned with respect to a calendar quarter against the first invoice in the subsequent month following such calendar quarter. 

 

	4.8	Weighting Factors; Amounts at Risk 

  

	 	(a)	BPaaS 

  

	 	(i)	BPaaS Weighting Factor limit. In no event shall any single Weighting Factor for a Critical Service Level (excluding Non-BPaaS IT Service Levels) exceed ***(***) points. 

 

	 	(ii)	BPaaS Weighting Factor comprehensive limit. In no event shall the sum of the Weighting Factors for all Critical Service Levels (excluding Non-BPaaS IT Service Levels) exceed the BPaaS Pool Percentage Available
for Allocation. 

  

	 	(iii)	BPaaS Amount at Risk limit. The total amount of Performance Payments payable by Supplier (excluding Service Level Credits payable with respect to 

  

					
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Non-BPaaS IT Service Levels and excluding Performance Guarantee Group Payment Amounts as described in Sections 4.6(g) and 4.8(c)(ii)) relating
to a calendar month shall not exceed the BPaaS Amount at Risk for such calendar month. 
  

	 	(iv)	Security Service Levels. 

  

	 	(A)	In no event shall the Weighting Factor points (from both the BPaaS Pool Percentage Available for Allocation and the Non-BPaaS Pool Percentage Available for Allocation) allocated to any Security Service Level exceed ***.

  

	 	(B)	Weighting Factor points allocated to Security Service Levels from the BPaaS Pool Percentage Available for Allocation, and Performance Payments resulting therefrom, shall be included for purposes of applying the
restrictions set forth in Sections 4.8(a)(ii) and (iii), but Weighting Factor points allocated to Security Service Levels from the Non-BPaaS Pool Percentage Available for Allocation, and Performance Payments resulting therefrom, shall not be
included for purposes of applying such restrictions. 

  

	 	(b)	Non-BPaaS 

  

	 	(i)	Non-BPaaS Weighting Factor limit. In no event shall any single Weighting Factor for a Non-BPaaS IT Service Level exceed ***. 

  

	 	(ii)	Non-BPaaS Weighting Factor comprehensive limit. In no event shall the sum of the Weighting Factors for all Non-BPaaS IT Service Levels exceed the Non- BPaaS Pool Percentage Available for Allocation.

  

	 	(iii)	Non-BPaaS Amount at Risk limit. The total amount of Performance Payments payable by Supplier for Non-BPaaS IT Service Levels relating to a calendar month shall not exceed the Non-BPaaS Amount at Risk for such
calendar month. 

  

	 	(iv)	Security Service Levels. Weighting Factor points allocated to Security Service Levels from the Non-BPaaS Pool Percentage Available for Allocation, and Performance Payments resulting therefrom, shall be included
for purposes of applying the restrictions set forth in Sections 4.8(b)(ii) and (iii), but Weighting Factor points allocated to Security Service Levels from the BPaaS Pool Percentage Available for Allocation, and Performance Payments resulting
therefrom, shall not be included for purposes of applying such restrictions, 

  

	 	(c)	***. 

  

	 	(d)	Rules Relating to Stakeholder Satisfaction Survey as it relates to Amounts at Risk. The Parties agree that if there is a Stakeholder Satisfaction Survey Credit with respect to any calendar quarter, that for
purposes of determining whether either of the Amounts at Risk will limit payment of such credit, the amount of such credit shall be divided by the number of months in the survey period (the “Allocated Per Month Stakeholder Satisfaction
Survey Credit”). ***. 

  

					
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	 	(e)	Designation of Weighting Factors. Health Net may from time to time during the Term change, in its sole discretion, the Weighting Factor for any one or more Service Levels and Critical Service Levels upon written
notice to Supplier; provided, however, that 

  

	 	(i)	Health Net may provide only one (1) such notice during any calendar quarter (which notice may contain multiple changes), which notice shall be effective on the first day of the second month following giving such
notice. 

  

	5.	MODIFICATIONS AND IMPROVEMENTS TO SERVICE LEVELS 

  

	5.1	Deletions of Service Levels 

 Health Net may at any time during the Term, in its sole
discretion upon written notice to Supplier, delete a then-existing Service Level. 
  

	5.2	New Operational Service Levels 

 Health Net may, in its sole discretion upon written
notice to Supplier, add a new Operational Service Level. Any additions with respect to Operational Service Levels shall be subject to the following: 
  

	 	(a)	If Health Net adds a new Service Level for which there is at least ***of historical data within the past ***and such data indicates performance that is acceptable to Health Net, then the Service Level metric shall be
the arithmetic mean of the most recent three (3) months of historical data. For example, if the three (3) months of historical data are 99.90%, 99.92%, and 99.95%, then the Service Level would be the arithmetic mean (99.923%) (calculated
as ((99.90% + 99.92% + 99.95%) / 3). Such Service Level shall become effective as of a date determined by Health Net, but no earlier than thirty (30) days after written notice from Health Net. 

 

	 	(b)	If Health Net adds a new Service Level for which there is at least ***of historical data within the past***, but such data does not indicate performance that is acceptable to Health Net, then, upon Health Net’s
written request, Supplier will perform an assessment of the root causes of the unacceptable level of historical performance and seek to improve performance within sixty (60) days. 

 

	 	(i)	At the end of such sixty (60) day period, if Health Net reasonably determines that Supplier’s performance is below an acceptable level (e.g., by reference to industry standards), then Supplier *** to improve
its performance of the affected Services to a level of service acceptable to Health Net. 

  

	 	(ii)	At the end of such***, if Health Net determines that Supplier’s performance is at an acceptable level, then the Service Level metric shall be determined in accordance with Section 5.2(a). 

 

	 	(c)	If Health Net adds a new Service Level for which at least ***of historical data within the past ***does not exist, then such Service Level shall be baselined in accordance with the following: 

 

	 	(i)	Supplier and Health Net shall promptly meet to agree upon the tools and procedures to be used to measure such new Service Level. Upon such agreement, Supplier or Health Net, as applicable, shall promptly implement such
agreed upon tools and/or procedures and begin measuring the new Service Level. 

  

					
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	 	(ii)	The “Baselining Period” for each such Service Level shall begin on the first day of the calendar month following the date upon which Supplier or Health Net, as applicable, is capable of beginning
to measure such Service Level using the agreed upon tools and procedures, and continue for three (3) months. Health Net, acting in its sole discretion, may extend the Baselining Period by informing Supplier of such extension. 

 

	 	(iii)	Supplier or Health Net, as applicable, shall begin to measure its performance against each such Service Level commencing on the start date of the relevant Baselining Period, and shall report on its performance with
respect to each such Service Level as provided in Section 3 or as otherwise agreed by the Parties. 

  

	 	(iv)	Each such Service Level shall become effective as of the expiration of such Baselining Period, and the corresponding Service Level metric shall be determined in accordance with Section 5.2(a). 

 

	5.3	New Compliance Service Levels and Compliance Measures and Changes to Existing Compliance Service Levels and Compliance Measures 

Health Net may ***to Supplier: 
  

	 	(a)	add an additional Compliance Service Level and corresponding Compliance Measures, or 

  

	 	(b)	add an additional Compliance Measure to an existing Compliance Service Level, or 

  

	 	(c)	modify an existing Compliance Service Level or Compliance Measure; 

 provided that in each case
such addition or modification is a result of changes to existing Laws or new Laws with which the Services are required to comply, or the result of an updated interpretation of a Law, or direction by a Regulator, or change in the threshold at which
the Regulator enforces a Law, or identification of a target after the Effective Date that existed prior to the Effective Date. Any such addition or modification shall be implemented in accordance with Section 17.5 of the Terms and Conditions,
Change Control, provided that Supplier shall have financial responsibility for any such additional or modified Service Level except as set forth in Section 13 of Schedule C (Charges). 

 

	5.4	New Performance Guarantee Group Service Levels and Changes to Existing PGG Service Levels 

  

	 	(a)	*** 

  

	 	(i)	*** 

  

	 	(ii)	The service levels to be included in the new or modified Performance Guarantee Group contract are within the standards set forth on Schedule B-3-1 (Standards for New or Modified Performance Guarantee Group Service
Levels). 

  

					
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	 	(b)	All Performance Guarantee Group Service Levels existing as of the Effective Date are grandfathered under this Agreement, even if they fall outside the standards set forth in Schedule B-3-1. 

 

	 	(c)	The Performance Guarantee Group Service Levels that are attached as Schedule B-3 (Performance Guarantee Group Service Level Metrics) shall be updated to reflect the actual Performance Group Guarantee Service
Levels set forth in Health Net’s Performance Guarantee Group contracts in effect during 2015, provided that any such 2015 Performance Group Guarantee Service Level that is outside the standards set forth on Schedule B-3-1 (Standards for New
or Modified Performance Guarantee Group Service Levels) shall be subject to Section 5.4(d) below. 

  

	 	(d)	If Health Net desires to (i) add a new Performance Guarantee Group Service Level (or modify an existing one) to a level that is greater or lower than the standards set forth on Schedule B-3-1 (Standards for New
or Modified Performance Guarantee Group Service Levels), or (ii) modify the standards set forth in Schedule B-3-1 (Standards for New or Modified Performance Guarantee Group Service Levels), then such new or modified Performance
Guarantee Service Level and such modified standards shall be changed via the Change Control Process, provided that the Parties agree that the pricing impacts associated with such changes shall be subject to the following: 

 

	 	(i)	*** 

  

	5.5	Continuous Improvement 

  

	 	(a)	In addition to any improvements in Service Levels resulting from application of the review processes described in Section 5.6, then, with respect to the Service Levels described in Section 5.5(c), on the first
anniversary of the Effective Date and annually thereafter on each subsequent anniversary of the Effective Date, each Service Level shall be automatically adjusted by adding to the then-current Service Level being adjusted a sum equal to five percent
(5%) of the difference between the level of perfect performance (e.g., 100% Availability) and the then-current Service Level. For example, if the Service Level being adjusted were 99.0%, the increase would be 0.05% (i.e., from 99.0% to 99.05%),
calculated as ((100.0%-99.0%) x 0.05 = 0.05%). 

  

	 	(b)	The improvements to the Service Levels made pursuant to Section 5.5(a) above shall be capped at a maximum metric of ***%. 

  

	 	(c)	The continuous improvement process of this Section 5.5 shall apply to all Service Levels for which continuous improvement is noted on Schedule A-1 (Initial SOWs Cross Functional Solution Description), B-1
(Certain Service Levels) or the Exhibit B-1s to each SOW. 

  

	 	(d)	The Parties agree that for purposes of computing continuous improvement for the Abandon Rate Service Level, “perfect performance” as used in Section 5.5(a) shall be deemed to be zero
(0) percent. Continuous improvement shall apply to the Abandon Rate Service Level, provided that the maximum improvement is as set forth in the right hand column (under “New SLA”) in the table below: 

*** 

  

					
	Schedule A-1		B-17		Health Net / Cognizant Confidential

 Final 
  

	 	(e)	The descriptions of the Services Levels will be updated on an annual basis to reflect the results of the continuous improvement modifications described above; provided, however, that such modifications shall be
effective automatically notwithstanding the absence of any such update to such Schedule or Exhibit. 

  

	5.6	Quarterly Meeting to Adjust Service Levels 

 Health Net and Supplier will meet to review
the Service Levels on a quarterly basis to discuss the Service Levels and will make adjustments to the Service Levels as appropriate to reflect improved performance capabilities associated with advances in technology, processes, methods and tools.
As new technologies, processes methods and tools are introduced, additional Service Levels reflecting industry best practices for those technologies and processes will be established by the Parties. 

 

	6.	STAKEHOLDER SATISFACTION SURVEY 

 Both as a management feedback tool and in an effort to
help ensure that Supplier’s performance of the Services achieves Health Net’s objectives set forth in the Agreement, Health Net will assess key Health Net’s key stakeholders’ satisfaction of Supplier, taking into consideration
the strategic direction and objectives of the relationship, using the methodology set forth below: 
  

	 	(a)	The Stakeholder Satisfaction Survey is attached hereto as Schedule B-4 (“Stakeholder Satisfaction Survey”). Health Net has the right, from time to time during the Term, to modify the Stakeholder
Satisfaction Survey in its sole discretion, upon notice to Supplier. 

  

	 	(b)	No later than first quarter after the BPaaS Services Commencement Date and quarterly thereafter, Health Net shall administer the Stakeholder Satisfaction Survey (in its then-current form). 

 

	 	(c)	Health Net shall administer the Stakeholder Satisfaction Survey to no fewer than ten (10) and no more than twenty (20) key stakeholders within the Health Net organization (as will be identified by Health Net
in advance of each Stakeholder Satisfaction Survey). Prior to each Stakeholder Satisfaction Survey, the Parties will jointly inform and educate the key stakeholders taking such survey about the questions, criteria, metrics, credit assessment, and
goals of the Stakeholder Satisfaction Survey. The Stakeholder Satisfaction Survey shall be scored and the results of such scoring shall be as follows: 

  

	 	(i)	Each key stakeholder completing the Stakeholder Satisfaction Survey shall provide an overall score, which shall range between 1.0 (poor) and 5.0 (excellent). The score from each key stakeholder will be averaged to
calculate the aggregate Stakeholder Satisfaction Survey score (the “Score”). 

  

	 	(ii)	If the Score for any category is less than 3.0, then the Parties shall meet to discuss the reason(s) for such Score. Within thirty (30) days of the administration of the applicable Stakeholder Satisfaction Survey,
Supplier shall be required to develop a plan (“Remediation Plan”) designed to improve Supplier’s performance and Score. The Remediation Plan is subject to Health Net’s approval and Supplier shall promptly implement
the Health Net-approved Remediation Plan; and 

  

					
	Schedule B		B-18		Health Net / Cognizant Confidential

 Final 
  

	 	(iii)	If the Score for the survey is less than***, Supplier shall pay Health Net the applicable Stakeholder Satisfaction Survey Credit in accordance with Section 4.7. 

 

	 	(d)	Health Net may not use the results of the Stakeholder Satisfaction Survey as the sole basis for a claim that Supplier is in material breach of this Agreement for purposes of exercising Health Net’s termination
rights under Section 16.1 of the Terms and Conditions. 

  

	7.	OTHER TERMS 

  

	7.1	Changes to Service Levels via Change Control 

 If Health Net requests, Supplier to
implement a new Service Level at a particular level and the Parties agree upon the payment amount for such new Service Level, then baselining shall not be required, notwithstanding Section 5.2 or any other Section hereof. 

 

	7.2	Comparable Critical Service Levels and Performance Guarantee Group Service Levels 

 For
the avoidance of doubt, the determination of whether Supplier has met or failed to meet any Critical Service Level shall be made without regard to whether Supplier has met or failed to meet any Performance Guarantee Group Service Level that is
comparable to, but less demanding than, such Critical Service Level; similarly, the determination of whether Supplier has met or failed to meet any Performance Guarantee Group Service Level shall be made without regard to whether Supplier has met or
failed to meet any Critical Service Level that is comparable to, but less demanding than, such Performance Guarantee Group Service Level. 

*** *** 

  

					
	Schedule B		B-19		Health Net / Cognizant Confidential

 Final 
  

 SCHEDULE B-1 

CERTAIN SERVICE LEVELS 
  

	1.	SERVICE LEVELS GENERALLY 

  

	    	All Service Levels are subject to the Service Level Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement. 

 

	2.	STAKEHOLDER SATISFACTION SURVEY SERVICE LEVEL 

  

																			
	 Ref

#
	  	 Category / Name
	  	 Description
	  	 Measurement
Period
	  	 Measurement Tool
	  	 Service
Level
	  	 BPaaS
Weighting

Factor
	  	 Non-BPaaS
Weighting
Factor
	  	 Code
	  	 Continuous
Improve

										
	1	  	Stakeholder Satisfaction Survey	  	See Section 6 (Stakeholder Satisfaction Survey) of Schedule B (Service Levels)	  	Quarterly	  	Manual calculation based on Stakeholder Satisfaction Survey results	  	See Section 6(c)(iii) of Schedule B (Service Levels)	  	TBD	  	TBD	  	A	  	No

  

	3.	SECURITY SERVICE LEVELS 

  

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting

Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	 1.
	  	Security & Privacy Training	 	Measures the level of compliance for Supplier to complete mandatory security and privacy training on time.	 	Monthly	 	Training system records or Health Net training coordinator records	 	100%	 	Number of Supplier Personnel completing training on time within the last month / Total number of Supplier Personnel assigned to perform Services x 100	 	TBD	 	TBD	 	A	 	N

  

					
	Schedule B-1	  	B-1-1	  	Health Net / Cognizant Confidential

 Final 

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting

Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	2.	  	IAVM Patching	 	 Measures the number of IAVM-required security patches installed on systems and Available for Use in for hosting (a) Critical Services and on
all Federal Services systems within IAVM
 timelines.
	 	Monthly	 	Patch Management Systems, Vulnerability Scanners, Security Assessments	 	397%	 	(Number of IAVM-required patches installed on Critical Service and Federal Services systems that are Available for Use within IAVM timeframes / Number of IAVM-required patches applicable to Critical Services and Federal Services
systems that are Available for Use) x 100 (not including exceptions agreed in advance in writing)	 	TBD	 	TBD	 	A	 	Y
											
	3.	  	Vulnerability Remediation for Critical Systems	 	 Measures the number of High and Moderate Severity Vulnerabilities (including missing patches) remediated on systems that are Available for Use
hosting Critical Services
 within 30 days
	 	Monthly	 	Patch Management Systems, Vulnerability Scanners, Security Assessments	 	397%	 	(Number of High and Moderate-Severity Vulnerabilities remediated on systems that are Available for Use hosting Critical Services within 30 days / Number of High and Moderate-Severity Vulnerabilities identified on systems that are
Available for Use hosting Critical Services) x 100 (not including exceptions agreed in advance in writing)	 	TBD	 	TBD	 	A	 	Y
											
	4.	  	High Risk Vulnerability Remediation	 	Measures the number of High-Severity Vulnerabilities (including missing patches) remediated on devices that are Available for Use within 30 days	 	Monthly	 	Patch Management Systems, Vulnerability Scanners, Security Assessments	 	397%	 	(Number of High-Severity Vulnerabilities remediated on devices that are Available for Use within 30 days / Number of High-Severity Vulnerabilities identified on devices that are Available for Use) x 100 (not including exceptions
agreed in advance in writing)	 	TBD	 	TBD	 	A	 	Y

  

					
	Schedule B-1	  	B-1-2	  	Health Net / Cognizant Confidential

 Final 

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting

Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	5.	  	Vulnerability Remediation for All Systems	 	Measures the number of Vulnerabilities (including missing patches) remediated on available devices within 90 days	 	Monthly	 	 Patch Management Systems, Vulnerability Scanners,

Security
 Assessments
	 	397%	 	(Number of High and Moderate-severity vulnerabilities remediated on available devices within 90 days / Number of High and Moderate-severity Vulnerabilities identified on available devices) x 100 (not including exceptions agreed in
advance in writing)	 	TBD	 	TBD	 	A	 	Y
											
	6.	  	Security & Privacy Incident Response	 	Measures the time to report Information Security Incidents and Privacy incidents	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	100% of incidents reported within 1 Business Day	 	Number of Information Security Incidents and Privacy incidents with Response Time £ 1 Business Day / total number of Information Security Incidents and Privacy incidents	 	TBD	 	TBD	 	A	 	N
											
	7.	  	Security & Privacy Incident Response - Noncompliance Reporting	 	Measures the time to report security and privacy non-compliance where Confidential Information has not been disclosed and is not at significant risk.	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 90% of incidents reported within 1 Business Day	 	Number of Information Security Incidents and Privacy incidents where Confidential Information is not at significant risk with Response Time £ 1 Business Day / total number of Information
Security Incidents and Privacy incidents where Confidential Information is not at significant risk	 	TBD	 	TBD	 	A	 	Y

  

					
	Schedule B-1	  	B-1-3	  	Health Net / Cognizant Confidential

 Final 

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting

Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	8.	  	Firewall Availability	 	Measures continued protection of networks and systems through continuously functioning firewalls and associated access controls.	 	Monthly	 	SIEM and System Monitoring Logs, Alerts, and Reports, Firewall Logs	 	100%	 	Amount of time networks and systems are unprotected by a firewall over the measurement period.	 	TBD	 	TBD	 	A	 	N
											
	9.	  	Configuration Management	 	 Measures the configuration drift from baseline technical specifications on a quarterly basis to validate the configuration meets
specifications.
  
 Initial baseline technical specification will be the ISEC document, and
will be updated and expanded from there as mutually agreed by the parties.
	 	Monthly	 	Measured initially via SCCM and Altiris. Later measured through CMDB. Data validated in part by security scans.	 	399%	 	(Number of systems with configuration differences from documented technical specifications or approved exception document / number of systems with documented configuration requirements) x 100.	 	TBD	 	TBD	 	C	 	N
											
	10.	  	Security & Privacy Incident Response - Confidential and Non- Confidential Information Exposure Remediation	 	Measures the time to implement preventive controls during Information Security Incidents and Privacy incidents when Confidential or non-Confidential Information has been inappropriately disclosed or is at significant risk or of
disclosure	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	 (a) Confidential Information: 98% of requested controls put into place within 15 minutes; and

(b) Non- confidential Information:
	 	(a) Number of Information Security Incidents and Privacy incidents where Confidential Information is at risk and requested controls are put in place in £ 15 minutes / total number of
Information Security Incidents and Privacy Incidents where Confidential Information is at risk; and	 	TBD	 	TBD	 	A	 	Y

  

					
	Schedule B-1	  	B-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting
Factor
	 	 Non-
BPaaS
Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
		  		 		 		 		 	90% of requested controls put into place within 1 Business Day	 	(b) Number of Information Security Incidents and Privacy Incidents where Confidential Information is not at significant risk and requested controls are put in place in £ 1 Business Day /
total number of Information Security Incidents and Privacy incidents where Confidential Information is not at significant risk	 		 		 		 	
											
	11.	  	Security & Privacy Incident Response - Identified Compromised System Isolation	 	Measures the time to isolate (e.g., remove from the network or place network restrictions around) identified compromised systems during Information Security Incidents and Privacy incidents where system isolation has been requested
(measured from the time at which a request for system isolation is made by Health Net).	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	390% of requested controls put into place within 1 hour	 	Number of Information Security Incidents and Privacy incidents where system isolation is requested in which requested controls are put in place within £ 1 hour / total number of
Information Security Incidents and Privacy incidents where system isolation is requested	 	TBD	 	TBD	 	A	 	Y
											
	12.	  	Security & Privacy Incident Response - Reporting	 	Measures the time to provide requested after action report and lessons learned during Information Security Incidents and Privacy incidents where such information has been requested	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 98% of requested information provided within 5 days	 	Number of Information Security Incidents and Privacy incidents where an after action or lessons learned report is requested and provided in £ 5 days / total number of Security and Privacy
incidents where an after action or lessons learned report is requested	 	TBD	 	TBD	 	A	 	N

  

					
	Schedule B-1	  	B-1-5	  	Health Net / Cognizant Confidential

 Final 

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting
Factor
	 	 Non-
BPaaS
Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	13.	  	Information Security and Privacy Detection Response	 	Measures the mean time to reporting (MTTREP) of security alerts, events, event-related information, suspicious, anomalous or malicious activity in the environment and reported to the HN Security Team.	 	Monthly	 	CTS responsible for entering request for Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 99% of incidents reported within 5 minutes	 	Number of Information Security Incidents and Privacy incidents and alerts, with reporting time <5 minutes / total number of Information Security Incidents and Privacy Incidents	 	TBD	 	TBD	 	C	 	N
											
	14.	  	Information Security and Privacy Incident Response - Information and Content Request Response Process	 	Measures the time to respond to requests for application, host or network information and content, related to security and privacy events, including the requested information.	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	 (a) 3 99% of security and privacy incident related information requests responded to within 5
minutes and
 (b) 3 99% of security and privacy incident related information request data provided to security
team within 10 minutes
	 	 (a) Number of Information Security Incidents and Privacy incidents with Response Time <5 minutes / total number of Information Security
Incidents and Privacy Incidents and
 (b) Number of Information Security Incidents and Privacy Incidents with information requests fulfilled in < 10
minutes / total number of Information Security Incident and Privacy Incident information requests
	 	TBD	 	TBD	 	C	 	N

  

					
	Schedule B-1	  	B-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting
Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
	15.	  	Information Security and Privacy Incident Response - Priority 1 Response Remediation Process	 	Measures the time to complete remediation action required for network, host, authentication/identity, application or other change requests related to Information Security Incident and Privacy Incidents, except isolation requests
covered by Service Level #64.	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 95% of Information Security Incidents and Privacy Incident change requests made with confirmation provided to the security team within 10 minutes	 	Number of Information Security Incidents and Privacy Incident change requests fulfilled in < 10 minutes / total number of Information Security Incident and Privacy Incident change requests	 	TBD	 	TBD	 	C	 	N
											
	16.	  	Information Security and Privacy Incident Response - Priority 2 Response Remediation Process	 	Measures the time to complete remediation action required for network, host, authentication/identity, application or other change requests related to Information Security Incident and Privacy Incidents.	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 95% of Information Security Incidents and Privacy Incident change requests made with confirmation provided to the security team within 15 minutes	 	Number of Information Security Incidents and Privacy Incident change requests fulfilled in < 15 minutes / total number of Information Security Incident and Privacy Incident change requests	 	TBD	 	TBD	 	C	 	N
											
	17.	  	Information Security and Privacy Incident Response - Priority 3 Response Remediation	 	Measures the time to complete remediation action required for network, host, authentication/identity, application or other change requests related to Information Security	 	Monthly	 	Change Management System, Incident Reporting Systems (email, phone systems, etc.)	 	3 95% of Information Security Incidents and Privacy Incident change requests made	 	Number of Information Security Incidents and Privacy Incident change requests fulfilled in < 30 minutes / total number of Information Security Incident and Privacy Incident change requests	 	TBD	 	TBD	 	C	 	N

  

					
	Schedule B-1	  	B-1-7	  	Health Net / Cognizant Confidential

 Final 

																					
	 #
	  	 Service Area
	 	 Description
	 	 Measurement
Period
	 	 Measurement
Tools /
Process
	 	 Service Level
Metric
	 	 Formula
	 	 BPaaS
Weighting
Factor
	 	 Non-
BPaaS

Weighting
Factor
	 	 Code
	 	 Continuous
Improvement

											
		  	Process	 	Incident and Privacy Incidents.	 		 		 	with confirmation provided to the security team within 30 minutes	 		 		 		 		 	

  

	4.	DEFINITIONS 

  

			
		
	Vulnerability	  	A security vulnerability is a weakness in a product (hardware or software) that could allow an attacker to compromise the integrity, availability, or confidentiality of that product.
		
	High-Severity Vulnerabilities	  	Vulnerabilities that Health Net has determined represent a major risk to security, that must be corrected as soon as possible without circumventing standard processes, and that must be prioritized for mitigation and remediation
above less severe Vulnerabilities.
		
	Moderate-Severity Vulnerabilities	  	Vulnerabilities that Health Net has determined represent a significant risk to security, that must be corrected without circumventing standard processes, and that must be prioritized for mitigation and remediation above less
severe Vulnerabilities.
		
	IAVM	  	Department of Defense Information Assurance Vulnerability Management. The IAVM program provides notifications and guidance for security patching within timelines based on threat determinations resulting from Department of Defense
cyber security analysis.
		
	Information Security Incidents	  	The attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with systems operations in an information system, or, the actual or possible loss of control,
unauthorized disclosure, or unauthorized access of personal information in which persons other than authorized users gain access or potential access to such information for other than authorized purposes in which one or more individuals will be
adversely affected. These Incidents are categorized utilizing the framework defined by NIST SP 800-61 rev2 and documented within the Information Security Incident Response Plan. Information Security will be the primary decision maker around the
declaration that a Security Event is an Incident.

  

					
	Schedule B-1	  	B-1-8	  	Health Net / Cognizant Confidential

 Final 
  

			
		
	Privacy Incidents		A Privacy Incident is defined as a violation of the law or company security policies, standards or procedures, or an event which causes a loss of data confidentiality, disruption of data or system integrity, or disruption or
denial of availability compromises (or has the potential to compromise) the confidentiality, integrity, security, or availability of Protected Health Information (“PHI”) or Personally Identifiable Information (“PII”). The term
Privacy Incident covers all events that compromise or may compromise PHI or PII, regardless of whether characterized as involving “technical security,” “physical security,” or “privacy” issues. Health Net’s Privacy
Office will determine if and declare that a Privacy Incident or Breach has occurred.
		
	Confidential Information		Without limiting the definition in Section 21.1 of the Terms and Conditions, with respect to Health Net, Confidential Information includes without limitation personal information concerning Health Net employees or members or
customers, medical information including diagnosis, treatment or benefit administration of any member, financial information relating to employees, hospitals, physicians and provider-specific information related to credentialing/recredentialing
proceedings, quality review, malpractice suits and peer-review determination.

  

					
	Schedule B-1		B-1-9		Health Net / Cognizant Confidential

 Final 

			
		
	Security and Privacy Incident - Severity High or Priority 1		 A Priority 1 incident is defined as an event that Health Net has determined will have a significant impact on one or more of the
following:
  
 •    The
ability to provide products/goods/services to a significant number of Health Net’s customers.
  

•    The ability to control/measure/record/track/account for a significant amount of
inventory/goods/revenue/cash
  

•    The unacceptable risk of significant punitive regulatory actions, contractual penalties,
fraudulent criminal activity and or civil litigation
  

•    Significant notoriety that has the potential to affect the stock price adversely, damage
the brand, and/or cause widespread concern amongst customers/shareholders.
  
 A Priority
1 should be met with the full support of the corporation and outsourced agencies. A Priority 1 incident may involve any or all of the following:
  

•    Executive involvement

 
 •    Several areas of
due diligence on the part of Health Net including: operational impact, criminal prosecution, contractual and statutory reporting, litigation preparation.
  

•    Unsolicited third-party involvement such as law enforcement, regulatory entities, civil
subpoenas, and/or third-party contractual obligations.
  

•    Obligatory releases of internal information to the public, extensive media, and
shareholder scrutiny.

		
	Security and Privacy Incident - Severity Medium or Priority 2		 A Medium or Priority 2 incident is defined as an event that Health Net has determined will meet any or all conditions as follows:

 
 •    Does not fall
within the description of a Priority 1 incident
  

•    Subject to mandatory reporting or notification

 
 •    Requires due
diligence by Health Net to assess, identify, and correct a deficiency within the organization’s data processing , data usage, and /or information security infrastructure
  

•    Presents the potential but not the likelihood of litigation and/or media attention.

 
 A Priority 2 incident response may involve any or all of the following:

 
 •    Execution at a
level of management appropriate to address and resolve all issues raised.
  

•    A determination as to resources and functions required for resolution as well as reports
required
  

•    Documentation of all efforts

 
 •    Management status
reporting notifications

  

					
	Schedule B-1		B-1-10		Health Net / Cognizant Confidential

 Final 

			
		
	Security and Privacy Incident - Severity Low/None or Priority 3		 Health Net routinely deals with malware, lost or stolen devices, and one off issues that affect a small group of people with limited risk to
the organization.
  
 A Priority 3 incident may involve any or all of the following:

 
 •    Execution at a
level of management appropriate to address and resolve the incident.
  

•    A determination as to resources and functions required for resolution as well as reports
required.
  

•    Documentation of efforts.

		
	Protected Health Information “PHI”		“PHI” or “Protected Health Information” has the meaning given in Section 2.1 of the Terms and Conditions.
		
	Personally Identifiable Information “PII”		“PII” or “Personally Identifiable Information” has the meaning given in Section 2.1(lll) of the Terms and Conditions.

  

					
	Schedule B-1		B-1-11		Health Net / Cognizant Confidential

 Final 
  

 SCHEDULE B-2 

COMPLIANCE SERVICE LEVEL METRICS 
  

	I.	DEFINITIONS 

 The following capitalized terms will have the meanings given them below:

  

	 	A.	“Medicare – Part C and Part C and D Combined Compliance Measures” mean the Compliance Measures designated as Group Code 4 in Schedule B-2-1 (Compliance Measures). 

 

	 	B.	“Medicare – Part D Compliance Measures” mean the Compliance Measures designated as Group Code 8 in
Schedule B-2-1 (Compliance Measures). 

  

	 	C.	“Commercial – CA Compliance Measures” mean the Compliance Measures designated as Group Code 1 in Schedule B-2-1 (Compliance Measures). This includes California DMHC, CDI, DOL and HHS
Compliance Measures as well as Commercial Compliance Measures combining regions. 

  

	 	D.	“Commercial – AZ Compliance Measures” mean the Compliance Measures designated as Group Code 3 in Schedule B-2-1 (Compliance Measures). This includes Arizona ADOI, DOL and CMS
Compliance Measures. 

  

	 	E.	“Commercial – OR/WA Compliance Measures” mean the Compliance Measures designated as Group Code 2 in Schedule B-2-1 (Compliance Measures). This includes OR/ OID and WA OIC Compliance
Measures. 

  

	 	F.	“SHP – CA Compliance Measures” mean the Compliance Measures designated as Group Code 5 in Schedule B-2-1 (Compliance Measures). This includes SHP – CA DMHC, DHCS and HHS
Compliance Measures. Includes combined Compliance Measures for CA and AZ. 

  

	 	G.	“Duals Compliance Measures” mean the Compliance Measures designated as Group Code 7 in Schedule B-2-1 (Compliance Measures). This includes CA D, HCS and CMS Compliance Measures.

  

	 	H.	“SHP – AZ Compliance Measures” mean the Compliance Measures designated as Group Code 6 in Schedule B-2-1 (Compliance Measures). This includes SHP – AZ – AHCCCS Compliance
Measures. 

  

					
	Schedule B-2		B-2-1		Health Net / Cognizant Confidential

 Final 
  

	II.	COMPLIANCE SERVICE LEVELS 

  

											
	 Category
	  	Group Code	  	 Service Level Description
	  	 Measurement

Period
	  	 Critical

(Y/N)
	  	 Weighting

Factor

	Compliance - Medicare - Part C and Part C and D Combined Measures	  	4	  	100% compliance with all Medicare - Part C and C and D Combined Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - Medicare - Part D	  	8	  	100% compliance with all Medicare - Part D Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - Commercial - CA	  	1	  	100% compliance with all Commercial - CA Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - Commercial - AZ	  	3	  	100% compliance with all Commercial - AZ Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - Commercial - OR/WA	  	2	  	100% compliance with all Commercial OR/WA Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - SHP - CA	  	5	  	100% compliance with all SHP - CA Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - Duals	  	7	  	100% compliance with all SHP - Duals Compliance Measures.	  	Monthly	  	Y	  	***
						
	Compliance - SHP - AZ	  	6	  	100% compliance with all SHP - AZ Compliance Measures.	  	Monthly	  	Y	  	***

  

					
	Schedule B-2	  	B-2-2	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	Location	 	Regulator	 	Metric
Type	 	Target
	A&G Metrics	 		 		 		 		 		 		 	
	 Metric Data as of Apr-2014
	 		 		 		 		 		 	
	CPD-1	 	A&G	 	1	 	HMO/POS Member Appeals Acknowledgement TAT (PG)	 	% of appeals acknowledged within 5 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-2	 	A&G	 	1	 	HMO/POS Member Grievances Acknowledgement TAT (PG)	 	% of grievances acknowledged within 5 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-3	 	A&G	 	1	 	HMO/POS Expedited Appeals Resolution TAT (PG)	 	% of expedited appeals resolved within 3 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-4	 	A&G	 	1	 	PPO/EPO Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 3 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	p	 	CA	 	CDI	 	Compliance	 	= 100%
												
	CPD-5	 	A&G	 	1	 	PPO/EPO Appeals Resolution TAT	 	% of non-expedited appeals resolved within 30 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CDI	 	Compliance	 	= 100%
												
	CPD-6	 	A&G	 	1	 	HMO/POS Appeals Resolution TAT (PG)	 	% of appeals resolved within 30 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-7	 	A&G	 	1	 	PPO/EPO Grievances Resolution TAT	 	% of grievances resolved within 15 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CDI	 	Compliance	 	= 100%
												
	CPD-8	 	A&G	 	1	 	HMO/POS Grievances Resolution TAT (PG)	 	% of grievances resolved within 30 calendar days of receipt	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-10	 	A&G	 	3	 	HMO/PPO Member Formal Appeals ACK TAT	 	within 5 business days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-11	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration ACK & Appeals Packet TAT	 	within 5 business days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-12	 	A&G	 	3	 	HMO/PPO Grievance ACK TAT	 	within 5 business days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-13	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 1 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	DOL	 	Compliance	 	= 100%
												
	CPD-14	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 2 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	DOL	 	Compliance	 	= 100%
												
	CPD-15	 	A&G	 	3	 	HMO/PPO Expedited Med Review TAT	 	within 1 business day	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-16	 	A&G	 	3	 	HMO/PPO External Independent Review TAT (to ADOI)	 	Fwd within 5 business days	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-17	 	A&G	 	3	 	HMO/PPO Expedited External Review TAT (to ADOI)	 	Fwd within 1 business days	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	ADOI	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	A&G Metrics	 		 		 		 		 		 		 		 		 		 	
	 Metric Data as of Apr-2014
	 		 		 		 		 		 		 		 		 	
	CPD-1	 	A&G	 	1	 	HMO/POS Member Appeals Acknowledgement TAT (PG)	 	% of appeals acknowledged within 5 calendar days of receipt	 	457	 	N/A	 	98.11%	 	97.89%	 	98.00%	 	99.28%	 	98.54%	 	97.95%	 	98.62%	 	99.20%	 	97.36%
																
	CPD-2	 	A&G	 	1	 	HMO/POS Member Grievances Acknowledgement TAT (PG)	 	% of grievances acknowledged within 5 calendar days of receipt	 	388	 	N/A	 	96.43%	 	98.89%	 	98.58%	 	96.07%	 	97.31%	 	96.60%	 	97.98%	 	98.79%	 	98.52%
																
	CPD-3	 	A&G	 	1	 	HMO/POS Expedited Appeals Resolution TAT (PG)	 	% of expedited appeals resolved within 3 calendar days of receipt	 	48	 	N/A	 	95.71%	 	100.00%	 	100.00%	 	98.28%	 	98.28%	 	100.00%	 	100.00%	 	94.55%	 	85.19%
																
	CPD-4	 	A&G	 	1	 	PPO/EPO Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 3 calendar days of receipt	 	11	 	N/A	 	90.91%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	93.75%	 	91.67%	 	90.91%	 	100.00%
																
	CPD-5	 	A&G	 	1	 	PPO/EPO Appeals Resolution TAT	 	% of non-expedited appeals resolved within 30 calendar days of receipt	 	334	 	N/A	 	99.06%	 	99.32%	 	98.56%	 	97.90%	 	98.08%	 	97.72%	 	97.83%	 	99.53%	 	99.57%
																
	CPD-6	 	A&G	 	1	 	HMO/POS Appeals Resolution TAT (PG)	 	% of appeals resolved within 30 calendar days of receipt	 	457	 	N/A	 	100.00%	 	99.79%	 	99.25%	 	99.76%	 	98.54%	 	99.74%	 	99.77%	 	100.00%	 	99.34%
																
	CPD-7	 	A&G	 	1	 	PPO/EPO Grievances Resolution TAT	 	% of grievances resolved within 15 calendar days of receipt	 	132	 	N/A	 	97.59%	 	100.00%	 	100.00%	 	98.99%	 	100.00%	 	98.85%	 	100.00%	 	98.73%	 	98.46%
																
	CPD-8	 	A&G	 	1	 	HMO/POS Grievances Resolution TAT (PG)	 	% of grievances resolved within 30 calendar days of receipt	 	388	 	N/A	 	99.55%	 	99.63%	 	100.00%	 	98.25%	 	99.55%	 	98.72%	 	98.79%	 	100.00%	 	99.51%
																
	CPD-10	 	A&G	 	3	 	HMO/PPO Member Formal Appeals ACK TAT	 	within 5 business days	 	26	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-11	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration ACK & Appeals Packet TAT	 	within 5 business days	 	41	 	N/A	 	97.06%	 	100.00%	 	100.00%	 	97.44%	 	93.33%	 	100.00%	 	100.00%	 	100.00%	 	96.97%
																
	CPD-12	 	A&G	 	3	 	HMO/PPO Grievance ACK TAT	 	within 5 business days	 	119	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.44%	 	100.00%	 	100.00%	 	97.14%	 	100.00%
																
	CPD-13	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 1 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	13	 	N/A	 	100.00%	 	100.00%	 	96.15%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-14	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 2 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	15	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	87.50%	 	87.50%	 	NULL
UNIVERSE	 	100.00%
																
	CPD-15	 	A&G	 	3	 	HMO/PPO Expedited Med Review TAT	 	within 1 business day	 	Null
Universe	 	Null
Universe	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-16	 	A&G	 	3	 	HMO/PPO External Independent Review TAT (to ADOI)	 	Fwd within 5 business days	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-17	 	A&G	 	3	 	HMO/PPO Expedited External Review TAT (to ADOI)	 	Fwd within 1 business days	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	 A&G Metrics
	 		 		 		 		 				 				 			
	 Metric Data as of Apr-2014
	 		 		 		 				 				 			
	CPD-1	 	A&G	 	1	 	HMO/POS Member Appeals Acknowledgement TAT (PG)	 	% of appeals acknowledged within 5 calendar days of receipt	 	97.54%	 	99.09%	 	97.86%	 	96.06%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-2	 	A&G	 	1	 	HMO/POS Member Grievances Acknowledgement TAT (PG)	 	% of grievances acknowledged within 5 calendar days of receipt	 	94.37%	 	95.43%	 	96.94%	 	97.42%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-3	 	A&G	 	1	 	HMO/POS Expedited Appeals Resolution TAT (PG)	 	% of expedited appeals resolved within 3 calendar days of receipt	 	98.33%	 	98.08%	 	100.00%	 	97.92%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-4	 	A&G	 	1	 	PPO/EPO Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 3 calendar days of receipt	 	92.31%	 	86.67%	 	92.31%	 	90.91%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-5	 	A&G	 	1	 	PPO/EPO Appeals Resolution TAT	 	% of non-expedited appeals resolved within 30 calendar days of receipt	 	98.09%	 	100.00%	 	100.00%	 	99.40%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-6	 	A&G	 	1	 	HMO/POS Appeals Resolution TAT (PG)	 	% of appeals resolved within 30 calendar days of receipt	 	99.64%	 	100.00%	 	98.93%	 	99.78%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-7	 	A&G	 	1	 	PPO/EPO Grievances Resolution TAT	 	% of grievances resolved within 15 calendar days of receipt	 	99.05%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-8	 	A&G	 	1	 	HMO/POS Grievances Resolution TAT (PG)	 	% of grievances resolved within 30 calendar days of receipt	 	99.57%	 	99.71%	 	99.49%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-10	 	A&G	 	3	 	HMO/PPO Member Formal Appeals ACK TAT	 	within 5 business days	 	100.00%	 	100.00%	 	88.89%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-11	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration ACK & Appeals Packet TAT	 	within 5 business days	 	95.65%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-12	 	A&G	 	3	 	HMO/PPO Grievance ACK TAT	 	within 5 business days	 	94.87%	 	99.20%	 	100.00%	 	96.64%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-13	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 1 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-14	 	A&G	 	3	 	HMO/PPO Post Svc Administrative Appeals Level 2 TAT (co-ins, copay, deduct only)	 	within 30 calendar days	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-15	 	A&G	 	3	 	HMO/PPO Expedited Med Review TAT	 	within 1 business day	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-16	 	A&G	 	3	 	HMO/PPO External Independent Review TAT (to ADOI)	 	Fwd within 5 business days	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-17	 	A&G	 	3	 	HMO/PPO Expedited External Review TAT (to ADOI)	 	Fwd within 1 business days	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-3	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	SHP-19	 	A&G	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to letter date. 100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be
compliant 100% of the time for Claims and Provider Disputes TATs.	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	CPD-20	 	A&G	 	3	 	HMO/PPO Member Appeal Post-Svc Resolution TAT	 	within 30 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-21	 	A&G	 	3	 	HMO/PPO Member Appeal Medical Necessity Resolution TAT	 	within 15 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-22	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Medical Necessity Resolution TAT	 	within 15 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	p	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-23	 	A&G	 	3	 	HMO/PPO Grievance Resolution	 	within 30 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-24	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Post-Svc Resolution TAT	 	within 30 calendar days	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	ADOI	 	Compliance	 	= 100%
												
	CPD-25	 	A&G	 	2	 	Member Appeals Acknowledgement TAT	 	% of appeals acknowledged within 7 calendar days of receipt	 	Prime, ODW	 		 	—	 	OR	 	OID	 	Compliance	 	= 100%
												
	CPD-26	 	A&G	 	2	 	Member Grievances Acknowledgement TAT	 	% of grievances acknowledged within 7 calendar days of receipt	 	Prime, ODW	 		 	—	 	OR	 	OID	 	Compliance	 	= 100%
												
	CPD-27	 	A&G	 	2	 	Internal Appeals Resolution TAT	 	% of internal appeals resolved within 30 calendar days or within 45 calendar days, if 15-day extension requested and agreed to by enrollee	 	Prime, ODW	 		 	—	 	OR	 	OID	 	Compliance	 	= 100%
												
	CPD-28	 	A&G	 	2	 	Grievances Resolution TAT	 	% of grievances acknowledged within 30 calendar days or within 45 calendar days if 15-calendar-day extension requested and agreed to by enrollee	 	Prime, ODW	 		 	—	 	OR	 	OID	 	Compliance	 	= 100%
												
	CPD-29	 	A&G	 	2	 	Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 72 hours of receipt	 	Prime, ODW	 		 	—	 	OR	 	OID	 	Compliance	 	= 100%
												
	CPD-32	 	A&G	 	2	 	Routine Appeal for Adverse Determination Resolution TAT	 	% of routine adverse determination appeals resolved within 14 calendar days or within 30 calendar days with an extension of receipt	 	Prime, ODW	 		 	—	 	WA	 	OIC	 	Compliance	 	= 100%
												
	CPD-33	 	A&G	 	2	 	Enrollee Grievances Resolution TAT	 	% of grievances resolved within 30 calendar days of receipt	 	Prime, ODW	 		 	—	 	WA	 	OIC	 	Compliance	 	= 100%
												
	CPD-34	 	A&G	 	2	 	Expedited Appeal for Adverse Determination Resolution TAT	 	% of expedited adverse determination appeals resolved within 72 hours of receipt	 	Prime, ODW	 		 	n	 	WA	 	OIC	 	Compliance	 	= 100%
												
	CPD-36	 	A&G	 	2	 	Enrollee Appeals for Experimental/ Investigational Treatment Resolution TAT	 	% of appeals for experimental/investigational treatment resolved within 20 business days of receipt	 	Prime, ODW	 		 	n	 	WA	 	OIC	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric
Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	SHP-19	 	A&G	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to letter date. 100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be
compliant 100% of the time for Claims and Provider Disputes TATs.	 	23	 	N/A	 	90.91%	 	100.00%	 	96.97%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-20	 	A&G	 	3	 	HMO/PPO Member Appeal Post-Svc Resolution TAT	 	within 30 calendar days	 	15	 	N/A	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%
																
	CPD-21	 	A&G	 	3	 	HMO/PPO Member Appeal Medical Necessity Resolution TAT	 	within 15 calendar days	 	11	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-22	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Medical Necessity Resolution TAT	 	within 15 calendar days	 	13	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-23	 	A&G	 	3	 	HMO/PPO Grievance Resolution	 	within 30 calendar days	 	119	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.44%	 	100.00%	 	100.00%	 	97.14%	 	100.00%
																
	CPD-24	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Post-Svc Resolution TAT	 	within 30 calendar days	 	28	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.74%	 	100.00%	 	100.00%	 	100.00%	 	95.24%
																
	CPD-25	 	A&G	 	2	 	Member Appeals Acknowledgement TAT	 	% of appeals acknowledged within 7 calendar days of receipt	 	49	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	95.45%	 	96.67%
																
	CPD-26	 	A&G	 	2	 	Member Grievances Acknowledgement TAT	 	% of grievances acknowledged within 7 calendar days of receipt	 	12	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	91.67%	 	100.00%
																
	CPD-27	 	A&G	 	2	 	Internal Appeals Resolution TAT	 	% of internal appeals resolved within 30 calendar days or within 45 calendar days, if 15-day extension requested and agreed to by enrollee	 	49	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	90.63%	 	95.45%	 	96.67%
																
	CPD-28	 	A&G	 	2	 	Grievances Resolution TAT	 	% of grievances acknowledged within 30 calendar days or within 45 calendar days if 15-calendar-day extension requested and agreed to by enrollee	 	12	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	85.71%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-29	 	A&G	 	2	 	Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 72 hours of receipt	 	1	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-32	 	A&G	 	2	 	Routine Appeal for Adverse Determination Resolution TAT	 	% of routine adverse determination appeals resolved within 14 calendar days or within 30 calendar days with an extension of receipt	 	5	 	N/A	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	83.33%
																
	CPD-33	 	A&G	 	2	 	Enrollee Grievances Resolution TAT	 	% of grievances resolved within 30 calendar days of receipt	 	1	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE
																
	CPD-34	 	A&G	 	2	 	Expedited Appeal for Adverse Determination Resolution TAT	 	% of expedited adverse determination appeals resolved within 72 hours of receipt	 	Null
Universe	 	Null
Universe	 	0.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	100.00%
																
	CPD-36	 	A&G	 	2	 	Enrollee Appeals for Experimental/ Investigational Treatment Resolution TAT	 	% of appeals for experimental/investigational treatment resolved within 20 business days of receipt	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	SHP-19	 	A&G	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to letter date. 100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be
compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-20	 	A&G	 	3	 	HMO/PPO Member Appeal Post-Svc Resolution TAT	 	within 30 calendar days	 	100.00%	 	100.00%	 	75.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-21	 	A&G	 	3	 	HMO/PPO Member Appeal Medical Necessity Resolution TAT	 	within 15 calendar days	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-22	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Medical Necessity Resolution TAT	 	within 15 calendar days	 	100.00%	 	100.00%	 	93.75%	 	92.31%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-23	 	A&G	 	3	 	HMO/PPO Grievance Resolution	 	within 30 calendar days	 	97.44%	 	99.20%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-24	 	A&G	 	3	 	HMO/PPO Member Informal Reconsideration / Post-Svc Resolution TAT	 	within 30 calendar days	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-25	 	A&G	 	2	 	Member Appeals Acknowledgement TAT	 	% of appeals acknowledged within 7 calendar days of receipt	 	96.97%	 	100.00%	 	100.00%	 	95.92%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-26	 	A&G	 	2	 	Member Grievances Acknowledgement TAT	 	% of grievances acknowledged within 7 calendar days of receipt	 	100.00%	 	88.24%	 	93.75%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-27	 	A&G	 	2	 	Internal Appeals Resolution TAT	 	% of internal appeals resolved within 30 calendar days or within 45 calendar days, if 15-day extension requested and agreed to by enrollee	 	100.00%	 	100.00%	 	96.55%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-28	 	A&G	 	2	 	Grievances Resolution TAT	 	% of grievances acknowledged within 30 calendar days or within 45 calendar days if 15-calendar-day extension requested and agreed to by enrollee	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-29	 	A&G	 	2	 	Expedited Appeals Resolution TAT	 	% of expedited appeals resolved within 72 hours of receipt	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-32	 	A&G	 	2	 	Routine Appeal for Adverse Determination Resolution TAT	 	% of routine adverse determination appeals resolved within 14 calendar days or within 30 calendar days with an extension of receipt	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-33	 	A&G	 	2	 	Enrollee Grievances Resolution TAT	 	% of grievances resolved within 30 calendar days of receipt	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-34	 	A&G	 	2	 	Expedited Appeal for Adverse Determination Resolution TAT	 	% of expedited adverse determination appeals resolved within 72 hours of receipt	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-36	 	A&G	 	2	 	Enrollee Appeals for Experimental/ Investigational Treatment Resolution TAT	 	% of appeals for experimental/investigational treatment resolved within 20 business days of receipt	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	CPD-37	 	A&G	 	2	 	TAT to Forward Medical Information for an IMR Regular Review	 	% of responses no later than the 3rd business day after receipt	 	Prime, ODW	 		 	n	 	WA	 	OIC	 	Compliance	 	= 100%
												
	CPD-39	 	A&G	 	2	 	Member Communications Response TAT (group insurance contracts) - WA	 	% of responses to enrollee complaints regarding claims within 15 business days of receipt	 	Prime, ODW	 		 	n	 	WA	 	OIC	 	Compliance	 	= 100%
												
	CPD-40	 	A&G	 	2	 	Enrollee Appeal Acknowledgement
TAT - WA	 	% of appeals acknowledged when received	 	Prime, ODW	 		 	—	 	WA	 	OIC	 	Compliance	 	= 100%
												
	MPD-102	 	A&G	 	4	 	Standard Part C - Appeals TAT (Oregon)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	OR	 	CMS	 	Compliance	 	= 100%
												
	MPD-103	 	A&G	 	4	 	Standard Part C - Appeals TAT (CA)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CMS	 	Compliance	 	= 100%
												
	MPD-104	 	A&G	 	4	 	Standard Part C - Appeals TAT (AZ)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-105	 	A&G	 	4	 	Expedited Part C - Appeals TAT (Oregon)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	OR	 	CMS	 	Compliance	 	= 100%
												
	MPD-106	 	A&G	 	4	 	Expedited Part C - Appeals TAT (CA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CMS	 	Compliance	 	= 100%
												
	MPD-107	 	A&G	 	4	 	Expedited Part C - Appeals TAT (AZ)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-108	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (Oregon - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	OR	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-7	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric
Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-37	 	A&G	 	2	 	TAT to Forward Medical Information for an IMR Regular Review	 	% of responses no later than the 3rd business day after receipt	 	NULL
Universe	 	NULL
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-39	 	A&G	 	2	 	Member Communications Response TAT (group insurance contracts) - WA	 	% of responses to enrollee complaints regarding claims within 15 business days of receipt	 	NULL
Universe	 	NULL
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-40	 	A&G	 	2	 	Enrollee Appeal Acknowledgement TAT - WA	 	% of appeals acknowledged when received	 	5	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	87.50%	 	100.00%	 	83.33%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-102	 	A&G	 	4	 	Standard Part C - Appeals TAT (Oregon)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	40	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.63%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-103	 	A&G	 	4	 	Standard Part C - Appeals TAT (CA)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	61	 	N/A	 	100.00%	 	97.89%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	98.78%	 	100.00%	 	98.38%
																
	MPD-104	 	A&G	 	4	 	Standard Part C - Appeals TAT (AZ)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	27	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.96%	 	100.00%
																
	MPD-105	 	A&G	 	4	 	Expedited Part C - Appeals TAT (Oregon)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	10	 	N/A	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	83.33%	 	100.00%	 	100.00%
																
	MPD-106	 	A&G	 	4	 	Expedited Part C - Appeals TAT (CA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	16	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.55%	 	100.00%	 	93.54%	 	100.00%	 	92.30%
																
	MPD-107	 	A&G	 	4	 	Expedited Part C - Appeals TAT (AZ)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	2	 	N/A	 	100.00%	 	75.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	83.33%	 	100.00%	 	85.71%
																
	MPD-108	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (Oregon - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-8	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	CPD-37	 	A&G	 	2	 	TAT to Forward Medical Information for an IMR Regular Review	 	% of responses no later than the 3rd business day after receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-39	 	A&G	 	2	 	Member Communications Response TAT (group insurance contracts) - WA	 	% of responses to enrollee complaints regarding claims within 15 business days of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	CPD-40	 	A&G	 	2	 	Enrollee Appeal Acknowledgement TAT - WA	 	% of appeals acknowledged when received	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-102	 	A&G	 	4	 	Standard Part C - Appeals TAT (Oregon)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-103	 	A&G	 	4	 	Standard Part C - Appeals TAT (CA)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	98.36%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-104	 	A&G	 	4	 	Standard Part C - Appeals TAT (AZ)	 	Written notice must be issued within 30 calendar days of the request for reconsideration for Pre-Service and 60 calendar days for Post-Service appeals - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-105	 	A&G	 	4	 	Expedited Part C - Appeals TAT (Oregon)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-106	 	A&G	 	4	 	Expedited Part C - Appeals TAT (CA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-107	 	A&G	 	4	 	Expedited Part C - Appeals TAT (AZ)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	77.78%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  
													
	MPD-108	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (Oregon - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	 	0	  	 	 	0	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-9	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	MPD-109	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (CA - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CMS	 	Compliance	 	= 100%
												
	MPD-110	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (AZ - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-111	 	A&G	 	8	 	Standard Part D - Appeals TAT (Oregon)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	OR	 	CMS	 	Compliance	 	= 100%
												
	MPD-112	 	A&G	 	8	 	Standard Part D - Appeals TAT (CA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CMS	 	Compliance	 	= 100%
												
	MPD-113	 	A&G	 	8	 	Standard Part D - Appeals TAT (AZ)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-115	 	A&G	 	8	 	Expedited Part D - Appeals TAT (Oregon)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request- 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	OR	 	CMS	 	Compliance	 	= 100%
												
	MPD-116	 	A&G	 	8	 	Expedited Part D - Appeals TAT (CA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request- 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	—	 	CA	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-10	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	MPD-109	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (CA - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	1	 	N/A	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	MPD-110	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (AZ - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	98.14%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE
																
	MPD-111	 	A&G	 	8	 	Standard Part D - Appeals TAT (Oregon)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	25	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	87.50%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-112	 	A&G	 	8	 	Standard Part D - Appeals TAT (CA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	28	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-113	 	A&G	 	8	 	Standard Part D - Appeals TAT (AZ)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	31	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-115	 	A&G	 	8	 	Expedited Part D - Appeals TAT (Oregon)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request- 100% of the time	 	6	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE
																
	MPD-116	 	A&G	 	8	 	Expedited Part D - Appeals TAT (CA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request- 100% of the time	 	9	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-11	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 MPD-109
	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (CA - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-110
	 	A&G	 	4	 	IRE - Autoforward Part C - Appeals TAT (AZ - MA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 MPD-111
	 	A&G	 	8	 	Standard Part D - Appeals TAT (Oregon)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	100.00%	 	96.29%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-112
	 	A&G	 	8	 	Standard Part D - Appeals TAT (CA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	96.87%	 	97.56%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-113
	 	A&G	 	8	 	Standard Part D - Appeals TAT (AZ)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-115
	 	A&G	 	8	 	Expedited Part D - Appeals TAT (Oregon)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request - 100% of the time	 	100.00%	 	75.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-116
	 	A&G	 	8	 	Expedited Part D - Appeals TAT (CA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-12	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 MPD-117
	 	A&G	 	8	 	Expedited Part D - Appeals TAT (AZ)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	•	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	 MPD-120
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (Oregon - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	OR	 	CMS	 	Compliance	 	= 100%
												
	 MPD-121
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (CA - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	CA	 	CMS	 	Compliance	 	= 100%
												
	 MPD-122
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (AZ - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	 MPD-123
	 	A&G	 	4	 	Standard Part C - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	•	 	OR	 	CMS	 	Compliance	 	= 100%
												
	 MPD-124
	 	A&G	 	4	 	Standard Part C - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	•	 	CA	 	CMS	 	Compliance	 	= 100%
												
	 MPD-125
	 	A&G	 	4	 	Standard Part C - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	•	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	 MPD-126
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	OR	 	CMS	 	Compliance	 	= 100%
												
	 MPD-127
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	CA	 	CMS	 	Compliance	 	= 100%
												
	 MPD-128
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic (current), Prime (future), ODW	 		 	n	 	AZ	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-13	  	Health Net / Cognizant Confidential

 Final 

																																	
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013	 
	 MPD-117
	 	A&G	 	8	 	Expedited Part D - Appeals TAT (AZ)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request - 100% of the time	 	9	 	N/A	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	100.00	% 
																
	 MPD-120
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (Oregon - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	88.88%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 
 	NULL
UNIVERSE	  
  
																
	 MPD-121
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (CA - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 
 	NULL
UNIVERSE	  
  
																
	 MPD-122
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (AZ - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 
 	NULL
UNIVERSE	  
  
																
	 MPD-123
	 	A&G	 	4	 	Standard Part C - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	63	 	N/A	 	98.41%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	100.00	% 
																
	 MPD-124
	 	A&G	 	4	 	Standard Part C - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	295	 	N/A	 	98.78%	 	100.00%	 	99.66%	 	100.00%	 	100.00%	 	98.96%	 	100.00%	 	100.00%	 	 	100.00	% 
																
	 MPD-125
	 	A&G	 	4	 	Standard Part C - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	98	 	N/A	 	95.71%	 	100.00%	 	98.28%	 	100.00%	 	98.27%	 	100.00%	 	100.00%	 	100.00%	 	 	100.00	% 
																
	 MPD-126
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 
 	NULL
UNIVERSE	  
  
																
	 MPD-127
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	 
 	NULL
UNIVERSE	  
  
																
	 MPD-128
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 
 	NULL
UNIVERSE	  
  

  

					
	Schedule B-2-1	  	B-2-1-14	  	Health Net / Cognizant Confidential

 Final 

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 MPD-117
	 	A&G	 	8	 	Expedited Part D - Appeals TAT (AZ)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice must be mailed within 3 calendar days of that notification. If oral notification was unsuccessful then the plan must provide written notice within 72 hours of the receipt of request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
	 MPD-120
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (Oregon - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
	 MPD-121
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (CA - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
	 MPD-122
	 	A&G	 	8	 	IRE - Autoforward Part D - Appeals TAT (AZ - Part D)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe - 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
	 MPD-123
	 	A&G	 	4	 	Standard Part C - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	99.06%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
	 MPD-124
	 	A&G	 	4	 	Standard Part C - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	99.65%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
	 MPD-125
	 	A&G	 	4	 	Standard Part C - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
	 MPD-126
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
	 MPD-127
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
	 MPD-128
	 	A&G	 	4	 	Expedited Part C - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-15	  	Health Net / Cognizant Confidential

 Final 

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement
Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 MPD-129
	 	A&G	 	8	 	Standard Part D - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	•	 	OR	 	CMS	 	Compliance	 	= 100%
												
	 MPD-130
	 	A&G	 	8	 	Standard Part D - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	•	 	CA	 	CMS	 	Compliance	 	= 100%
												
	 MPD-131
	 	A&G	 	8	 	Standard Part D - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	•	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	 MPD-133
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	n	 	OR	 	CMS	 	Compliance	 	= 100%
												
	 MPD-134
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	n	 	CA	 	CMS	 	Compliance	 	= 100%
												
	 MPD-135
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Macess/Magic
(current),
Prime
(future),
ODW	 		 	n	 	AZ	 	CMS	 	Compliance	 	= 100%
												
	 SHP-136
	 	A&G	 	5	 	Medi-Cal: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	¿	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-137
	 	A&G	 	5	 	Medi-Cal: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-138
	 	A&G	 	5	 	Medi-Cal: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-139
	 	A&G	 	5	 	Medi-Cal: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-140
	 	A&G	 	5	 	Medi-Cal: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-141
	 	A&G	 	5	 	Medi-Cal: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-16	  	Health Net / Cognizant Confidential

 Final 

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 MPD-129
	 	A&G	 	8	 	Standard Part D - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	10	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-130
	 	A&G	 	8	 	Standard Part D - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	56	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-131
	 	A&G	 	8	 	Standard Part D - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	18	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-133
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	 MPD-134
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	 MPD-135
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	 SHP-136
	 	A&G	 	5	 	Medi-Cal: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	17	 	N/A	 	94.44%	 	90.00%	 	100.00%	 	90.00%	 	100.00%	 	100.00%	 	87.50%	 	91.67%	 	100.00%
																
	 SHP-137
	 	A&G	 	5	 	Medi-Cal: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	63	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	97.73%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.44%
																
	 SHP-138
	 	A&G	 	5	 	Medi-Cal: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	79	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	88.89%	 	88.46%	 	100.00%
																
	 SHP-139
	 	A&G	 	5	 	Medi-Cal: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	275	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	98.41%	 	99.51%	 	100.00%	 	99.41%	 	100.00%
																
	 SHP-140
	 	A&G	 	5	 	Medi-Cal: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	63	 	N/A	 	98.08%	 	100.00%	 	97.73%	 	95.45%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.44%
																
	 SHP-141
	 	A&G	 	5	 	Medi-Cal: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	275	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	99.52%	 	99.47%	 	99.51%	 	98.80%	 	99.41%	 	97.80%

  

					
	Schedule B-2-1	  	B-2-1-17	  	Health Net / Cognizant Confidential

 Final 

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 MPD-129
	 	A&G	 	8	 	Standard Part D - Grievances TAT (Oregon)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-130
	 	A&G	 	8	 	Standard Part D - Grievances TAT (CA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-131
	 	A&G	 	8	 	Standard Part D - Grievances TAT (AZ)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	87.50%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 MPD-133
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (Oregon)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 MPD-134
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (CA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 MPD-135
	 	A&G	 	8	 	Expedited Part D - Grievances TAT (AZ)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 SHP-136
	 	A&G	 	5	 	Medi-Cal: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	100.00%	 	100.00%	 	90.91%	 	88.24%	 	94.99	 	0	 	0	 	95
													
	 SHP-137
	 	A&G	 	5	 	Medi-Cal: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-138
	 	A&G	 	5	 	Medi-Cal: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	97.37%	 	97.83%	 	95.16%	 	96.20%	 	94.99	 	0	 	0	 	95
													
	 SHP-139
	 	A&G	 	5	 	Medi-Cal: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	99.44%	 	100.00%	 	99.63%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-140
	 	A&G	 	5	 	Medi-Cal: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	97.30%	 	98.57%	 	98.41%	 	94.99	 	0	 	0	 	95
													
	 SHP-141
	 	A&G	 	5	 	Medi-Cal: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	99.44%	 	98.07%	 	98.13%	 	99.27%	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-18	  	Health Net / Cognizant Confidential

 Final 

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement
Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 SHP-142
	 	A&G	 	5	 	Cal-Viva: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	n	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-143
	 	A&G	 	5	 	Cal-Viva: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	Prime,
ODW	 		 	p	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-144
	 	A&G	 	5	 	Cal-Viva: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-145
	 	A&G	 	5	 	Cal-Viva: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-146
	 	A&G	 	5	 	Cal-Viva: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	p	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-147
	 	A&G	 	5	 	Cal-Viva: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 DPD-152
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- LA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 DPD-153
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- SD)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 DPD-154
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-LA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	 DPD-155
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-SD)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-19	  	Health Net / Cognizant Confidential

 Final 

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 SHP-142
	 	A&G	 	5	 	Cal-Viva: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Null
Universe	 	Null
Universe	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE
																
	 SHP-143
	 	A&G	 	5	 	Cal-Viva: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	17	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-144
	 	A&G	 	5	 	Cal-Viva: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	7	 	N/A	 	87.50%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-145
	 	A&G	 	5	 	Cal-Viva: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	37	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-146
	 	A&G	 	5	 	Cal-Viva: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	17	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-147
	 	A&G	 	5	 	Cal-Viva: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	37	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	93.75%	 	100.00%	 	96.67%
																
	 DPD-152
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- LA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-153
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- SD)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-154
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-LA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-155
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-SD)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV

  

					
	Schedule B-2-1	  	B-2-1-20	  	Health Net / Cognizant Confidential

 Final 

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-142
	 	A&G	 	5	 	Cal-Viva: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 SHP-143
	 	A&G	 	5	 	Cal-Viva: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	94.12%	 	94.99	 	0	 	0	 	95
													
	 SHP-144
	 	A&G	 	5	 	Cal-Viva: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	75.00%	 	100.00%	 	90.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-145
	 	A&G	 	5	 	Cal-Viva: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-146
	 	A&G	 	5	 	Cal-Viva: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	91.67%	 	94.12%	 	94.99	 	0	 	0	 	95
													
	 SHP-147
	 	A&G	 	5	 	Cal-Viva: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	97.30%	 	94.99	 	0	 	0	 	95
													
	 DPD-152
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- LA)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-153
	 	A&G	 	7	 	Standard Appeals TAT (Part D Pharmacy- SD)	 	Written notice must be provided to the enrollee no later than 7 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-154
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-LA)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-155
	 	A&G	 	7	 	Expedited Cal MediConnect - Appeals TAT (CA-SD)	 	Oral notice must be issued within 72 hours and if successful written notice mailed within 3 calendar days. If oral notice is unsuccessful then written notice must be mailed and received by the enrollee within the 72 hour timeframe -
100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-21	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	DPD-158	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (LA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	Prime,
ODW	 		 	n	 	LA
 COUNTY
	 	CMS,DHCS	 	Compliance	 	= 100%
												
	DPD-159	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (SD)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	DPD-160	 	A&G	 	7	 	IRE Appeals TAT (LA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	CPD-161	 	A&G	 	2	 	Response to Regulator Inquiry about Claims TAT	 	% of responses to regulator inquiries about claims within 21 calendar days of receipt	 	Prime,
ODW	 		 	n	 	OR	 	OID	 	Compliance	 	= 100%
												
	DPD-161	 	A&G	 	7	 	IRE Appeals TAT (SD)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	CPD-162	 	A&G	 	2	 	Response to Inquiry from Regulator Regarding a Claim TAT	 	% of responses submitted to the regulator from an inquiry involving a claim within 15 business days	 	Prime,
ODW	 		 	n	 	WA	 	OIC	 	Compliance	 	= 100%
												
	DPD-162	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	DPD-163	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	DPD-166	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-LA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	DPD-167	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-SD)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	•	 	SD
COUNTY	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-22	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 DPD-158
	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (LA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-159
	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (SD)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-160
	 	A&G	 	7	 	IRE Appeals TAT (LA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 CPD-161
	 	A&G	 	2	 	Response to Regulator Inquiry about Claims TAT	 	% of responses to regulator inquiries about claims within 21 calendar days of receipt	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	50.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 DPD-161
	 	A&G	 	7	 	IRE Appeals TAT (SD)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 CPD-162
	 	A&G	 	2	 	Response to Inquiry from Regulator Regarding a Claim TAT	 	% of responses submitted to the regulator from an inquiry involving a claim within 15 business days	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	 DPD-162
	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-163
	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-166
	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-LA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-167
	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-SD)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	1	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV

  

					
	Schedule B-2-1	  	B-2-1-23	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 DPD-158
	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (LA)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-159
	 	A&G	 	7	 	Expedited Appeals TAT (Part D Pharmacy) (SD)	 	Notice may be provided orally or in writing, within 72 hours, for fully favorable (overturn) decisions. For adverse (uphold), or partially adverse (partially uphold) decisions, oral notice may be issued within 72 hours, and if
successful, a written notice.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-160
	 	A&G	 	7	 	IRE Appeals TAT (LA)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 CPD-161
	 	A&G	 	2	 	Response to Regulator Inquiry about Claims TAT	 	% of responses to regulator inquiries about claims within 21 calendar days of receipt	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-161
	 	A&G	 	7	 	IRE Appeals TAT (SD)	 	Standard case is forwarded to IRE within 24 hours of the expiration of the applicable timeframe or when the decision is an ‘Uphold’ or ‘Partial Uphold’ - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 CPD-162
	 	A&G	 	2	 	Response to Inquiry from Regulator Regarding a Claim TAT	 	% of responses submitted to the regulator from an inquiry involving a claim within 15 business days	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-162
	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-163
	 	A&G	 	7	 	Appeals Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-166
	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-LA)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-167
	 	A&G	 	7	 	Standard Cal MediConnect - Grievances TAT (CA-SD)	 	Written notice must be provided to all concerned parties no later than 30 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	100.00%	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-24	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 DPD-170
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA-LA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	 DPD-171
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA-SD)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	 DPD-172
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	 DPD-173
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS	 	Compliance	 	= 100%
												
	 DPD-176
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 DPD-177
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Prime,
ODW	 		 	n	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 DPD-186
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	n	 	LA
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 DPD-187
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	SD
COUNTY	 	CMS,DHCS	 	Compliance	 	= 100%
												
	 SHP-266
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	¿	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-267
	 	A&G	 	5	 	Medi-Cal SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-268
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-269
	 	A&G	 	5	 	Medi-Cal SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-25	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 DPD-170
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA-LA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-171
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA-SD)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-172
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-173
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-176
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-177
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-186
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-187
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	1	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 SHP-266
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	11	 	N/A	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	100.00%	 	87.50%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-267
	 	A&G	 	5	 	Medi-Cal SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	37	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	95.45%
																
	 SHP-268
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	38	 	N/A	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	90.00%	 	84.62%	 	100.00%
																
	 SHP-269
	 	A&G	 	5	 	Medi-Cal SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	118	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	98.96%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-26	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 DPD-170
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA- LA)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
 DEV
	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-171
	 	A&G	 	7	 	Standard Part D - Grievances TAT (CA- SD)	 	Written notice must be provided to all concerned parties, as expeditiously as the enrollee’s health condition requires, but no later than 30 calendar days from the date the plan received the request - 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-172
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-173
	 	A&G	 	7	 	Expedited Cal MediConnect - Grievances TAT (CA-SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-176
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (LA)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-177
	 	A&G	 	7	 	Expedited Grievances TAT (Part D Pharmacy) (SD)	 	Notification either orally or written, when mandated within 24 hours of receipt. 100% of the time	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-186
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (LA)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-187
	 	A&G	 	7	 	Grievance Acknowledgement Letters Sent Timely (SD)	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-266
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	100.00%	 	100.00%	 	100.00%	 	81.82%	 	94.99	 	0	 	0	 	95
													
	 SHP-267
	 	A&G	 	5	 	Medi-Cal SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	97.30%	 	94.99	 	0	 	0	 	95
													
	 SHP-268
	 	A&G	 	5	 	Medi-Cal SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	100.00%	 	95.24%	 	96.43%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-269
	 	A&G	 	5	 	Medi-Cal SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	98.57%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-27	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 SHP-270
	 	A&G	 	5	 	Medi-Cal SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-271
	 	A&G	 	5	 	Medi-Cal SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-272
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	n	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-273
	 	A&G	 	5	 	Cal-Viva SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	Prime,
ODW	 		 	¿	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-274
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-275
	 	A&G	 	5	 	Cal-Viva SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	•	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-276
	 	A&G	 	5	 	Cal-Viva SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	¿	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-277
	 	A&G	 	5	 	Cal-Viva SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	Prime,
ODW	 		 	p	 	CA	 	DMHC	 	Compliance	 	= 100%
												
	 SHP-382
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Standard)	 	Contractor shall acknowledge receipt of standard appeals in writing within 5 business days of receipt	 	SHP
database
(current),
Prime
(future),
ODW	 		 	•	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-383
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Expedited)	 	Contractor shall acknowledge receipt of expedited appeals with 1 business day of receipt.	 	SHP
database
(current),
Prime
(future),
ODW	 		 	•	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-384
	 	A&G	 	6	 	Member Appeal TAT (Expedited Denial Notice)	 	If the Contractor denies a request for expedited resolution, it must transfer the appeal to the 30-day timeframe for a standard appeal. The Contractor must make reasonable efforts to give the enrollee prompt oral notice and
follow-up within 2 days with a written notice of the denial of expedited resolution.	 	SHP
database
(current),
Prime
(future),
ODW	 		 	n	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-385
	 	A&G	 	6	 	Member Appeal Resolution TAT (Standard)	 	Contractor shall resolve standard appeals no later than 30 days from the date of receipt of the appeal unless an extension is in effect.	 	SHP
database
(current),
Prime
(future),
ODW	 		 	•	 	AZ	 	AHCCCS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-28	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 SHP-270
	 	A&G	 	5	 	Medi-Cal SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	37	 	N/A	 	96.97%	 	100.00%	 	100.00%	 	96.30%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	95.45%
	 SHP-271
	 	A&G	 	5	 	Medi-Cal SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	118	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	98.96%	 	100.00%	 	100.00%	 	100.00%	 	96.47%
	 SHP-272
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE
	 SHP-273
	 	A&G	 	5	 	Cal-Viva SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	6	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
	 SHP-274
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	3	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
	 SHP-275
	 	A&G	 	5	 	Cal-Viva SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	13	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
	 SHP-276
	 	A&G	 	5	 	Cal-Viva SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	6	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
	 SHP-277
	 	A&G	 	5	 	Cal-Viva SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	13	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	84.62%	 	100.00%	 	100.00%
	 SHP-382
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Standard)	 	Contractor shall acknowledge receipt of standard appeals in writing within 5 business days of receipt	 	4	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%
	 SHP-383
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Expedited)	 	Contractor shall acknowledge receipt of expedited appeals with 1 business day of receipt.	 	1	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
	 SHP-384
	 	A&G	 	6	 	Member Appeal TAT (Expedited Denial Notice)	 	If the Contractor denies a request for expedited resolution, it must transfer the appeal to the 30-day timeframe for a standard appeal. The Contractor must make reasonable efforts to give the enrollee prompt oral notice and
follow-up within 2 days with a written notice of the denial of expedited resolution.	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
	 SHP-385
	 	A&G	 	6	 	Member Appeal Resolution TAT (Standard)	 	Contractor shall resolve standard appeals no later than 30 days from the date of receipt of the appeal unless an extension is in effect.	 	4	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-29	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-270
	 	A&G	 	5	 	Medi-Cal SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-271
	 	A&G	 	5	 	Medi-Cal SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	98.57%	 	98.88%	 	97.22%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-272
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Appeals Resolution Rate	 	within 3 calendar days	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 SHP-273
	 	A&G	 	5	 	Cal-Viva SPD: Standard Appeals Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measure from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	83.33%	 	94.99	 	0	 	0	 	95
													
	 SHP-274
	 	A&G	 	5	 	Cal-Viva SPD: Expedited Grievances Resolution Rate	 	within 3 calendar days	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-275
	 	A&G	 	5	 	Cal-Viva SPD: Standard Grievances Resolution Rate	 	Resolution letters are sent within 30 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	0	 	0	 	95
													
	 SHP-276
	 	A&G	 	5	 	Cal-Viva SPD: Appeals Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	80.00%	 	83.33%	 	94.99	 	0	 	0	 	95
													
	 SHP-277
	 	A&G	 	5	 	Cal-Viva SPD: Grievance Acknowledgement Letters Sent Timely	 	Acknowledgement letters are sent within 5 calendar days of receipt. Timeliness is measured from date of receipt to letter date.	 	100.00%	 	100.00%	 	100.00%	 	92.31%	 	94.99	 	0	 	0	 	95
													
	 SHP-382
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Standard)	 	Contractor shall acknowledge receipt of standard appeals in writing within 5 business days of receipt	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-383
	 	A&G	 	6	 	Member Appeal Acknowledgment Letter TAT (Expedited)	 	Contractor shall acknowledge receipt of expedited appeals with 1 business day of receipt.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-384
	 	A&G	 	6	 	Member Appeal TAT (Expedited Denial Notice)	 	If the Contractor denies a request for expedited resolution, it must transfer the appeal to the 30-day timeframe for a standard appeal. The Contractor must make reasonable efforts to give the enrollee prompt oral notice and
follow-up within 2 days with a written notice of the denial of expedited resolution.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	95	 	96.99	 	97
													
	 SHP-385
	 	A&G	 	6	 	Member Appeal Resolution TAT (Standard)	 	Contractor shall resolve standard appeals no later than 30 days from the date of receipt of the appeal unless an extension is in effect.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	94.99	 	95	 	96.99	 	97

  

					
	Schedule B-2-1	  	B-2-1-30	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement
Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 SHP-386
	 	A&G	 	6	 	Member Appeal Resolution TAT (Expedited)	 	Contractor shall resolve all expedited appeals no later than 3 business days from the date the Contractor receives the appeal unless an extension is in effect.	 	SHP database
(current), Prime
(future), ODW	 		 	•	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-387
	 	A&G	 	6	 	Member Grievance Resolution TAT	 	Contractor must resolve each grievance within 10 business days of receipt. No grievances shall exceed 90 days for resolution	 	SHP database
(current), Prime
(future), ODW	 		 	•	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-388
	 	A&G	 	6	 	Member State Fair Hearing TAT	 	Request for State Fair Hearings are forwarded within 5 days of receipt	 	SHP database
(current), Prime
(future), ODW	 		 	n	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 CPD-685
	 	A&G	 	1	 	PPO/EPO Appeals Notification TAT	 	% of non-expedited appeals with letters sent within 15 calendar days of receipt if appeal not resolved at that time (to include known facts regarding the specific case)	 	Macess/Magic
(current), Prime
(future), ODW	 		 	p	 	CA	 	CDI	 	Compliance	 	= 100%
	
	 Customer Call Center Metrics

Metric Data as of Apr-2014

												
	 SHP-130
	 	CC	 	5	 	Customer Call Center Abandonment Rate (Medi-Cal)	 	Call abandonment rate of less than or equal to 5%. (Medi-cal without CalViva).	 	Aspect ACD,
database	 		 	•	 	CA	 	DMHC	 	Compliance	 	<= 5%
												
	 SHP-131
	 	CC	 	5	 	Customer Call Center Abandonment Rate (CalViva)	 	Call abandonment rate of less than or equal to 5%.	 	Aspect ACD,
database	 		 	•	 	CA	 	DMHC	 	Compliance	 	<= 5%
												
	 SHP-133
	 	CC	 	5	 	Customer Call Center Service Level Rate (Medi-Cal)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds. (Medi-cal without CalViva)	 	Aspect ACD,
database	 		 	p	 	CA	 	DMHC	 	Compliance	 	>= 80%
												
	 SHP-134
	 	CC	 	5	 	Customer Call Center Service Level Rate (CalViva)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds.	 	Aspect ACD,
database	 		 	•	 	CA	 	DMHC	 	Compliance	 	>= 80%
												
	 DPD-138
	 	CC	 	7	 	Abandonment Trend (LA)	 	Ratio of calls abandoned to calls offered	 	Aspect ACD,
database	 		 	n	 	LA
COUNTY	 	CMS,
DHCS	 	Compliance	 	<= 5%
												
	 DPD-139
	 	CC	 	7	 	Abandonment Trend (SD)	 	Ratio of calls abandoned to calls offered	 	Aspect ACD,
database	 		 	•	 	SD
COUNTY	 	CMS,
DHCS	 	Compliance	 	<= 5%
												
	 DPD-140
	 	CC	 	7	 	Service Level Trend (LA)	 	Percentage of calls answered in 30 seconds or less	 	Aspect ACD,
database	 		 	n	 	LA
COUNTY	 	CMS,
DHCS	 	Compliance	 	= 80%
												
	 DPD-141
	 	CC	 	7	 	Service Level Trend (SD)	 	Percentage of calls answered in 30 seconds or less	 	Aspect ACD,
database	 		 	•	 	SD
COUNTY	 	CMS,
DHCS	 	Compliance	 	= 80%
												
	 DPD-142
	 	CC	 	7	 	Wait to Speak to Live Rep (LA)	 	Hold time <2 mins (average)	 	Aspect ACD,
database	 		 	n	 	LA
COUNTY	 	CMS,
DHCS	 	Compliance	 	>= 95%
												
	 DPD-143
	 	CC	 	7	 	Wait to Speak to Live Rep (SD)	 	Hold time <2 mins (average)	 	Aspect ACD,
database	 		 	n	 	SD
COUNTY	 	CMS,
DHCS	 	Compliance	 	>= 95%
												
	 SHP-163
	 	CC	 	5	 	CalViva Medi-Cal Call Center Wait to Speak to Live Rep	 	non recorded voice within 10 mins	 	Aspect ACD,
database	 		 	n	 	CA	 	DHCS	 	Compliance	 	>= 95%
												
	 CPD-167
	 	CC	 	1	 	HMO/POS Speed to Answer Calls	 	% of calls answered within 10 minutes	 	Aspect ACD,
database	 		 	n	 	CA	 	DMHC	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-31	  	Health Net / Cognizant Confidential

 Final 

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	SHP-386	 	A&G	 	6	 	Member Appeal Resolution TAT (Expedited)	 	Contractor shall resolve all expedited appeals no later than 3 business days from the date the Contractor receives the appeal unless an extension is in effect.	 	1	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	SHP-387	 	A&G	 	6	 	Member Grievance Resolution TAT	 	Contractor must resolve each grievance within 10 business days of receipt. No grievances shall exceed 90 days for resolution	 	14	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%
																
	SHP-388	 	A&G	 	6	 	Member State Fair Hearing TAT	 	Request for State Fair Hearings are forwarded within 5 days of receipt	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-685	 	A&G	 	1	 	PPO/EPO Appeals Notification TAT	 	% of non-expedited appeals with letters sent within 15 calendar days of receipt if appeal not resolved at that time (to include known facts regarding the specific case)	 	103	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	98.76%	 	99.14%	 	97.50%
										
	 Customer Call Center Metrics

Metric Data as of Apr-2014
	 		 		 		 		 		 		 		 		 	
																
	SHP-130	 	CC	 	5	 	Customer Call Center Abandonment Rate (Medi-Cal)	 	Call abandonment rate of less than or equal to 5%. (Medi-cal without CalViva).	 	75220	 	N/A	 	3.11%	 	3.14%	 	2.39%	 	2.52%	 	4.00%	 	2.99%	 	3.60%	 	NULL
UNIVERSE	 	11.89%
																
	SHP-131	 	CC	 	5	 	Customer Call Center Abandonment Rate (CalViva)	 	Call abandonment rate of less than or equal to 5%.	 	8857	 	N/A	 	4.09%	 	4.43%	 	4.33%	 	4.38%	 	4.96%	 	3.67%	 	5.34%	 	NULL
UNIVERSE	 	3.48%
																
	SHP-133	 	CC	 	5	 	Customer Call Center Service Level Rate (Medi-Cal)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds. (Medi-cal without CalViva)	 	75220	 	N/A	 	85.49%	 	84.23%	 	88.36%	 	87.15%	 	79.23%	 	80.75%	 	80.36%	 	NULL
UNIVERSE	 	70.63%
																
	SHP-134	 	CC	 	5	 	Customer Call Center Service Level Rate (CalViva)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds.	 	8857	 	N/A	 	92.07%	 	92.48%	 	92.61%	 	90.52%	 	89.54%	 	93.96%	 	87.57%	 	NULL
UNIVERSE	 	85.69%
																
	DPD-138	 	CC	 	7	 	Abandonment Trend (LA)	 	Ratio of calls abandoned to calls offered	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	DPD-139	 	CC	 	7	 	Abandonment Trend (SD)	 	Ratio of calls abandoned to calls offered	 	443	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	DPD-140	 	CC	 	7	 	Service Level Trend (LA)	 	Percentage of calls answered in 30 seconds or less	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	DPD-141	 	CC	 	7	 	Service Level Trend (SD)	 	Percentage of calls answered in 30 seconds or less	 	443	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	DPD-142	 	CC	 	7	 	Wait to Speak to Live Rep (LA)	 	Hold time <2 mins (average)	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	DPD-143	 	CC	 	7	 	Wait to Speak to Live Rep (SD)	 	Hold time <2 mins (average)	 	N/A	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	SHP-163	 	CC	 	5	 	CalViva Medi-Cal Call Center Wait to Speak to Live Rep	 	non recorded voice within 10 mins	 	Null
Universe	 	Null
Universe	 	99.57%	 	99.47%	 	99.92%	 	99.00%	 	98.14%	 	97.97%	 	97.02%	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-167	 	CC	 	1	 	HMO/POS Speed to Answer Calls	 	% of calls answered within 10 minutes	 	Null
Universe	 	Null
Universe	 	96.52%	 	97.41%	 	93.83%	 	94.99%	 	97.09%	 	98.12%	 	94.48%	 	95.65%	 	90.48%

  

					
	Schedule B-2-1	  	B-2-1-32	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-386
	 	A&G	 	6	 	Member Appeal Resolution TAT (Expedited)	 	Contractor shall resolve all expedited appeals no later than 3 business days from the date the Contractor receives the appeal unless an extension is in effect.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-387
	 	A&G	 	6	 	Member Grievance Resolution TAT	 	Contractor must resolve each grievance within 10 business days of receipt. No grievances shall exceed 90 days for resolution	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-388
	 	A&G	 	6	 	Member State Fair Hearing TAT	 	Request for State Fair Hearings are forwarded within 5 days of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	95	 	96.99	 	97
													
	 CPD-685
	 	A&G	 	1	 	PPO/EPO Appeals Notification TAT	 	% of non-expedited appeals with letters sent within 15 calendar days of receipt if appeal not resolved at that time (to include known facts regarding the specific case)	 	89.29%	 	89.19%	 	89.61%	 	93.20%	 	94.99	 	0	 	0	 	95
							
	 Customer Call Center Metrics

Metric Data as of Apr-2014
	 		 		 		 		 		 	
													
	 SHP-130
	 	CC	 	5	 	Customer Call Center Abandonment Rate (Medi-Cal)	 	Call abandonment rate of less than or equal to 5%. (Medi-cal without CalViva).	 	14.50%	 	8.95%	 	10.03%	 	3.82%	 	4.99	 	0	 	0	 	5
													
	 SHP-131
	 	CC	 	5	 	Customer Call Center Abandonment Rate (CalViva)	 	Call abandonment rate of less than or equal to 5%.	 	2.26%	 	1.52%	 	1.77%	 	0.89%	 	4.99	 	0	 	0	 	5
													
	 SHP-133
	 	CC	 	5	 	Customer Call Center Service Level Rate (Medi-Cal)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds. (Medi-cal without CalViva)	 	63.86%	 	63.62%	 	51.33%	 	75.44%	 	79.99	 	0	 	0	 	80
													
	 SHP-134
	 	CC	 	5	 	Customer Call Center Service Level Rate (CalViva)	 	Service level greater than or equal to 80% of phone calls answered by a recorded voice within 30 seconds.	 	87.89%	 	90.77%	 	88.18%	 	93.03%	 	79.99	 	0	 	0	 	80
													
	 DPD-138
	 	CC	 	7	 	Abandonment Trend (LA)	 	Ratio of calls abandoned to calls offered	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	5.1	 	0	 	0	 	5
													
	 DPD-139
	 	CC	 	7	 	Abandonment Trend (SD)	 	Ratio of calls abandoned to calls offered	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	1.35%	 	5.1	 	0	 	0	 	5
													
	 DPD-140
	 	CC	 	7	 	Service Level Trend (LA)	 	Percentage of calls answered in 30 seconds or less	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	79.99	 	0	 	0	 	80
													
	 DPD-141
	 	CC	 	7	 	Service Level Trend (SD)	 	Percentage of calls answered in 30 seconds or less	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	87.13%	 	79.99	 	0	 	0	 	80
													
	 DPD-142
	 	CC	 	7	 	Wait to Speak to Live Rep (LA)	 	Hold time <2 mins (average)	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 DPD-143
	 	CC	 	7	 	Wait to Speak to Live Rep (SD)	 	Hold time <2 mins (average)	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	N/A	 	94.99	 	0	 	0	 	95
													
	 SHP-163
	 	CC	 	5	 	CalViva Medi-Cal Call Center Wait to Speak to Live Rep	 	non recorded voice within 10 mins	 	84.83%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	UNIVERSE
NULL	 	94.99	 	0	 	0	 	95
													
	 CPD-167
	 	CC	 	1	 	HMO/POS Speed to Answer Calls	 	% of calls answered within 10 minutes	 	91.62%	 	89.60%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-33	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 SHP-223
	 	CC	 	5	 	Medi-Cal Call Center Wait to Speak to Live Rep	 	Non recorded voice within 10 mins	 	Aspect ACD, database	 		 	n	 	CA	 	DHCS	 	Compliance	 	>= 95%
												
	 MPD-230
	 	CC	 	4	 	Abandonment Trend - Medicare CA Member	 	Ratio of calls abandoned to calls offered	 	Aspect ACD, database	 		 	—	 	CA	 	CMS	 	Compliance	 	<= 5%
												
	 MPD-231
	 	CC	 	4	 	Abandonment Trend - Medicare OR Member	 	Ratio of calls abandoned to calls offered	 	Aspect ACD, database	 		 	—	 	OR	 	CMS	 	Compliance	 	<= 5%
												
	 MPD-233
	 	CC	 	4	 	Abandonment Trend - Medicare AZ Member	 	Ratio of calls abandoned to calls offered	 	Aspect ACD, database	 		 	—	 	AZ	 	CMS	 	Compliance	 	<= 5%
												
	 MPD-239
	 	CC	 	4	 	Service Level Trend - Medicare CA Member	 	Percentage of calls answered in 30 seconds or less	 	Aspect ACD, database	 		 	—	 	CA	 	CMS	 	Compliance	 	= 80%
												
	 MPD-240
	 	CC	 	4	 	Service Level Trend - Medicare OR Member	 	Percentage of calls answered in 30 seconds or less	 	Aspect ACD, database	 		 	—	 	OR	 	CMS	 	Compliance	 	= 80%
												
	 MPD-242
	 	CC	 	4	 	Service Level Trend - Medicare AZ Member	 	Percentage of calls answered in 30 seconds or less	 	Aspect ACD, database	 		 	¿	 	AZ	 	CMS	 	Compliance	 	= 80%
												
	 SHP-369
	 	CC	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	NOTE- This metric is transitioning under the Claims tower. Removing from CCC tower.	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-370
	 	CC	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	NOTE- This metric is transitioning under the Claims tower. Removing from CCC tower.	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-371
	 	CC	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	NOTE- This metric is transitioning under the Claims tower. Removing from CCC tower.	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-372
	 	CC	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	NOTE- This metric is transitioning under the Claims tower. Removing from CCC tower.	 		 	n	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-389
	 	CC	 	6	 	Customer Call Center - Average Speed of Answer (ASOA)	 	The ASOA must be 45 seconds or less.	 	Aspect ACD, database	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	< = 45
Seconds
												
	 SHP-390
	 	CC	 	6	 	Customer Call Center - Monthly Average Abandnment Rate (MAAR)	 	The MAAR must be 5% or less. This is determined by the number of calls abandoned in a 24-hour period, divided by the total number of calls received in the same 24-hour period, summed for each day of the month and then divided by the
number of days in the monthly reporting period.	 	Aspect ACD, database	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	< = 5%
												
	 SHP-391
	 	CC	 	6	 	Customer Call Center - Monthly First Contact Call Resolution Rate (MFCCCR)	 	The MFCCR must be 70% or better. This is the sum of the Daily FCCRs divided by the number of days in the reporting period.	 	Macess, Omni, ODW	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	> = 70%

  

					
	Schedule B-2-1	  	B-2-1-34	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	SHP-223	 	CC	 	5	 	Medi-Cal Call Center Wait to Speak to Live Rep	 	Non recorded voice within 10 mins	 	Null
Universe	 	Null
Universe	 	98.35%	 	98.45%	 	98.52%	 	98.14%	 	96.42%	 	96.08%	 	93.84%	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	MPD-230	 	CC	 	4	 	Abandonment Trend - Medicare CA Member	 	Ratio of calls abandoned to calls offered	 	34479	 	N/A	 	1.45%	 	1.09%	 	1.72%	 	2.34%	 	2.63%	 	4.81%	 	18.53%	 	6.72%	 	8.52%
																
	MPD-231	 	CC	 	4	 	Abandonment Trend - Medicare OR Member	 	Ratio of calls abandoned to calls offered	 	11013	 	N/A	 	1.74%	 	2.83%	 	2.13%	 	4.65%	 	4.08%	 	2.82%	 	5.74%	 	4.51%	 	10.79%
																
	MPD-233	 	CC	 	4	 	Abandonment Trend - Medicare AZ Member	 	Ratio of calls abandoned to calls offered	 	14020	 	N/A	 	2.81%	 	2.99%	 	3.14%	 	3.80%	 	3.61%	 	3.04%	 	6.44%	 	6.70%	 	7.65%
																
	MPD-239	 	CC	 	4	 	Service Level Trend - Medicare CA Member	 	Percentage of calls answered in 30 seconds or less	 	34479	 	N/A	 	82.12%	 	84.06%	 	83.56%	 	81.51%	 	81.68%	 	73.66%	 	31.67%	 	68.22%	 	68.89%
																
	MPD-240	 	CC	 	4	 	Service Level Trend - Medicare OR Member	 	Percentage of calls answered in 30 seconds or less	 	11013	 	N/A	 	86.94%	 	88.62%	 	84.02%	 	78.24%	 	85.63%	 	79.43%	 	66.67%	 	75.12%	 	62.51%
																
	MPD-242	 	CC	 	4	 	Service Level Trend - Medicare AZ Member	 	Percentage of calls answered in 30 seconds or less	 	14020	 	N/A	 	83.46%	 	84.28%	 	81.79%	 	76.11%	 	76.67%	 	80.39%	 	64.76%	 	65.53%	 	61.60%
																
	SHP-369	 	CC	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	36	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	SHP-370	 	CC	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	41	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	SHP-371	 	CC	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	37	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	SHP-372	 	CC	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	Null
Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	SHP-389	 	CC	 	6	 	Customer Call Center - Average Speed of Answer (ASOA)	 	The ASOA must be 45 seconds or less.	 	11855	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	23.00	 	10.00	 	26.00
																
	SHP-390	 	CC	 	6	 	Customer Call Center - Monthly Average Abandnment Rate (MAAR)	 	The MAAR must be 5% or less. This is determined by the number of calls abandoned in a 24-hour period, divided by the total number of calls received in the same 24-hour period, summed for each day of the month and then divided by the
number of days in the monthly reporting period.	 	11855	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	3.04%	 	1.62%	 	2.11%
																
	SHP-391	 	CC	 	6	 	Customer Call Center - Monthly First Contact Call Resolution Rate (MFCCCR)	 	The MFCCR must be 70 % or better. This is the sum of the Daily FCCRs divided by the number of days in the reporting period.	 	13032	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	96.99%	 	97.02%	 	96.99%

  

					
	Schedule B-2-1	  	B-2-1-35	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-223
	 	CC	 	5	 	Medi-Cal Call Center Wait to Speak to Live Rep	 	Non recorded voice within 10 mins	 	85.86%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	94.99	 	0	 	0	 	95
													
	 MPD-230
	 	CC	 	4	 	Abandonment Trend - Medicare CA Member	 	Ratio of calls abandoned to calls offered	 	16.01%	 	5.81%	 	6.57%	 	3.03%	 	4.99	 	0	 	0	 	5
													
	 MPD-231
	 	CC	 	4	 	Abandonment Trend - Medicare OR Member	 	Ratio of calls abandoned to calls offered	 	10.49%	 	4.19%	 	4.34%	 	1.72%	 	4.99	 	0	 	0	 	5
													
	 MPD-233
	 	CC	 	4	 	Abandonment Trend - Medicare AZ Member	 	Ratio of calls abandoned to calls offered	 	14.40%	 	9.13%	 	4.57%	 	1.89%	 	4.99	 	0	 	0	 	5
													
	 MPD-239
	 	CC	 	4	 	Service Level Trend - Medicare CA Member	 	Percentage of calls answered in 30 seconds or less	 	54.09%	 	80.46%	 	67.43%	 	81.04%	 	79.99	 	0	 	0	 	80
													
	 MPD-240
	 	CC	 	4	 	Service Level Trend - Medicare OR Member	 	Percentage of calls answered in 30 seconds or less	 	49.34%	 	80.34%	 	72.09%	 	81.50%	 	79.99	 	0	 	0	 	80
													
	 MPD-242
	 	CC	 	4	 	Service Level Trend - Medicare AZ Member	 	Percentage of calls answered in 30 seconds or less	 	54.42%	 	79.31%	 	69.26%	 	77.08%	 	79.99	 	0	 	0	 	80
													
	 SHP-369
	 	CC	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	97.30%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-370
	 	CC	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	97.56%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-371
	 	CC	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-372
	 	CC	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	94.99	 	95	 	96.99	 	97
													
	 SHP-389
	 	CC	 	6	 	Customer Call Center - Average Speed of Answer (ASOA)	 	The ASOA must be 45 seconds or less.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	20.00	 	LAG
MONTH	 	45.01	 	0	 	0	 	45
													
	 SHP-390
	 	CC	 	6	 	Customer Call Center - Monthly Average Abandnment Rate (MAAR)	 	The MAAR must be 5% or less. This is determined by the number of calls abandoned in a 24-hour period, divided by the total number of calls received in the same 24-hour period, summed for each day of the month and then divided by the
number of days in the monthly reporting period.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	2.91%	 	LAG
MONTH	 	4.99	 	0	 	0	 	5
													
	 SHP-391
	 	CC	 	6	 	Customer Call Center - Monthly First Contact Call Resolution Rate (MFCCCR)	 	The MFCCR must be 70 % or better. This is the sum of the Daily FCCRs divided by the number of days in the reporting period.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	95.20%	 	LAG
MONTH	 	69.99	 	0	 	0	 	70

  

					
	Schedule B-2-1	  	B-2-1-36	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 SHP-392
	 	CC	 	6	 	Customer Call Center - Monthly Average Service Level (MASL)	 	MASL must be 75 % or better. The total of the month?s calls answered within 45 seconds divided by the sum of the following: all calls answered in the month, all calls abandoned calls in the month and all calls receiving a busy
signal in the month	 	Aspect ACD, database	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	> = 75%
												
	 CPD-655
	 	CC	 	2	 	TAT of Member Continuation of Coverage form request.	 	Upon member request, continuation of coverage form must be mailed to member within two business days.	 	Macess, Omni, ODW	 		 	n	 	OR	 	OID	 	Compliance	 	= 100%
												
	 MPD
	 	CC	 	4	 	Average Speed to Answer-Medicare CA Member	 	Average speed in which a call is answered	 	Aspect ACD, database	 	New
SLA	 		 	CA	 	CMS	 	Compliance	 	2 minutes
												
	 MPD
	 	CC	 	4	 	Average Speed to Answer-Medicare OR Member	 	Average speed in which a call is answered	 	Aspect ACD, database	 	New
SLA	 		 	OR	 	CMS	 	Compliance	 	2 minutes
												
	 MPD
	 	CC	 	4	 	Average Speed to Answer-Medicare AZ Member	 	Average speed in which a call is answered	 	Aspect ACD, database	 	New
SLA	 		 	AZ	 	CMS	 	Compliance	 	2 minutes
												
	 CPD
	 	CC	 	1	 	Exempt Grievance (MHN)	 	Case resolved within one business day	 	Symposium	 	New
SLA	 		 	CA	 	DMHC	 	Compliance	 	100.00%
												
	 CPD
	 	CC	 	1	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 	Qcare, HNCS, Omni,
Page Center	 	New
SLA	 		 	CA	 	DMHC,
CDI	 	Compliance	 	100.00%
												
	 SHP
	 	CC	 	5	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 	Qcare, HNCS, Omni,
Page Center	 	New
SLA	 		 	CA	 	DHCS	 	Compliance	 	100.00%
												
	 CPD
	 	CC	 	1	 	Respond to DMHC calls after hours within 60 minutes	 	Percentage of calls responded to within 60 minutes	 	Macess, Omni, ODW	 	New
SLA	 		 	CA	 	DMHC	 	Compliance	 	100.00%
												
	 CPD
	 	CC	 	1	 	Respond to DMHC calls during business hours within 30 minutes	 	Percentage of calls responded to within 30 minutes	 	Macess, Omni, ODW	 	New
SLA	 		 	CA	 	DMHC	 	Compliance	 	100.00%
												
	 CPD
	 	CC	 	1	 	After hours post stabilization	 	Percentage of calls responded to within 30 minutes	 	Macess, Omni, ODW	 	New
SLA	 		 	CA	 	DMHC	 	Compliance	 	100.00%
												
	 CPD
	 	CC	 	2	 	Provide a member cost estimate within 1 BD	 	Percentage of cost estimates completed in 1 BD	 	Macess, Omni, ODW	 	New
SLA	 		 	OR	 	OID	 	Complance	 	100.00%
												
	 CPD
	 	CC	 	2	 	Oregon continuation form requests to portability members within 2 business days	 	Percentage of requests completed within 2 business days	 	Macess, Omni, ODW	 	New
SLA	 		 	OR	 	OID	 	Compliance	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-37	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	SHP-392	 	CC	 	6	 	Customer Call Center - Monthly Average Service Level (MASL)	 	MASL must be 75 % or better. The total of the month?s calls answered within 45 seconds divided by the sum of the following: all calls answered in the month, all calls abandoned calls in the month and all calls receiving a busy
signal in the month	 	11855	 	N/A	 	NULL
 UNIVERSE
	 	 NULL

UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	 NULL

UNIVERSE
	 	NULL
UNIVERSE	 	89.68%	 	96.22%	 	90.75%
																
	CPD-655	 	CC	 	2	 	TAT of Member Continuation of Coverage form request.	 	Upon member request, continuation of coverage form must be mailed to member within two business days.	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	 NULL
UNIVERSE
	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	MPD	 	CC	 	4	 	Average Speed to Answer - Medicare CA Member	 	Average speed in which a call is answered	 	N/a	 	N/a	 		 		 		 		 		 		 		 		 	
																
	MPD	 	CC	 	4	 	Average Speed to Answer - Medicare OR Member	 	Average speed in which a call is answered	 	N/a	 	N/a	 		 		 		 		 		 		 		 		 	
																
	MPD	 	CC	 	4	 	Average Speed to Answer - Medicare AZ Member	 	Average speed in which a call is answered	 	N/a	 	N/a	 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	1	 	Exempt Grievance (MHN)	 	Case resolved within one business day	 	N/a	 	N/a	 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	1	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 		 		 		 		 		 		 		 		 		 		 	
																
	SHP	 	CC	 	5	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	1	 	Respond to DMHC calls after hours within 60 minutes	 	Percentage of calls responded to within 60 minutes	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	1	 	Respond to DMHC calls during business hours within 30 minutes	 	Percentage of calls responded to within 30 minutes	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	1	 	After hours post stabilization	 	Percentage of calls responded to within 30 minutes	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	2	 	Provide a member cost estimate within 1 BD	 	Percentage of cost estimates completed in 1 BD	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	CC	 	2	 	Oregon continuation form requests to portability members within 2 business days	 	Percentage of requests completed within 2 business days	 		 		 		 		 		 		 		 		 		 		 	

  

					
	Schedule B-2-1	  	B-2-1-38	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-392
	 	CC	 	6	 	Customer Call Center - Monthly Average Service Level (MASL)	 	MASL must be 75 % or better. The total of the month?s calls answered within 45 seconds divided by the sum of the following: all calls answered in the month, all calls abandoned calls in the month and all calls receiving a busy
signal in the month	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.00%	 	LAG
MONTH	 	74.99	 	0	 	0	 	75
													
	 CPD-655
	 	CC	 	2	 	TAT of Member Continuation of Coverage form request.	 	Upon member request, continuation of coverage form must be mailed to member within two business days.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	0	 	0	 	95
													
	 MPD
	 	CC	 	4	 	Average Speed to Answer- Medicare CA Member	 	Average speed in which a call is answered	 		 		 		 		 	2.01	 	0	 	0	 	2
													
	 MPD
	 	CC	 	4	 	Average Speed to Answer- Medicare OR Member	 	Average speed in which a call is answered	 		 		 		 		 	2.01	 	0	 	0	 	2
													
	 MPD
	 	CC	 	4	 	Average Speed to Answer- Medicare AZ Member	 	Average speed in which a call is answered	 		 		 		 		 	2.01	 	0	 	0	 	2
													
	 CPD
	 	CC	 	1	 	Exempt Grievance (MHN)	 	Case resolved within one business day	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	1	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 SHP
	 	CC	 	5	 	Complete Provider Group Rollouts and notifications within 30 days for PCP’s and 60 days for PPG’s Complete Provider Rollouts and notifications (MediCal) within 30 days Complete Hospital Termination notifications 60 days
prior to the termination effective date	 	The percentage of rollouts, member notifications completed within appropriate timeframes 30/60 days	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	1	 	Respond to DMHC calls after hours within 60 minutes	 	Percentage of calls responded to within 60 minutes	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	1	 	Respond to DMHC calls during business hours within 30 minutes	 	Percentage of calls responded to within 30 minutes	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	1	 	After hours post stabilization	 	Percentage of calls responded to within 30 minutes	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	2	 	Provide a member cost estimate within 1 BD	 	Percentage of cost estimates completed in 1 BD	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	CC	 	2	 	Oregon continuation form requests to portability members within 2 business days	 	Percentage of requests completed within 2 business days	 		 		 		 		 	99.99	 	0	 	0	 	100

  

					
	Schedule B-2-1	  	B-2-1-39	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 SHP
	 	CC	 	5	 	Silver Link Welcome Calls	 	Welcome calls must be done within the same month the member became active. The purpose of the call is to advise them to make apt with doctor for IHA (initial health assessment) within 90 days of being enrolled.	 	Qcare, HNCS, Omni,
Page Center	 	New
SLA	 		 	ALL	 	DHCS,
AHCCCS	 	Compliance	 	100.00%
								
	 Claims Metrics

Metric Data as of Apr-2014
	 		 		 		 		 		 		 	
												
	 CPD-85
	 	Claims	 	1	 	PPO/EPO PDR Acknowledgement TAT	 	Average speed in which a call is answered	 	Qcare, HNCS, Omni,
Page Center	 		 	—	 	CA	 	CDI	 	Compliance	 	=100%
												
	 CPD-101
	 	Claims	 	3	 	Interest on Clean Claims Paid Late	 	Interest shall be calculated beginning on the date that the payment to the health care provider is due	 	Quality Audit and
Training (Monthly)	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-102
	 	Claims	 	3	 	HMO/PPO Correct Claim Determination-Non-contracted Emergent Svcs	 	% of non-contracted emergent services NOT denied for lack of prior authorization	 	Quality Audit and
Training (Monthly)	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-103
	 	Claims	 	3	 	HMO/PPO Correct Claim Determination-Non-contracted Ambulance Svcs	 	% of non-contracted emergency ambulance services NOT denied for lack of prior authorization	 	Quality Audit and
Training (Monthly)	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-104
	 	Claims	 	2	 	‘Clean’ New Day Claims Resolution TAT (PG)	 	% of clean new day claims resolved within 30 calendar days	 	ABS -Monthly
Adhoc Report	 		 	—	 	OR	 	OID	 	Compliance	 	100%
												
	 CPD-106
	 	Claims	 	2	 	Initial Notification Regarding ‘Unclean’ New Day Claims TAT	 	% of notices sent for ‘unclean’ new day claims requesting additional information within 30 calendar days	 	ABS - Monthly
Adhoc Report	 		 	p	 	OR	 	OID	 	Compliance	 	100%
												
	 CPD-107
	 	Claims	 	2	 	Claims Interest Payment Accuracy	 	% of claims requiring interest that include accurate interest payment	 	Quality Audit and
Training (Monthly)	 		 	—	 	OR	 	OID	 	Compliance	 	100%
												
	 CPD-109
	 	Claims	 	2	 	Claims Correct Date of Receipt Recorded	 	% of claims with accurate date of receipt recorded in system	 	Quality Audit and
Training (Monthly)	 		 	—	 	OR	 	OID	 	Compliance	 	100%
												
	 CPD-111
	 	Claims	 	2	 	New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ‘clean’ new day claims resolved within 30 calendar days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	WA	 	OIC	 	Compliance	 	>= 95%
												
	 CPD-112
	 	Claims	 	2	 	‘Unclean’ New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ALL claims resolved within 60 calendar days of receipt	 	ABS - Monthly
Adhoc Report	 		 	n	 	WA	 	OIC	 	Compliance	 	>= 95%
												
	 CPD-113
	 	Claims	 	2	 	WA Interest Payment Accuracy	 	Accurate interest payment starting day 61 after the date of receipt	 	Quality Audit and
Training (Monthly)	 		 	n	 	WA	 	OIC	 	Compliance	 	100%
												
	 CPD-115
	 	Claims	 	2	 	Claims Acknowledgement TAT (under group insurance contracts)	 	% of claims acknowledged within 15 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	WA	 	OIC	 	Compliance	 	100%
												
	 CPD-116
	 	Claims	 	2	 	Record Correct Date of Claims Receipt	 	% of claims recorded with accurate date of receipt	 	Quality Audit and
Training (Monthly)	 		 	n	 	WA	 	OIC	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-40	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	SHP	 	CC	 	5	 	Silver Link Welcome Calls	 	Welcome calls must be done within the same month the member became active. The purpose of the call is to advise them to make apt with doctor for IHA (initial health assessment) within 90 days of being enrolled.	 		 		 		 		 		 		 		 		 		 		 	
												
	 Claims Metrics
 Metric
Data as of Apr-2014
	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD-85	 	Claims	 	1	 	PPO/EPO PDR Acknowledgement TAT	 	Average speed in which a call is answered	 	2798	 	N/A	 	98.99%	 	99.00%	 	99.99%	 	99.10%	 	99.00%	 	99.00%	 	99.00%	 	99.00%	 	99.00%
																
	CPD-101	 	Claims	 	3	 	Interest on Clean Claims Paid Late	 	Interest shall be calculated beginning on the date that the payment to the health care provider is due	 	1656	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	84.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-102	 	Claims	 	3	 	 HMO/PPO Correct Claim Determination-

Non-contracted Emergent Svcs
	 	% of non-contracted emergent services NOT denied for lack of prior authorization	 	1883	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	99.94%	 	98.82%	 	99.75%	 	99.81%	 	99.78%	 	99.90%
																
	CPD-103	 	Claims	 	3	 	HMO/PPO Correct Claim Determination- Non-contracted Ambulance Svcs	 	 % of non-contracted emergency
 ambulance services
NOT denied for lack of prior authorization
	 	1883	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	99.94%	 	99.53%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-104	 	Claims	 	2	 	‘Clean’ New Day Claims Resolution TAT (PG)	 	% of clean new day claims resolved within 30 calendar days	 	41976	 	N/A	 	98.40%	 	99.30%	 	99.40%	 	99.70%	 	99.60%	 	99.60%	 	99.80%	 	99.90%	 	99.70%
																
	CPD-106	 	Claims	 	2	 	Initial Notification Regarding ‘Unclean’ New Day Claims TAT	 	% of notices sent for ‘unclean’ new day claims requesting additional information within 30 calendar days	 	106	 	N/A	 	98.15%	 	100.00%	 	99.49%	 	98.97%	 	98.72%	 	97.25%	 	98.00%	 	96.84%	 	94.29%
																
	CPD-107	 	Claims	 	2	 	Claims Interest Payment Accuracy	 	% of claims requiring interest that include accurate interest payment	 	219	 	25	 	84.21%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	94.44%	 	100.00%	 	75.00%	 	100.00%
																
	CPD-109	 	Claims	 	2	 	Claims Correct Date of Receipt Recorded	 	% of claims with accurate date of receipt recorded in system	 	219	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-111	 	Claims	 	2	 	New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ‘clean’ new day claims resolved within 30 calendar days of receipt	 	1029	 	N/A	 	99.60%	 	99.90%	 	99.40%	 	100.00%	 	99.40%	 	99.90%	 	99.90%	 	99.80%	 	99.90%
																
	CPD-112	 	Claims	 	2	 	‘Unclean’ New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ALL claims resolved within 60 calendar days of receipt	 	Null
Universe	 	Null
Universe	 	99.40%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.50%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-113	 	Claims	 	2	 	WA Interest Payment Accuracy	 	Accurate interest payment starting day 61 after the date of receipt	 	Null
Universe	 	Null
Universe	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE

																
	CPD-115	 	Claims	 	2	 	Claims Acknowledgement TAT (under group insurance contracts)	 	% of claims acknowledged within 15 business days of receipt	 	6369	 	N/A	 	95.52%	 	99.40%	 	99.67%	 	99.50%	 	99.40%	 	99.40%	 	99.40%	 	98.99%	 	99.50%
																
	CPD-116	 	Claims	 	2	 	Record Correct Date of Claims Receipt	 	% of claims recorded with accurate date of receipt	 	Null
Universe	 	Null
Universe	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-41	  	Health Net / Cognizant Confidential

 Final 
  

																																	
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	 SHP
	 	CC	 	5	 	Silver Link Welcome Calls	 	Welcome calls must be done within the same month the member became active. The purpose of the call is to advise them to make apt with doctor for IHA (initial health assessment) within 90 days of being enrolled.	 		 		 		 		 	 	99.99	  	 				 	 	0	  	 	 	0 100	  
										
	Claims Metrics	 		 		 		 		 		 				 				 				 			
	Metric Data as of Apr-2014	 		 		 		 		 		 				 				 				 			
													
	 CPD-85
	 	Claims	 	1	 	PPO/EPO PDR Acknowledgement TAT	 	Average speed in which a call is answered	 	99.00%	 	99.00%	 	99.00%	 	100%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-101
	 	Claims	 	3	 	Interest on Clean Claims Paid Late	 	Interest shall be calculated beginning on the date that the payment to the health care provider is due	 	100.00%	 	100.00%	 	96.00%	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-102
	 	Claims	 	3	 	HMO/PPO Correct Claim Determination- Non-contracted Emergent Svcs	 	% of non-contracted emergent services NOT denied for lack of prior authorization	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-103
	 	Claims	 	3	 	HMO/PPO Correct Claim Determination- Non-contracted Ambulance Svcs	 	% of non-contracted emergency ambulance services NOT denied for lack of prior authorization	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-104
	 	Claims	 	2	 	‘Clean’ New Day Claims Resolution TAT (PG)	 	% of clean new day claims resolved within 30 calendar days	 	99.70%	 	99.03%	 	98.61%	 	98.80%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-106
	 	Claims	 	2	 	Initial Notification Regarding ‘Unclean’ New Day Claims TAT	 	% of notices sent for ‘unclean’ new day claims requesting additional information within 30 calendar days	 	96.26%	 	97.62%	 	96.88%	 	93.20%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-107
	 	Claims	 	2	 	Claims Interest Payment Accuracy	 	% of claims requiring interest that include accurate interest payment	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-109
	 	Claims	 	2	 	Claims Correct Date of Receipt Recorded	 	% of claims with accurate date of receipt recorded in system	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-111
	 	Claims	 	2	 	New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ‘clean’ new day claims resolved within 30 calendar days of receipt	 	99.50%	 	97.80%	 	98.50%	 	98.40%	 	 	94.99	  	 	 	0	  	 	 	0	  	 	 	95	  
													
	 CPD-112
	 	Claims	 	2	 	‘Unclean’ New Day Claims TAT (for contracted providers ONLY) (PG)	 	% of ALL claims resolved within 60 calendar days of receipt	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	 	94.99	  	 	 	0	  	 	 	0	  	 	 	95	  
													
	 CPD-113
	 	Claims	 	2	 	WA Interest Payment Accuracy	 	Accurate interest payment starting day 61 after the date of receipt	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-115
	 	Claims	 	2	 	Claims Acknowledgement TAT (under group insurance contracts)	 	% of claims acknowledged within 15 business days of receipt	 	98.40%	 	98.40%	 	99.80%	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 CPD-116
	 	Claims	 	2	 	Record Correct Date of Claims Receipt	 	% of claims recorded with accurate date of receipt	 	NULL
UNIVERSE	 	NULL
 UNIVERSE
	 	NULL
 UNIVERSE
	 	LAG
MONTH	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-42	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 CPD-117
	 	Claims	 	2	 	Provider Claims Dispute Resolution TAT (PG)	 	% of provider claims disputes resolved within 30 calendar days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	WA	 	OIC	 	Compliance	 	100%
												
	 CPD-664
	 	Claims	 	1	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports
from both HN IT
and our
Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%
												
	 CPD-665
	 	Claims	 	1	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports
from both HN IT
and our Clearing
Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%
												
	 CPD-666
	 	Claims	 	1	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday.	 	Monthly Reports
from both HN IT
and our Clearing
Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 CPD-667
	 	Claims	 	1	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday	 	Monthly Reports
from both HN IT
and our Clearing
Houses.	 		 	—
	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 CPD-691
	 	Claims	 	1	 	PPO/EPO Initial Notification Regarding Contested New Day Claims TAT	 	% of notices sent for contested new day claims requesting additional information within 30 working days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD-708
	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted processed TAT	 	% of clean claims processed within 30 calendar days	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-709
	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted paid TAT	 	% of clean claims paid within 30 calendar days of processed date	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-43	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-117	 	Claims	 	2	 	Provider Claims Dispute Resolution TAT (PG)	 	% of provider claims disputes resolved within 30 calendar days of receipt	 	7	 	N/A	 	91.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	90.90%
																
	CPD-664	 	Claims	 	1	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	887875	 	N/A	 	97.60%	 	100.00%	 	98.19%	 	98.39%	 	97.04%	 	98.57%	 	97.65%	 	99.28%	 	93.15%
																
	CPD-665	 	Claims	 	1	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	38179	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	98.48%	 	99.28%	 	93.66%	 	98.06%	 	99.90%	 	69.48%
																
	CPD-666	 	Claims	 	1	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday.	 	972127	 	N/A	 	99.00%	 	96.00%	 	99.00%	 	99.00%	 	96.00%	 	97.00%	 	99.00%	 	98.00%	 	98.00%
																
	CPD-667	 	Claims	 	1	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday	 	34932	 	N/A	 	N/A	 	98.00%	 	99.00%	 	100.00%	 	98.00%	 	99.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-691	 	Claims	 	1	 	PPO/EPO Initial Notification Regarding Contested New Day Claims TAT	 	% of notices sent for contested new day claims requesting additional information within 30 working days of receipt	 	1088	 	N/A	 	94.06%	 	95.67%	 	95.91%	 	93.95%	 	92.79%	 	91.60%	 	89.98%	 	90.19%	 	82.37%
																
	CPD-708	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted processed TAT	 	% of clean claims processed within 30 calendar days	 	113989	 	N/A	 	97.05%	 	98.12%	 	98.52%	 	98.64%	 	98.76%	 	98.43%	 	98.08%	 	96.62%	 	97.41%
																
	CPD-709	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted paid TAT	 	% of clean claims paid within 30 calendar days of processed date	 	101925	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-44	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 CPD-117
	 	Claims	 	2	 	Provider Claims Dispute Resolution TAT (PG)	 	% of provider claims disputes resolved within 30 calendar days of receipt	 	87.50%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-664
	 	Claims	 	1	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	98.26%	 	98.43%	 	99.22%	 	98.46%	 	89.99	 	0	 	0	 	89.99
													
	 CPD-665
	 	Claims	 	1	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	97.00%	 	99.35%	 	99.97%	 	98.35%	 	89.99	 	0	 	0	 	89.99
													
	 CPD-666
	 	Claims	 	1	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday.	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 CPD-667
	 	Claims	 	1	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 CPD-691
	 	Claims	 	1	 	PPO/EPO Initial Notification Regarding Contested New Day Claims TAT	 	% of notices sent for contested new day claims requesting additional information within 30 working days of receipt	 	73.22%	 	96.64%	 	89.99%	 	96.21%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-708
	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted processed TAT	 	% of clean claims processed within 30 calendar days	 	98.23%	 	98.23%	 	98.19%	 	98.70%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-709
	 	Claims	 	3	 	HMO/PPO Clean Claims - Contracted/Non-contracted paid TAT	 	% of clean claims paid within 30 calendar days of processed date	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-45	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 CPD-711
	 	Claims	 	1	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	Monthly Reports
from both HN
IT and our
Clearing
Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	>= 90%
												
	 CPD-74
	 	Claims	 	1	 	HMO/POS New Day Claims Resolution TAT (PG)	 	% of new day claims resolved within 45 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-75
	 	Claims	 	1	 	PPO/EPO New Day Claims TAT (PG)	 	% of new day claims resolved within 30 working days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD-76
	 	Claims	 	1	 	HMO/POS TAT to Forward Claims to Delegated Entity	 	% of claims forwarded to delegated entity within 10 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	p	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-77
	 	Claims	 	1	 	HMO/POS Interest Payment Accuracy	 	% interest and penalties paid accurately when due	 	Quality Audit
and Training
(Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-78
	 	Claims	 	1	 	PPO/EPO Interest & Penalty Payment Accuracy	 	% of claims paid requiring interest and penalties paid accurately	 	Quality Audit
and Training
(Monthly)	 		 	—	 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD-79
	 	Claims	 	1	 	HMO/POS Claim Acknowledgement TAT - Electronic Claims/Paper Claims	 	% of electronic claims acknowledged within 2 business days of receipt and paper claims acknowledged within 15 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-81
	 	Claims	 	1	 	PPO/EPO Claim Acknowledgement TAT	 	% of claims acknowledged within 15 calendar days	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD-82
	 	Claims	 	1	 	HMO/POS Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-83
	 	Claims	 	1	 	PPO/EPO Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD-84
	 	Claims	 	1	 	HMO/POS PDR Acknowledgement TAT - Electronic/Paper	 	% of electronic PDRs acknowledged within 2 business days of receipt and paper PDRs acknowledged within 15 business days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-87
	 	Claims	 	1	 	HMO/POS PDR Paid Date TAT after Determination	 	% of PDRs paid within 5 business days of determination	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-88
	 	Claims	 	1	 	HMO/POS PDR Reimbursement Accuracy	 	% of PDRs paid accurately, including interest & penalties	 	Quality Audit
and Training
(Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-89
	 	Claims	 	1	 	HMO/POS PDR Correct Date of Receipt	 	% of PDRs with accurate date of receipt recorded in system	 	Quality Audit
and Training
(Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-90
	 	Claims	 	1	 	HMO/POS PDR Determination Letter Sent to Provider with Dispute Determination Reason	 	% of time determination letter is sent to provider and/or dispute determination is included within the letter	 	Quality Audit
and Training
(Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-46	  	Health Net / Cognizant Confidential

 Final 

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-711	 	Claims	 	1	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	70339	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A
																
	CPD-74	 	Claims	 	1	 	HMO/POS New Day Claims Resolution TAT (PG)	 	% of new day claims resolved within 45 business days of receipt	 	700821	 	N/A	 	99.95%	 	100.00%	 	99.92%	 	97.56%	 	99.95%	 	99.99%	 	99.34%	 	99.69%	 	99.77%
																
	CPD-75	 	Claims	 	1	 	PPO/EPO New Day Claims TAT (PG)	 	% of new day claims resolved within 30 working days of receipt	 	118084	 	N/A	 	98.60%	 	99.48%	 	97.26%	 	97.29%	 	97.13%	 	96.22%	 	98.07%	 	97.94%	 	95.30%
																
	CPD-76	 	Claims	 	1	 	HMO/POS TAT to Forward Claims to Delegated Entity	 	% of claims forwarded to delegated entity within 10 business days of receipt	 	40303	 	N/A	 	95.40%	 	95.38%	 	95.57%	 	95.69%	 	95.01%	 	92.16%	 	93.44%	 	93.77%	 	93.70%
																
	CPD-77	 	Claims	 	1	 	HMO/POS Interest Payment Accuracy	 	% interest and penalties paid accurately when due	 	59	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	92.00%	 	100.00%	 	100.00%	 	100.00%	 	96.00%
																
	CPD-78	 	Claims	 	1	 	PPO/EPO Interest & Penalty Payment Accuracy	 	% of claims paid requiring interest and penalties paid accurately	 	129	 	25	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	98.00%	 	92.00%	 	100.00%	 	95.65%	 	100.00%
																
	CPD-79	 	Claims	 	1	 	HMO/POS Claim Acknowledgement TAT - Electronic Claims/Paper Claims	 	% of electronic claims acknowledged within 2 business days of receipt and paper claims acknowledged within 15 business days of receipt	 	251	 	150	 	98.00%	 	99.33%	 	100.00%	 	100.00%	 	98.67%	 	100.00%	 	100.00%	 	100.00%	 	99.33%
																
	CPD-81	 	Claims	 	1	 	PPO/EPO Claim Acknowledgement TAT	 	% of claims acknowledged within 15 calendar days	 	251	 	150	 	98.00%	 	99.33%	 	100.00%	 	100.00%	 	98.67%	 	100.00%	 	100.00%	 	100.00%	 	99.33%
																
	CPD-82	 	Claims	 	1	 	HMO/POS Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	3980	 	N/A	 	97.13%	 	96.57%	 	98.06%	 	96.83%	 	97.74%	 	98.64%	 	99.37%	 	98.87%	 	98.75%
																
	CPD-83	 	Claims	 	1	 	PPO/EPO Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	2043	 	N/A	 	97.20%	 	96.56%	 	98.12%	 	97.03%	 	99.03%	 	99.30%	 	99.44%	 	99.75%	 	99.44%
																
	CPD-84	 	Claims	 	1	 	HMO/POS PDR Acknowledgement TAT - Electronic/Paper	 	% of electronic PDRs acknowledged within 2 business days of receipt and paper PDRs acknowledged within 15 business days of receipt	 	251	 	150	 	98.00%	 	99.33%	 	100.00%	 	100.00%	 	98.67%	 	100.00%	 	100.00%	 	100.00%	 	99.33%
																
	CPD-87	 	Claims	 	1	 	HMO/POS PDR Paid Date TAT after Determination	 	% of PDRs paid within 5 business days of determination	 	2635	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-88	 	Claims	 	1	 	HMO/POS PDR Reimbursement Accuracy	 	% of PDRs paid accurately, including interest & penalties	 	251	 	150	 	97.33%	 	98.67%	 	98.67%	 	97.33%	 	99.33%	 	98.67%	 	99.33%	 	99.33%	 	98.00%
																
	CPD-89	 	Claims	 	1	 	HMO/POS PDR Correct Date of Receipt	 	% of PDRs with accurate date of receipt recorded in system	 	251	 	150	 	100.00%	 	98.67%	 	100.00%	 	100.00%	 	99.33%	 	99.33%	 	99.33%	 	99.33%	 	99.33%
																
	CPD-90	 	Claims	 	1	 	HMO/POS PDR Determination Letter Sent to Provider with Dispute Determination Reason	 	% of time determination letter is sent to provider and/or dispute determination is included within the letter	 	251	 	150	 	100.00%	 	98.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.33%	 	100.00%	 	99.33%

  

					
	Schedule B-2-1	  	B-2-1-47	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 CPD-711
	 	Claims	 	1	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	93.00%	 	97.41%	 	99.38%	 	99.93%	 	89.99	 	0	 	0	 	89.99
													
	 CPD-74
	 	Claims	 	1	 	HMO/POS New Day Claims Resolution TAT (PG)	 	% of new day claims resolved within 45 business days of receipt	 	99.80%	 	99.90%	 	99.90%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-75
	 	Claims	 	1	 	PPO/EPO New Day Claims TAT (PG)	 	% of new day claims resolved within 30 working days of receipt	 	99.00%	 	96.16%	 	96.95%	 	97.29%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-76
	 	Claims	 	1	 	HMO/POS TAT to Forward Claims to Delegated Entity	 	% of claims forwarded to delegated entity within 10 business days of receipt	 	96.42%	 	94.84%	 	95.60%	 	94.04%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-77
	 	Claims	 	1	 	HMO/POS Interest Payment Accuracy	 	% interest and penalties paid accurately when due	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-78
	 	Claims	 	1	 	PPO/EPO Interest & Penalty Payment Accuracy	 	% of claims paid requiring interest and penalties paid accurately	 	100.00%	 	100.00%	 	96.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-79
	 	Claims	 	1	 	HMO/POS Claim Acknowledgement TAT - Electronic Claims/Paper Claims	 	% of electronic claims acknowledged within 2 business days of receipt and paper claims acknowledged within 15 business days of receipt	 	100.00%	 	99.33%	 	99.33%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-81
	 	Claims	 	1	 	PPO/EPO Claim Acknowledgement TAT	 	% of claims acknowledged within 15 calendar days	 	100.00%	 	99.33%	 	99.33%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-82
	 	Claims	 	1	 	HMO/POS Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	96.35%	 	99.35%	 	99.00%	 	98.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-83
	 	Claims	 	1	 	PPO/EPO Provider Dispute Resolution (PDR) TAT	 	% of PDRs resolved within 45 business days of receipt	 	99.61%	 	99.34%	 	99.00%	 	96.80%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-84
	 	Claims	 	1	 	HMO/POS PDR Acknowledgement TAT - Electronic/Paper	 	% of electronic PDRs acknowledged within 2 business days of receipt and paper PDRs acknowledged within 15 business days of receipt	 	100.00%	 	99.33%	 	99.33%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-87
	 	Claims	 	1	 	HMO/POS PDR Paid Date TAT after Determination	 	% of PDRs paid within 5 business days of determination	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-88
	 	Claims	 	1	 	HMO/POS PDR Reimbursement Accuracy	 	% of PDRs paid accurately, including interest & penalties	 	96.67%	 	98.67%	 	99.33%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-89
	 	Claims	 	1	 	HMO/POS PDR Correct Date of Receipt	 	% of PDRs with accurate date of receipt recorded in system	 	100.00%	 	99.33%	 	99.33%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-90
	 	Claims	 	1	 	HMO/POS PDR Determination Letter Sent to Provider with Dispute Determination Reason	 	% of time determination letter is sent to provider and/or dispute determination is included within the letter	 	100.00%	 	99.33%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-48	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Measurement Tools	 	Comment	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 CPD-91
	 	Claims	 	1	 	HMO/POS Claims Denial Accuracy	 	% of denied claims that are denied accurately	 	Quality Audit and
Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-92
	 	Claims	 	1	 	HMO/POS Claims Correct Date of Receipt	 	% claims dates of receipt recorded accurately in the system	 	Quality Audit and
Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-93
	 	Claims	 	1	 	HMO/POS Clear Explanation for Denials	 	% of denial letters with a clear explanation of denial reason	 	Quality Audit and
Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD-96
	 	Claims	 	3	 	HMO/PPO Provider Grievance TAT	 	within 30 business days	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-97
	 	Claims	 	3	 	HMO/PPO Provider Grievance Type Coding	 	HN must categorize each grievance it receives into one of eleven grievance types listed in Attachment A of Regulatory Bulletin 2006-2	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD-99
	 	Claims	 	3	 	HMO/PPO Request for additional information for Unclean Claims TAT	 	% of written requests for additional information on unclean claims to the contracted/noncontracted provided, enrollee or third party within thirty days of receipt.	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	ADOI	 	Compliance	 	100%
												
	 CPD
	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA)	 	Acknowledgement letters are sent within 15 business days of receipt.	 	Macess/Magic,
Prime, ODW	 		 		 	All	 	DOL	 	Compliance	 	=100%
												
	 CPD
	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded)	 	Contractor shall resolve all standards appeals no later than 45 business days days from the date the Contractor receives the appeal.	 	Macess/Magic,
Prime, ODW	 		 		 	All	 	DOL	 	Compliance	 	=100%
												
	 CPD
	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA) Post Service Clinical	 	Acknowledgement letters are sent within 5 calendar days of receipt.	 	Macess/Magic,
Prime, ODW	 		 		 	All	 	DOL	 	Compliance	 	=100%
												
	 CPD
	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded) Post Service Clinical	 	Contractor shall resolve all standards appeals no later than 30 calendar days from the date the	 	Macess/Magic,
Prime, ODW	 		 		 	All	 	DOL	 	Compliance	 	=100%
												
	 MPD-11
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNAZ)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	ABS - Monthly
Adhoc Report	 		 	—	 	AZ	 	CMS	 	Compliance	 	100%
												
	 MPD-13
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CMS	 	Compliance	 	100%
												
	 MPD-14
	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time.	 	ABS - Monthly
Adhoc Report	 		 	—	 	CA	 	CMS	 	Compliance	 	95%
												
	 MPD-146
	 	Claims	 	4	 	OC03 - Timely Payment of Non-Contracting Provider Clean Claims (OR)	 	The MAO must pay 95% of ‘clean’ claims from non-contracting providers within 30 calendar days of receipt	 	ABS - Monthly
Adhoc Report	 		 	—	 	OR	 	CMS	 	Compliance	 	95%
												
	 MPD-15
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNOR)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	ABS - Monthly
Adhoc Report	 		 	—	 	OR	 	CMS	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-49	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-91	 	Claims	 	1	 	HMO/POS Claims Denial Accuracy	 	% of denied claims that are denied accurately	 	48302	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-92	 	Claims	 	1	 	HMO/POS Claims Correct Date of Receipt	 	% claims dates of receipt recorded accurately in the system	 	48302	 	25	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.00%	 	100.00%
																
	CPD-93	 	Claims	 	1	 	HMO/POS Clear Explanation for Denials	 	% of denial letters with a clear explanation of denial reason	 	48302	 	25	 	96.00%	 	96.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-96	 	Claims	 	3	 	HMO/PPO Provider Grievance TAT	 	within 30 business days	 	956	 	N/A	 	92.55%	 	93.85%	 	92.09%	 	97.11%	 	79.52%	 	85.79%	 	71.12%	 	99.63%	 	99.85%
																
	CPD-97	 	Claims	 	3	 	HMO/PPO Provider Grievance Type Coding	 	HN must categorize each grievance it receives into one of eleven grievance types listed in Attachment A of Regulatory Bulletin 2006-2	 	1241	 	70	 	98.84%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-99	 	Claims	 	3	 	HMO/PPO Request for additional information for Unclean Claims TAT	 	% of written requests for additional information on unclean claims to the contracted/noncontracted provided, enrollee or third party within thirty days of receipt.	 	1883	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	99.94%	 	99.87%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA)	 	Acknowledgement letters are sent within 15 business days of receipt.	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded)	 	Contractor shall resolve all standards appeals no later than 45 business days days from the date the Contractor receives the appeal.	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA) Post Service Clinical	 	Acknowledgement letters are sent within 5 calendar days of receipt.	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded) Post Service Clinical	 	Contractor shall resolve all standards appeals no later than 30 calendar days from the date the	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD-11	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNAZ)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	4850	 	31	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.67%	 	100.00%
																
	MPD-13	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	7484	 	30	 	96.67%	 	100.00%	 	100.00%	 	96.77%	 	96.67%	 	96.67%	 	96.67%	 	100.00%	 	100.00%
																
	MPD-14	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time.	 	6796	 	30	 	96.67%	 	93.33%	 	100.00%	 	96.55%	 	100.00%	 	100.00%	 	96.67%	 	100.00%	 	96.43%
																
	MPD-146	 	Claims	 	4	 	OC03 - Timely Payment of Non- Contracting Provider Clean Claims (OR)	 	The MAO must pay 95% of ‘clean’ claims from non-contracting providers within 30 calendar days of receipt	 	10531	 	29	 	96.43%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.67%
																
	MPD-15	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNOR)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	12023	 	31	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.67%

  

					
	Schedule B-2-1	  	B-2-1-50	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 CPD-91
	 	Claims	 	1	 	HMO/POS Claims Denial Accuracy	 	% of denied claims that are denied accurately	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-92
	 	Claims	 	1	 	HMO/POS Claims Correct Date of Receipt	 	% claims dates of receipt recorded accurately in the system	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-93
	 	Claims	 	1	 	HMO/POS Clear Explanation for Denials	 	% of denial letters with a clear explanation of denial reason	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-96
	 	Claims	 	3	 	HMO/PPO Provider Grievance TAT	 	within 30 business days	 	99.96%	 	98.90%	 	96.88%	 	99.12%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-97
	 	Claims	 	3	 	HMO/PPO Provider Grievance Type Coding	 	HN must categorize each grievance it receives into one of eleven grievance types listed in Attachment A of Regulatory Bulletin 2006-2	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 CPD-99
	 	Claims	 	3	 	HMO/PPO Request for additional information for Unclean Claims TAT	 	% of written requests for additional information on unclean claims to the contracted/noncontracted provided, enrollee or third party within thirty days of receipt.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA)	 	Acknowledgement letters are sent within 15 business days of receipt.	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded)	 	Contractor shall resolve all standards appeals no later than 45 business days days from the date the Contractor receives the appeal.	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	Claims	 	1	 	Provider Acknowledgement Letter TAT (Self Funded ERISA) Post Service Clinical	 	Acknowledgement letters are sent within 5 calendar days of receipt.	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 CPD
	 	Claims	 	1	 	Provider Appeal Resolution TAT (Self Funded) Post Service Clinical	 	Contractor shall resolve all standards appeals no later than 30 calendar days from the date the	 		 		 		 		 	99.99	 	0	 	0	 	100
													
	 MPD-11
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNAZ)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 MPD-13
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 MPD-14
	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNCA HMO, HNLCA PPO)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time.	 	100.00%	 	93.33%	 	100.00%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
													
	 MPD-146
	 	Claims	 	4	 	OC03 - Timely Payment of Non- Contracting Provider Clean Claims (OR)	 	The MAO must pay 95% of ‘clean’ claims from non-contracting providers within 30 calendar days of receipt	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
													
	 MPD-15
	 	Claims	 	4	 	Non-Par Non-Clean Claims TAT: MA (HNOR)	 	Process non-clean, non-par provider claims within 60 calendar days of receipt 100% of the time.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-51	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	 MPD-533
	 	Claims	 	4	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	ABS - Monthly Adhoc Report	 		 	—	 	ALL	 	HHS	 	Compliance	 	>= 90%
												
	 MPD-534
	 	Claims	 	4	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%
												
	 MPD-535
	 	Claims	 	4	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%
												
	 MPD-536
	 	Claims	 	4	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 MPD-537
	 	Claims	 	4	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 MPD-9
	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNAZ)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time	 	ABS - Monthly Adhoc Report	 		 	—	 	AZ	 	CMS	 	Compliance	 	95%

  

					
	Schedule B-2-1	  	B-2-1-52	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	MPD-533	 	Claims	 	4	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	70339	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A
																
	MPD-534	 	Claims	 	4	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	887875	 	N/A	 	97.60%	 	100.00%	 	98.19%	 	98.39%	 	97.04%	 	98.57%	 	97.65%	 	99.28%	 	93.15%
																
	MPD-535	 	Claims	 	4	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	38179	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	98.48%	 	99.28%	 	93.66%	 	98.06%	 	99.90%	 	69.48%
																
	MPD-536	 	Claims	 	4	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday.	 	972127	 	N/A	 	99.00%	 	96.00%	 	99.00%	 	99.00%	 	96.00%	 	97.00%	 	99.00%	 	98.00%	 	98.00%
																
	MPD-537	 	Claims	 	4	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday	 	34932	 	N/A	 	N/A	 	98.00%	 	99.00%	 	100.00%	 	98.00%	 	99.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-9	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNAZ)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time	 	4108	 	29	 	100.00%	 	100.00%	 	93.10%	 	100.00%	 	96.55%	 	100.00%	 	96.67%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-53	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 MPD-533
	 	Claims	 	4	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	93.00%	 	97.41%	 	99.38%	 	99.93%	 	89.99	 	0	 	0	 	89.99
													
	 MPD-534
	 	Claims	 	4	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	98.26%	 	98.43%	 	99.22%	 	98.46%	 	89.99	 	0	 	0	 	89.99
													
	 MPD-535
	 	Claims	 	4	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	97.00%	 	99.35%	 	99.97%	 	98.35%	 	89.99	 	0	 	0	 	89.99
													
	 MPD-536
	 	Claims	 	4	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday.	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 MPD-537
	 	Claims	 	4	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01 am Sunday to 12:01 am the following Sunday	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 MPD-9
	 	Claims	 	4	 	Non-Par Clean Claims TAT: MA (HNAZ)	 	Process non-par provider claims within 30 calendar days of receipt 95% of the time	 	100.00%	 	100.00%	 	96.55%	 	LAG MONTH	 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-54	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 SHP-1
	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	ABS - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-8
	 	Claims	 	5	 	Provider Dispute Resolution TAT (Medi-Cal)	 	100%* processed within 45 working days. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-9
	 	Claims	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Medi-Cal)	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes
TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-11
	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-12
	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	p	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-20
	 	Claims	 	5	 	Provider Dispute Resolution TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-29
	 	Claims	 	5	 	Provider Dispute Resolution TAT (CalViva Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. *CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-10
	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-55	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	SHP-1	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	229217	 	N/A	 	98.80%	 	99.20%	 	99.40%	 	99.20%	 	99.25%	 	99.36%	 	99.60%	 	99.33%	 	99.11%
																
	SHP-8	 	Claims	 	5	 	Provider Dispute Resolution TAT (Medi-Cal)	 	100%* processed within 45 working days. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	988	 	N/A	 	98.16%	 	84.47%	 	93.72%	 	98.70%	 	99.07%	 	99.37%	 	99.34%	 	98.72%	 	98.29%
																
	SHP-9	 	Claims	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Medi-Cal)	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes
TATs.	 	1036	 	N/A	 	99.42%	 	98.76%	 	99.54%	 	99.53%	 	100.00%	 	99.74%	 	99.91%	 	100.00%	 	100.00%
																
	SHP-11	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	986	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	96.00%	 	100.00%	 	100.00%
																
	SHP-12	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	986	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	92.00%	 	100.00%
																
	SHP-20	 	Claims	 	5	 	Provider Dispute Resolution TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	25	 	N/A	 	89.66%	 	100.00%	 	97.56%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-29	 	Claims	 	5	 	Provider Dispute Resolution TAT (CalViva Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. *CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	912	 	N/A	 	98.26%	 	95.03%	 	98.12%	 	99.41%	 	99.40%	 	99.18%	 	99.06%	 	99.68%	 	99.50%
																
	SHP-10	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	986	 	25	 	100.00%	 	96.00%	 	96.00%	 	100.00%	 	100.00%	 	100.00%	 	84.00%	 	76.00%	 	92.00%

  

					
	Schedule B-2-1	  	B-2-1-56	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 SHP-1
	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	99.22%	 	99.38%	 	99.40%	 	99.50%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-8
	 	Claims	 	5	 	Provider Dispute Resolution TAT (Medi-Cal)	 	100%* processed within 45 working days. Timeliness is measured from receipt date to check date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	87.31%	 	97.27%	 	96.10%	 	95.55%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-9
	 	Claims	 	5	 	Provider Dispute Resolution Acknowledgement Letter TAT (Medi-Cal)	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes
TATs.	 	100.00%	 	100.00%	 	99.32%	 	99.71%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-11
	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	96.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-12
	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	92.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-20
	 	Claims	 	5	 	Provider Dispute Resolution TAT (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	86.67%	 	100.00%	 	100.00%	 	88.00%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-29
	 	Claims	 	5	 	Provider Dispute Resolution TAT (CalViva Medi-Cal)	 	Timeliness is measured from receipt date to check date. 100%* processed within 45 working days. *CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for Claims and Provider
Disputes TATs.	 	91.70%	 	98.24%	 	98.27%	 	97.48%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-10
	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	88.00%	 	92.00%	 	80.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-57	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	 SHP-17
	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date plus 2 days.	 	ABS - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	>= 90%
												
	 SHP-18
	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. Process 100%* of claims within 45 working days of receipt Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Disputes TATs.	 	QCARE - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-2
	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 90%* of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	QCARE - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	90%
												
	 SHP-21
	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi-Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	QCARE - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	>= 90%
												
	 SHP-22
	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi-Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Dispute	 	QCARE - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-299
	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (CalViva Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	PDR Database	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-3
	 	Claims	 	5	 	Interest Payment Accuracy (Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-116
	 	Claims	 	5	 	CalViva Medi-Cal PDR Acknow. Letter TAT	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date.	 	Prime, ODW	 		 	—	 	CA	 	DMHC	 	Compliance	 	=100%
												
	 SHP-300
	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-58	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	SHP-17	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date plus 2 days.	 	2002	 	N/A	 	93.44%	 	93.89%	 	93.79%	 	94.16%	 	94.83%	 	93.35%	 	96.24%	 	96.15%	 	95.78%
																
	SHP-18	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. Process 100%* of claims within 45 working days of receipt Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Disputes TATs.	 	2002	 	N/A	 	98.14%	 	98.09%	 	98.99%	 	98.91%	 	97.95%	 	97.88%	 	98.62%	 	99.07%	 	99.25%
																
	SHP-2	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 90%* of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	229217	 	N/A	 	92.90%	 	96.03%	 	93.94%	 	94.90%	 	95.43%	 	93.73%	 	95.00%	 	95.40%	 	93.44%
																
	SHP-21	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi- Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	192380	 	N/A	 	95.10%	 	96.79%	 	95.60%	 	96.95%	 	95.49%	 	94.27%	 	96.12%	 	96.22%	 	94.29%
																
	SHP-22	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi- Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Dispute	 	192380	 	N/A	 	99.43%	 	99.58%	 	99.63%	 	99.56%	 	98.97%	 	99.57%	 	99.87%	 	99.70%	 	99.04%
																
	SHP-299	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (CalViva Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	708	 	25	 	100.00%	 	100.00%	 	76.00%	 	88.00%	 	92.00%	 	76.00%	 	84.00%	 	80.00%	 	92.00%
																
	SHP-3	 	Claims	 	5	 	Interest Payment Accuracy (Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	247	 	25	 	100.00%	 	100.00%	 	92.00%	 	96.00%	 	100.00%	 	96.00%	 	100.00%	 	92.00%	 	84.00%
																
	SHP-116	 	Claims	 	5	 	CalViva Medi-Cal PDR Acknow. Letter TAT	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date.	 	839	 	N/A	 	99.02%	 	99.94%	 	100.00%	 	96.99%	 	100.00%	 	99.49%	 	100.00%	 	99.89%	 	100.00%
																
	SHP-300	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	708	 	25	 	100.00%	 	100.00%	 	100.00%	 	92.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-59	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 SHP-17
	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date plus 2 days.	 	88.70%	 	90.02%	 	87.38%	 	92.40%	 	89.99	 	0	 	0	 	89.99
													
	 SHP-18
	 	Claims	 	5	 	New Day Claims (Molina Medi-Cal)	 	Timeliness is measured from receipt date to check date. Process 100%* of claims within 45 working days of receipt Molina Medi-Cal is in Riverside and San Bernardino counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Disputes TATs.	 	98.64%	 	98.72%	 	97.61%	 	99.10%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-2
	 	Claims	 	5	 	New Day Claims (Medi-Cal)	 	Process 90%* of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	90.79%	 	92.34%	 	99.70%	 	92.10%	 	89.99	 	0	 	0	 	89.99
													
	 SHP-21
	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi-Cal)	 	Process 90% of claims within 30 calendar days of receipt. Timeliness is measured from receipt date to check date.	 	92.85%	 	94.07%	 	92.00%	 	92.70%	 	89.99	 	0	 	0	 	89.99
													
	 SHP-22
	 	Claims	 	5	 	HNCA New Day Claims (CalViva Medi-Cal)	 	Process 100%* of claims within 45 working days of receipt. Timeliness is measured from receipt date to check date. CalViva Medi-Cal is in Fresno, Kings and Madera Counties. *HNCA is required to be compliant 100% of the time for
Claims and Provider Dispute	 	99.67%	 	99.70%	 	99.65%	 	99.80%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-299
	 	Claims	 	5	 	Provider Dispute Resolution Reimbursement Accuracy (CalViva Medi-Cal)	 	100%* accuracy of Reimbursement to Provider. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	92.00%	 	92.00%	 	84.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-3
	 	Claims	 	5	 	Interest Payment Accuracy (Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	80.00%	 	56.00%	 	52.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-116
	 	Claims	 	5	 	CalViva Medi-Cal PDR Acknow. Letter TAT	 	100%* within 2 working days (for Electronic) and within 15 working days (for Paper). Timeliness is measured from receipt date to letter date.	 	100.00%	 	100.00%	 	100.00%	 	99.88%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-300
	 	Claims	 	5	 	Provider Dispute Resolution Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Received Date entered into the System. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	LAG MONTH	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-60	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 SHP-301
	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (CalViva Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-302
	 	Claims	 	5	 	Interest Payment Accuracy (CalViva Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-303
	 	Claims	 	5	 	Claims Denial Accuracy (CalViva Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-304
	 	Claims	 	5	 	Denied Claims Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-305
	 	Claims	 	5	 	Explanation for Claim Denials (CalViva Medi-Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-369
	 	Claims	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-370
	 	Claims	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-371
	 	Claims	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	Qcare, HNCS, Omni, Page Center	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	= 100%
												
	 SHP-372
	 	Claims	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	Qcare, HNCS, Omni, Page Center	 		 	n	 	AZ	 	AHCCCS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-61	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample
Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	SHP-301	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (CalViva Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	708	 	25	 	100.00%	 	100.00%	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	100.00%	 	88.00%	 	92.00%
																
	SHP-302	 	Claims	 	5	 	Interest Payment Accuracy (CalViva Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	166	 	25	 	92.00%	 	100.00%	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	82.35%	 	84.00%	 	96.00%
																
	SHP-303	 	Claims	 	5	 	Claims Denial Accuracy (CalViva Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	16715	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-304	 	Claims	 	5	 	Denied Claims Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	16715	 	25	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-305	 	Claims	 	5	 	Explanation for Claim Denials (CalViva Medi-Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	16715	 	25	 	96.00%	 	100.00%	 	96.00%	 	96.00%	 	100.00%	 	100.00%	 	92.00%	 	96.00%	 	100.00%
																
	SHP-369	 	Claims	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	36	 	N/A	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	SHP-370	 	Claims	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	41	 	N/A	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	SHP-371	 	Claims	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	37	 	N/A	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	SHP-372	 	Claims	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	Null Universe	 	Null Universe	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-62	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-301
	 	Claims	 	5	 	Provider Dispute Resolution Correct Determination Made (CalViva Medi-Cal)	 	100%* accuracy with correct determination made and letter being sent to Provider and/or Dispute Determination included within the Letter. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-302
	 	Claims	 	5	 	Interest Payment Accuracy (CalViva Medi-Cal)	 	Interest Payment is calculated and applied accurately 100%* of the time. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	92.00%	 	60.00%	 	52.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-303
	 	Claims	 	5	 	Claims Denial Accuracy (CalViva Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-304
	 	Claims	 	5	 	Denied Claims Correct Date of Receipt Recorded (CalViva Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-305
	 	Claims	 	5	 	Explanation for Claim Denials (CalViva Medi-Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	96.00%	 	96.00%	 	88.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-369
	 	Claims	 	6	 	Provider Claims Dispute - Acknowledgment Letter TAT	 	Claim disputes are acknowledged in writing and within 5 business days of receipt.	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	97.30%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-370
	 	Claims	 	6	 	Provider Claims Dispute - Resolution TAT	 	Contractor’s Notice of Decision shall be mailed to all parties no later than 30 days after the provider files a claim dispute with the Contractor.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	97.56%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-371
	 	Claims	 	6	 	Provider Claims Disputes - Overturned (Adjustments) TAT	 	If the claim dispute is overturned, in full or in part, the Contractor shall reprocess and pay the claim(s) in a manner consistent with the decision within 15 business days of the date of the Decision.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-372
	 	Claims	 	6	 	Provider Claims Disputes - Request for State Fair Hearing TAT	 	Contractor must ensure that all supporting documentation is received by the AHCCCS Office of Administrative Legal Services (OALS), no later than 5 business days from the date the Contractor receives the provider’s written
hearing request.	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	94.99	 	95	 	96.99	 	97

  

					
	Schedule B-2-1	  	B-2-1-63	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 	 Metric Name
	 	
        Metric Measure        
	 	 Measurement Tools
	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	 Target

	 SHP-373
	 	Claims	 	 	5	  	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	ABS - Monthly Adhoc Report	 		 	—	 	ALL	 	HHS	 	Compliance	 	>= 90%
												
	 SHP-374
	 	Claims	 	 	6	  	 	Claim Timeliness (0-30 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim.	 	QCARE - Monthly Adhoc Report	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	>= 95%
												
	 SHP-375
	 	Claims	 	 	6	  	 	Claim Timeliness (0-60 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 99% of all clean claims are adjudicated within 60 days of receipt of the clean claim.	 	QCARE - Monthly Adhoc Report	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	>= 99%
												
	 SHP-376
	 	Claims	 	 	6	  	 	Claims - Electronic Submission (Professional, Intitutional, Dental)	 	Receive 60% of each claim type (professional, institutional and dental) based on volume of actual claims excluding claims processed by Pharmacy Benefit Managers (PBMs) electronically.	 	ABS - Monthly Adhoc Report	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	>= 60%
												
	 SHP-377
	 	Claims	 	 	6	  	 	Claims - Electronic Remittance Advice	 	Produce and distribute 60% of remittances electronically	 	ABS - Monthly Adhoc Report	 		 	—	 	AZ	 	AHCCCS	 	Compliance	 	>= 60%
												
	 SHP-378
	 	Claims	 	 	6	  	 	Claims Payment - Electronic Funds Transfer	 	60% of claims payments are via EFT	 	ABS - Monthly Adhoc Report	 		 	 ̈	 	AZ	 	AHCCCS	 	Compliance	 	>= 60%
												
	 SHP-393
	 	Claims	 	 	5	  	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%
												
	 SHP-394
	 	Claims	 	 	5	  	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 90%

  

					
	Schedule B-2-1	  	B-2-1-64	  	Health Net / Cognizant Confidential

 Final 
  

																																	
	 Metric ID
	 	Tower	 	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 SHP-373
	 	 	Claims	  	 	5	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	70339	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A
																
	 SHP-374
	 	 	Claims	  	 	6	 	Claim Timeliness (0-30 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim.	 	27261	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	100.00%	 	98.58%	 	96.34%
																
	 SHP-375
	 	 	Claims	  	 	6	 	Claim Timeliness (0-60 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 99% of all clean claims are adjudicated within 60 days of receipt of the clean claim.	 	27261	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-376
	 	 	Claims	  	 	6	 	Claims - Electronic Submission (Professional, Intitutional, Dental)	 	Receive 60% of each claim type (professional, institutional and dental) based on volume of actual claims excluding claims processed by Pharmacy Benefit Managers (PBMs) electronically.	 	33968	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	93.75%	 	77.61%	 	71.20%
																
	 SHP-377
	 	 	Claims	  	 	6	 	Claims - Electronic Remittance Advice	 	Produce and distribute 60% of remittances electronically	 	27261	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	69.56%	 	63.15%	 	57.65%
																
	 SHP-378
	 	 	Claims	  	 	6	 	Claims Payment - Electronic Funds Transfer	 	60% of claims payments are via EFT	 	27261	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	28.50%	 	29.73%	 	34.38%
																
	 SHP-393
	 	 	Claims	  	 	5	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	887875	 	N/A	 	97.60%	 	100.00%	 	98.19%	 	98.39%	 	97.04%	 	98.57%	 	97.65%	 	99.28%	 	93.15%
																
	 SHP-394
	 	 	Claims	  	 	5	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	38179	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	98.48%	 	99.28%	 	93.66%	 	98.06%	 	99.90%	 	69.48%

  

					
	Schedule B-2-1	  	B-2-1-65	  	Health Net / Cognizant Confidential

 Final 
  

																																					
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	 	Mar-2014	 	 	Apr-2014	 	RED
HI	 	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	 SHP-373
	 	Claims	 	5	 	90% Reassociation EFT & ERA within 3 days	 	Core Rule 370 A health plan must release for transmission to the healthcare provider the v5010 X12 835 corresponding to the Healthcare EFT Standards: No sooner than three business days, prior to the Effective Entry Date, and No
later than three business days after the Effective Entry Date, 90% of the time as measured within a calendar month.	 	93.00%	 	 	97.41	% 	 	 	99.38	% 	 	99.93%	 	 	89.99	  	 	 	0	  	 	 	0	  	 	 	89.99	  
													
	 SHP-374
	 	Claims	 	6	 	Claim Timeliness (0-30 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim.	 	98.00%	 	 	99.40	% 	 	 	99.60	% 	 	98.80%	 	 	94.99	  	 	 	0	  	 	 	0	  	 	 	95	  
													
	 SHP-375
	 	Claims	 	6	 	Claim Timeliness (0-60 days)	 	Contractor shall ensure that for each form type (Dental/Professional/Institutional), 99% of all clean claims are adjudicated within 60 days of receipt of the clean claim.	 	99.95%	 	 	99.90	% 	 	 	99.90	% 	 	99.70%	 	 	98.99	  	 	 	0	  	 	 	0	  	 	 	99	  
													
	 SHP-376
	 	Claims	 	6	 	Claims - Electronic Submission (Professional, Intitutional, Dental)	 	Receive 60% of each claim type (professional, institutional and dental) based on volume of actual claims excluding claims processed by Pharmacy Benefit Managers (PBMs) electronically.	 	76.17%	 	 	78.70	% 	 	 	84.00	% 	 	81.20%	 	 	54.9	  	 	 	55	  	 	 	59.9	  	 	 	60	  
													
	 SHP-377
	 	Claims	 	6	 	Claims - Electronic Remittance Advice	 	Produce and distribute 60% of remittances electronically	 	61.94%	 	 	66.10	% 	 	 	63.20	% 	 	61.10%	 	 	54.9	  	 	 	55	  	 	 	59.9	  	 	 	60	  
													
	 SHP-378
	 	Claims	 	6	 	Claims Payment - Electronic Funds Transfer	 	60% of claims payments are via EFT	 	37.79%	 	 	47.50	% 	 	 	50.20	% 	 	48.00%	 	 	54.9	  	 	 	55	  	 	 	59.9	  	 	 	60	  
													
	 SHP-393
	 	Claims	 	5	 	HIPAA Eligibility Verification Real Time 20 second Rule	 	Real Time (Core Rule 156) 270/271 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	98.26%	 	 	98.43	% 	 	 	99.22	% 	 	98.46%	 	 	89.99	  	 	 	0	  	 	 	0	  	 	 	89.99	  
													
	 SHP-394
	 	Claims	 	5	 	HIPAA Claims Status Real Time 20 Second Response Time Rule	 	Real Time (Core Rule 156) 276/277 Transaction 20 second response time rule. This rule is achieved when 90 percent of all required requests and responses are within a 20 second turnaround time in a calendar month.	 	97.00%	 	 	99.35	% 	 	 	99.97	% 	 	98.35%	 	 	89.99	  	 	 	0	  	 	 	0	  	 	 	89.99	  

  

					
	Schedule B-2-1	  	B-2-1-66	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	Comment	 	Status	 	Location	 	Regulator	 	Metric
Type	 	 Target

	 SHP-395
	 	Claims	 	5	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday.	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 SHP-396
	 	Claims	 	5	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday	 	Monthly Reports from both HN IT and our Clearing Houses.	 		 	—	 	ALL	 	HHS	 	Compliance	 	=> 86%
												
	 SHP-4
	 	Claims	 	5	 	Claim Forwarding TAT (Medi-Cal)	 	100%* within 10 working days. Timeliness measured from receipt date to date forwarded to the contracting provider group. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	ABS - Monthly Adhoc Report	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-5
	 	Claims	 	5	 	Claims Denial Accuracy (Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-6
	 	Claims	 	5	 	Denied Claims Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%
												
	 SHP-7
	 	Claims	 	5	 	Explanation for Claim Denials (Medi- Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	Quality Audit and Training (Monthly)	 		 	—	 	CA	 	DMHC	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-67	  	Health Net / Cognizant Confidential

 Final 
  

																																	
	 Metric ID
	 	Tower	 	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 SHP-395
	 	 	Claims	  	 	5	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday.	 	972127	 	N/A	 	99.00%	 	96.00%	 	99.00%	 	99.00%	 	96.00%	 	97.00%	 	99.00%	 	98.00%	 	98.00%
																
	 SHP-396
	 	 	Claims	  	 	5	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday	 	34932	 	N/A	 	N/A	 	98.00%	 	99.00%	 	100.00%	 	98.00%	 	99.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-4
	 	 	Claims	  	 	5	 	Claim Forwarding TAT (Medi-Cal)	 	100%* within 10 working days. Timeliness measured from receipt date to date forwarded to the contracting provider group. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	57945	 	N/A	 	97.78%	 	97.44%	 	97.68%	 	96.83%	 	97.04%	 	97.09%	 	97.17%	 	95.82%	 	97.06%
																
	 SHP-5
	 	 	Claims	  	 	5	 	Claims Denial Accuracy (Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	37792	 	25	 	96.00%	 	92.00%	 	100.00%	 	96.00%	 	92.00%	 	96.00%	 	96.00%	 	92.00%	 	100.00%
																
	 SHP-6
	 	 	Claims	  	 	5	 	Denied Claims Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	37792	 	25	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 SHP-7
	 	 	Claims	  	 	5	 	Explanation for Claim Denials (Medi-Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	37792	 	25	 	96.00%	 	100.00%	 	100.00%	 	96.00%	 	100.00%	 	100.00%	 	92.00%	 	100.00%	 	92.00%

  

					
	Schedule B-2-1	  	B-2-1-68	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	 SHP-395
	 	Claims	 	5	 	Eligibility Verification System Availability 86% Rule	 	Core Rule 157 Eligibility and Benefits System Availability Rule: Real Time Transaction 270/271 System availability must be no less then 86 percent per calendar week for both real time and batch processing modes. System is defined as
having all necessary means of processing a 270 inquiry and returning a response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday.	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 SHP-396
	 	Claims	 	5	 	Claims Status System Availability 86% Rule	 	Core Rule 250 Claims status rule (276/277) refers to Core Rule 157 for system availability requirements. Real Time Transaction 276/277 System availability must be no less then 86 percent per calendar week for both real time and
batch processing modes. System is defined as having all necessary means of processing a 276 inquiry and returning a 277 response. Calendar week is defined as 12:01am Sunday to 12:01am the following Sunday	 	99.00%	 	98.00%	 	99.00%	 	99.00%	 	85.99	 	0	 	0	 	85.99
													
	 SHP-4
	 	Claims	 	5	 	Claim Forwarding TAT (Medi-Cal)	 	100%* within 10 working days. Timeliness measured from receipt date to date forwarded to the contracting provider group. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	96.69%	 	96.85%	 	97.18%	 	97.02%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-5
	 	Claims	 	5	 	Claims Denial Accuracy (Medi-Cal)	 	100%* Accuracy of Claims Denials. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	92.00%	 	100.00%	 	96.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-6
	 	Claims	 	5	 	Denied Claims Correct Date of Receipt Recorded (Medi-Cal)	 	100%* accuracy of Date of Receipt recorded in the system. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	100.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95
													
	 SHP-7
	 	Claims	 	5	 	Explanation for Claim Denials (Medi-Cal)	 	100%* accuracy of Clear Explanation of Denial Reason being on Denial Letters. *HNCA is required to be compliant 100% of the time for Claims and Provider Disputes TATs.	 	100.00%	 	100.00%	 	96.00%	 	LAG
MONTH	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-69	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	90% of claims processed within 30 calendar days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox-Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 	ABS - Monthly Adhoc Report	 	New SLA	 		 	CA	 	CMS & DHCS	 	Compliance	 	
												
	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	100% of claims processed within 45 working days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox-Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 	ABS - Monthly Adhoc Report	 	New SLA	 		 	CA	 	CMS & DHCS	 	Compliance	 	
												
	 SHP
	 	Claims	 	6	 	Date of Receipt (AHCCCS)	 	The receipt date of the claim is the date stamp on the claim or the date electronically received. The receipt date is the day the claim is received at the Contractor’s specified claim mailing address. The Contractor shall
forward all claims received to the subcontractor responsible for claims adjudication.	 	Quality Audit and Training (Monthly)	 	New SLA	 		 	AZ	 	AHCCCS	 	Compliance	 	

  

					
	Schedule B-2-1	  	B-2-1-70	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	90% of claims processed within 30 calendar days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox- Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 		 		 		 		 		 		 		 		 		 		 	
																
	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	100% of claims processed within 45 working days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox- Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 		 		 		 		 		 		 		 		 		 		 	
																
	 SHP
	 	Claims	 	6	 	Date of Receipt (AHCCCS)	 	The receipt date of the claim is the date stamp on the claim or the date electronically received. The receipt date is the day the claim is received at the Contractor’s specified claim mailing address. The Contractor shall
forward all claims received to the subcontractor responsible for claims adjudication.	 		 		 		 		 		 		 		 		 		 		 	

  

					
	Schedule B-2-1	  	B-2-1-71	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	90% of claims processed within 30 calendar days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox-Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 		 		 		 		 	84.99	 	85	 	89.99	 	90
													
	 DPD
	 	Claims	 	7	 	Claim Timeliness (Duals)	 	100% of claims processed within 45 working days of receipt. Follow the current Medi-Cal claims TAT standards for CMC claims in order to meet the current and more stringent Knox- Keene and regulatory requirements as cited in the DHCS
contract and as referenced in the 3 Way Contract 2.1.3. CMS and DHCS should accept that 100% of all claims will be processed within 45 working days under the more stringent Knox Keene requirement.	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 SHP
	 	Claims	 	6	 	Date of Receipt (AHCCCS)	 	The receipt date of the claim is the date stamp on the claim or the date electronically received. The receipt date is the day the claim is received at the Contractor’s specified claim mailing address. The Contractor shall
forward all claims received to the subcontractor responsible for claims adjudication.	 		 		 		 		 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-72	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	 SHP
	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	95% within 30 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type (Dental/Professional/Institutional) 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim.
The Contractor shall not pay: 1. Claims initially submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or 2. Claims that are submitted as clean
claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted
providers	 	ABS - Monthly Adhoc Report	 	New SLA	 		 	AZ	 	AHCCCS	 	Compliance	 	
												
	 SHP
	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	 99% within 60 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type
(Dental/Professional/Institutional) 99% are adjudicated within 60 days of receipt of the clean claim. The Contractor shall not pay:
 1. Claims initially
submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or

2. Claims that are submitted as clean claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is
posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted
	 	ABS - Monthly Adhoc Report	 	New SLA	 		 	AZ	 	AHCCCS	 	Compliance	 	
												
	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 	Monthly report from OPUS that is sample audited for timeliness.	 	Measured at time of audit. Regulation is 30 days for contracted and 60 days for non-contracted. (The internal target is to process within 1 day of determination but has not been tracked for historical purposes). This measurment
needs to be tracked going forward.	 		 	CA	 	CMS	 	Compliance	 	95% > within the stated time frames

  

					
	Schedule B-2-1	  	B-2-1-73	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	SHP	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	 95% within 30 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type
(Dental/Professional/Institutional) 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim. The Contractor shall not pay:
 1.
Claims initially submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or

2. Claims that are submitted as clean claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is
posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted providers
	 		 		 		 		 		 		 		 		 		 		 	
																
	SHP	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	 99% within 60 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type
(Dental/Professional/Institutional) 99% are adjudicated within 60 days of receipt of the clean claim. The Contractor shall not pay:
 1. Claims initially
submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or

2. Claims that are submitted as clean claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is
posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted
	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 		 		 		 		 		 		 	

  

					
	Schedule B-2-1	  	B-2-1-74	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 SHP
	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	 95% within 30 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type
(Dental/Professional/Institutional) 95% of all clean claims are adjudicated within 30 days of receipt of the clean claim. The Contractor shall not pay:
 1.
Claims initially submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or

2. Claims that are submitted as clean claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is
posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted providers
	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 SHP
	 	Claims	 	6	 	Clean Claim Tineliness (AHCCCS)	 	 99% within 60 days: Unless a subcontract specifies otherwise, Contractors shall ensure that for each form type
(Dental/Professional/Institutional) 99% are adjudicated within 60 days of receipt of the clean claim. The Contractor shall not pay:
 1. Claims initially
submitted more than six months after date of service for which payment is claimed or after the date that eligibility is posted, whichever date is later; or

2. Claims that are submitted as clean claims more than 12 months after date of service for which payment is claimed or after the date that eligibility is
posted, whichever date is later (A.R.S.§36-2904.G). Claim payment requirements pertain to both contracted and non-contracted
	 		 		 		 		 	94.99	 	95	 	98.99	 	99
													
	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-75	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 	Monthly report from OPUS that is sample audited for timeliness.	 	Measured at time of audit. Regulation is 30 days for contracted and 60 days for non-contracted. (The internal target is to process within 1 day of determination but has not been tracked for historical purposes). This measurment
needs to be tracked going forward.	 		 	OR	 	CMS	 	Compliance	 	95% > within the stated time frames
												
	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 	Monthly report from OPUS that is sample audited for timeliness.	 	Measured at time of audit. Regulation is 30 days for contracted and 60 days for non-contracted. (The internal target is to process within 1 day of determination but has not been tracked for historical purposes). This measurment
needs to be tracked going forward.	 		 	AZ	 	CMS	 	Compliance	 	95% > within the stated time frames
												
	 CPD
	 	Claims	 	3	 	AZ Development Letters	 	every 30 days from contested date	 	ACCESS Data Base	 	Measured at time of audit. Must be within 30 days with minimum of 2 attempts made. This measurement needs to be tracked going forward.	 		 	AZ	 	ADOI	 	Compliance	 	95% > within the stated time frames
												
	 CPD
	 	Claims	 	2	 	OR Development Letters	 	sent once within 30 days from contested date	 	ACCESS Data Base	 	Measured at time of audit. Must be within 30 days with minimum of 2 attempts made. This measurement needs to be tracked going forward.	 		 	OR	 	ORDOI	 	Compliance	 	95% > within the stated time frames
												
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 	ACCESS Data Base	 	Measured at time of audit. Must have a minimum of 2 attempts to get the required information within a 60 day period. This measurement needs to be tracked going forward.	 		 	AZ	 	CMS	 	Compliance	 	95% > within the stated time frames
												
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 	ACCESS Data Base	 	Measured at time of audit. Must have a minimum of 2 attempts to get the required information within a 60 day period. This measurement needs to be tracked going forward.	 		 	CA	 	CMS	 	Compliance	 	95% > within the stated time frames
												
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 	ACCESS Data Base	 	Measured at time of audit. Must have a minimum of 2 attempts to get the required information within a 60 day period. This measurement needs to be tracked going forward.	 		 	OR	 	CMS	 	Compliance	 	95% > within the stated time frames
												
	 CPD
	 	Claims	 	1	 	CA Turn Around Time	 	99% of claims processed within 30 calendar days	 	Monthly report from OPUS	 		 	 ̈	 	CA	 	DMHC	 	Compliance	 	99%
												
	 CPD
	 	Claims	 	2	 	OR Turn Around Time	 	99% of claims processed within 30 calendar days	 	Monthly report from OPUS	 		 	—	 	OR	 	ORDOI	 	Compliance	 	99%
												
	 CPD
	 	Claims	 	3	 	AZ Turn Around Time	 	99% of claims processed within 30 calendar days	 	Monthly report from OPUS	 		 	—	 	AZ	 	ADOI	 	Compliance	 	99%

 Membership Accounting Compliance Metrics 

Metric Data as of Apr-2014 

  

					
	Schedule B-2-1	  	B-2-1-76	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	MPD	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	3	 	AZ Development Letters	 	every 30 days from contested date	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	2	 	OR Development Letters	 	sent once within 30 days from contested date	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 		 		 		 		 		 		 	
																
	MPD	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 		 		 		 		 		 		 	
																
	CPD	 	Claims	 	1	 	CA Turn Around Time	 	99% of claims processed within 30 calendar days	 		 		 	98.75%	 	99.39%	 	98.98%	 	99.37%	 	99.02%	 	98.40%	 	98.06%	 	96.04%	 	88.92%
																
	CPD	 	Claims	 	2	 	OR Turn Around Time	 	99% of claims processed within 30 calendar days	 		 		 	98.43%	 	98.29%	 	98.54%	 	98.27%	 	97.24%	 	98.24%	 	98.40%	 	98.14%	 	98.09%
																
	CPD	 	Claims	 	3	 	AZ Turn Around Time	 	99% of claims processed within 30 calendar days	 		 		 	98.71%	 	99.15%	 	98.42%	 	98.90%	 	96.00%	 	99.05%	 	99.43%	 	99.47%	 	98.93%

 Membership Accounting Compliance Metrics 

Metric Data as of Apr-2014 

  

					
	Schedule B-2-1	  	B-2-1-77	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 MPD
	 	Claims	 	4	 	Medicare NDP Letters	 	30 days from denial date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	3	 	AZ Development Letters	 	every 30 days from contested date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	2	 	OR Development Letters	 	sent once within 30 days from contested date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 MPD
	 	Claims	 	4	 	Medicare Development Letters	 	for non contracted providers, notification is sent of contested claim and claim must be finalized by 60th day from received date	 		 		 		 		 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	1	 	CA Turn Around Time	 	99% of claims processed within 30 calendar days	 	84.27%	 	80.81%	 	90.44%	 	93.90%	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	2	 	OR Turn Around Time	 	99% of claims processed within 30 calendar days	 	97.40%	 	98.95%	 	95.07%	 	98.11%	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	Claims	 	3	 	AZ Turn Around Time	 	99% of claims processed within 30 calendar days	 	97.44%	 	98.94%	 	98.61%	 	98.88%	 	89.99	 	90	 	94.99	 	95

 Membership Accounting Compliance Metrics 

Metric Data as of Apr-2014 

  

					
	Schedule B-2-1	  	B-2-1-78	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	ID cards sent within 10 business days of receiving complete and accurate enrollment information from the exchange and premium.	 	Manual Calculation between data from a future report extracted from ABS and data from the OCOE.	 	New SLA	 		 	CA/AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	99%
												
	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	The Exchange will receive the 999 file within one business day of receipt of the 834/820 file 85% of the time and within 3 business days of receiept of the 834/820 file 99% of the time within any given month.	 	ITG Extract	 	New SLA	 		 	CA/AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	99%
												
	 CPD
	 	MAE	 	1	 	ACA- Effectuation of Enrollment	 	The exchange will receive the 834 file wthin one business day of receipt of the member’s initial payment file 85% of the time and within 3 business days of receipt of the member’s initial payment 99% of the time within any
given month.	 	ITG Extract	 	New SLA	 		 	CA/AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	98%
												
	 CPD
	 	MAE	 	1	 	ACA-Member Payment	 	The Exchange will receive the 820 file within one business day of receipt of the member’s payment file 95% of the time and within 3 business days of receipt of the member’s payment 99% of the time within any given
month.	 	ITG Extract	 	New SLA	 		 	CA/AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	99%
												
	 CPD
	 	MAE	 	1	 	ACA- Enrollment Change upon Non-receipt of member payment, 30 day notice and termination.	 	The Exchange will receive the 834 file within one business day of receipt of change of the member’s status 95% of the time and within 3 business days of reciept of the member’s status 99% of the time within any given
month.	 	ITG Extract	 	New SLA	 		 	CA/AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	99%
												
	 CPD
	 	MAE	 	1	 	HMO/POS Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 	Data from ODW & Access Database	 	New SLA, HSC 1365	 		 	CA	 	DMHC	 	Compliance	 	100%
												
	 CPD
	 	MAE	 	1	 	PPO/EPO Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 	Data from ODW & Access Database	 	New SLA, CIC 10273.4	 		 	CA	 	CDI	 	Compliance	 	100%
												
	 CPD
	 	MAE	 	1	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 	Data from ODW & Access Database	 	New SLA, CFR 156.270	 		 	CA	 	CMS, DMHC, CDI	 	Compliance	 	100%
												
	 CPD
	 	MAE	 	3	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 	Data from ODW & Access Database	 	New SLA, CFR 156.270	 		 	AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	100%
												
	 CPD
	 	MAE	 	1	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payment to the exchange by the 10th of the month	 	ITG Extract	 	New SLA	 		 	CA	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	100%
												
	 CPD
	 	MAE	 	3	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payments to the Federal Exchange by the 5th of the month	 	ITG Extract	 	New SLA	 		 	AZ	 	CMS/DMHC/CDI/AD OI	 	Compliance	 	100%

  

					
	Schedule B-2-1	  	B-2-1-79	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	
Dec-2013

	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	ID cards sent within 10 business days of receiving complete and accurate enrollment information from the exchange and premium.	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	The Exchange will receive the 999 file within one business day of receipt of the 834/820 file 85% of the time and within 3 business days of receiept of the 834/820 file 99% of the time within any given month.	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	ACA- Effectuation of Enrollment	 	The exchange will receive the 834 file wthin one business day of receipt of the member’s initial payment file 85% of the time and within 3 business days of receipt of the member’s initial payment 99% of the time within any
given month.	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	ACA-Member Payment	 	The Exchange will receive the 820 file within one business day of receipt of the member’s payment file 95% of the time and within 3 business days of receipt of the member’s payment 99% of the time within any given
month.	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	ACA- Enrollment Change upon Non- receipt of member payment, 30 day notice and termination.	 	The Exchange will receive the 834 file within one business day of receipt of change of the member’s status 95% of the time and within 3 business days of reciept of the member’s status 99% of the time within any given
month.	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	HMO/POS Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	PPO/EPO Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	3	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	1	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payment to the exchange by the 10th of the month	 		 		 		 		 		 		 		 		 		 		 	
																
	 CPD
	 	MAE	 	3	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payments to the Federal Exchange by the 5th of the month	 		 		 		 		 		 		 		 		 		 		 	

  

					
	Schedule B-2-1	  	B-2-1-80	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED
HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	ID cards sent within 10 business days of receiving complete and accurate enrollment information from the exchange and premium.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	ACA- Processing ID Cards	 	The Exchange will receive the 999 file within one business day of receipt of the 834/820 file 85% of the time and within 3 business days of receiept of the 834/820 file 99% of the time within any given month.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	ACA- Effectuation of Enrollment	 	The exchange will receive the 834 file wthin one business day of receipt of the member’s initial payment file 85% of the time and within 3 business days of receipt of the member’s initial payment 99% of the time within any
given month.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	ACA-Member Payment	 	The Exchange will receive the 820 file within one business day of receipt of the member’s payment file 95% of the time and within 3 business days of receipt of the member’s payment 99% of the time within any given
month.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	ACA- Enrollment Change upon Non- receipt of member payment, 30 day notice and termination.	 	The Exchange will receive the 834 file within one business day of receipt of change of the member’s status 95% of the time and within 3 business days of reciept of the member’s status 99% of the time within any given
month.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	HMO/POS Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	PPO/EPO Delinquency Notice	 	% of risk of termination notices sent to delinquent members 30 days prior to termination	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	3	 	On Exchange Delinquency Notice	 	% of notices sent to delinquent members with APTC three months prior to termination	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	1	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payment to the exchange by the 10th of the month	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95
													
	 CPD
	 	MAE	 	3	 	ACA- Reporting Cancellations	 	Reporting Cancellations for Non- Payments to the Federal Exchange by the 5th of the month	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-81	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 CPD-663
	 	MAE	 	1	 	TAT of Termination Notice due to non- payment of premium for life insurance policies	 	% of notices sent to the life insurance policy owner, and their designee (if individual) at least 30 days prior to the effective date of lapse or termination and within 30 days after premium is due and unpaid.	 	Genelco generated Report, manual tracking	 		 	—	 	ALL	 	CDI	 	Compliance	 	= 100%
												
	 CPD-673
	 	MAE	 	1	 	MSP Input & TIN Reference Files - Submission Timeliness	 	TIN Reference File: Submitted by the assigned submission period each quarter. MSP Input File: Submitted within the assigned, 7-day submission period each quarter.	 	Health Net Data Warehouse automated FTP file to CMS with automated email verification from CMS of receipt	 	Quarterly	 	—	 	AZ & CA & OR & WA	 	CMS	 	Compliance	 	= 100%
												
	 CPD-674
	 	MAE	 	1	 	MSP Response File Errors	 	Percentage of errors resolved prior to the next submission.	 	CMS Response file received from CMS used as a manual tracking file for % resolved.	 	Quarterly	 	n	 	AZ & CA & OR	 	CMS	 	Compliance	 	= 100%
												
	 DPD
	 	MAE	 	7	 	ID Card Mailing Passive Enrollments	 	ID Cards to be in the members hands prior to their effective date	 	Tracked in Access Data Future report from ABS	 	New SLA	 		 	ALL	 	CMS/DHCS	 	Compliance	 	= 100%
												
	 DPD
	 	MAE	 	7	 	ID Card Mailing Voluntary Enrollments	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 	Tracked in Access Data Future report from ABS	 	New SLA	 		 	ALL	 	CMS/DHCS	 	Compliance	 	= 100%
												
	 DPD-263
	 	MAE	 	7	 	FIR Error transactions are corrected timely	 	Within 15 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor.	 	SQL/Oracle back end with an Access database / front end	 		 	n	 	ALL	 	CMS	 	Compliance	 	100%
												
	 DPD-264
	 	MAE	 	7	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	During weekly processing, load COB file received from CMS into Caremark’s system for Part D claim adjudication. (NOTE: Special Business Process: Any new COB Medicare Secondary Payer (MSP) record for a member will first be
validated prior to loading into Caremark and is included in the weekly processing and loading.)	 	SQL/Oracle back end with an Access database / front end	 		 	n	 	ALL	 	CMS	 	Compliance	 	= 100%
												
	 DPD-265
	 	MAE	 	7	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS.	 	SQL/Oracle back end with an Access database / front end	 		 	—	 	ALL	 	CMS	 	Compliance	 	= 98%
												
	 DPD-266
	 	MAE	 	7	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	SQL/Oracle back end with an Access database / front end	 		 	—	 	ALL	 	CMS	 	Compliance	 	= 98%
												
	 MPD
	 	MAE	 	4	 	ID Card Mailing	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 	Future report from ABS	 	New SLA	 		 	All	 	CMS	 	Compliance	 	= 100%
												
	 MPD
	 	MAE	 	4	 	Member Refunds	 	Member refunds to be mailed with in 30 calander days	 	Future report from ABS	 	New SLA	 		 	ALL	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-82	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	
Dec-2013

	 CPD-663
	 	MAE	 	1	 	TAT of Termination Notice due to non- payment of premium for life insurance policies	 	% of notices sent to the life insurance policy owner, and their designee (if individual) at least 30 days prior to the effective date of lapse or termination and within 30 days after premium is due and unpaid.	 	66	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 CPD-673
	 	MAE	 	1	 	MSP Input & TIN Reference Files - Submission Timeliness	 	TIN Reference File: Submitted by the assigned submission period each quarter. MSP Input File: Submitted within the assigned, 7-day submission period each quarter.	 	2	 	N/A	 	50.00%	 	—  	 	—  	 	100.00%	 	—  	 	—  	 	100.00%	 	—  	 	—  
																
	 CPD-674
	 	MAE	 	1	 	MSP Response File Errors	 	Percentage of errors resolved prior to the next submission.	 	7429	 	N/A	 	UNDER
DEV	 	UNDER
DEV	 	49.87%	 	—  	 	—  	 	84.15%	 	—  	 	—  	 	61.70%
																
	 DPD
	 	MAE	 	7	 	ID Card Mailing Passive Enrollments	 	ID Cards to be in the members hands prior to their effective date	 		 		 		 		 		 		 		 		 		 		 	
																
	 DPD
	 	MAE	 	7	 	ID Card Mailing Voluntary Enrollments	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 		 		 		 		 		 		 		 		 		 		 	
																
	 DPD-263
	 	MAE	 	7	 	FIR Error transactions are corrected timely	 	Within 15 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor.	 	Null Universe	 	Null
Universe	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV
																
	 DPD-264
	 	MAE	 	7	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	During weekly processing, load COB file received from CMS into Caremark’s system for Part D claim adjudication. (NOTE: Special Business Process: Any new COB Medicare Secondary Payer (MSP) record for a member will first be
validated prior to loading into Caremark and is included in the weekly processing and loading.)	 	Null Universe	 	Null Universe	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV
																
	 DPD-265
	 	MAE	 	7	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS.	 	168	 	N/A	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV
																
	 DPD-266
	 	MAE	 	7	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	168	 	N/A	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV
																
	 MPD
	 	MAE	 	4	 	ID Card Mailing	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 		 		 		 		 		 		 		 		 		 		 	
																
	 MPD
	 	MAE	 	4	 	Member Refunds	 	Member refunds to be mailed with in 30 calander days	 		 		 		 		 		 		 		 		 		 		 	

  

					
	Schedule B-2-1	  	B-2-1-83	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 CPD-663
	 	MAE	 	1	 	TAT of Termination Notice due to non-payment of premium for life insurance policies	 	% of notices sent to the life insurance policy owner, and their designee (if individual) at least 30 days prior to the effective date of lapse or termination and within 30 days after premium is due and unpaid.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-673
	 	MAE	 	1	 	MSP Input & TIN Reference Files - Submission Timeliness	 	TIN Reference File: Submitted by the assigned submission period each quarter. MSP Input File: Submitted within the assigned, 7-day submission period each quarter.	 	100.00%	 	—  	 	—  	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 CPD-674
	 	MAE	 	1	 	MSP Response File Errors	 	Percentage of errors resolved prior to the next submission.	 	—  	 	—  	 	25.58%	 	—  	 	89.99	 	90	 	94.99	 	95
													
	 DPD
	 	MAE	 	7	 	ID Card Mailing Passive Enrollments	 	ID Cards to be in the members hands prior to their effective date	 		 		 		 		 	94.99	 	0	 	0	 	95
													
	 DPD
	 	MAE	 	7	 	ID Card Mailing Voluntary Enrollments	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 		 		 		 		 	94.99	 	0	 	0	 	95
													
	 DPD-263
	 	MAE	 	7	 	FIR Error transactions are corrected timely	 	Within 15 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor.	 	UNDER
DEV	 	UNDER
DEV	 	UNDER
DEV	 	NULL
UNIVERSE	 	14	 	13	 	11	 	10
													
	 DPD-264
	 	MAE	 	7	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	During weekly processing, load COB file received from CMS into Caremark’s system for Part D claim adjudication. (NOTE: Special Business Process: Any new COB Medicare Secondary Payer (MSP) record for a member will first be
validated prior to loading into Caremark and is included in the weekly processing and loading.)	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	NULL UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	 DPD-265
	 	MAE	 	7	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	100.00%	 	88.19	 	88.2	 	93.09	 	93.1
													
	 DPD-266
	 	MAE	 	7	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	UNDER DEV	 	UNDER DEV	 	UNDER DEV	 	100.00%	 	88.19	 	88.2	 	93.09	 	93.1
													
	 MPD
	 	MAE	 	4	 	ID Card Mailing	 	ID Cards to be mailed with in 10 days of the reciept of the TRR	 		 		 		 		 	94.99	 	0	 	0	 	95
													
	 MPD
	 	MAE	 	4	 	Member Refunds	 	Member refunds to be mailed with in 30 calander days	 		 		 		 		 	94.99	 	0	 	0	 	95

  

					
	Schedule B-2-1	  	B-2-1-84	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 MPD-1
	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment TAT, Audit Element ER05: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Issue acknowledgment notice within 10 calendar days of receipt 100% of the time (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	Manual using a Self Audit	 		 	•	 	OR & CA & AZ	 	CMS	 	Compliance	 	= 100%
												
	 MPD-3
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0562) (HNCA HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H0562)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	CA	 	CMS	 	Compliance	 	>= 90%
												
	 MPD-336
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5439) (HNCA PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5439)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	CA	 	CMS	 	Compliance	 	>= 90%
												
	 MPD-337
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5520) (HNOR PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5520)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 90%
												
	 MPD-338
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H6815) (HNOR HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H6815)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 90%
												
	 MPD-345
	 	MAE	 	8	 	LIS Processing Accuracy (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5439)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	CA	 	CMS	 	Compliance	 	>= 95%
												
	 MPD-346
	 	MAE	 	8	 	LIS Processing Accuracy (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5520)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 95%
												
	 MPD-347
	 	MAE	 	8	 	LIS Processing Accuracy (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H6815)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 95%
												
	 MPD-348
	 	MAE	 	8	 	LIS Processing Accuracy (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0351)	 	Manual SQL/Oracle back end with an Access database / front end	 		 	•	 	AZ	 	CMS	 	Compliance	 	>= 95%
												
	 MPD-350
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5439)	 	Manual Reporting using TRR data via SQL/Oracle back end with an Access database / front end	 		 	•	 	CA	 	CMS	 	Compliance	 	>= 99%
												
	 MPD-351
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5520)	 	Manual Reporting using TRR data via SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 99%
												
	 MPD-352
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H6815)	 	Manual Reporting using TRR data via SQL/Oracle back end with an Access database / front end	 		 	•	 	OR	 	CMS	 	Compliance	 	>= 99%
												
	 MPD-353
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0351)	 	Manual Reporting using TRR data via SQL/Oracle back end with an Access database / front end	 		 	•	 	AZ	 	CMS	 	Compliance	 	>= 99%

  

					
	Schedule B-2-1	  	B-2-1-85	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	
Dec-2013

	 MPD-1
	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment TAT, Audit Element ER05: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Issue acknowledgment notice within 10 calendar days of receipt 100% of the time (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	5151	 	121	 	99.17%	 	100.00%	 	99.19%	 	98.23%	 	98.29%	 	100.00%	 	99.17%	 	97.67%	 	96.90%
																
	 MPD-3
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0562) (HNCA HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H0562)	 	3672	 	N/A	 	98.68%	 	99.10%	 	99.50%	 	99.30%	 	98.80%	 	100.00%	 	98.00%	 	97.20%	 	94.30%
																
	 MPD-336
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5439) (HNCA PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5439)	 	52	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	97.60%	 	100.00%	 	100.00%	 	94.20%	 	92.70%	 	90.10%
																
	 MPD-337
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5520) (HNOR PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5520)	 	334	 	N/A	 	99.05%	 	97.90%	 	97.90%	 	99.10%	 	98.70%	 	100.00%	 	96.80%	 	96.50%	 	96.20%
																
	 MPD-338
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H6815) (HNOR HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H6815)	 	377	 	N/A	 	98.31%	 	100.00%	 	98.20%	 	95.10%	 	100.00%	 	100.00%	 	98.70%	 	98.20%	 	96.90%
																
	 MPD-345
	 	MAE	 	8	 	LIS Processing Accuracy (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5439)	 	614	 	N/A	 	100.00%	 	100.00%	 	99.80%	 	99.80%	 	99.50%	 	99.30%	 	99.70%	 	99.20%	 	99.70%
																
	 MPD-346
	 	MAE	 	8	 	LIS Processing Accuracy (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5520)	 	5810	 	N/A	 	99.90%	 	99.90%	 	99.90%	 	99.80%	 	99.90%	 	99.90%	 	99.90%	 	99.50%	 	99.80%
																
	 MPD-347
	 	MAE	 	8	 	LIS Processing Accuracy (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H6815)	 	1507	 	N/A	 	100.00%	 	100.00%	 	99.60%	 	100.00%	 	99.70%	 	100.00%	 	99.70%	 	99.70%	 	100.00%
																
	 MPD-348
	 	MAE	 	8	 	LIS Processing Accuracy (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0351)	 	9038	 	N/A	 	99.80%	 	99.80%	 	99.70%	 	99.90%	 	99.80%	 	99.60%	 	100.00%	 	99.20%	 	99.80%
																
	 MPD-350
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5439)	 	3	 	N/A	 	100.00%	 	100.00%	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	0.00%	 	50.00%
																
	 MPD-351
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5520)	 	17	 	N/A	 	100.00%	 	N/A	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	83.33%	 	99.97%
																
	 MPD-352
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H6815)	 	11	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	N/A	 	N/A	 	100.00%	 	N/A	 	N/A	 	100.00%
																
	 MPD-353
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0351)	 	26	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.98%

  

					
	Schedule B-2-1	  	B-2-1-86	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 MPD-1
	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment TAT, Audit Element ER05: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Issue acknowledgment notice within 10 calendar days of receipt 100% of the time (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	93.02%	 	97.46%	 	99.17%	 	LAG MONTH	 	94.99	 	0	 	0	 	95
													
	 MPD-3
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0562) (HNCA HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H0562)	 	97.70%	 	98.00%	 	97.00%	 	98.90%	 	89.99	 	0	 	0	 	90
													
	 MPD-336
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5439) (HNCA PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5439)	 	93.20%	 	96.60%	 	97.60%	 	94.20%	 	89.99	 	0	 	0	 	90
													
	 MPD-337
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H5520) (HNOR PPO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H5520)	 	92.30%	 	96.10%	 	93.30%	 	99.10%	 	89.99	 	0	 	0	 	90
													
	 MPD-338
	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H6815) (HNOR HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request. (covers contract number: H6815)	 	97.20%	 	99.00%	 	94.60%	 	98.40%	 	89.99	 	0	 	0	 	90
													
	 MPD-345
	 	MAE	 	8	 	LIS Processing Accuracy (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5439)	 	99.24%	 	99.40%	 	99.40%	 	99.50%	 	94.99	 	0	 	0	 	95
													
	 MPD-346
	 	MAE	 	8	 	LIS Processing Accuracy (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 95% (covers contract number: H5520)	 	98.10%	 	99.00%	 	99.00%	 	98.90%	 	94.99	 	0	 	0	 	95
													
	 MPD-347
	 	MAE	 	8	 	LIS Processing Accuracy (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H6815)	 	100.00%	 	99.60%	 	99.60%	 	99.80%	 	94.99	 	0	 	0	 	95
													
	 MPD-348
	 	MAE	 	8	 	LIS Processing Accuracy (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0351)	 	98.96%	 	99.20%	 	99.20%	 	99.60%	 	94.99	 	0	 	0	 	95
													
	 MPD-350
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5439) (HNCA PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5439)	 	100.00%	 	N/A	 	100.00%	 	100.00%	 	89.99	 	0	 	0	 	90
													
	 MPD-351
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H5520) (HNOR PPO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H5520)	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	0	 	0	 	90
													
	 MPD-352
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H6815) (HNOR HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H6815)	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	0	 	0	 	90
													
	 MPD-353
	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0351) (HNAZ HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0351)	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	0	 	0	 	90

  

					
	Schedule B-2-1	  	B-2-1-87	  	Health Net / Cognizant Confidential

 Final 

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	MPD-36	 	MAE	 	4	 	Refund Timeliness, Audit Element DN04 when applicable (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	QA&T Monthly Self Audit	 		 	—	 	OR & CA & AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-4	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0351) (HNAZ HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request (covers contract number: H0351)	 	QA&T Monthly Self Audit	 		 	—	 	AZ	 	CMS	 	Compliance	 	>= 90%
												
	MPD-41	 	MAE	 	8	 	LIS Processing Accuracy (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0562)	 	QA&T Monthly Self Audit	 		 	—	 	CA	 	CMS	 	Compliance	 	>= 95%
												
	MPD-435	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment Notice Content Audit Element ER06: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Notice Accuracy (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	QA&T Monthly Self Audit	 		 	¿	 	OR & CA & AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-436	 	MAE	 	4	 	Acknowledgment of Disenrollment Request Notice Content , Audit Element DN03: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: H0562, H5439, H5520, H6815)	 	QA&T Monthly Self Audit	 		 	—	 	OR & CA & AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-50	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0562)	 	Manual Reporting using TRR data via SQL/Oracle back end with an Access database / front end	 		 	—	 	CA	 	CMS	 	Compliance	 	>= 99%
												
	MPD-7	 	MAE	 	4	 	Acknowledgment of Disenrollment Request TAT, Audit Element DN02: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	QA&T Monthly Self Audit	 		 	—	 	OR & CA & AZ	 	CMS	 	Compliance	 	= 100%
												
	MPD-79	 	MAE	 	8	 	FIR Error transactions are corrected timely	 	Within 30 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor	 	SQL/Oracle back end with an Access database / front end	 		 	—	 	ALL	 	CMS	 	Compliance	 	= 100%
												
	MPD-80	 	MAE	 	8	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	Weekly process to load COB file received from CMS into Caremark’s system for Part D claim adjudication. NOTE Special Business Process: any new COB Medicare Secondary Payer (MSP) record for a member will first be validated prior
to loading into Caremark.	 	SQL/Oracle back end with an Access database / front end	 		 	—	 	ALL	 	CMS	 	Compliance	 	= 100%
												
	MPD-81	 	MAE	 	8	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS. New requirement, developing for monthly	 	SQL/Oracle back end with an Access database / front end	 		 	—	 	ALL	 	CMS	 	Compliance	 	>= 98%
												
	MPD-82	 	MAE	 	8	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	SQL/Oracle back end with an Access database / front end	 		 	¿	 	ALL	 	CMS	 	Compliance	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-88	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	MPD-36	 	MAE	 	4	 	Refund Timeliness, Audit Element DN04 when applicable (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	380	 	1	 	N/A	 	N/A	 	N/A	 	100.00%	 	100.00%	 	N/A	 	100.00%	 	100.00%	 	0.00%
																
	MPD-4	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0351) (HNAZ HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request (covers contract number: H0351)	 	621	 	N/A	 	98.98%	 	98.70%	 	98.90%	 	98.90%	 	98.20%	 	100.00%	 	98.10%	 	97.90%	 	95.20%
																
	MPD-41	 	MAE	 	8	 	LIS Processing Accuracy (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0562)	 	44695	 	N/A	 	99.90%	 	99.90%	 	99.70%	 	99.90%	 	99.90%	 	99.70%	 	99.90%	 	99.60%	 	99.50%
																
	MPD-435	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment Notice Content Audit Element ER06: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Notice Accuracy (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	5151	 	121	 	98.33%	 	96.55%	 	98.39%	 	98.23%	 	98.29%	 	96.46%	 	97.52%	 	63.57%	 	41.86%
																
	MPD-436	 	MAE	 	4	 	Acknowledgment of Disenrollment Request Notice Content , Audit Element DN03: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: H0562, H5439, H5520, H6815)	 	261	 	30	 	66.67%	 	56.67%	 	100.00%	 	100.00%	 	100.00%	 	93.33%	 	100.00%	 	96.67%	 	90.00%
																
	MPD-50	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0562)	 	56	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	67.31%	 	100.00%	 	100.00%	 	100.00%	 	43.75%	 	99.95%
																
	MPD-7	 	MAE	 	4	 	Acknowledgment of Disenrollment Request TAT, Audit Element DN02: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) H5439, H5520, H6815) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: (H0351, H0562,	 	261	 	30	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	93.33%
																
	MPD-79	 	MAE	 	8	 	FIR Error transactions are corrected timely	 	Within 30 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor	 	473	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-80	 	MAE	 	8	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	Weekly process to load COB file received from CMS into Caremark’s system for Part D claim adjudication. NOTE Special Business Process: any new COB Medicare Secondary Payer (MSP) record for a member will first be validated prior
to loading into Caremark.	 	603	 	N/A	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-81	 	MAE	 	8	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS. New requirement, developing for monthly	 	2577233	 	N/A	 	99.96%	 	99.99%	 	99.97%	 	99.97%	 	99.97%	 	99.98%	 	99.98%	 	99.98%	 	99.98%
																
	MPD-82	 	MAE	 	8	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	65617	 	N/A	 	92.66%	 	91.00%	 	91.00%	 	N/A	 	88.00%	 	87.00%	 	87.50%	 	86.70%	 	86.70%

  

					
	Schedule B-2-1	  	B-2-1-89	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	MPD-36	 	MAE	 	4	 	Refund Timeliness, Audit Element DN04 when applicable (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Greater than or equal to 95% (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	100.00%	 	N/A	 	100.00%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
	MPD-4	 	MAE	 	4	 	Submission of Enrollment TAT: MA/Part D (H0351) (HNAZ HMO) (ABS)	 	Submit enrollment to CMS within 7 calendar days of receipt of the completed enrollment request (covers contract number: H0351)	 	96.30%	 	98.30%	 	95.80%	 	97.40%	 	89.99	 	0	 	0	 	90
	MPD-41	 	MAE	 	8	 	LIS Processing Accuracy (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 95% (covers contract number: H0562)	 	99.39%	 	99.60%	 	99.60%	 	99.70%	 	94.99	 	0	 	0	 	95
	MPD-435	 	MAE	 	4	 	Acknowledgment of Enrollment Request and Confirmation of Enrollment Notice Content Audit Element ER06: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Notice Accuracy (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	33.33%	 	84.75%	 	73.55%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
	MPD-436	 	MAE	 	4	 	Acknowledgment of Disenrollment Request Notice Content , Audit Element DN03: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: H0562, H5439, H5520, H6815)	 	93.33%	 	96.67%	 	100.00%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
	MPD-50	 	MAE	 	8	 	4RX Submission to CMS, Timeliness (H0562) (HNCA HMO) (ABS)	 	Greater than or equal to 99% of the total CMS-generated enrollments are responded to within 72 hours (covers contract number: H0562)	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	0	 	0	 	99
	MPD-7	 	MAE	 	4	 	Acknowledgment of Disenrollment Request TAT, Audit Element DN02: MA/Part D (HNCA HMO, HNCA PPO, HNOR PPO, HNOR HMO, HNAZ HMO) (ABS)	 	Submit disenrollment transaction within 7 calendar days of receipt. (covers contract numbers: (H0351, H0562, H5439, H5520, H6815)	 	93.33%	 	100.00%	 	100.00%	 	LAG
MONTH	 	94.99	 	0	 	0	 	95
	MPD-79	 	MAE	 	8	 	FIR Error transactions are corrected timely	 	Within 30 days, correct FIR issue so that Caremark is able to successfully transfer member’s financial Part D dollars to and from CMS’ Vendor	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.99	 	0	 	0	 	100
	MPD-80	 	MAE	 	8	 	Coordination of Benefits (COB) loaded into Caremark’s system timely	 	Weekly process to load COB file received from CMS into Caremark’s system for Part D claim adjudication. NOTE Special Business Process: any new COB Medicare Secondary Payer (MSP) record for a member will first be validated prior
to loading into Caremark.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	99.99	 	0	 	0	 	100
	MPD-81	 	MAE	 	8	 	Prescription Drug Event (PDE) Timely Submissions to CMS	 	Within 30 days, ensure all Part D eligible claims are successfully submitted as a PDE to CMS. New requirement, developing for monthly	 	99.98%	 	100.00%	 	100.00%	 	100.00%	 	97.99	 	0	 	0	 	98
	MPD-82	 	MAE	 	8	 	Prescription Drug Event (PDE) Error Timely Correction to CMS	 	Within 90 days, PDE Errors are corrected and submitted back to CMS and accepted by CMS. New requirement.	 	100.00%	 	100.00%	 	100.00%	 	57.10%	 	99.99	 	0	 	0	 	100

  

					
	Schedule B-2-1	  	B-2-1-90	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	MPD	 	MAE	 	4	 	OEV	 	The OEV letter must be mailed out to the beneficiary within fifteen (15) calendar days of receipt of the enrollment request.	 	OEV reporting and systems	 	Medicare all regions; New metric per new OEV regulations	 		 	All	 	MPD	 	Compliance	 	<= 15 calendar days

 Medical Management Metrics 

Metric Data as of Jun-2014 
  

																							
												
	CPD-288	 	MM	 	1	 	HMO/POS Routine Pre-Service Authorization Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	Auditing Database	 		 	¿	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-292	 	MM	 	1	 	HMO/POS Urgent Concurrent Authorization Request Decision TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	Auditing Database	 		 	¿	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-286	 	MM	 	1	 	HMO/POS Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	Auditing Database	 		 	¿	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-287	 	MM	 	1	 	PPO/EPO Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization requests decided within 72 hours of receipt	 	Auditing Database	 		 	¿	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-297	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Initial Provider Communication	 	% of provider notified (communicated) within 24 hours after pre-service authorization request decision	 	Auditing Database	 		 	p	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-294	 	MM	 	1	 	PPO/EPO Urgent Concurrent Authorization Request Resolution TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt	 	Auditing Database	 		 	p	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-296	 	MM	 	1	 	HMO/POS Notification to Provider of Decision on Pre-Service Authorization Reques	 	% of notifications (communications) to requesting providers of pre-service authorization decision made within 24 hours after decision	 	Auditing Database	 		 	—	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-290	 	MM	 	1	 	HMO/POS Post-Service Authorization Request Resolution TAT	 	% of retrospective review (post-service authorization) decisions within 30 calendar days of receipt of the info reasonably necessary to make the determination	 	Auditing Database	 		 	—	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-311	 	MM	 	1	 	HMO/POS Second Opinion Authorization Request Resolution TAT	 	% of second opinion urgent requests decided within 72 hours of receipt	 	Auditing Database	 		 	—	 	CA	 	DMHC	 	N/A	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-91	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	MPD	 	MAE	 	4	 	OEV	 	The OEV letter must be mailed out to the beneficiary within fifteen (15) calendar days of receipt of the enrollment request.	 	N/
A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A	 	N/A
													
	Medical Management Metrics	 		 		 		 		 		 		 		 		 		 		 		 	
	Metric Data as of Jun-2014	 		 		 		 		 		 		 		 		 		 		 		 	
																
	CPD-288	 	MM	 	1	 	HMO/POS Routine Pre-Service Authorization Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	167	 	30	 	100.00%	 	97.00%	 		 	93.00%	 	100.00%	 	100.00%	 	80.00%	 	90.00%	 	73.00%
																
	CPD-292	 	MM	 	1	 	HMO/POS Urgent Concurrent Authorization Request Decision TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	76	 	30	 	100.00%	 	97.00%	 		 	100.00%	 	86.67%	 	97.00%	 	93.33%	 	93.00%	 	93.00%
																
	CPD-286	 	MM	 	1	 	HMO/POS Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	127	 	30	 	93.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.00%	 	87.00%
																
	CPD-287	 	MM	 	1	 	PPO/EPO Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization requests decided within 72 hours of receipt	 	314	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	93.33%	 	100.00%	 	97.00%
																
	CPD-297	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Initial Provider Communication	 	% of provider notified (communicated) within 24 hours after pre-service authorization request decision	 	249	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-294	 	MM	 	1	 	PPO/EPO Urgent Concurrent Authorization Request Resolution TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt	 	253	 	30	 	97.00%	 	100.00%	 		 	100.00%	 	96.67%	 	97.00%	 	100.00%	 	97.00%	 	100.00%
																
	CPD-296	 	MM	 		 	HMO/POS Notification to Provider of Decision on Pre-Service Authorization Reques	 	% of notifications (communications) to requesting providers of pre-service authorization decision made within 24 hours after decision	 	294	 	8	 	100.00%	 	100.00%	 		 	100.00%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-290	 	MM	 	1	 	HMO/POS Post-Service Authorization Request Resolution TAT	 	% of retrospective review (post-service authorization) decisions within 30 calendar days of receipt of the info reasonably necessary to make the determination	 	8	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-311	 	MM	 	1	 	HMO/POS Second Opinion Authorization Request Resolution TAT	 	% of second opinion urgent requests decided within 72 hours of receipt	 	1	 	N/A	 	100.00%	 	0.00%	 		 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-92	  	Health Net / Cognizant Confidential

 Final 
  

																											
	 Metric
ID
	 	 Tower
	 	Group
Code	 	 Metric
Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	 	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	MPD	 	MAE	 	4	 	OEV	 	The OEV letter must be mailed out to the beneficiary within fifteen (15) calendar days of receipt of the enrollment request.	 	N/A	 	N/A	 	N/A	 	N/A	 		 	15.01	 	0	 	0	 	15
		 		 		 		 		 		 		 		 		 		 		 		 		 	

 Medical Management Metrics 

Metric Data as of Jun-2014 
  

																											
	CPD-288	 	MM	 	1	 	HMO/POS Routine Pre-Service Authorization Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	100.00%	 	80.00%	 	76.67%	 	90.00%	 		 	89.99	 	90	 	94.99	 	95
	CPD-292	 	MM	 	1	 	HMO/POS Urgent Concurrent Authorization Request Decision TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	93.33%	 	86.67%	 	76.67%	 	76.67%	 		 	89.99	 	90	 	94.99	 	95
	CPD-286	 	MM	 	1	 	HMO/POS Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization decisions made within 72 hours of receipt of the info reasonably necessary and requested by plan to make the determination	 	93.33%	 	96.67%	 	86.67%	 	93.33%	 		 	89.99	 	90	 	94.99	 	95
	CPD-287	 	MM	 	1	 	PPO/EPO Urgent Pre-Service Authorization Request Decision TAT (PG)	 	% of urgent pre-service authorization requests decided within 72 hours of receipt	 	93.33%	 	100.00%	 	100.00%	 	93.33%	 		 	89.99	 	90	 	94.99	 	95
	CPD-297	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Initial Provider Communication	 	% of provider notified (communicated) within 24 hours after pre-service authorization request decision	 	96.67%	 	100.00%	 	96.67%	 	100.00%	 		 	89.99	 	90	 	94.99	 	95
	CPD-294	 	MM	 	1	 	PPO/EPO Urgent Concurrent Authorization Request Resolution TAT	 	% of urgent concurrent authorization request decisions made within 72 hours of receipt	 	86.67%	 	96.67%	 	100.00%	 	93.33%	 		 	89.99	 	90	 	94.99	 	95
	CPD-296	 	MM	 	1	 	HMO/POS Notification to Provider of Decision on Pre-Service Authorization Reques	 	% of notifications (communications) to requesting providers of pre-service authorization decision made within 24 hours after decision	 	96.67%	 	100.00%	 	100.00%	 	98.36%	 		 	89.99	 	90	 	94.99	 	95
	CPD-290	 	MM	 	1	 	HMO/POS Post-Service Authorization Request Resolution TAT	 	% of retrospective review (post-service authorization) decisions within 30 calendar days of receipt of the info reasonably necessary to make the determination	 	92.31%	 	100.00%	 	100.00%	 	100.00%	 		 	89.99	 	90	 	94.99	 	95
	CPD-311	 	MM	 	1	 	HMO/POS Second Opinion Authorization Request Resolution TAT	 	% of second opinion urgent requests decided within 72 hours of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-93	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	CPD-301	 	MM	 	1	 	HMO/POS Written Notice to Member of Pre-Service Authorization Request Denial, De	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	Auditing Database	 		 	—	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-299	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Pre	 	% of written notifications to providers of pre-service authorization request denial, delay or modifications within 2 business days of decision	 	Auditing Database	 		 	—	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-319	 	MM	 	3	 	HMO/PPO Standard Pre-Service Auth TAT	 	within ten (10) business days after receipt of request	 	Auditing Database	 		 	—	 	AZ	 	ADOI	 	N/A	 	= 100%
												
	CPD-303	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Request Provider Communication TAT	 	% of providers notified within 24 hours after concurrent review authorization request decision	 	Auditing Database	 		 	—	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-291	 	MM	 	1	 	PPO/EPO Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt	 	Auditing Database	 		 	—	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-300	 	MM	 	1	 	PPO/EPO Pre-Service Authorization Denial Member Communication TAT	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	Auditing Database	 		 	—	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-289	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	Auditing Database	 		 	—	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-298	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Provider Written Communication	 	% of provider letters sent written notification within 2 business days after pre-service authorization request denial decision	 	Auditing Database	 		 	—	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-322	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decision made within 72 hours or 2 business days, whichever is first, of receipt	 	Auditing Database	 		 	—	 	OR	 	OID	 	N/A	 	= 100%
												
	CPD-337	 	MM	 	2	 	Authorization Request for Immediate Request Situations TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	CPD-306	 	MM	 	1	 	HMO/POS Notice to Enrollee with Terminal Illness of Reasons for Denying Authoriz	 	% of notices to enrollees with a terminal illness with reasons for denying authorization coverage request within 5 business days of receipt	 	Auditing Database	 		 	n	 	CA	 	DMHC	 	N/A	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-94	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-301	 	MM	 	1	 	HMO/POS Written Notice to Member of Pre-Service Authorization Request Denial, De	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	35	 	8	 	100.00%	 	100.00%	 		 	97.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-299	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Pre	 	% of written notifications to providers of pre-service authorization request denial, delay or modifications within 2 business days of decision	 	35	 	8	 	100.00%	 	100.00%	 		 	97.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-319	 	MM	 	3	 	HMO/PPO Standard Pre-Service Auth TAT	 	within ten (10) business days after receipt of request	 	2	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	96.67%	 	100.00%	 	90.00%
																
	CPD-303	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Request Provider Communication TAT	 	% of providers notified within 24 hours after concurrent review authorization request decision	 	253	 	30	 	100.00%	 	100.00%	 		 	93.00%	 	100.00%	 	100.00%	 	100.00%	 	97.00%	 	100.00%
																
	CPD-291	 	MM	 	1	 	PPO/EPO Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt	 	16	 	8	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-300	 	MM	 	1	 	PPO/EPO Pre-Service Authorization Denial Member Communication TAT	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	32	 	8	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-289	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	249	 	8	 	100.00%	 	100.00%	 		 	97.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-298	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Provider Written Communication	 	% of provider letters sent written notification within 2 business days after pre-service authorization request denial decision	 	17	 	8	 	100.00%	 	100.00%	 		 	100.00%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-322	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decision made within 72 hours or 2 business days, whichever is first, of receipt	 	1	 	N/A	 	93.00%	 	100.00%	 		 	100.00%	 	100.00%	 	97.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-337	 	MM	 	2	 	Authorization Request for Immediate Request Situations TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-306	 	MM	 	1	 	HMO/POS Notice to Enrollee with Terminal Illness of Reasons for Denying Authoriz	 	% of notices to enrollees with a terminal illness with reasons for denying authorization coverage request within 5 business days of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 		 		 		 		 		 		 		 	NULL
UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-95	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric
ID
	 	 Tower
	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	CPD-301	 	MM	 	1	 	HMO/POS Written Notice to Member of Pre-Service Authorization Request Denial, De	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-299	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Pre	 	% of written notifications to providers of pre-service authorization request denial, delay or modifications within 2 business days of decision	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-319	 	MM	 	3	 	HMO/PPO Standard Pre-Service Auth TAT	 	within ten (10) business days after receipt of request	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-303	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Request Provider Communication TAT	 	% of providers notified within 24 hours after concurrent review authorization request decision	 	100.00%	 	100.00%	 	90.00%	 	95.67%	 	89.99	 	90	 	94.99	 	95
													
	CPD-291	 	MM	 	1	 	PPO/EPO Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-300	 	MM	 	1	 	PPO/EPO Pre-Service Authorization Denial Member Communication TAT	 	% of written notices sent to members regarding pre-service authorization requests denials, delays or modifications within 2 business days of decision	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-289	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Decision TAT (PG)	 	% of routine pre-service authorization requests decided within 5 business days of receipt of the info reasonably necessary and requested by plan to make the determination	 	100.00%	 	100.00%	 	90.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-298	 	MM	 	1	 	PPO/EPO Routine Pre-Service Authorization Request Provider Written Communication	 	% of provider letters sent written notification within 2 business days after pre-service authorization request denial decision	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-322	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decision made within 72 hours or 2 business days, whichever is first, of receipt	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-337	 	MM	 	2	 	Authorization Request for Immediate Request Situations TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-306	 	MM	 	1	 	HMO/POS Notice to Enrollee with Terminal Illness of Reasons for Denying Authoriz	 	% of notices to enrollees with a terminal illness with reasons for denying authorization coverage request within 5 business days of receipt	 	—  	 	NULL
UNIVERSE	 	—  	 	—  	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-96	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

	CPD-307	 	MM	 	1	 	HMO/POS TAT for Notice to Enrollee with Terminal Illness Providing Opportunity t	 	% of notices sent to enrollees with terminal illness notifying them of the opportunity for a conference within 30 calendar days of receipt of a complaint form	 	Auditing Database	 		 	n	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-304	 	MM	 	1	 	HMO/POS Written Notice to Member of Concurrent Authorization Request Denial, Del	 	% of written notices sent to members regarding concurrent authorization requests denials, delays or modifications within 2 business days of decision	 	Auditing Database	 		 	n	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-302	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Con	 	% of written notices sent to providers within 2 business days of denial, delay or modification for concurrent review authorization request	 	Auditing Database	 		 	n	 	CA	 	DMHC	 	N/A	 	= 100%
												
	CPD-320	 	MM	 	3	 	HMO/PPO Expedited Service Auth TAT	 	within 72 hours of receipt of request	 	Auditing Database	 		 	n	 	AZ	 	ADOI	 	N/A	 	= 100%
												
	CPD-334	 	MM	 	2	 	Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt of all nec info or expiration of the deadline to respond	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	CPD-324	 	MM	 	2	 	Post-Service Authorization Resolution Request TAT	 	% of post-service review requests decided within 30 calendar days of receipt	 	Auditing Database	 		 	n	 	OR	 	OID	 	N/A	 	= 100%
												
	CPD-305	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Denial Member Written Communication TAT	 	% of written notices sent to enrollees within 2 business days of denial for concurrent review authorization request	 	Auditing Database	 		 	n	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-308	 	MM	 	1	 	PPO/EPO TAT to provide the enrollee an opportunity to attend a conference after	 	% of reviews conducted for enrollees requesting review after denial for request for experimental treatment for enrollee with terminal illness within 30 calendar days of the request or within 5 business days if the treating physician
and medical director	 	Auditing Database	 		 	n	 	CA	 	CDI	 	N/A	 	= 100%
												
	CPD-339	 	MM	 	2	 	Pre-Service Authorization Request for Experimental/Investigational Service Resol	 	% of pre-service authorization requests for experimental/investigational services made within 20 business days of receipt of a fully documented request	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	CPD-323	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization request decision made within 2 business days of receipt	 	Auditing Database	 		 	n	 	OR	 	OID	 	N/A	 	= 100%
												
	CPD-333	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization requests decisions made within 5 calendar days of receipt of all nec info or expiration of the deadline to respond	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-97	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric
Measure
	 	Universe	 	Sample
Size 	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-307	 	MM	 	1	 	HMO/POS TAT for Notice to Enrollee with Terminal Illness Providing Opportunity t	 	% of notices sent to enrollees with terminal illness notifying them of the opportunity for a conference within 30 calendar days of receipt of a complaint form	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 		 		 		 		 		 		 		 	NULL
UNIVERSE
																
	CPD-304	 	MM	 	1	 	HMO/POS Written Notice to Member of Concurrent Authorization Request Denial, Del	 	% of written notices sent to members regarding concurrent authorization requests denials, delays or modifications within 2 business days of decision	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-302	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Con	 	% of written notices sent to providers within 2 business days of denial, delay or modification for concurrent review authorization request	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-320	 	MM	 	3	 	HMO/PPO Expedited Service Auth TAT	 	within 72 hours of receipt of request	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.00%	 	100.00%
																
	CPD-334	 	MM	 	2	 	Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	CPD-324	 	MM	 	2	 	Post-Service Authorization Resolution Request TAT	 	% of post-service review requests decided within 30 calendar days of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-305	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Denial Member Written Communication TAT	 	% of written notices sent to enrollees within 2 business days of denial for concurrent review authorization request	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE
																
	CPD-308	 	MM	 	1	 	PPO/EPO TAT to provide the enrollee an opportunity to attend a conference after	 	% of reviews conducted for enrollees requesting review after denial for request for experimental treatment for enrollee with terminal illness within 30 calendar days of the request or within 5 business days if the treating physician
and medical director	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 		 		 		 		 		 		 		 	NULL
UNIVERSE
																
	CPD-339	 	MM	 	2	 	Pre-Service Authorization Request for Experimental/Investigational Service Resol	 	% of pre-service authorization requests for experimental/investigational services made within 20 business days of receipt of a fully documented request	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE
																
	CPD-323	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization request decision made within 2 business days of receipt	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	97.00%	 	100.00%	 	97.00%	 	100.00%	 	100.00%	 	100.00%
																
	CPD-333	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization requests decisions made within 5 calendar days of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	97.00%

  

					
	Schedule B-2-1	  	B-2-1-98	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric
ID
	 	 Tower
	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED
HI	 	YELLOW
LO	 	YELLOW
HI	 	GREEN
LO
	CPD-307	 	MM	 	1	 	HMO/POS TAT for Notice to Enrollee with Terminal Illness Providing Opportunity t	 	% of notices sent to enrollees with terminal illness notifying them of the opportunity for a conference within 30 calendar days of receipt of a complaint form	 	—  	 	NULL
UNIVERSE	 	—  	 	—  	 	89.99	 	90	 	94.99	 	95
													
	CPD-304	 	MM	 	1	 	HMO/POS Written Notice to Member of Concurrent Authorization Request Denial, Del	 	% of written notices sent to members regarding concurrent authorization requests denials, delays or modifications within 2 business days of decision	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-302	 	MM	 	1	 	HMO/POS Written Notification to Provider of Denial, Delay or Modification of Con	 	% of written notices sent to providers within 2 business days of denial, delay or modification for concurrent review authorization request	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-320	 	MM	 	3	 	HMO/PPO Expedited Service Auth TAT	 	within 72 hours of receipt of request	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-334	 	MM	 	2	 	Post-Service Authorization Request Resolution TAT	 	% of post-service authorization request decisions made within 30 calendar days of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-324	 	MM	 	2	 	Post-Service Authorization Resolution Request TAT	 	% of post-service review requests decided within 30 calendar days of receipt	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-305	 	MM	 	1	 	PPO/EPO Concurrent Review Authorization Denial Member Written Communication TAT	 	% of written notices sent to enrollees within 2 business days of denial for concurrent review authorization request	 	100.00%	 	0.00%	 	100.00%	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-308	 	MM	 	1	 	PPO/EPO TAT to provide the enrollee an opportunity to attend a conference after	 	% of reviews conducted for enrollees requesting review after denial for request for experimental treatment for enrollee with terminal illness within 30 calendar days of the request or within 5 business days if the treating physician
and medical director	 	—  	 	NULL
UNIVERSE	 	—  	 	—  	 	89.99	 	90	 	94.99	 	95
													
	CPD-339	 	MM	 	2	 	Pre-Service Authorization Request for Experimental/Investigational Service Resol	 	% of pre-service authorization requests for experimental/investigational services made within 20 business days of receipt of a fully documented request	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	CPD-323	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization request decision made within 2 business days of receipt	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	0.00%	 	89.99	 	90	 	94.99	 	95
													
	CPD-333	 	MM	 	2	 	Routine Pre-Service Authorization Request Resolution TAT	 	% of routine pre-service authorization requests decisions made within 5 calendar days of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-99	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric
Type
	 	 Target

												
	CPD-335	 	MM	 	2	 	Urgent Concurrent Authorization Decision TAT	 	% of urgent concurrent authorization request decisions made no later than 24 hours of receipt of all nec info or expiration of the deadline to respond	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	CPD-332	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decisions made within 48 hours of receipt of all nec info or expiration of the deadline to respond	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	CPD-336	 	MM	 	2	 	Written Notification Provider and Enrollee of Urgent Denial TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	Auditing Database	 		 	n	 	WA	 	OIC	 	N/A	 	= 100%
												
	MPD-160	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (AZ	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	¿	 	AZ	 	CMS	 	MA	 	= 100%
												
	MPD-175	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	¿	 	CA	 	CMS	 	MA	 	= 100%
												
	MPD-212	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care(OR)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	Auditing Database	 		 	¿	 	OR	 	CMS	 	MA	 	= 100%
												
	MPD-162	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (AZ)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	p	 	AZ	 	CMS	 	MA	 	= 100%
												
	MPD-188	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA PPO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	p	 	CA	 	CMS	 	MA	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-100	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric
Measure
	 	Universe	 	Sample
Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	CPD-335	 	MM	 	2	 	Urgent Concurrent Authorization Decision TAT	 	% of urgent concurrent authorization request decisions made no later than 24 hours of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	82.00%	 	86.00%	 		 	85.00%	 	78.57%	 	70.00%	 	90.00%	 	87.00%	 	60.00%
																
	CPD-332	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decisions made within 48 hours of receipt of all nec info or expiration of the deadline to respond	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	94.00%	 	94.74%	 	92.00%	 	96.43%	 	100.00%	 	100.00%
																
	CPD-336	 	MM	 	2	 	Written Notification Provider and Enrollee of Urgent Denial TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	0.00%	 	100.00%
																
	MPD-160	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (AZ	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	11	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-175	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	22	 	N/A	 	94.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	81.00%
																
	MPD-212	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care(OR)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	1	 	N/A	 	NULL
UNIVERSE	 	100.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	MPD-162	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (AZ)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	183	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	MPD-188	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA PPO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	41	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-101	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric

ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	Mar-2014	 	Apr-2014	 	RED HI	 	YELLOW
LO	 	YELLOW
HI	  	GREEN
LO
	CPD-335	 	MM	 	2	 	Urgent Concurrent Authorization Decision TAT	 	% of urgent concurrent authorization request decisions made no later than 24 hours of receipt of all nec info or expiration of the deadline to respond	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	  	95
													
	CPD-332	 	MM	 	2	 	Urgent Pre-Service Authorization Request Resolution TAT	 	% of urgent pre-service authorization request decisions made within 48 hours of receipt of all nec info or expiration of the deadline to respond	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	  	95
													
	CPD-336	 	MM	 	2	 	Written Notification Provider and Enrollee of Urgent Denial TAT	 	% of authorization request decisions for immediate request situations made within 1 business day when the lack of treatment may result in an emergency visit or emergency admission	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	  	95
													
	MPD-160	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (AZ	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	  	95
													
	MPD-175	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	85.71%	 	100.00%	 	85.71%	 	94.12%	 	89.99	 	90	 	94.99	  	95
													
	MPD-212	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care(OR)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	89.99	 	90	 	94.99	  	95
													
	MPD-162	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (AZ)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	96.67%	 	96.67%	 	90.00%	 	90.00%	 	89.99	 	90	 	94.99	  	95
													
	MPD-188	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (CA PPO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	83.33%	 	100.00%	 	90.00%	 	89.99	 	90	 	94.99	  	95

  

					
	Schedule B-2-1	  	B-2-1-102	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 MPD-173
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-186
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	=
100%
												
	 MPD-199
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	=
100%
												
	 MPD-320
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	=
100%
												
	 MPD-201
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	=
100%
												
	 MPD-321
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR HMO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	=
100%
												
	 MPD-166
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	Auditing Database	 		 	—	 	AZ	 	CMS	 	MA	 	=
100%
												
	 MPD-179
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	=
100%
												
	 MPD-192
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	=
100%

  

					
	Schedule B-2-1	  	B-2-1-103	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 MPD-173
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	15	 	N/A	 	86.00%	 	100.00%	 		 	100.00%	 	100.00%	 	97.00%	 	93.00%	 	91.00%	 	100.00%
																
	 MPD-186
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	1	 	N/A	 	83.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-199
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	12	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	96.67%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-320
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	4	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-201
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	223	 	30	 	93.00%	 	100.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	97.00%
																
	 MPD-321
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR HMO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	85	 	30	 	100.00%	 	100.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-166
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	194	 	41	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-179
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	37	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	97.00%	 	100.00%	 	100.00%
																
	 MPD-192
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	42	 	31	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-104	  	Health Net / Cognizant Confidential

 Final 
  

																																	
	 Metric
ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	 MPD-173
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-186
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (CA	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-199
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	90.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-320
	 	MM	 	4	 	OP01 - Adverse Standard Pre-Service Organization Determinations (Timeliness) (OR	 	% Enrollee notification of an adverse determination no later than 14 calendar days after receiving the request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	100.00%	 	85.71%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-201
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	96.67%	 	100.00%	 	83.33%	 	86.67%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-321
	 	MM	 	4	 	OP04 - Requests for Expedited Organization Determinations (Timeliness) (OR HMO)	 	% Enrollees notified of the expedited organization determination (favorable or adverse) within 72 hours of request Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	96.67%	 	83.33%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-166
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-179
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	100.00%	 	100.00%	 	96.88%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	 MPD-192
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-105	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric
ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric Type	 	Target
	 MPD-205
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-322
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-168
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	Auditing Database	 		 	—	 	AZ	 	CMS	 	MA	 	= 100%
												
	 MPD-181
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-194
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-207
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-323
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-169
	 	MM	 	4	 	OP12 - Detailed Explanation of Non- Coverage of Provider Services (Timeliness) (A	 	Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	Auditing Database	 		 	—	 	AZ	 	CMS	 	MA	 	= 100%
												
	 MPD-182
	 	MM	 	4	 	OP12 - Detailed Explanation of Non- Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-195
	 	MM	 	4	 	OP12 - Detailed Explanation of Non- Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	Auditing Database	 		 	—	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-209
	 	MM	 	4	 	OP12 - Detailed Explanation of Non- Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-324
	 	MM	 	4	 	OP12 - Detailed Explanation of Non- Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	Auditing Database	 		 	—	 	OR	 	CMS	 	MA	 	= 100%
												
	 MPD-172
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (AZ)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	Auditing Database	 		 	—	 	AZ	 	CMS	 	MA	 	= 100%
												
	 MPD-185
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (CA)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	Auditing Database	 		 	n	 	CA	 	CMS	 	MA	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-106	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Universe	 	Sample Size	 	Apr-2013	 	May-2013	 	Jun-2013	 	Jul-2013	 	Aug-2013	 	Sep-2013	 	Oct-2013	 	Nov-2013	 	Dec-2013
	 MPD-205
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	235	 	42	 	100.00%	 	100.00%	 		 	100.00%	 	97.67%	 	100.00%	 	97.00%	 	100.00%	 	100.00%
																
	 MPD-322
	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	89	 	34	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-168
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	1090	 	30	 	97.00%	 	97.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-181
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	42	 	30	 	90.00%	 	93.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-194
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	75	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	100.00%
																
	 MPD-207
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	1391	 	30	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-323
	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	423	 	30	 	93.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.00%
																
	 MPD-169
	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (A	 	Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	1	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	97.00%	 	100.00%	 	100.00%	 	100.00%
																
	 MPD-182
	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	23	 	N/A	 	100.00%	 	94.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-195
	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	2	 	N/A	 	100.00%	 	100.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-209
	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	18	 	N/A	 	100.00%	 	100.00%	 		 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%
																
	 MPD-324
	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	2	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 	94.75%	 	94.20%	 	96.21%	 	96.12%	 	96.35%	 	UNIVERSE
NULL
																
	 MPD-172
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (AZ)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	1	 	N/A	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 		 	13.61%	 	13.28%	 	15.67%	 	14.66%	 	13.64%	 	UNIVERSE
NULL
																
	 MPD-185
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (CA)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	100.00%	 	100.00%	 		 	1.40%	 	184.00%	 	1.25%	 	1.97%	 	2.32%	 	100.00%

  

					
	Schedule B-2-1	  	B-2-1-107	  	Health Net / Cognizant Confidential

 Final 
  

																																	
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	Jan-2014	 	Feb-2014	 	Mar-2014	 	Apr-2014	 	RED HI	 	 	YELLOW
LO	 	 	YELLOW
HI	 	 	GREEN
LO	 
	MPD-205	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-322	 	MM	 	4	 	OP08 - Correctly Distinguishes Between Organization Determinations and Reconside	 	% requests correctly distinguished as an organization determination and not a reconsideration	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-168	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	100.00%	 	96.67%	 	100.00%	 	96.67%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-181	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	100.00%	 	96.67%	 	96.43%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-194	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	100.00%	 	96.67%	 	100.00%	 	96.67%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-207	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	96.67%	 	100.00%	 	96.67%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-323	 	MM	 	4	 	OP09 - Favorable Standard Pre-Service Organization Determinations (Timeliness) (	 	% Enrollees notified of favorable determinations within 14 calendar days of request.	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-169	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (A	 	Decision TAT is all inclusive of Reciept date until member is notified by oral or in writing	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-182	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	96.67%	 	96.43%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-195	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (C	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-209	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-324	 	MM	 	4	 	OP12 - Detailed Explanation of Non-Coverage of Provider Services (Timeliness) (O	 	% of cases in which a written DENC notice is issued to the enrollee by the close of business on the day the QIO notification is received	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	NULL
UNIVERSE	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-172	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (AZ)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	NULL
UNIVERSE	 	100.00%	 	NULL
UNIVERSE	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  
													
	MPD-185	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (CA)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	75.00%	 	100.00%	 	100.00%	 	100.00%	 	 	89.99	  	 	 	90	  	 	 	94.99	  	 	 	95	  

  

					
	Schedule B-2-1	  	B-2-1-108	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	Tower	 	Group
Code	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	Status	 	Location	 	Regulator	 	Metric
Type	 	Target
	 MPD-198
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (CA PPO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	Auditing Database	 		 	n	 	CA	 	CMS	 	MA	 	= 100%
												
	 MPD-326
	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care(OR HMO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	Auditing Database	 		 	n	 	OR	 	CMS	 	MA	 	= 100%
												
	 SHP-181
	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations-extension needed TAT	 	Decision to pend within 3 calendar days of receipt of request and decision to approve, deny or modify within 1 working day (24 hrs) of receipt of requested info necessary to render decision.	 	Auditing Database	 		 	¿	 	CA	 	DMHC,
NCQA,
DHS	 	CalViva	 	= 100%
												
	 SHP-173
	 	MM	 	5	 	Medi-Cal Expedited Authorizations-extension needed TAT	 	Within 3 calendar days of receipt of a request, a decision must be made to approve, deny, or note the decision is ‘pending’. Decisions noted as ‘pending’ require further information from the provider. For
requests noted as ‘pending’, a decision to approve, deny or modify must be done within 1 business day of receipt of the additional information.	 	Excel TAT report	 		 	¿	 	CA	 	DMHC,
NCQA,
DHS	 	Medi-Cal	 	= 100%
												
	 SHP-179
	 	MM	 	5	 	CalViva Medi-Cal Routine Authorizations-extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	Excel TAT report	 		 	p	 	CA	 	DMHC,
NCQA,
DHS	 	CalViva	 	= 100%
												
	 SHP-381
	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Expedited)	 	A request for the authorization of services which the provider or a Contractor determines that using the standard timeframe could seriously jeopardize the member’s life or health or the ability to attain, maintain or regain
maximum function. The Contractor must make an expedited authorization decision and provide notice as expeditiously as the member’s health condition requires but no later than 3 working days following the receipt of the authorization
request.	 	Excel TAT report	 		 	—	 	AZ	 	AHCCCS	 	AHCCCS	 	= 100%
												
	 SHP-380
	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Standard)	 	A request for the authorization of services for which a Contractor must provide a decision as expeditiously as the member’s health condition requires, but not later than 14 calendar days following the receipt of the
authorization request.	 	Excel TAT report	 		 	—	 	AZ	 	AHCCCS	 	AHCCCS	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-109	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group

Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	MPD-198	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care (CA PPO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	NULL UNIVERSE	 	NULL UNIVERSE	 	100.00%	 	NULL UNIVERSE	 		 	21.34%	 	15.63%	 	18.90%	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	MPD-326	 	MM	 	4	 	OP15 - Detailed Notice of Discharge of Inpatient Hospital Care(OR HMO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 		 	17.90%	 	19.19%	 	16.50%	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	SHP-181	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations-extension needed TAT	 	Decision to pend within 3 calendar days of receipt of request and decision to approve, deny or modify within 1 working day (24 hrs) of receipt of requested info necessary to render decision.	 	10	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	NULL UNIVERSE	 	100.00%	 	100.00%	 	100.00%
																
	SHP-173	 	MM	 	5	 	Medi-Cal Expedited Authorizations- extension needed TAT	 	Within 3 calendar days of receipt of a request, a decision must be made to approve, deny, or note the decision is ‘pending’. Decisions noted as ‘pending’ require further information from the provider. For
requests noted as ‘pending’, a decision to approve, deny or modify must be done within 1 business day of receipt of the additional information.	 	10	 	N/A	 	50.00%	 	100.00%	 		 	NULL UNIVERSE	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-179	 	MM	 	5	 	CalViva Medi-Cal Routine Authorizations-extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	45	 	30	 	100.00%	 	98.50%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	97.40%	 	100.00%
																
	SHP-381	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Expedited)	 	A request for the authorization of services which the provider or a Contractor determines that using the standard timeframe could seriously jeopardize the member’s life or health or the ability to attain, maintain or regain
maximum function. The Contractor must make an expedited authorization decision and provide notice as expeditiously as the member’s health condition requires but no later than 3 working days following the receipt of the authorization
request.	 	98	 	N/A	 	-   	 	-   	 		 	-   	 	-   	 	-   	 	-   	 	-   	 	-   
																
	SHP-380	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Standard)	 	A request for the authorization of services for which a Contractor must provide a decision as expeditiously as the member’s health condition requires, but not later than 14 calendar days following the receipt of the
authorization request.	 	278	 	N/A	 	-   	 	-   	 		 	-   	 	-   	 	-   	 	-   	 	-   	 	-   

  

					
	Schedule B-2-1	  	B-2-1-110	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric ID
	 	 Tower
	 	 Group

Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED HI
	 	 YELLOW

LO
	 	 YELLOW

HI
	 	 GREEN

LO

	 MPD-198
	 	MM	 	4	 	OP15—Detailed Notice of Discharge of Inpatient Hospital Care (CA PPO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	 NULL

UNIVERSE
	 	100.00%	 	 NULL

UNIVERSE
	 	 NULL

UNIVERSE
	 	89.99	 	90	 	94.99	 	95
													
	 MPD-326
	 	MM	 	4	 	OP15—Detailed Notice of Discharge of Inpatient Hospital Care(OR HMO)	 	% of cases in which the Detailed Notice of Discharge was provided to the enrollee no later than noon of the day after QIO’s notification	 	 NULL

UNIVERSE
	 	100.00%	 	100.00%	 	 NULL

UNIVERSE
	 	89.99	 	90	 	94.99	 	95
													
	 SHP-181
	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations-extension needed TAT	 	Decision to pend within 3 calendar days of receipt of request and decision to approve, deny or modify within 1 working day (24 hrs) of receipt of requested info necessary to render decision.	 	87.50%	 	100.00%	 	100.00%	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-173
	 	MM	 	5	 	Medi-Cal Expedited Authorizations- extension needed TAT	 	Within 3 calendar days of receipt of a request, a decision must be made to approve, deny, or note the decision is ‘pending’. Decisions noted as ‘pending’ require further information from the provider. For
requests noted as ‘pending’, a decision to approve, deny or modify must be done within 1 business day of receipt of the additional information.	 	100.00%	 	100.00%	 	100.00%	 	80.00%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-179
	 	MM	 	5	 	CalViva Medi-Cal Routine Authorizations-extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	92.00%	 	97.50%	 	97.62%	 	93.75%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-381
	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Expedited)	 	A request for the authorization of services which the provider or a Contractor determines that using the standard timeframe could seriously jeopardize the member’s life or health or the ability to attain, maintain or regain
maximum function. The Contractor must make an expedited authorization decision and provide notice as expeditiously as the member’s health condition requires but no later than 3 working days following the receipt of the authorization
request.	 	100.00%	 	97.92%	 	100.00%	 	100.00%	 	94.99	 	95	 	96.99	 	97
													
	 SHP-380
	 	MM	 	6	 	AHCCCS Prior Authorization TAT (Standard)	 	A request for the authorization of services for which a Contractor must provide a decision as expeditiously as the member’s health condition requires, but not later than 14 calendar days following the receipt of the
authorization request.	 	100.00%	 	100.00%	 	99.49%	 	100.00%	 	94.99	 	95	 	96.99	 	97

  

					
	Schedule B-2-1	  	B-2-1-111	  	Health Net / Cognizant Confidential

 Final 
  

																							
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Measurement Tools
	 	 Comment
	 	 Status
	 	 Location
	 	 Regulator
	 	 Metric Type
	 	 Target

	 SHP-185
	 	MM	 	5	 	CalViva Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar day (24 hrs) of receipt of the request.	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	CalViva	 	= 100%
												
	 SHP-180
	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	CalViva	 	= 100%
												
	 SHP-178
	 	MM	 	5	 	CalViva Medi-cal Routine Authorizations TAT	 	decision within 5 working days of recpt of request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	CalViva	 	= 100%
												
	 SHP-177
	 	MM	 	5	 	Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar days (24 hrs) of receipt of the request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%
												
	 SHP-172
	 	MM	 	5	 	Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%
												
	 SHP-174
	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%
												
	 SHP-171
	 	MM	 	5	 	Medi-Cal Routine Authorizations- extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%
												
	 SHP-170
	 	MM	 	5	 	Medi-Cal Routine Authorizations TAT	 	Decision within 5 working days of recpt of request	 	Excel TAT report	 		 	—	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%
												
	 SHP-183
	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution-extension nee	 	Decision to pend within 30 calendar days of receipt of requested info necessary to render decision	 	Excel TAT report	 		 	n	 	CA	 	DMHC, NCQA, DHS	 	CalViva	 	= 100%
												
	 SHP-182
	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	Excel TAT report	 		 	n	 	CA	 	DMHC, NCQA, DHS	 	CalViva	 	= 100%
												
	 SHP-175
	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution-extension needed TAT	 	Decision within 30 calendar days of receipt of requested info necessary to render decision	 	Excel TAT report	 		 	n	 	CA	 	DMHC, NCQA, DHS	 	Medi-Cal	 	= 100%

  

					
	Schedule B-2-1	  	B-2-1-112	  	Health Net / Cognizant Confidential

 Final 
  

																															
	 Metric ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Universe
	 	 Sample Size
	 	 Apr-2013
	 	 May-2013
	 	 Jun-2013
	 	 Jul-2013
	 	 Aug-2013
	 	 Sep-2013
	 	 Oct-2013
	 	 Nov-2013
	 	 Dec-2013

	SHP-185	 	MM	 	5	 	CalViva Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar day (24 hrs) of receipt of the request.	 	1	 	N/A	 	63.60%	 	100.00%	 		 	87.50%	 	100.00%	 	91.70%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-180	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	521	 	31	 	99.50%	 	99.10%	 		 	98.70%	 	99.30%	 	99.80%	 	99.50%	 	96.90%	 	99.20%
																
	SHP-178	 	MM	 	5	 	CalViva Medi-cal Routine Authorizations TAT	 	decision within 5 working days of recpt of request	 	2201	 	31	 	99.40%	 	99.60%	 		 	99.20%	 	99.50%	 	99.50%	 	99.70%	 	100.00%	 	99.50%
																
	SHP-177	 	MM	 	5	 	Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar days (24 hrs) of receipt of the request	 	67	 	N/A	 	76.10%	 	97.70%	 		 	97.20%	 	100.00%	 	97.30%	 	98.00%	 	100.00%	 	98.10%
																
	SHP-172	 	MM	 	5	 	Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	394	 	33	 	98.50%	 	99.10%	 		 	99.40%	 	98.00%	 	99.70%	 	98.70%	 	100.00%	 	99.20%
																
	SHP-174	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	2	 	N/A	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%	 	100.00%
																
	SHP-171	 	MM	 	5	 	Medi-Cal Routine Authorizations- extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	58	 	30	 	100.00%	 	100.00%	 		 	98.40%	 	100.00%	 	100.00%	 	98.60%	 	98.30%	 	100.00%
																
	SHP-170	 	MM	 	5	 	Medi-Cal Routine Authorizations TAT	 	Decision within 5 working days of recpt of request	 	1724	 	31	 	99.60%	 	99.70%	 		 	99.40%	 	99.70%	 	99.90%	 	99.70%	 	99.80%	 	99.80%
																
	SHP-183	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution-extension nee	 	Decision to pend within 30 calendar days of receipt of requested info necessary to render decision	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 		 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE
																
	SHP-182	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	NULL UNIVERSE	 	NULL UNIVERSE	 	100.00%	 	100.00%	 		 	100.00%	 	100.00%	 	100.00%	 	NULL UNIVERSE	 	NULL UNIVERSE	 	100.00%
																
	SHP-175	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution-extension needed TAT	 	Decision within 30 calendar days of receipt of requested info necessary to render decision	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 		 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE

  

					
	Schedule B-2-1	  	B-2-1-113	  	Health Net / Cognizant Confidential

 Final 
  

																									
	 Metric
ID
	 	 Tower
	 	 Group
Code
	 	 Metric Name
	 	 Metric Measure
	 	 Jan-2014
	 	 Feb-2014
	 	 Mar-2014
	 	 Apr-2014
	 	 RED HI
	 	 YELLOW
LO
	 	 YELLOW
HI
	 	 GREEN
LO

	 SHP-185
	 	MM	 	5	 	CalViva Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar day (24 hrs) of receipt of the request.	 	100.00%	 	90.00%	 	75.00%	 	50.00%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-180
	 	MM	 	5	 	CalViva Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	97.71%	 	98.66%	 	97.36%	 	98.44%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-178
	 	MM	 	5	 	CalViva Medi-cal Routine Authorizations TAT	 	decision within 5 working days of recpt of request	 	99.23%	 	98.81%	 	98.77%	 	98.17%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-177
	 	MM	 	5	 	Medi-Cal Concurrent expedited Auth Resolution TAT	 	Decision within 1 calendar days (24 hrs) of receipt of the request	 	94.00%	 	100.00%	 	91.43%	 	83.33%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-172
	 	MM	 	5	 	Medi-Cal Expedited Authorizations TAT	 	Decision within 3 calendar days (72 hours) of recpt of request	 	95.97%	 	98.88%	 	98.46%	 	94.35%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-174
	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	100.00%	 	100.00%	 	NULL UNIVERSE	 	100.00%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-171
	 	MM	 	5	 	Medi-Cal Routine Authorizations- extension needed TAT	 	Decision to pend within 5 working days. Decision to approve, deny or modify no longer than 28 calendar days of receipt of request if additional info is necessary to render decision	 	96.30%	 	90.24%	 	97.62%	 	91.18%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-170
	 	MM	 	5	 	Medi-Cal Routine Authorizations TAT	 	Decision within 5 working days of recpt of request	 	98.98%	 	97.94%	 	98.39%	 	97.41%	 	89.99	 	90	 	94.99	 	95
													
	 SHP-183
	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution-extension nee	 	Decision to pend within 30 calendar days of receipt of requested info necessary to render decision	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	 SHP-182
	 	MM	 	5	 	CalViva Medi-Cal Post- Service/Retrospective Review Auth Resolution TAT	 	Decision within 30 calendar days of receipt of request	 	100.00%	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	89.99	 	90	 	94.99	 	95
													
	 SHP-175
	 	MM	 	5	 	Medi-Cal Post-Service/Retrospective Review Auth Resolution-extension needed TAT	 	Decision within 30 calendar days of receipt of requested info necessary to render decision	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	NULL UNIVERSE	 	89.99	 	90	 	94.99	 	95

  

					
	Schedule B-2-1	  	B-2-1-114	  	Health Net / Cognizant Confidential

 MSA Schedule B-2-2 

SCHEDULE B-2-2 
 PAYMENT
OF FINES THAT COVER CRITICAL COMPLIANCE SERVICE LEVEL 
 FAILURES 

*** 
 [Represents 1 page of material pursuant to
a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 MSA Schedule B-3 

SCHEDULE B-3 
 ***
Measures 
 *** 
 [Represents 13
pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 Final 

SCHEDULE B-3-1 
 STANDARDS
FOR NEW OR MODIFIED 
 *** SERVICE LEVELS 

  

					
	Schedule B-3-1		 		Health Net / Cognizant Confidential

 Final 

TABLE OF CONTENTS 
  

									
	 HNAZ CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS
		 	2	  
			
	 1.
		DISTRIBUTION OF ID CARDS		 	3	  
			1.1		PROPOSED PERFORMANCE STANDARD		 	3	  
			1.2		PERFORMANCE STANDARD METHODOLOGY		 	3	  
			1.3		NOTES		 	3	  
			
	 2.    
		ID CARD ACCURACY RATE		 	4	  
			2.1    		PROPOSED PERFORMANCE STANDARD		 	4	  
			2.2		PERFORMANCE STANDARD METHODOLOGY		 	4	  
			2.3		NOTES		 	4	  
			
	 3.
		ELIGIBILITY DATA		 	5	  
			3.1		PROPOSED PERFORMANCE STANDARD		 	5	  
			3.2		PERFORMANCE STANDARD METHODOLOGY		 	5	  
			3.3		NOTES		 	5	  
			
	 4.
		CLAIMS PROCESSING TURNAROUND TIME		 	6	  
			4.1		PROPOSED PERFORMANCE STANDARDS		 	6	  
			4.2		PERFORMANCE STANDARD METHODOLOGY		 	6	  
			4.3		NOTES		 	6	  
			
	 5.
		CLAIM FINANCIAL ACCURACY		 	7	  
			5.1		PROPOSED PERFORMANCE STANDARD		 	7	  
			5.2		PERFORMANCE STANDARD METHODOLOGY		 	7	  
			5.3		NOTES		 	7	  
			
	 6.
		CLAIM PROCEDURAL ACCURACY		 	8	  
			6.1		PROPOSED PERFORMANCE STANDARD		 	8	  
			6.2		PERFORMANCE STANDARD METHODOLOGY		 	8	  
			6.3		NOTES		 	8	  
			
	 7.
		CLAIM PAYMENT ACCURACY		 	9	  
			7.1		PROPOSED PERFORMANCE STANDARD		 	9	  
			7.2		PERFORMANCE STANDARD METHODOLOGY		 	9	  
			7.3		NOTES		 	9	  
			
	 8.
		CLAIM OVERALL PROCESSING		 	10	  
			8.1		PROPOSED PERFORMANCE STANDARD		 	10	  
			8.2		PERFORMANCE STANDARD METHODOLOGY		 	10	  
			8.3		NOTES		 	10	  

  

					
	Schedule B-3-1		B-3-1-i		Health Net / Cognizant Confidential

 Final 
  

									
			
	 9.
		RESPONSE TO TELEPHONE INQUIRIES		 	11	  
			9.1		PROPOSED PERFORMANCE STANDARD		 	11	  
			9.2		PERFORMANCE STANDARD METHODOLOGY		 	11	  
			9.3		NOTES		 	11	  
			
	 10.    
		TELEPHONE ABANDONMENT RATE		 	12	  
			10.1    		PROPOSED PERFORMANCE STANDARD		 	12	  
			10.2		PERFORMANCE STANDARD METHODOLOGY		 	12	  
			10.3		NOTES		 	12	  
			
	 11.
		INITIAL CALL RESOLUTION		 	13	  
			11.1		PROPOSED PERFORMANCE STANDARD		 	13	  
			11.2		PERFORMANCE STANDARD METHODOLOGY		 	13	  
			11.3		NOTES		 	13	  
			
	 12.
		RESPONSE TO WRITTEN INQUIRIES		 	14	  
			12.1		PROPOSED PERFORMANCE STANDARDS		 	14	  
			12.2		PERFORMANCE STANDARD METHODOLOGY		 	14	  
			12.3		NOTES		 	14	  
			
	 13.
		RESPONSE TIME TO APPEALS		 	15	  
			13.1		PROPOSED PERFORMANCE STANDARDS		 	15	  
			13.2		PERFORMANCE STANDARD METHODOLOGY		 	15	  
			13.3		NOTES		 	15	  
			
	 14.
		RESPONSE TIME TO GRIEVANCES		 	16	  
			14.1		PROPOSED PERFORMANCE STANDARDS		 	16	  
			14.2		PERFORMANCE STANDARD METHODOLOGY		 	16	  
			14.3		NOTES		 	16	  
		
	 HNCA CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS
		 	17	  
			
	 15.
		DISTRIBUTION OF ID CARDS		 	18	  
			15.1		PROPOSED PERFORMANCE STANDARD		 	18	  
			15.2		PERFORMANCE STANDARD METHODOLOGY		 	18	  
			15.3		NOTES		 	18	  
			
	 16.
		ID CARD ACCURACY RATE		 	19	  
			16.1		PROPOSED PERFORMANCE STANDARD		 	19	  
			16.2		PERFORMANCE STANDARD METHODOLOGY		 	19	  
			16.3		NOTES		 	19	  
			
	 17.
		ELIGIBILITY DATA		 	20	  
			17.1		PROPOSED PERFORMANCE STANDARD		 	20	  

  

					
	Schedule B-3-1		B-3-1-ii		Health Net / Cognizant Confidential

 Final 

									
			17.2		PERFORMANCE STANDARD METHODOLOGY		 	20	  
			17.3		NOTES		 	20	  
			
	 18.    
		CLAIMS PROCESSING TURNAROUND TIME		 	21	  
			18.1    		PROPOSED PERFORMANCE STANDARDS		 	21	  
			18.2		PERFORMANCE STANDARD METHODOLOGY		 	21	  
			18.3		NOTES		 	21	  
			
	 19.
		CLAIM FINANCIAL ACCURACY		 	22	  
			19.1		PROPOSED PERFORMANCE STANDARD		 	22	  
			19.2		PERFORMANCE STANDARD METHODOLOGY		 	22	  
			19.3		NOTES		 	22	  
			
	 20.
		CLAIM PROCEDURAL ACCURACY		 	23	  
			20.1		PROPOSED PERFORMANCE STANDARD		 	23	  
			20.2		PERFORMANCE STANDARD METHODOLOGY		 	23	  
			20.3		NOTES		 	23	  
			
	 21.
		CLAIM PAYMENT ACCURACY		 	24	  
			21.1		PROPOSED PERFORMANCE STANDARD		 	24	  
			21.2		PERFORMANCE STANDARD METHODOLOGY		 	24	  
			21.3		NOTES		 	24	  
			
	 22.
		CLAIM OVERALL PROCESSING		 	25	  
			22.1		PROPOSED PERFORMANCE STANDARD		 	25	  
			22.2		PERFORMANCE STANDARD METHODOLOGY		 	25	  
			22.3		NOTES		 	25	  
			
	 23.
		RESPONSE TO TELEPHONE INQUIRIES		 	26	  
			23.1		PROPOSED PERFORMANCE STANDARD		 	26	  
			23.2		PERFORMANCE STANDARD METHODOLOGY		 	26	  
			23.3		NOTES		 	26	  
			
	 24.
		TELEPHONE ABANDONMENT RATE		 	27	  
			24.1		PROPOSED PERFORMANCE STANDARD		 	27	  
			24.2		PERFORMANCE STANDARD METHODOLOGY		 	27	  
			24.3		NOTES		 	27	  
			
	 25.
		INITIAL CALL RESOLUTION		 	28	  
			25.1		PROPOSED PERFORMANCE STANDARD		 	28	  
			25.2		PERFORMANCE STANDARD METHODOLOGY		 	28	  
			25.3		NOTES		 	28	  

  

					
	Schedule B-3-1		B-3-1-iii		Health Net / Cognizant Confidential

 Final 

									
			
	 26.    
		RESPONSE TO WRITTEN INQUIRIES		 	29	  
			26.1    		PROPOSED PERFORMANCE STANDARDS		 	29	  
			26.2		PERFORMANCE STANDARD METHODOLOGY		 	29	  
			26.3		NOTES		 	29	  
			
	 27.
		RESPONSE TO WRITTEN INQUIRIES - MEDICARE		 	30	  
			27.1		PROPOSED PERFORMANCE STANDARDS		 	30	  
			27.2		PERFORMANCE STANDARD METHODOLOGY		 	30	  
			27.3		NOTES		 	30	  
			
	 28.
		RESPONSE TIME TO APPEALS		 	31	  
			28.1		PROPOSED PERFORMANCE STANDARDS		 	31	  
			28.2		PERFORMANCE STANDARD METHODOLOGY		 	31	  
			28.3		NOTES		 	31	  
			
	 29.
		RESPONSE TIME TO APPEALS - MEDICARE		 	32	  
			29.1		PROPOSED PERFORMANCE STANDARDS		 	32	  
			29.2		PERFORMANCE STANDARD METHODOLOGY		 	32	  
			29.3		NOTES		 	32	  
			
	 30.
		RESPONSE TIME TO GRIEVANCES		 	33	  
			30.1		PROPOSED PERFORMANCE STANDARDS		 	33	  
			30.2		PERFORMANCE STANDARD METHODOLOGY		 	33	  
			30.3		NOTES		 	33	  
			
	 31.
		RESPONSE TIME TO GRIEVANCES - MEDICARE		 	34	  
			31.1		PROPOSED PERFORMANCE STANDARDS		 	34	  
			31.2		PERFORMANCE STANDARD METHODOLOGY		 	34	  
			31.3		NOTES		 	34	  
		
	 HNOR CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS
		 	35	  
			
	 32.
		DISTRIBUTION OF ID CARDS		 	36	  
			32.1		PROPOSED PERFORMANCE STANDARD		 	36	  
			32.2		PERFORMANCE STANDARD METHODOLOGY		 	36	  
			32.3		NOTES		 	36	  
			
	 33.
		ID CARD ACCURACY RATE		 	37	  
			33.1		PROPOSED STANDARD PERFORMANCE 		 	37	  
			33.2		PERFORMANCE STANDARD METHODOLOGY		 	37	  
			33.3		NOTES		 	37	  
			
	 34.
		ELIGIBILITY DATA		 	38	  
			34.1		PROPOSED STANDARD METHODOLOGY		 	38	  

  

					
	Schedule B-3-1		B-3-1-iv		Health Net / Cognizant Confidential

 Final 
  

									
			34.2    		PERFORMANCE STANDARD METHODOLOGY		 	38	  
			34.3		NOTES		 	38	  
			
	 35.    
		CLAIMS PROCESSING TURNAROUND TIME		 	39	  
			35.1		PROPOSED PERFORMANCE STANDARDS		 	39	  
			35.2		PERFORMANCE STANDARD METHODOLOGY		 	39	  
			35.3		NOTES		 	39	  
			
	 36.
		CLAIM FINANCIAL ACCURACY		 	40	  
			36.1		PROPOSED PERFORMANCE STANDARD		 	40	  
			36.2		PERFORMANCE STANDARD METHODOLOGY		 	40	  
			36.3		NOTES		 	40	  
			
	 37.
		CLAIM PROCEDURAL ACCURACY		 	41	  
			37.1		PROPOSED PERFORMANCE STANDARD		 	41	  
			37.2		PERFORMANCE STANDARD METHODOLOGY		 	41	  
			37.3		NOTES		 	41	  
			
	 38.
		CLAIM PAYMENT ACCURACY		 	42	  
			38.1		PROPOSED PERFORMANCE STANDARD		 	42	  
			38.2		PERFORMANCE STANDARD METHODOLOGY		 	42	  
			38.3		NOTES		 	42	  
			
	 39.
		CLAIM OVERALL PROCESSING		 	43	  
			39.1		PROPOSED PERFORMANCE STANDARD		 	43	  
			39.2		PERFORMANCE STANDARD METHODOLOGY		 	43	  
			39.3		NOTES		 	43	  
			
	 40.
		RESPONSE TO TELEPHONE INQUIRIES		 	44	  
			40.1		PROPOSED PERFORMANCE STANDARD		 	44	  
			40.2		PERFORMANCE STANDARD METHODOLOGY		 	44	  
			40.3		NOTES		 	44	  
			
	 41.
		TELEPHONE ABANDONMENT RATE		 	45	  
			41.1		PROPOSED PERFORMANCE STANDARD		 	45	  
			41.2		PERFORMANCE STANDARD METHODOLOGY		 	45	  
			41.3		NOTES		 	45	  
			
	 42.
		INITIAL CALL RESOLUTION		 	46	  
			42.1		PROPOSED PERFORMANCE STANDARD		 	46	  
			42.2		PERFORMANCE STANDARD METHODOLOGY		 	46	  
			42.3		NOTES		 	46	  

  

					
	Schedule B-3-1		B-3-1-v		Health Net / Cognizant Confidential

 Final 

									
			
	 43.    
		RESPONSE TO WRITTEN INQUIRIES		 	47	  
			43.1		PROPOSED PERFORMANCE STANDARDS		 	47	  
			43.2    		PERFORMANCE STANDARD METHODOLOGY		 	47	  
			43.3		NOTES		 	47	  
		
	 [2015] MHN *** PRODUCT: BEHAVIORAL HEALTH
				
		
	 [2015] MHN *** PRODUCT: EAP
				

  

					
	Schedule B-3-1		B-3-1-vi		Health Net / Cognizant Confidential

 DRAFT 

SCHEDULE B-3-1 

STANDARDS FOR NEW OR MODIFIED 

*** SERVICE LEVELS 
 CONTENTS 

This Schedule B-3-1 (Standards for New or Modified *** Group Service Levels) consists of the following standards: 

 

	 	•	 	HNAZ Corporate Performance Standards for Operations - August 2014 

  

	 	•	 	HNCA Corporate Performance Standards for Operations - August 2014 

  

	 	•	 	HNOR Corporate Performance Standards for Operations - August 2014 

  

	 	•	 	MHN Behavioral Health *** Template for Operations - August 2014 

  

	 	•	 	MHN EAP *** Template for Operations - August 2014 

  

					
	Schedule B-3-1		B-3-1-1		Health Net / Cognizant Confidential

 Final 
  

 
 HNAZ CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS 

(Membership, Claims, Customer Service, A&G, Correspondence) 

August 2014 

  

					
	Schedule B-3-1		B-3-1-2		Health Net / Cognizant Confidential

 Final 

1. DISTRIBUTION OF ID CARDS 
  

	1.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	1.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	1.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-3		Health Net / Cognizant Confidential

 Final 

2. ID CARD ACCURACY RATE 
  

	2.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	2.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	2.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-4		Health Net / Cognizant Confidential

 Final 

3. ELIGIBILITY DATA 
  

	3.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	3.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	3.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-5		Health Net / Cognizant Confidential

 Final 

4. CLAIMS PROCESSING TURNAROUND TIME 
  

	4.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	4.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	4.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-6		Health Net / Cognizant Confidential

 Final 

5. CLAIM FINANCIAL ACCURACY 
  

	5.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	5.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	5.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-7		Health Net / Cognizant Confidential

 Final 

6. CLAIM PROCEDURAL ACCURACY 
  

	6.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	6.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	6.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-8		Health Net / Cognizant Confidential

 Final 

7. CLAIM PAYMENT ACCURACY 
  

	7.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	7.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	7.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-9		Health Net / Cognizant Confidential

 Final 

8. CLAIM OVERALL PROCESSING 
  

	8.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	8.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	8.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-10		Health Net / Cognizant Confidential

 Final 

9. RESPONSE TO TELEPHONE INQUIRIES 
  

	9.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	9.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	9.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-11		Health Net / Cognizant Confidential

 Final 

10. TELEPHONE ABANDONMENT RATE 
  

	10.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	10.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	10.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-12		Health Net / Cognizant Confidential

 Final 

11. INITIAL CALL RESOLUTION 
  

	11.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	11.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	11.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-13		Health Net / Cognizant Confidential

 Final 

12. RESPONSE TO WRITTEN INQUIRIES 
  

	12.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	12.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	12.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-14		Health Net / Cognizant Confidential

 Final 

13. RESPONSE TIME TO APPEALS 
  

	13.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	13.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	13.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-15		Health Net / Cognizant Confidential

 Final 

14. RESPONSE TIME TO GRIEVANCES 
  

	14.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	14.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	14.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-16		Health Net / Cognizant Confidential

 Final 
  

 
 HNCA CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS 

(Membership, Claims, Customer Service, A&G, Correspondence) 

August 2014 

  

					
	Schedule B-3-1		B-3-1-17		Health Net / Cognizant Confidential

 Final 

15. DISTRIBUTION OF ID CARDS 
  

	15.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	15.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	15.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-18		Health Net / Cognizant Confidential

 Final 

16. ID CARD ACCURACY RATE 
  

	16.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	16.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	16.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-19		Health Net / Cognizant Confidential

 Final 

17. ELIGIBILITY DATA 
  

	17.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	17.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	17.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-20		Health Net / Cognizant Confidential

 Final 

18. CLAIMS PROCESSING TURNAROUND TIME 
  

	18.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	18.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	18.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-21		Health Net / Cognizant Confidential

 DRAFT 

19. CLAIM FINANCIAL ACCURACY 
  

	19.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	19.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	19.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-22		Health Net / Cognizant Confidential

 Final 

20. CLAIM PROCEDURAL ACCURACY 
  

	20.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	20.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	20.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-23		Health Net / Cognizant Confidential

 Final 

21. CLAIM PAYMENT ACCURACY 
  

	21.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	21.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	21.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-24		Health Net / Cognizant Confidential

 Final 

22. CLAIM OVERALL PROCESSING 
  

	22.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	22.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	22.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-25		Health Net / Cognizant Confidential

 Final 

23. RESPONSE TO TELEPHONE INQUIRIES 
  

	23.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	23.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	23.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-26		Health Net / Cognizant Confidential

 Final 

24. TELEPHONE ABANDONMENT RATE 
  

	24.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	24.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	24.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-27		Health Net / Cognizant Confidential

 Final 

25. INITIAL CALL RESOLUTION 
  

	25.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	25.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	25.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-28		Health Net / Cognizant Confidential

 Final 

26. RESPONSE TO WRITTEN INQUIRIES 
  

	26.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	26.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	26.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-29		Health Net / Cognizant Confidential

 Final 

27. RESPONSE TO WRITTEN INQUIRIES - MEDICARE 
  

	27.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	27.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	27.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-30		Health Net / Cognizant Confidential

 Final 

28. RESPONSE TIME TO APPEALS 
  

	28.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	28.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	28.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-31		Health Net / Cognizant Confidential

 Final 

29. RESPONSE TIME TO APPEALS - MEDICARE 
  

	29.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	29.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	29.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-32		Health Net / Cognizant Confidential

 Final 

30. RESPONSE TIME TO GRIEVANCES 
  

	30.1	PROPOSED PERFORMANCE STANDARDS 

 ¿    *** 
  

	30.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	30.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-33		Health Net / Cognizant Confidential

 Final 

31. RESPONSE TIME TO GRIEVANCES - MEDICARE 
  

	31.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	31.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	31.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-34		Health Net / Cognizant Confidential

 Final 
  

 
 HNOR CORPORATE PERFORMANCE STANDARDS FOR OPERATIONS 

(Membership, Claims, Customer Service, A&G, Correspondence) 

August 2014 

  

					
	Schedule B-3-1		B-3-1-35		Health Net / Cognizant Confidential

 Final 

32. DISTRIBUTION OF ID CARDS 
  

	32.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	32.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	32.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-36		Health Net / Cognizant Confidential

 Final 

33. ID CARD ACCURACY RATE 
  

	33.1	PROPOSED STANDARD PERFORMANCE 

 *** 

 

	33.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	33.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-37		Health Net / Cognizant Confidential

 Final 

34. ELIGIBILITY DATA 
  

	34.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	34.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	34.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-38		Health Net / Cognizant Confidential

 Final 

35. CLAIMS PROCESSING TURNAROUND TIME 
  

	35.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	35.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	35.3	NOTES 

¿    *** 

  

					
	Schedule B-3-1		B-3-1-39		Health Net / Cognizant Confidential

 Final 

36. CLAIM FINANCIAL ACCURACY 
  

	36.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	36.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	36.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-40		Health Net / Cognizant Confidential

 Final 

37. CLAIM PROCEDURAL ACCURACY 
  

	37.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	37.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	37.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-41		Health Net / Cognizant Confidential

 Final 

38. CLAIM PAYMENT ACCURACY 
  

	38.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	38.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	38.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-42		Health Net / Cognizant Confidential

 Final 

39. CLAIM OVERALL PROCESSING 
  

	39.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	39.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	39.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-43		Health Net / Cognizant Confidential

 Final 

40. RESPONSE TO TELEPHONE INQUIRIES 
  

	40.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	40.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	40.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-44		Health Net / Cognizant Confidential

 Final 

41. TELEPHONE ABANDONMENT RATE 
  

	41.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	41.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	41.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-45		Health Net / Cognizant Confidential

 Final 

42. INITIAL CALL RESOLUTION 
  

	42.1	PROPOSED PERFORMANCE STANDARD 

 *** 

 

	42.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	42.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-46		Health Net / Cognizant Confidential

 Final 

43. RESPONSE TO WRITTEN INQUIRIES 
  

	43.1	PROPOSED PERFORMANCE STANDARDS 

 *** 

 

	43.2	PERFORMANCE STANDARD METHODOLOGY 

 *** 

 

	43.3	NOTES 

 *** 

  

					
	Schedule B-3-1		B-3-1-47		Health Net / Cognizant Confidential

 Final 

*** 
 *** 

*** 
 *** 

  

					
	Schedule B-3-1		B-3-1-48		Health Net / Cognizant Confidential

 Final 

SCHEDULE B-4 

STAKEHOLDER SAT SURVEY 

  

					
	Schedule B-4		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE B-4 
 STAKEHOLDER
SATISFACTION SURVEY 
 Scoring 
  

	5	Regularly exceeding expectations and perceived to be adding significant value above and beyond requirements or SLAs. 

  

	4	Consistently meeting expectations and occasionally exceeding expectations by adding value above requirements or SLAs. 

  

	3	Consistently meeting expectations and perceived to be contributing to client success within the scope of services contracted for. 

 

	2	Some inconsistency in meeting expectations and perceptions that client is having to intervene to ensure performance - improvement required. 

 

	1	Consistently not meeting expectations - situation requires immediate and substantial improvement. 

Stakeholder Scoring Matrix 
  

					
	Category	  	Score	 
	 Account Management
	  	 	3	  
	 Operational Management
	  	 	3	  
	 Knowledge Management
	  	 	3	  
	 Business Enablement & Innovation
	  	 	3	  
	 Value of Services
	  	 	3	  
	 Customer Experience
	  	 	3	  
	 Brand Impact
	  	 	3	  
	 Overall Score
	  	 	3	  

 Please provide specific comments, observations, concerns, recommendations for improvement, etc. of any ratings less than 3

 Considerations for Category Scoring (Note: each consideration does not have to be demonstrated in each quarter to achieve a 3 or higher.) 

Account Management Team 
 Account
Management Team leadership skills. 
 Timely and informative reporting and communications. 

Openness to suggestions / criticism and responsiveness to Client Leadership concerns. 

Attitude and responsiveness for dealing with unforeseen business needs or events, as approptiate for Supplier’s scope. 

Ability to manage up and out across the Supplier’s delivery organization(s) (e.g. , foreign delivery locations or business units).

 Tracking and resolution of Client issues that have been referred within Supplier’s delivery organization. 

Ability to identify and leverage the “right” people from Supplier to support Client’s needs. 

Ease of interaction with Account Management Team. 

Operational Management 
 Operational
excellence of Supplier (the achievement of SLAs without material Client intervention or attention). 
 Quality of change execution.

 Proactive in addressing potential or actual operational failures (e.g. , incident avoidance, attention of resources to recurring
problems). 
 Openness and communication of operational problems (v. failing to inform or attempting to cover over problems). 

Knowledge of Client policies, procedures and methodologies and training of client personnel. 

Ability to recover upon a service failure. 

Supplier management of turnover of Key Resources and/or “Knowledge Critical” resources. 

Knowledge Management 
 Availability and
ease of use of Supplier’s Knowledge Management solution including access by all appropriate Client and other necessary supplier resources. 

Quality of material contained in Knowledge Management System. 

Proactive updating and improvement of the information contained in the Knowledge Management System by Supplier resources. 

Value of Knowledge Management to speed of resolution, improvements in client experience and/or operational hand-offs between delivery centers.

 Business Enablement and Innovation 

Supplier’s knowledge of Client’s business and industry. 

Supplier’s knowledge of current and trending technology and proactive communication of potential value/threat to Client’s business.

 Supplier observations and recommendations to improve Client performance both within and around Supplier’s Services. 

Supplier’s proactive delivery of Supplier subject matter experts (industry, technical, operational, etc.) to inform and improve Supplier
Services. 
 Value of Services 

Perceived value of ongoing efforts by Supplier to improve quality of Services after Supplier transition. 

Value of Supplier’s integration, tools, process best practices, methodologies and effective leverage of same in delivery of Services. 

Customer Experience 
 Overall perception
of value of Supplier’s delivery on Customer experience. 
 Quality and effectiveness of communications to Customers as appropriate for
Supplier’s scope. 
 Perception of Business Stakeholder’s satisfaction as obtained by Customer surveys and other feedback from the
businesses. 
 Ease of Customer interaction with Supplier as appropriate for Supplier scope. 

Brand Impact 
 Stakeholder’s
perception of Supplier’s efforts to protect the Client’s brand. 
 Supplier’s impact on brand through proactive management of
quality and compliance challenges. 
 Supplier’s impact on brand through proactive avoidance of information or other security breaches.

 Outcome of industry and other surveys based on Customer experiences associated with Supplier’s delivery of Services. 

  

					
	Schedule B-4	  	B-4-1	  	Health Net / Cognizant Confidential

 MSA Schedule C 

SCHEDULE C 
 CHARGES

 *** 
 [Represents 54 pages of
material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 MSA Schedule C Subschedules 

SCHEDULES C SUBSCHEDULES 

(C-1 THROUGH C-17) 
 ***

 [Represents 172 pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has
been filed separately with the Securities and Exchange Commission] 

 Final 

SCHEDULE D 
 KEY SUPPLIER
POSITIONS 

  

					
	Schedule D		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE D 
 KEY SUPPLIER
POSITIONS 
  

							
	 Key Cognizant Position
	 	 Name
	 	 Rebadge (Y/N)
	 	 Comments

	 Operating Officer
	 	TBD	 	N	 	
				
	 Business Process Services - Head
	 	TBD	 	Y	 	
				
	 Transition & Transformation Head
	 	TBD	 	N	 	
				
	 Claims – Lead
	 	TBD	 	Y	 	
				
	 Membership – Lead
	 	TBD	 	Y	 	
				
	 Business Configuration – Lead
	 	TBD	 	Y	 	
				
	 Medical Management Intake – Lead
	 	TBD	 	N	 	
				
	 Customer Care – Lead
	 	TBD	 	Y	 	
				
	 Appeals & Grievances – Lead
	 	TBD	 	Y	 	
				
	 QA & Training – Lead
	 	TBD	 	Y	 	
				
	 Chief Information Officer
	 	TBD	 	Y	 	
				
	 IT Applications Development & Maintenance – Head
	 	 TBD

(Onshore)
	 	N	 	
				
	 IT Applications Development & Maintenance – Head
	 	TBD (Offshore)	 	N	 	
				
	 PPMO Lead
	 	TBD	 	Y	 	

  

					
	Schedule D	  	D-1	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Key Cognizant Position
	 	 Name
	 	 Rebadge (Y/N)
	 	 Comments

	 Infrastructure Services - Head
	 	TBD	 	Y	 	
				
	 Technology Transformation Lead
	 	TBD	 	TBD	 	
				
	 Head of IT Security &

Compliance (CSO)
	 	TBD	 	N	 	
				
	 P5 Operations Transition Lead
	 	TBD	 	Y	 	Up until Steady State
				
	 P5 IT Transition Lead
	 	TBD	 	Y	 	Up until Steady State
				
	 Relationship Executive
	 	TBD	 	N	 	
				
	 Teleperformance
	 		 		 	Placeholder for key personnel above the SOW level for TP

 Note 1: Cognizant shall propose individuals to occupy these Key Supplier Positions for Health Net’s approval
within thirty (30) days after the Effective Date, and the approved individuals shall be appointed to fill these Key Supplier Positions within Ninety (90) days after the Effective Date. 

Note 2: Health Net shall have the right to designate five (5) additional full time Key Supplier Positions to address Service quality concerns by
giving written notice to Supplier. 

  

					
	Schedule D	  	D-2	  	Health Net / Cognizant Confidential

 MSA Schedule E 

SCHEDULE E 
 TRANSITIONED
EMPLOYEES 
 *** 
 [Represents 15
pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 MSA Schedule E Annex 1 

ANNEX TO SCHEDULE E 

SEVERANCE TERMS 
 ***

 [Represents 7 pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has
been filed separately with the Securities and Exchange Commission] 

 Final 

SCHEDULE F 
 SUPPLIER
FACILITIES 
  

  

					
	Schedule F		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE F 
 SUPPLIER
FACILITIES 
  

	1.	OFFSHORE SUPPLIER FACILITIES 

 This section sets forth the offshore Supplier Facilities
from which Supplier will perform the Services. A “Primary” classification indicates a facility from which Supplier will normally perform the Services, and a “Secondary” classification indicates a disaster recovery facility. 

 

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
	MEPZ	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Plot no A15,16,17 B20,C10,C1 &D2 NH 45 ,Tambaram GST Road, Chennai -600045, India
	  	 IT Applications Development & Testing, Application Maintenance
  

BPS – Claims, A&G, Quality Assurance
	  	Primary, except for BPS-A&G. For BPS A&G this will be a Secondary site.	  	YES	  	NO	  	NO
							
	GMR	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Varalakshmi Tech Park, 5/639, Old Mahabalipuram Road, Kandanchavadi, Chennai-600096, India
	  	IT Applications Development & Testing, Application Maintenance	  	Primary	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-1	  	Health Net / Cognizant Confidential

 Final 

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
	CKC	  	Cognizant Technology Solutions India Pvt. Ltd, Plot No. 1 & 2, ELCOT IT Park, Survey No. 602/3, Sholinganallur Village, Tambaram Taluk, Kancheepuram District - 600119, India	  	IT Applications Development & Testing, Application Maintenance	  	Primary,	  	YES	  	NO	  	NO
							
	PKN	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Cee Dee Yes Software Technology Park, No 56/3a, 3b, 5a, 5b, Pallikaranai Village, Thoraipakkam, Pallvaram 200 Feet Road, Chennai – 601302, India
	  	BPS Claims, Membership, Configuration, Quality Assurance	  	Secondary	  	YES	  	NO	  	NO
							
	CRC	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Carr Tower, Ramanujan IT, SEZ, Taramani, Rajiv Gandhi Salai (OMR), Chennai- 600113,
  

India
	  	 IT Applications Development & Testing, Application Maintenance
  

BPS Claims, Membership, Configuration, Quality Assurance
	  	Primary, except for BPS-Claims. For BPS-Claims, this will be a Secondary site	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-2	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
	CBE-SEZ	  	 Cognizant -Delivery Center, Coimbatore C3 — Chill Special Economic Zone Keeranatham Village, Saravanampatti Via,

 
 Coimbatore 641 035

 
 TamilNadu
  

India
	  	ITO L1, L2 & L3 Services Delivery & Operations BPS – Claims, Quality Assurance	  	Primary, except for BPS-Claims and ITO L2 & L3 Services. For BPS- Claims, ITO L2 & L3 Services this will be a Secondary site	  	YES	  	NO	  	NO
							
	CBE - Mountain View Campus	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Unit I, STPI IT Park, Kumaraguru College of Technology Campus, Saravanampatti, Coimbatore – 641006, India
	  	IT Applications Development & Testing, Application Maintenance	  	Primary	  	YES	  	NO	  	NO
							
	Manyata Embassy Business(MBP) Park	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Outer Ring Road, Rachenahalli Village Nagavaraha, Bangalore -
	  	IT Applications Development & Testing, Application Maintenance, ITO L1, L2 & L3 Services	  	Primary, except for BPS- Configuration and Membership and ITO L1 Services. For BPS-	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-3	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
		  	 560045
  

India
	  	 Delivery & Operations
  

BPS Configuration, Membership, Quality Assurance
	  	Configuration and, Membership , ITO L1 Services this will be a Secondary site	  		  		  	
							
	KOL - ITP - STZ	  	 Cognizant Technology Solutions Pvt. Ltd.
  

InfoSpace Unitech Hi-tech Structures Ltd., IT/ITeS SEZ, Tower G2, 6th floor, SEZ Unit 2, Plot No.DH- 1, DH-2, DH-3 & DH-3/1, Block No. DH, Action Area I,
New Town, Kolkata- 700156
  
 India
	  	IT Applications Development & Testing, Application Maintenance	  	Primary	  	YES	  	NO	  	NO
							
	HYD - DLF - PH1/2/3	  	 Cognizant Technology Solutions Pvt. Ltd.
  

Floors Ground,I,II, Plot No: 129,130,131,132-SEZ, APHB Colony, Gachibowli Hyderabad.- 500081,

 
 India
	  	 IT Applications Development & Testing, Application Maintenance
  

BPS Claims, Quality Assurance
	  	Primary, except for BPS-Claims. For BPS-Claims this will be a Secondary site	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-4	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	 	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	 	  	May
Department
of Defense
Data be
Stored at
this
Facility?	 
							
	 HYD -Raheja
	  	Cognizant Technology Solutions Pvt. Ltd Mind space Hyderabad Plot No. 64, APIIC layout, Besides VSNL & Madhapur Hi-tech city, Hyderabad - 400081	  	BPS Claims, Quality Assurance	  	Secondary	  	 	YES	  	  	 	NO	  	  	 	NO	  
							
	 Manila - Taguig
	  	 Cognizant Technology Solutions Pvt. Ltd. -8/10 Upper Mckinley Building

 
 No. 10, Floor 5 & 6, Upper Mckinley Road, Mckinley Hills, Fort Bonifacio, Taguig,
Manila- 1634, Philippines
	  	 IT Testing
  

BPS A&G, Membership, Medical Management & Quality Assurance
	  	Primary	  	 	YES	  	  	 	NO	  	  	 	NO	  
							
	 -Cebu
	  	 Cognizant Technology Solutions Pvt. Ltd.
  

11th - 12th Flr, Skyrise 4 (Block 2, Lot 4 Geonzon St. Cebu IT Park), 6000 Cebu City, Cebu, Philippines
	  	 ITO – Commercial Service Desk Operations
  

BPS- A&G, Membership, Medical Management, Quality Assurance
	  	Primary, except for BPS-A&G, Membership & Medical Management. For BPS-A&G, Membership, & Medical Management, this will be a Secondary site	  	 	YES	  	  	 	NO	  	  	 	NO	  

  

					
	Schedule F	  	F-5	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
	Manila-Pasig	  	 Cognizant Technology Solutions Pvt. Ltd.
  

11th, 12th, 14th & 15th Floor, No. 17 Hanston Square Building, San Miguel Ave.,Ortigas Center, Pasig City 1605, Philippines
	  	 ITO – Commercial Service Desk Operations
  

BPS A&G, Membership ,Medical Management, Quality Assurance
	  	Secondary	  	YES	  	NO	  	NO
							
	 Manila – Makati
	  	 Cognizant Technology Solutions Pvt. Ltd.
  

4th & 5th Floor, Paseo Centre Building, 8757 Paseo de Roxas corner, Sedeno Street, Makati City 1277, Philippines
	  	BPS A&G, Membership, Medical Management, Quality Assurance	  	Primary	  	YES	  	NO	  	NO
							
	 CHIH-PS
	  	Miguel de Cervantes Saavedra 100, Complejo Industrial Chihuahua, 31109 Chihuahua, CHIH, Mexico	  	Contact Center Operations	  	Secondary	  	YES	  	NO	  	NO
							
	 Davao, Philippines
	  	Davao, Philippines 2nd Floor, SM City Davao	  	IB/OB call, off phone case follow up and	  	Primary	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-6	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility Address
	  	 Approved Services to
be Performed
	  	 Classification
	  	May Health
Net Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
		  	Annex, Quimpo Blvd, Dabao 8000	  	correspondence	  		  		  		  	
							
	Fairview, Quezon City, Philippines	  	Fairview Facility, Quezon City: 2/F New Annex, SM City, Fairview, Quezon City, Philippines	  	IB/OB call, off phone case follow up and correspondence	  	Primary	  	YES	  	NO	  	NO
							
	 Chihuahua, Mexico
	  	Teleperformance Mexico S.A. Miguel de Cervantes Saavedra 100, Complejo	  	IB/OB call, off phone case follow up and correspondence	  	Primary	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-7	  	Health Net / Cognizant Confidential

 Final 
  

	3.	ONSHORE SUPPLIER FACILITIES 

 This section sets forth the onshore Supplier Facilities
from which Supplier will perform the Services. A “Primary” classification indicates a facility from which Supplier will normally perform the Services, and a “Secondary” classification indicates a disaster recovery facility. 

 

													
	 Supplier Facility
Name
	  	 Supplier Facility
Address
	  	 Services to be
Performed
	  	 Classification
	  	May Health Net
Data be
Accessed from
this Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at this
Facility?
							
	CO-DC	  	Cognizant Data Center – Colorado (Latisys) 6900 S Peoria Centennial , CO 80523	  	ITO - Datacenter Hosting Services	  	Primary	  	YES	  	YES	  	YES
							
	AZ-DC	  	Cognizant Data Center – Arizona 2335 S Ellis St Chandler, AZ 85286	  	ITO – Datacenter Hosting Services	  	Secondary	  	YES	  	YES	  	YES
							
	AZ-DL	  	Cognizant – Delivery Center, Arizona 2512 West Dunlap Phoenix, AZ 8502	  	ITO –Federal Service Desk, ITO Services Delivery & Operations, BPS - Claims	  	Primary, except for ITO Services Delivery & Operations and BPS - Claims	  	YES	  	YES	  	YES
							
	FL-DL	  	Cognizant – Delivery Center, 10401 Highland Manor Drive, Suite 300, Tampa, FL 33610	  	ITO – Federal Service Desk	  	Secondary	  	YES	  	YES	  	NO
							
	Rancho Cordova, CA, USA	  	12033 & 11970, Foundation Pl Rancho Cordova, CA	  	ITO Services Delivery & Operations, Security Services	  	Primary	  	YES	  	YES	  	YES

  

					
	Schedule F	  	F-8	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility
Address
	  	 Services to be
Performed
	  	 Classification
	  	May Health Net
Data be
Accessed from
this Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at this
Facility?
							
	Aerojet-Rancho Cordova, CA, USA	  	2025 Aerojet Rd, Rancho Cordova, CA 95742	  	ITO Services Delivery & Operations, Security Services	  	Primary	  	YES	  	YES	  	YES
							
	Woodland Hills, CA, USA	  	21281 Burbank Blvd Los Angeles, CA	  	ITO Services Delivery & Operations, Security Services	  	Secondary	  	YES	  	YES	  	YES
							
	LAX-PS	  	5800 Bert Kouns Industrial Loop, Shreveport, LA, USA	  	Contact Center Operations	  	Primary	  	YES	  	YES	  	NO
							
	Rancho Cordova, CA, USA	  	12033 & 11970, Foundation Pl Rancho Cordova, CA	  	BPS Services (Contact Center, Claims, Membership & Configuration, Quality Assurance, Training & Medical Management)	  	Primary	  	YES	  	YES	  	YES
							
	Woodland Hills, CA, USA	  	21281 Burbank Blvd Los Angeles, CA	  	BPS Services Contact Center, Claims, Membership & Configuration, A&G, Quality Assurance, Training & Medical	  	Primary	  	YES	  	YES	  	YES

  

					
	Schedule F	  	F-9	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Supplier Facility
Name
	  	 Supplier Facility
Address
	  	 Services to be
Performed
	  	 Classification
	  	May Health Net
Data be
Accessed from
this Facility?	  	May
Department
of Defense
Data be
Accessed
from this
Facility?	  	May
Department
of Defense
Data be
Stored at
this
Facility?
							
		  		  	Management)	  		  		  		  	
							
	San Rafael	  	2370 Kerner Blvd. San Rafael, CA 94901	  	BPS Services (Membership & Quality Assurance)	  	Primary	  	YES	  	YES	  	YES
							
	Huntington Beach	  	7755 Center Ave, Huntington Beach, CA 92647	  	BPS Services (Quality Assurance, Contact Center)	  	Primary	  	YES	  	YES	  	YES
							
	Glendale	  	101 N Brand Blvd Ste 1500, Glendale, CA 91203	  	BPS Services (Medical Management)	  	Primary	  	YES	  	YES	  	YES
							
	Shreveport, LA	  	Shreveport, LA, USA TPUSA, Inc. 5800 Industrial Loop Shreveport, Louisiana USA 71129	  	IB/OB call, off phone case follow up	  	Primary	  	YES	  	YES	  	YES
							
	Irving, TX	  	5525 North Macarthur Boulevard # 800. Irving, TX	  	IB/OB call, off phone case follow up	  	Primary	  	YES	  	NO	  	NO
							
	Tempe, AZ	  	1230 West Washington Street Tempe Arizona 85281	  	A&G	  	Primary	  	YES	  	NO	  	NO

  

					
	Schedule F	  	F-10	  	Health Net / Cognizant Confidential

 Final 

SCHEDULE G 
 GOVERNANCE

  

  

					
	Schedule G		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE G 
 GOVERNANCE

  

	1.	GENERAL 

  

	 	(a)	This Schedule G (Governance) sets forth an integrated set of resources, committees, meetings, processes, plans and tools (“Contract Governance”). The purpose of Contract Governance is to
monitor and control all aspects of the Services in order to promote smooth operation of the Services in accordance with the Agreement. This Schedule G (Governance) describes the Contract Governance plan (“Contract Governance
Plan”), including Health Net’s and Supplier’s roles and responsibilities in Contract Governance, the relationship management structure, the decision making processes related to the Services, and other aspects of the Contract
Governance. 

  

	 	(b)	The following Schedules are included as part of this Schedule G (Governance): 

  

	 	(i)	Schedule G-1 (Supplier Organization) contains a description of Supplier’s management-level organizational unit involved in the performance of this Agreement. 

 

	 	(ii)	Schedule G-2 (Committee and Meeting Framework) describes the committee and meeting framework to be used by Health Net and Supplier to operationalize Contract Governance. 

 

	 	(iii)	Schedule G-3 (Management Reports) contains a list of certain of the management reports that will be provided by Supplier to Health Net as part of Contract Governance. 

 

	2.	CONTRACT GOVERNANCE PLAN 

  

	2.1	Development of Contract Governance Plan 

 Health Net and Supplier will jointly finalize
and implement the Contract Governance Plan within ninety (90) days, or as mutually agreed, following the Effective Date. The Contract Governance Plan will, at a minimum: 
  

	 	(a)	Specify the formal organizations, processes, and practices for managing Health Net’s and Supplier’s relationship under the Agreement; 

 

	 	(b)	Establish organizational interfaces for management and operation of the Agreement including: 

  

	 	(i)	the organization charts for Health Net and Supplier identifying the roles involved in Contract Governance; 

  

	 	(ii)	framework for governance reports and meetings, including those reports and meetings described in Section 3, below; and 

  

	 	(iii)	the operational and contractual authority and authorization levels of the Health Net and Supplier resources involved in Contract Governance; 

  

					
	Schedule G		G-1		Health Net / Cognizant Confidential

 Final 
  

	 	(c)	Specify the following Contract Governance processes: 

  

	 	(i)	Process to receive, qualify, identify, manage, and track Deliverables to completion; and 

  

	 	(ii)	Protocol for formal communications between Health Net and Supplier; 

  

	 	(d)	Establish a strategy for gathering appropriate inputs to Contract Governance and communicating appropriate outputs from Contract Governance to appropriate Health Net and Supplier resources; and 

 

	 	(e)	Include such other information as requested by Health Net to support the purpose of Contract Governance. 

  

	2.2	Other Governance-Related Processes 

 In addition to any other processes necessary to
support Contract Governance, the role of the Governance organization in the following processes (e.g., as the body to hear escalations, etc.) will be incorporated in the Contract Governance Plan: 

 

	 	(a)	Change Control Process, as defined and further described in Section 17.5 of the Terms and Conditions and Schedule H (Change Control); 

 

	 	(b)	The Action Plan and Step In Rights processes described in Section 17.4 of the Terms and Conditions; 

  

	 	(c)	The processes for determining end user and stakeholder satisfaction, as described in Schedule B (Service Levels); 

  

	 	(d)	The process for managing and evaluating performance against the Service Levels and remediating Service Level Failures, as described in Schedule B (Service Levels); 

 

	 	(e)	The dispute resolution process described in Section 26 of the Terms and Conditions; 

  

	 	(f)	The indemnification process and procedures described in Section 23 of the Terms and Conditions; 

  

	 	(g)	The process for the development and maintenance of the Procedures Manual described in Section 17.2 of the Terms and Conditions; 

 

	 	(h)	The Demand Intake Process consistent with Schedule J (Project Framework), Schedule C (Charges), and Schedule H (Change Control); 

 

	 	(i)	Processes related to the establishment of the BPaaS and non-BPaaS Road Map; and 

  

	 	(j)	Any other processes and procedures described in this Agreement that relate to how the Parties will interact with one another to govern and manage performance under and compliance with the Agreement. 

  

					
	Schedule G		G-2		Health Net / Cognizant Confidential

 Final 
  

	2.3	Responsibilities 

  

	 	(a)	Within ninety (90) days after the Effective Date (or as otherwise specified below), Supplier will: 

  

	 	(i)	assign an individual to be the single point of contact to Health Net for the Contract Governance Structure development and maintenance; 

 

	 	(ii)	identify the Supplier attendees for the meetings reflected in Schedule G-2 (Committee and Meeting Framework) and any updates as they occur; 

 

	 	(iii)	develop the Contract Governance Plan in collaboration with Health Net; 

  

	 	(iv)	review Health Net comments and feedback and revise the draft Contract Governance Plan and submit to Health Net for Health Net review and approval within ten (10) Business Days of receipt of Health Net’s
comments. For the avoidance of doubt, this process will be repeated until the Contract Governance Plan is approved by Health Net; and 

  

	 	(v)	provide appropriate Supplier Personnel access to the Contract Governance Plan, as needed. 

  

	 	(b)	Within ninety (90) days after the Effective Date (or as otherwise specified below), Health Net will: 

  

	 	(i)	assign an individual to be the single point of contact to Supplier for the Contract Governance Plan development and maintenance; 

  

	 	(ii)	provide a list of Health Net attendees for the meetings reflected in the meetings plan and any updates as they occur; 

  

	 	(iii)	collaborate with the Supplier on the development of the Contract Governance Plan; 

  

	 	(iv)	review and provide to Supplier, in writing, Health Net’s comments, questions and proposed changes to the draft plan within thirty (30) days following Health Net’s acknowledged receipt of the draft
Contract Governance Plan; and 

  

	 	(v)	provide the Contract Governance Plan to appropriate Health Net employees, as appropriate. 

  

	 	(c)	Within ninety (90) days after the Effective Date and regularly thereafter, Supplier will identify process inhibitors, and propose process improvements to Health Net, as required. 

 

	 	(d)	In accordance with Schedule R (Critical Milestones), Supplier will draft and deliver to Health Net the initial Contract Governance Plan. 

 

	 	(e)	The Parties will jointly review, on an annual basis or more frequently as requested by a Party, the Contract Governance Plan and update and/or maintain the Contract Governance Plan accordingly. 

  

					
	Schedule G		G-3		Health Net / Cognizant Confidential

 Final 
  

	3.	GOVERNANCE ORGANIZATION 

 Health Net and Cognizant will implement a governance
organization that continues to evolve from the Effective Date through to steady state. Diagram 1 below illustrates the phases of governance evolution as well as the targeted dates for each phase. 

Diagram 1 
  

 
  

	3.1	Governance Structure in Phases 1 and 2 

 Health Net and Supplier will organize their
joint governance during Phases 1 and 2 as illustrated in Diagram 2 below and described in this Section 3.1. 
 Diagram 2 

 
 

 

  

					
	Schedule G		G-4		Health Net / Cognizant Confidential

 Final 
  

	 	(a)	Board of Supervisors and Executive Council 

  

	 	    	Supplier will create and chair an executive forum responsible for the overall strategic direction and decision making related to the go-to-market strategy for the Technology Platform and related services (the
“Go to Market Forum”). Health Net will be a member of the Go To Market Forum and will provide strategic advice and industry expertise in connection with the various service offerings and associated technology. The focus and
overall strategy of the Go To Market Forum will include addressing the need to increase membership on the Technology Platform in order to reduce overall cost, leveraging and further developing the Technology Platform, leveraging synergies with other
Supplier products, and to build and market a product that has highly attractive distinguishing features for the target market. 

  

	 	(b)	Governance Committee 

  

	 	    	The parties will jointly form a Governance Committee consisting of three (3) senior executives from Health Net and three (3) senior executives from Cognizant who will: 

 

	 	(i)	Provide guidance to the Transformation Management Office; 

  

	 	(ii)	Oversee performance reviews (operational and financial); 

  

	 	(iii)	Oversee Service Levels including compliance and transformation metrics; 

  

	 	(iv)	Resolve escalations; 

  

	 	(v)	Decide resource allocations; and 

  

	 	(vi)	Address within their respective organizations and provide guidance to their respective organization on: 

  

	 	(A)	Portfolio/IT roadmap 

  

	 	(B)	Innovation oversight 

  

	 	(C)	Strategic Planning 

  

	 	(D)	Customer experience 

  

	 	(c)	Co-Operating Officers 

  

	 	    	The parties will each nominate a senior executive from their organization to serve as the Co-Operating Officers through Phase 2 who will: 

 

	 	(i)	Set strategy/structure for the Transformation Management Organization; 

  

	 	(ii)	Manage the Transition; 

  

	 	(iii)	Ensure that Health Net achieves the desired performance levels, cost reduction objectives and builds enhanced capacities; 

  

					
	Schedule G		G-5		Health Net / Cognizant Confidential

 Final 
  

	 	(iv)	Ensure that Supplier achieves targeted operational goals and metrics associated with delivery of the Services to Health Net; and 

  

	 	(v)	Ensure that Supplier builds and executes a viable line of business targeting acquisition of other health care clients. 

  

	 	    	The Supplier Operating Officer’s overall responsibilities for the Term are set forth in Section 5.2 below. 

  

	 	    	The Health Net Operating Officer will coach the Supplier Operating Officer on all aspects of health plan operations to enable the Supplier Operating Officer to assume greater responsibilities over time related to the
oversight of the Services. The Health Net Operating Officer will also have Transition related authority set forth in Section 13.3 of the Terms and Conditions. During Phases 1 and 2, the Health Net Operating Officer will have sole authority for
approving or denying each phase of the Transition as they become due (including whether Acceptance Criteria for Transition Deliverables and Transition Milestones have been met) in accordance with Section 1 of Schedule Z (High Level
Transition Information) and Section 13.4 of the Terms and Conditions. The governance of certain other Transition-related matters is set forth in Section 13.3 of the Terms and Conditions. For the avoidance of any doubt, Transition
shall mean each wave within each Statement of Work. 

  

	3.2	Governance Structure in Phase 3 

 Health Net and Supplier will organize their governance
during Phase 3 as illustrated in Diagram 3 below and described in this Section. 
 Diagram 3 

 
 

 

  

					
	Schedule G		G-6		Health Net / Cognizant Confidential

 Final 
  

	 	(a)	Supplier Board of Supervisors and Health Net Executive Council The Supplier Board of Supervisors and Health Net Executive Council will continue to operate during Phase 3 as set forth in Section 3.1(a).

  

	 	(b)	Governance Committee 

  

	 	    	The Governance Committee will continue to operate during steady state with responsibilities as set forth in Section 3.1(b)(ii)—3.1(b)(vi). 

 

	 	(c)	Supplier Operating Officer and the Health Net Oversight Officer (or designee) 

  

	 	    	At the end of Phase 2, (i) the Health Net Operating Officer will disengage and the Health Net Oversight Officer (or designee) will assume responsibility for representing Health Net in Phase 3/steady state, and
(ii) the Supplier Operating Officer will assume responsibility for functional oversight of the day-to-day operations. The Supplier Operating Officer’s overall responsibilities for the Term are set forth in Section 5.2 below and also
include the responsibilities set forth in Section 3.1(c)(iii)—3.1(c)(v). During Phase 3, if there is a disagreement between the Health Net Oversight Officer and the Supplier Operating Officer, the parties will escalate the dispute to the
Governance Committee for resolution. 

  

	4.	GOVERNANCE MEETINGS & REPORTS 

  

	    	Governance meetings and management reporting will be critical aspects of the Services provided by Supplier under this Agreement, as they will be the principal means by which Health Net’s management and overseers
will continue to have the requisite visibility into the operation of those aspects of Health Net’s business that are comprised by the Functions outsourced to Supplier pursuant to this Agreement. 

 

	4.1	Meetings 

 As part of the Contract Governance Plan, the Parties will set up the
governance meetings (“Governance Meetings”) listed in Schedule G-2 (Committee and Meeting Framework). Unless otherwise agreed by the Parties, Supplier will prepare and circulate a list of topics to be discussed for
each agenda item for each meeting sufficiently in advance of each meeting to give the participants an opportunity to prepare for the meeting. Supplier and Health Net will agree on a final agenda. The Parties will ensure that representatives with
appropriate knowledge and authority will participate in each Governance Meeting. Supplier will prepare and circulate a documented list of outcomes and action items after each meeting, which will not be binding on either Party if they are in any way
inconsistent with this Agreement. At any time during the Term, Health Net may reasonably request additional Governance Meetings or modifications to the type, frequency, purpose or attendance at existing Governance Meetings, and if it does, Supplier
shall reasonably consent to such modifications at no charge. 
 The framework for Governance Meetings and specific Governance Meetings are
set forth in Schedule G-2 (Committee and Meeting Framework). 
  

	4.2	Reports 

  

	 	(a)	During the Term, Supplier will be responsible for continuing to generate all reports (governance, operational, and management reports) produced by the Affected Employees at no additional Charge. 

  

					
	Schedule G		G-7		Health Net / Cognizant Confidential

 Final 
  

	 	(b)	Schedule A of the Agreement and each Statement of Work addresses the Supplier’s responsibilities to provide operational reporting as an integral part of the Services to be provided under this Agreement. This
Schedule G (Governance) addresses Supplier’s responsibilities with respect to “Management Reporting,” which means reporting by Supplier to Health Net management and external entities, such as Regulators, with
respect to the Functions outsourced to Supplier, in order to provide them with the requisite visibility into the relevant aspects of Health Net’s business. Management Reporting includes any reporting required by Regulators or applicable Laws.
The Parties have prepared a preliminary list of the Management Reporting to be provided by Supplier to Health Net on an ongoing basis, which is set forth in Schedule G-3 (Management Reports). Supplier will deliver all reports listed in
Schedule G-3 (Management Reports) at no additional charge to Health Net. If it is determined that any report listed in Schedule G-3 (Management Reports) is not yet being generated by Health Net as of the BPaaS Services Commencement
Date, the Parties will mutually agree to a schedule and process for implementing the report (at no additional charge to Health Net) or the Parties will mutually agree to remove the report from Schedule G-3 (Management Reports). No later than
six months after the BPaaS Services Commencement Date, Health Net may within reason update the list of Management Reports set forth in Schedule G-3 (Management Reports). As part of the Contract Governance Plan, the Parties will work together
during the Term to refine Schedule G- 3(Management Reports) from time to time as may be necessary so that Supplier’s Management Reporting meets the objective of providing Health Net’s management and overseers with the requisite degree of
visibility into the conduct of Health Net’s Functions that have been outsourced to Supplier, as they may change and evolve during the Term. Such Management Reporting will be no less comprehensive than (1) the Management Reporting of Health
Net’s outsourced Functions as of the Effective Date and (2) the Management Reporting provided to Health Net (x) by Supplier under the Original BPO Agreement and Original AO Agreement or (y) by other Health Net outsourcing
suppliers, as of the Effective Date, performing services similar to the Services prior to the Effective Date. 

  

	 	(i)	In addition to the Management Reporting described in this Section 4.2(b), Supplier will produce a monthly performance report describing Supplier’s performance of the Services in the preceding month (the
“Monthly Performance Report”). The Monthly Performance Report will be delivered to Health Net not later than the fifteenth (15th) day of each month. Each Monthly Performance Report will (A) assess the degree to
which Supplier has attained or failed to attain the pertinent objectives for the prior month, including the Service Levels and measurements with respect to metrics other than the Service Levels as specified by Health Net, if applicable;
(B) describe the status of each ongoing problem resolution effort and any other initiative; (C) explain deviations from the Service Levels in the prior month and include for each deviation a plan for corrective action; (D) set forth a
record of the Services, personnel changes and any other changes made during the reporting period that affect, or could affect, the Services and describe the planned changes during the upcoming month that may affect the Services; (E) set forth
utilization of each Supplier resource (e.g., hour, FTE, etc.) for which a charge is made under this Agreement; (F) include all documentation and other information that Health Net reasonably requests to verify compliance with this Agreement; and
(G) provide Health Net with a monthly financial projection of Supplier’s charges for the following month. 

  

					
	Schedule G		G-8		Health Net / Cognizant Confidential

 Final 
  

	 	(c)	At any time during the Term, Health Net may request additional reports or modifications to the type, frequency, or format of existing reports, and if it does, Supplier shall reasonably consent to such modifications at
no charge. 

  

	 	(d)	Supplier understands and agrees that a number of Affected Personnel, perform ad hoc reporting as a matter of course in their daily duties. With the transition of such Affected Personnel, Supplier shall continue to
provide such ad hoc reporting as may be requested by Health Net at no charge. 

  

	5.	RELATIONSHIP MANAGEMENT STRUCTURE 

  

	5.1	Relationship Executive 

 Within fifteen (15) days after the Effective Date, Health
Net and Supplier will each identify its own relationship executive (“Relationship Executive”) who will focus on Health Net’s and Supplier’s long-term strategic relationship and the mission, vision, and innovation as
they relate to the Services. Supplier’s Relationship Executive will be responsible for the achievement of the goals and the implementation of the Agreement, and will be Health Net’s single point of contact for executive issues and
escalation management. The Relationship Executives may not delegate execution of their role, but may involve other Health Net or Supplier resources as needed to facilitate execution of their role. 

 

	5.2	Supplier Operating Officer 

 For the Term, Supplier will identify an account executive
(the “Supplier Operating Officer”) who will focus on the day-to-day operations and delivery of the Services. The Supplier Operating Officer’s role will evolve during the Term as detailed in Sections 3.1(c) and 3.2(c)
above. Regardless of the Phase, during the Term the Supplier Operating Officer’s responsibilities include: 
  

	 	(a)	serving as the single point of accountability for Supplier for the Services, including all aspects of service delivery and the Supplier delivery organization, and have overall responsibility to ensure Health Net
satisfaction. The Supplier Operating Officer will also review all Transition activities to verify that critical processes and systems are smoothly and efficiently integrated or transitioned; 

 

	 	(b)	being the executive contact for Health Net on daily delivery performance and Supplier service delivery commitments, including managing performance and efficiency of Supplier’s third party delivery vendors;

  

	 	(c)	providing service management processes and reporting while being responsible for continuous delivery service improvement; and 

  

	 	(d)	working with the Health Net Co-Operating Officer or Health Net Oversight Executive or Designee to ensure client satisfaction and to support new strategies and Health Net business directions. 

Health Net leadership that serve on the Governance Committee and the Board of Supervisors will provide Supplier feedback relating to
performance of the Supplier Operating Officer. Health Net’s feedback will be used by Supplier as input for the overall performance appraisals for such individual. 

  

					
	Schedule G		G-9		Health Net / Cognizant Confidential

 Final 

SCHEDULE G-1 – SUPPLIER ORGANIZATION 
  

	1	SUPPLIER ORGANIZATION 

  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-1		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-2		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-3		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-4		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-5		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-6		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-7		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-8		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-9		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-10		Health Net / Cognizant Confidential

 Final 
  

			
	

  

					
	Schedule G-1 (Supplier Organization)		G-1-11		Health Net / Cognizant Confidential

 Final 

EXHIBIT G-2 
 MEETING
FRAMEWORK 
  

  

					
	Schedule G-2		G-2		Health Net / Cognizant Confidential

 Final 

SCHEDULE G-2 
 COMMITTEE
AND MEETING FRAMEWORK 
  

																	
	 		Committee Name		 		 		 		 		 		 		 
	 		 		Transition
Management		 Daily Tower

Status Meeting
		Service Delivery
Meeting		Performance
Meeting		Quarterly Business
Review		Technology/
Services Meeting		Strategic
Relationship
(Mission / Vision /
Innovation)
Meeting
									
	 		 		 Transition
Management
Review
		 Daily Operations
Review
		 Operations Review
Committee
		 Performance
Review Committee
		 Joint Management
& Operations
Committee
		 IT Management
Committee
		 Joint Steering
Committee
meetings &
Joint
Management &
Operations
Committee

									
	Committee Information		Description		Review transition progress and status in each of the Towers and the overall satisfaction of the Transition Plan. There will be multiple meetings required to review overall and specific Tower progress.		Review results from previous twenty-four (24) hours focusing on processing dashboards, systems availability and major processing issues including workarounds put in place.		Review service delivery performance and discuss operational issues. Review and approve operational process changes. Any procedural changes should be addressed during this meeting as well.		Review performance against contracted or stated expectations. Consider if changes are necessary to improve performance. Recommend operational changes to Service Delivery. Ongoing assessment of the effectiveness of the performance
framework (i.e., measures, metrics, weightings, credits, etc.). Recommend changes in the performance framework.		Review performance against contracted or stated expectations. Consider if changes are necessary to improve performance. Ongoing assessment of the effectiveness of the performance framework (i.e., measures, metrics, weightings,
credits, etc.).		Review and consideration of technology and service changes in alignment with direction from Mission / Vision / Innovation committee. Presentation and discussion of Supplier Services and Technology Product Road Map.		Update the mission and vision for strategic relationship and Services in scope. Review and approve Innovation Plan and evaluate outcomes. Approve Supplier Services and Technology Product Road Map. Identify short term specific goals
for the strategic relationship, including the timeframes for achieving such goals. Assess the overall success of the relationship.
									
			Agenda		 +Review specific progress toward achieving the Transition Plan and Milestones. +Discussion / Resolution of Transition issues /Mitigation of
risks
 /coordination of interdependencies
		+ Review daily turn over report		 + Performance Trends
 + Problems (RCAs)

+ Issues (process, actor, organizational, etc.)
		+ Review monthly performance results		+ Review quarterly performance results		 + Review Services and Technology Product Road Map

+ Vendor presentations on new solutions
		 + Business update
 + Goals setting, monitoring and
assessment
 + Review value creation opportunities
 + Innovation
Plan
 + Product Road Map

			Frequency		Daily, Weekly, Monthly		Daily		Monthly or more frequently depending on the stability and maturity of the operations.		Monthly		Quarterly		Semi-Annually		Semi-Annually

  

  

					
	Schedule G-2 (Committee and Meeting Framework)		G-2-2		Health Net / Cognizant Confidential

 Final 

SCHEDULE G-3 
 MANAGEMENT
REPORTS 

  

					
	Schedule G-3 (Management Reports)		 		Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Governance	  	Monthly Performance Report	  	A monthly performance report describing Supplier’s performance of the Services in the preceding month as further described in Section 4.2(b)(i) of Schedule G (Governance).	  	Monthly	  	Active	  		  	
							
	IT Vendor Relations	  	PC Refresh Status Report	  	Report outlining the number of PCs being refreshed, broken out by laptops and desktops, Corp vs. Govt Systems, completed/pending/no refresh and lost/unlocateable	  	Bi Weekly	  	Active	  	Data is a combination of detailed PC data from IBM Global Finance and PC data pulled from Altiris, inside of an Access db maintained by IBM.	  	IBM (IO PC Refresh Coordinator)
							
	IT Vendor Relations	  	Joint Operations Committee	  	Governance report - overview of low level tactical activities for Application Outsourcing Contract	  	Monthly	  	Active	  	Data pulled by SUPPLIER from Plan View, project/program plans, Remedy, financial systems	  	SUPPLIER
							
	IT Vendor Relations	  	Joint Operations Committee	  	Governance report - overview of low level tactical activities for Infrastructure Outsourcing Contract	  	Monthly	  	Active	  	Data pulled by IBM from their CLAIM (labor tracking), project/program plans, Remedy, financial systems, and GSMRT	  	IBM
							
	IT Vendor Relations	  	Monthly IT Contract Renewal SLA report	  	Scorecard outlining timeliness of renewals of contracts in the ITG Governance portfolio	  	Monthly	  	Active	  	Spreadsheets and SAP Contract Lifecycle Management (CLM) system	  	Health Net (Helen Poon)
							
	IT Vendor Relations	  	Monthly Ebuyer Cart Analysis report	  	Outlines volume and quality metrics for ebuyer cart processing for IO, AO, SA, and misc software/hardware managed by ITG Governance	  	Monthly	  	Active	  	SAP Ebuyer system	  	Health Net (Gary Ellis)

  

					
	Schedule G-3 (Management Reports)	  	G-3-1	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only - Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT Vendor Relations	  	Expiring Contracts Report	  	Lists contracts in CLM owned by ITG Governance that have either expired or will expire in the next 3 months.	  	Monthly	  	Active	  	SAP CLM system	  	Health Net (Lily Poon in SS&P)
							
	IT Vendor Relations	  	Software Purchase Reports	  	Lists of historical software procurements and upcoming renewals	  	Monthly	  	Active	  	Compucom ordering system	  	Compucom
							
	IT Vendor Relations	  	Blocked Report	  	Identifies mismatched amounts between Purchase Orders and Invoices	  	Weekly	  	Active	  	SAP core system	  	Health Net (Terry Durant in AP)
							
	IT SLM Team	  	Monthly Operations Report (MOR)	  	Displays a subset of metrics with explanation of any missed metrics for the current reporting month	  	Monthly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	IBM Monthly Scorecard	  	Displays a subset of IBM-related metrics	  	Monthly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	Supplier Monthly Scorecard	  	Displays a subset of Supplier-related metrics	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Health Net Quarterly Scorecard by Region (Overall)	  	Displays a subset of aggregated metrics for all Vendors and Health Net	  	Tracked Quarterly but distributed Monthly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	University of California - Web Site Availability Performance Guarantee Result Healthnet.com	  	Displays Availability of Healthnet.com during normal business hours for the previous Quarter.	  	Quarterly	  	Active	  	Remedy	  	Health Net SLM Team

  

					
	Schedule G-3 (Management Reports)	  	G-3-2	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only - Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	 JP Morgan Chase - Web Site Availability Performance Result - New MHN EAP PG

Group
	  	Displays Availability of MHN.com and Members.MHN.com for the previous Quarter.	  	Quarterly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Monthly Business PMR	  	Displays a subset of SLA’s for IBM and Supplier	  	Monthly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	Monthly Availability Metric Reports (Access DB)	  	Displays aggregated ticket detail data and summarized availability for all Vendors and Health Net	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	General System Availability (GSA) Reports	  	Displays a breakout of ticket detail and individualized system availability by Vendor and Health Net	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Supplier Project Exception Report (weekly)	  	Displays the service requests for project exceptions submitted by Supplier that were approved by Health Net Mgmt	  	Weekly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Monthly Remedy Ticket Counts	  	Displays the count of Remedy tickets arrived monthly by Case Type and Priority	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Lotus Notes Mailbox Counts (monthly)	  	Displays the count of Lotus Notes Mailboxes, broken out by mail server	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	Daily Morning Report Status	  	Displays a summary of the daily morning reports for VMS, FHP1, and HNNE	  	Daily	  	Active	  	Remedy	  	Health Net SLM Team

  

					
	Schedule G-3 (Management Reports)	  	G-3-3	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	 IBM
 Preliminary Metric Report
	  	Displays preliminary metric data on a weekly basis (IBM metrics only)	  	Weekly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	Supplier Monthly Attainment Topsheet	  	Displays all service levels and final attainment values for the month	  	Monthly	  	Active	  	Remedy	  	Health Net SLM Team
							
	IT SLM Team	  	IBM Monthly Attainment Topsheet	  	Displays all service levels and final attainment values for the month	  	Monthly	  	Active	  	Remedy, ISC Portal	  	Health Net SLM Team
							
	IT SLM Team	  	Resource Unit Improvement Report	  	Displays a list of the Resource Units with discrepancies to be discussed at the weekly meeting	  	Weekly	  	Active	  	Manual	  	IBM
							
	IT SLM Team	  	Topsheet h- Centive SLA Monthly Metrics Report	  	Displays a list of the SLAs, Metric Data and attainments for each SLA	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	ITAM	  	Executive Compliance Summary Potential Exposure	  	Displays the compliance for the given Software Product with Potential Exposure (Top 15)	  	Weekly	  	Active	  	Altiris	  	Health Net ITAM Team
							
	ITAM	  	Full - Detail Compliance Summary Report	  	Displays the compliance for the given Software Product - Full Report Detail	  	Weekly	  	Active	  	Altiris	  	Health Net ITAM Team
							
	ITAM	  	Single Trusted Source (STS)	  	Displays collection of Health Net IT Server Assets (CMDB)	  	Monthly	  	Active	  	IBM - Excel Spreadsheet (Manual Input & Update)	  	IBM
							
	ITAM	  	Softmart - Software VAR	  	Displays Health Net Purchase History - Software VARs	  	Monthly	  	Active	  	Softmart	  	Softmart

  

					
	Schedule G-3 (Management Reports)	  	G-3-4	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	ITAM	  	CompuCom - Software Management Data Export	  	Displays Health Net Purchase History - Software VARs	  	Monthly	  	Active	  	CompuCom	  	Health Net ITAM Team
							
	ITAM	  	CompuCom - Hardware Management Data Export	  	Displays Health Net Purchase History - Hardware VARs for Corp	  	Monthly	  	Active	  	CompuCom	  	CompuCom
							
	ITAM	  	Ideal	  	Displays Health Net Purchase History - Hardware VARs for HNFS	  	Monthly	  	Active	  	Ideal	  	Ideal
							
	ITAM	  	TAD4D	  	Displays Software Discovery - Servers Only	  	Monthly	  	Active	  	TADD	  	IBM
							
	ITAM	  	TAD4Z	  	Displays Software Discovery - Mainframe	  	Quarterly	  	Active	  	TADD	  	IBM
							
	ITAM	  	 Health Net Manual Scan BMC
 Discovery
(ADDM)
	  	Displays Software Discovery - BMC	  	Quarterly	  	Active	  	ADDM Server: BLD- APPADDM01 & BLD-APPADDM02	  	IBM
							
	ITAM	  	Health Net Manual Scan Commercial VMware	  	Displays Software Discovery - Corp VMware	  	Quarterly	  	Active	  	Corp VmWare Servers	  	IBM
							
	ITAM	  	Health Net Manual Scan Federal Vmware	  	Displays Software Discovery - Fed Vmware	  	Quarterly	  	Active	  	Fed VmWare Servers	  	IBM
							
	ITAM	  	 Health Net Manual Scan Virtual IO (VIO) and HMC

Commercial
	  	 Displays Software Discovery - Virtual I/O
 Server
and Hardware Management Console
	  	Quarterly	  	Active	  	IBM Virtual I/O Server(s) & IBM Hardware Management Console(s)	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-5	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	ITAM	  	Health Net NT Servers - Bravo Feed	  	Displays Software Discovery - NT Severs: WHSRVDB006, WHSRVDB009, WHSRVDB010	  	Quarterly	  	Active	  	BRAVO	  	IBM
							
	ITAM	  	Health Net OpenVMS Discovery	  	Displays Software Discovery - VMS	  	Quarterly	  	Active	  	TADD	  	IBM
							
	ITAM	  	iSeries Software Scan	  	Displays Software Discovery - iSeries	  	Quarterly	  	Active	  	iSeries Servers	  	IBM
							
	ITAM	  	DAD-Health Net Health Net Report	  	 Displays Software License - IBM Owned and Health Net Owned/IBM Manages

 
 EN = IBM owns license & pays bill (cust suspend their license, so IBM license is
used)
 IO = IBM owns & pays for license & license does NOT fall under the IBM MLA/VPA

CI = Health Net owns license, IBMGS acting as agent & pays the bill
	  	Quarterly	  	Active	  	IBM - Asset Tool	  	IBM
							
	ITAM	  	 Bravo Mass Missing SW Discrepancy Template (AS400

Nocturne)
	  	Displays Software Discovery - Nocturne	  	Quarterly	  	Active	  	BRAVO	  	IBM
							
	ITAM	  	Managed PCs with PO info (no servers)	  	Displays all active workstations and VM’s with Operating System, Domain & Locations	  	Monthly	  	Active	  	Altiris	  	Health Net ITAM Team
							
	IT SLM Team	  	Annual Health Net Satisfaction Survey	  	IO SLA01 - Measures Health Net Satisfaction with Vendor	  	Annually	  	Active	  	IBM 3rd Party Vendor	  	IBM
							
	IT SLM Team	  	Quarterly EU Services (Deskside)	  	IO SLA02 - Measures Cust Sat with Vendor Desktop services	  	Quarterly	  	Active	  	IBM	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-6	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	Quarterly Helpdesk Satisfaction Survey	  	IO SLA03 - Measures Cust Sat with Vendor Service Desk	  	Quarterly	  	Active	  	IBM	  	IBM
							
	IT SLM Team	  	Application Availability	  	IO SLA04 - Measures Application Availability for 23 appls	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	SAN	  	IO SLA05 - Measures SAN Availability	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	NAS	  	IO SLA06 - Measures NAS Availability	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Network Data (Network)	  	IO SLA07 - Measures Network Availability	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P1 Problems -Response Time (15 Min)	  	IO SLA08 - Measures Response TAT for Prob Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P1 Problems -Resolution Time (<4 Hrs)	  	IO SLA09 - Measures Resolution TAT for Prob Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P2 Problems - Response Time (<2 Hrs)	  	IO SLA10 - Measures Response TAT for Prob Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P2 Problems - Resolution Time (<8 Hrs)	  	IO SLA11 - Measures Resolution TAT for Prob Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P1 Incidents - Response Time (<2 Hrs)	  	IO SLA12 - Measures Response TAT for Incid Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P1 Incidents - Resolution Time (<1 Bus Day)	  	IO SLA13 - Measures Resolution TAT for Incid Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-7	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	P2 Incidents - Response Time (<4 Hrs)	  	IO SLA14 - Measures Response TAT for Incid Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P2 Incidents - Resolution Time(<2 Bus Days)	  	IO SLA15 - Measures Resolution TAT for Incid Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	First Call Resolution	  	IO SLA16 - Measures number of calls that were resolved by SD	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Average Speed to Answer	  	IO SLA17 - Average Speed to answer calls coming in to SD	  	Monthly	  	Active	  	ACD	  	IBM
							
	IT SLM Team	  	IMACS	  	IO SLA18 - Percentage of Incidents, Moves, Adds and Changes that were completed on time.	  	Monthly	  	Active	  	LN ISR, Rem SR	  	IBM
							
	IT SLM Team	  	Average Call Abandonment Rate	  	IOSLA19 - Number of calls that were abandoned by the caller prior to being answered by the SD	  	Monthly	  	Active	  	ACD	  	IBM
							
	IT SLM Team	  	P3 Incidents- Response Time (<1 Bus Day)	  	IOSLA21 - Measures Response TAT for Incid Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P3 Incidents- Resolution Time (<3 Bus Days)	  	IOSLA22 - Measures Resolution TAT for Incid Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P4 Incidents- Response Time (<2 Bus Days)	  	IOSLA23 - Measures Response TAT for Incid Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P4 Incidents- Resolution Time (<5 Bus Days)	  	IOSLA24 - Measures Resolution TAT for Incid Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-8	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	P3 Problem Response Time (<4 Hrs)	  	IOSLA25 - Measures Response TAT for Prob Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P3 Problems- Resolution Time (<3Bus Days)	  	IOSLA26 - Measures Resolution TAT for Prob Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P4 Problems- Response Time (<1 Bus Day)	  	IOSLA27 - Measures Response TAT for Prob Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P4 Problems- Resolution Time (5 Bus Days)	  	IOSLA28 - Measures Resolution TAT for Prob Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Citrix Remote Access Server	  	IO SLA31 - Measures Availability of Citrix	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Voice Availability (Voice)	  	IO SLA32 - Measures voice Availability by tickets	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	P1 Service Requests	  	IO SLA33 - Percentage of Pri 1 SRs completed on time	  	Monthly	  	Active	  	Remedy SR	  	IBM
							
	IT SLM Team	  	P2 Service Requests	  	IO SLA33 - Percentage of Pri 2 SRs completed on time	  	Monthly	  	Active	  	Remedy SR	  	IBM
							
	IT SLM Team	  	P3 Service Requests	  	IO SLA33 - Percentage of Pri 3 SRs completed on time	  	Monthly	  	Active	  	Remedy SR	  	IBM
							
	IT SLM Team	  	P4 Service Requests	  	IO SLA33 - Percentage of Pri 4 SRs completed on time	  	Monthly	  	Active	  	Remedy SR	  	IBM
							
	IT SLM Team	  	P5 Service Requests	  	IO SLA33 - Percentage of Pri 5 SRs completed on time	  	Monthly	  	Active	  	Remedy SR	  	IBM
							
	IT SLM Team	  	Availability of DEV Servers	  	IO SLA38 - Measures availability of DEV Servers	  	Monthly	  	Active	  	Remedy	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-9	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	Availability of Non-Prod Servers	  	IO SLA39 - Measures availability of Non Prod Svrs (QA, TEST, Trng)	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Online Response Time	  	IO SLA40 - Measures online response for online applications	  	Monthly	  	Active	  		  	IBM
							
	IT SLM Team	  	Speed of Messaging	  	IO SLA42 - Speed of messages delivered within Health Net Infrastructure	  	Monthly	  	Active	  	ACD	  	IBM
							
	IT SLM Team	  	Middleware Infrastructure Avail	  	IIOSLA45 - Availability of Middleware Servers	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Availability of Infrastructure Services	  	IO SLA46 - Availability of Infrastructure Services	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT PMO	  	Quarterly Project Management	  	IO SLA47 - Measures projects coming in at projected cost and schedule	  	Monthly	  	Active	  	IBM Tracking	  	IBM
							
	IT SLM Team	  	Measurement and Reporting	  	IO SLA49 - Percent of internal transaction response times under two seconds for applications (FARE, Medical, ABS)	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Production Batch Application Availability	  	IO SLA50 - Availability of Prod Batch ready to run at batch start time.	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT Chg Mgt	  	Change Backouts	  	IO SLA51 - Percentage of CMRs that were unsuccessful	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT Chg Mgt	  	Unplanned Change Records	  	IO SLA52 - Percentage of total CMRs that were Unplanned	  	Monthly	  	Active	  	Remedy	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-1-10	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT Chg Mgt	  	Methodology Compliance Change Mgmt	  	IO SLA53 - Percentage of CMRs that were implemented out of compliance (not following process, w/o CMR, w/o approvals, outside approved time, etc.).	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT Audit and Comp	  	Priv Access Accuracy & Delivery	  	IO SLA54 - Percentage of Priv Access Admin Requests provisioned on time	  	Monthly	  	Active	  	IBM	  	IBM
							
	IT Audit and Comp	  	Priv Access Compliancy and Reconciliation	  	IO SLA55 - Percentage of Priv Access Admin removed within 72 hours.	  	Monthly	  	Active	  	Remedy	  	IBM
							
	IT SLM Team	  	Access Admin BAU	  	IO SLA56 - Percentage of Bus As Usual Acces Admin requests fulfilled within 5 Bus Days.	  	Monthly	  	Active	  	LN ISR	  	IBM
							
	IT PMO	  	Project Intake	  	IO Amendment 4 SLA57 - Measures the total number of days various components of the Project Intake and percentage that made it within the established TAT	  	Monthly	  	Active	  	IBM, Health Net Tracking, PV	  	IBM
							
	IT PMO	  	Delivery of Project Budget	  	IO Amendment 4 SLA58 - Measures the costs of a project and whether in came within 10% of estimated costs.	  	Monthly	  	Active	  	IBM, Health Net Tracking, PV	  	IBM
							
	IT PMO	  	Delivery of Project Schedule	  	IO Amendment 4 SLA59 - Tracks project schedule and measures whether it came in within 10% of estimated delivery.	  	Monthly	  	Active	  	IBM, Health Net Tracking, PV	  	IBM
							
	IT PMO	  	Quality of Project Deliverables and Artifacts	  	IO Amendment 4 SLA60 - Measures the quality of project deliverables	  	Monthly	  	Active	  	IBM, Health Net Tracking, PV	  	IBM
							
	IT SLM Team	  	Business Function Services Availability	  	IO Amendment 4 SLA61 - Measures availability of established Business Function Services	  	Monthly	  	Active	  	Remedy, Service Now	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-11	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System
(Data Resides)
	  	 IT Only -Who
Generates Report
(Health
Net/IBM/CTS)

							
	IT SLM Team	  	Severity 1, Vital, Incident Ticket Resolution	  	IO Service Now SLA62 - Measures Resolution TAT for Sev Pri 1 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 1, Vital, Incident Ticket Response	  	IO Service Now SLA63 - Measures Response TAT for Sev Pri 1 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 2, Critical, Incident Ticket Resolution	  	IO Service Now SLA64 - Measures Resolution TAT for Sev Pri 2 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 2, Critical, Incident Ticket Response	  	IO Service Now SLA65 - Measures Response TAT for Sev Pri 2 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 3, High, Incident Ticket Resolution	  	IO Service Now SLA66 - Measures Resolution TAT for Sev Pri 3 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 3, High, Incident Ticket Response	  	IO Service Now SLA67 - Measures Response TAT for Sev Pri 3 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 4, Moderate, Incident Ticket Resolution	  	IO Service Now SLA68 - Measures Resolution TAT for Sev Pri 4 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 4, Moderate, Incident Ticket Response	  	IO Service Now SLA69 - Measures Response TAT for Sev Pri 4 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-12	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	Severity 5, Low, Incident Ticket Resolution	  	IO Service Now SLA70 - Measures Resolution TAT for Sev Pri 5 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 5, Low, Incident Ticket Response	  	IO Service Now SLA71 - Measures Response TAT for Sev Pri 5 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Application Availability	  	IO Service Now SLA72 - Measures Application Availability without Client Impact (Intermittent until Amendment 4 BFS is implemented).	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Application Availability - Tier 1	  	AO SLA01 - Measures Application Availability for Critical Appls	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Application Availability - MiddleWare	  	AO SLA02 - Measures Application Availability for Middleware Apps	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Application Availability - Tier 2	  	AO SLA03 - Measures Application Availability for Non-Critical Apps	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Application Availability - Tier 3	  	AO SLA04 - Measures Application Availability for New Apps undergoing base lining	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P1 Problems- Response Time	  	AO SLA05 - Measures Response TAT for Prob Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P1 Problems- Resolution Time	  	AO SLA06 - Measures Resolution TAT for Prob Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P2 Problems- Response Time	  	AO SLA07 - Measures Response TAT for Prob Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-13	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	P2 Problems- Resolution Time	  	AO SLA08 - Measures Resolution TAT for Prob Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P3 Problems- Response Time	  	AO SLA09 - Measures Response TAT for Prob Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P3 Problems- Resolution Time	  	AO SLA10 - Measures Resolution TAT for Prob Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P4 Problems- Response Time	  	AO SLA11 - Measures Response TAT for Prob Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P4 Problems- Resolution Time	  	AO SLA12 - Measures Resolution TAT for Prob Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P1 Incidents- Response Time	  	AO SLA13 - Measures Response TAT for Incid Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P1 Incidents- Resolution Time	  	AO SLA14 - Measures Resolution TAT for Incid Pri 1 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P2 Incidents- Response Time	  	AO SLA15 - Measures Response TAT for Incid Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P2 Incidents- Resolution Time	  	AO SLA16 - Measures Resolution TAT for Incid Pri 2 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P3 Incidents- Response Time	  	AO SLA17 - Measures Response TAT for Incid Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P3 Incidents- Resolution Time	  	AO SLA18 - Measures Resolution TAT for Incid Pri 3 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P4 Incidents- Response Time	  	AO SLA19 - Measures Response TAT for Incid Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-14	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	P4 Incidents- Resolution Time	  	AO SLA20 - Measures Resolution TAT for Incid Pri 4 Remedy Tickets	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	 P1 Problems RCA
 Completion
	  	AO SLA21 - Measures Root Cause Analysis TAT for Prob Pri 1	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	 P2 Problems RCA
 Completion
	  	AO SLA22 - Measures Root Cause Analysis TAT for Prob Pri 2	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Repeating & Nuisance items (Quarterly)	  	AOSLA23 - Problems and Incidents which cause the most loss to associate work that Health Net has targeted for improvement.	  	Quarterly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	On-Time Batch Processing Ready to Run	  	AO SLA24 - Critical batch jobs ready to run at start of batch window	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P1 Service Request Completion Time	  	AO SLA25 - Percentage of Pri 1 SRs completed on time	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P2 Service Request Completion Time	  	AO SLA26 - Percentage of Pri 2 SRs completed on time	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P3 Service Request Completion Time	  	AO SLA27 - Percentage of Pri 3 SRs completed on time	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	P4 Service Request Completion Time	  	AO SLA28 - Percentage of Pri 4 SRs completed on time	  	Monthly	  	Active	  	Remedy	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-15	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	P5 Service Request Completion Time	  	AO SLA29 - Percentage of Pri 5 SRs completed on time	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Production backouts	  	AO SLA30 - Percentage of CMRs that were unsuccessful	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Unplanned Change Records	  	AO SLA31 - Percentage of total CMRs that were Unplanned	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Methodology Compliance Change Management	  	AO SLA32 - Percentage of CMRs that were implemented out of compliance (not following process, w/o CMR, w/o approvals, outside approved time, etc.).	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	Project Estimation Response	  	AO SLA33 - Provides the number of Project Estimates submitted to Health Net within 5 BD of acceptance of a Project Brief.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	Project Time to Schedule	  	AO SLA34 - Provides percentage of project schedules submitted on time.	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	 LOE Estimate Deviation - OOM
 (Projects)
	  	AO SLA35 - Rough Order of Magnitude deviation compared to initial Work Order.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	 LOE Estimate Deviation - ROM
 (Projects)
	  	AO SLA36 - Refined Order of Magnitude deviation compared to Requirements phase in PDLC.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	 LOE Estimate Deviation - DOM
 (Projects)
	  	AO SLA37 - Definitive Estimate deviation to Design Phase in PDLC.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	On-Time Delivery of Projects into Production	  	AO SLA40 - Measures project delivery against the scheduled date.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-16	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	Programmer Effectiveness	  	AO SLA48 - Measures the percentage of deliverables submitted to Health Net for UAT with no Programming Std Defects.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	Defect Rate in Production	  	AO SLA49 - Compares the number of defects to the effort expended for each deliverable/release.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	LOE Estimate Deviation Rough Order of Magnitude (ME)	  	AO SLA51 - Measures Deviation of Rough Order of Magnitude provided in the initial Project Brief for ME.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	On-Time Delivery of Minor Enhancements into Production	  	AO SLA52 - Measures completion of ME against scheduled completion date.	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	Satisfaction Surveys (Annual)	  	AO SLA53 - Measures Health Net Satisfaction for Vendor Service	  	Annually	  	Active	  	Survey Monkey	  	Health Net
							
	IT SLM Team	  	 LMS
 Compliance
	  	AO SLA54 - Measures percentage of LMS Course compliancy for AO Supplier associates.	  	Monthly	  	Active	  	LMS	  	Supplier
							
	IT SLM Team	  	QA Cost%	  	AO SLA55 - Measures the costs of a project and whether in came within a percentage of estimated costs.	  	Monthly	  	Active	  	QC, Manual Tracking	  	Supplier
							
	IT SLM Team	  	Functional Defect Removal Effectiveness (DRE) %	  	AO SLA56 - Measures the effectiveness in detection and removal of functional defects during all phases of PDLC.	  	Monthly	  	Active	  	QC	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-17	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	QA Schedule Variance %	  	AO SLA57 - Tracks project schedule and measures whether it came in within a percentage of estimated delivery.	  	Monthly	  	Active	  	QC, Manual Tracking	  	Supplier
							
	IT SLM Team	  	AA Privilege Access Reporting Compliance (PARC)	  	AO SLA58 - Percentage of Priv Access Admin Requests provisioned on time	  	Monthly	  	Active	  	Supplier Tracking	  	Supplier
							
	IT SLM Team	  	AA Privilege Access Reconciliation Compliance (PARC)	  	AO SLA59 - Percentage of Priv Access Admin removed within 72 hours.	  	Monthly	  	Active	  	Remedy	  	Supplier
							
	IT SLM Team	  	AA Business As Usual Turnaround Time	  	AO SLA60 - Percentage of Bus As Usual Acces Admin requests fulfilled within 5 Bus Days.	  	Monthly	  	Active	  	ISR	  	Supplier
							
	IT SLM Team	  	AA User-ID Termination	  	AO SLA61 - Measures the TAT and full completion for ISR Account Termination requests	  	Monthly	  	Active	  	ISR	  	Supplier
							
	IT SLM Team	  	Severity 1, Vital, Incident Ticket Resolution	  	AO Service Now SLA62 - Measures Resolution TAT for Sev Pri 1 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 1, Vital, Incident Ticket Response	  	AO Service Now SLA63 - Measures Response TAT for Sev Pri 1 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 2, Critical, Incident Ticket Resolution	  	AO Service Now SLA64 - Measures Resolution TAT for Sev Pri 2 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-18	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	Severity 2, Critical, Incident Ticket Response	  	AO Service Now SLA65 - Measures Response TAT for Sev Pri 2 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 3, High, Incident Ticket Resolution	  	AO Service Now SLA66 - Measures Resolution TAT for Sev Pri 3 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 3, High, Incident Ticket Response	  	AO Service Now SLA67 - Measures Response TAT for Sev Pri 3 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 4, Moderate, Incident Ticket Resolution	  	AO Service Now SLA68 - Measures Resolution TAT for Sev Pri 4 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 4, Moderate, Incident Ticket Response	  	AO Service Now SLA69 - Measures Response TAT for Sev Pri 4 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 5, Low, Incident Ticket Resolution	  	AO Service Now SLA70 - Measures Resolution TAT for Sev Pri 5 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	Severity 5, Low, Incident Ticket Response	  	AO Service Now SLA71 - Measures Response TAT for Sev Pri 5 Service Now Tickets	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-19	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	Application Availability	  	AO Service Now SLA72 - Measures Application Availability without Client Impact (Intermittent until Amendment 4 BFS is implemented).	  	Monthly	  	Active	  	Service Now	  	Service Now / Health Net
							
	IT SLM Team	  	AA Emergency ID Termination	  	AO SLA73 - Measures TAT for ID Termination requests from OE	  	Monthly	  	Active	  	ISR	  	Supplier
							
	IT SLM Team	  	AA Open Inventory	  	AO SLA74 - Measures AA Requests Backlog	  	Monthly	  	Active	  	ISR	  	Supplier
							
	IT SLM Team	  	Communication Link Availability	  	SA SLA01 - Measures Availability of Supplier Network	  	Monthly	  	Active	  	Supplier, Remedy	  	Supplier
							
	IT SLM Team	  	Monthly Proj Milestone and Deliverable Status Rpt	  	SA SLA02 - Measures TAT of Report for Project Deliverable Status	  	Monthly	  	Active	  	Supplier, PMO	  	Supplier
							
	IT SLM Team	  	QA Cost	  	SA SLA03 - Measures the costs of a project and whether in came within a percentage of estimated costs.	  	Monthly	  	Active	  	QC, Manual Tracking	  	Supplier
							
	IT SLM Team	  	Defect Removal Effectiveness Percentage	  	SA SLA04 - Measures the effectiveness in detection and removal of functional defects during all phases of PDLC.	  	Monthly	  	Active	  	QC	  	Supplier
							
	IT SLM Team	  	QA Sched Variance Percentage	  	SA SLA05 - Tracks project schedule and measures whether it came in within a percentage of estimated delivery.	  	Monthly	  	Active	  	QC, Manual Tracking	  	Supplier
							
	IT SLM Team	  	Intake Transactions from Exchgs	  	hC SLA01 - Measures TAT for transaction delivery from Exchange	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Transmit Exchgs Ack	  	hC SLA02 - Measures Exchange Transactions Acknowledgement	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-20	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	IT SLM Team	  	Transmit Trans to Health Net (24 hr window)	  	hC SLA03 - Measures transactions received at Health Net within TAT window	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Transmit Health Net Trans to exchg in 24 Hrs	  	hC SLA04 - Measures Health Net Transactions back to Exchange within TAT window	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Supplier Process Trans Backlog	  	hC SLA05 - Number of transactions in backlog	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	File Server	  	hC SLA06 - Measures Server Availability	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Database Server	  	hC SLA07 - Measures Server Availability	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Business Process Server	  	hC SLA08 - Measures Server Availability	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Web Server (UI)	  	hC SLA09 - Measures Server Availability	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Average vs. Aggregate Total*	  	hC SLA10 - Overall Server Availability	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Class 1 - (15) Minute Response Time	  	hC SLA11 - Measures Response TAT for Pri 1 tickets	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Class 2 - (2) Hr Response Time	  	hC SLA12 - Measures Response TAT for Pri 2 tickets	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	Monthly Reporting	  	hC OPN01 - Defect Trends - Last Three Months (Info Only)	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net
							
	IT SLM Team	  	SaaS Application Recovery	  	hC OPN02 - Re-Open Rate (Info Only)	  	Monthly	  	Active	  	h-Centive	  	h-Centive and Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-1-21	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PMO	  	Internal Audit Manager Rpt	  	provides audit scores and remediation results	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	 IBM WO/PCR
 Log
	  	WO life cycle - TAT’s	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	Supplier Aged WO	  	WO life cycle - TAT’s	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	IBM Time Rpt	  	All project hours that are entered into PV	  	Monthly	  	Active	  		  	IBM
							
	PMO	  	Health Net Resource Estimates for Project / Programs	  	Health Net PM’s to provide manual # of resources and hours needed by dept/role	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	Supplier Timesheets	  	list of late timesheets that require Health Net PM approval	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	 IBM RFS
 Portfolio Status Rpt
	  	status of RFS	  	Weekly	  	Active	  		  	IBM
							
	PMO	  	Bi Weekly PM Project Status Rpt	  	projects status rpt to project stakeholder	  	Bi Weekly	  	Active	  		  	Health Net
							
	PMO	  	Project Status Report	  	projects status rpt to Health Net PM	  	Weekly	  	Active	  		  	IBM
							
	PMO	  	Minor Enhancement - Supplier	  	master list of all minor enhancements / status	  	Weekly	  	Active	  		  	Health Net
							
	PMO	  	Current DR PIDs	  	status pf RFS DR PIDs	  	Weekly	  	Active	  		  	IBM
							
	PMO	  	Minor Enhancements - IBM	  	master list of all minor enhancements / status	  	Weekly	  	Active	  		  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-1-22	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Web	  	 Prv_NextGen_
 <DATE>.xlsx
	  	Monthly report of Healthnet.com Provider portal activity	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb, ODW	  	Health Net
							
	Web	  	 Provider_Regis tration.<DATE

>.xlsx
	  	Monthly report of all provider registration by type	  	Monthly	  	Active	  	TR, HNWeb, ODW	  	Health Net
							
	Web	  	 Mbr_NextGen_
 <DATE>.xlsx
	  	Monthly report of Healthnet.com Member portal activity	  	Monthly	  	Active	  	 HNWeb TR
 SiteCatalyst ODW

ABS (EDD Group Pref File)
	  	Health Net
							
	Web	  	 Member_Regis tration_<DATE
 >.pdf
	  	Monthly report of all member registration by LOB	  	Monthly	  	Active	  	TR, HNWeb	  	Health Net
							
	Web	  	Employer_Web Metrics_<DAT E>.xlsx	  	Monthly report of Healthnet.com Employer portal activity	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net
							
	Web	  	 Broker_WebM etrics_<DATE
 >.xlsx
	  	Monthly report of Healthnet.com Broker portal activity	  	Monthly	  	Active	  	 Adobe Site Catalyst, TR, HNWeb,

Connecture
	  	Health Net
							
	Web	  	StaterBros_<D ATE>.pdf	  	Monthly activity report for employer group: Stater Bros	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net
							
	Web	  	 CVS_<DATE>
 .pdf
	  	Monthly activity report for employer group: CVS	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net
							
	Web	  	UC_Web_Rep ort_<DATE>.xls	  	Monthly activity report for employer group: UC	  	Monthly / Quarterly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net
							
	Web	  	Raytheon_<DA TE>.pdf	  	Monthly activity report for employer group: Raytheon	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-23	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Web	  	SCE_Web_Usage
_<Q>_<YE AR>.xls	  	Quarterly web usage/activity report for employer group: SCE	  	Quarterly	  	Active	  	Adobe Site Catalyst, TR, HNWeb	  	Health Net
							
	Web	  	 Medicare-
SNP_<DAtE>.
 pdf
	  	Monthly report of Medicare SNP registration	  	Monthly	  	Active	  	TR, HNWeb	  	Health Net
							
	Web	  	Boeing_Web_
Adoption_<DATE>.pdf	  	Monthly activity report and electronic document distribution report for employer group: Boeing	  	Monthly	  	Active	  	TR, HNWeb	  	Health Net
							
	Web	  	 EDD_<DATE>
 .pdf
	  	Monthly activity report on member opt-ins for electronic document distribution	  	Monthly	  	Active	  	TR, HNWeb	  	Health Net
							
	Web	  	Member_Registered
_Optin_<DATE>.xlsx	  	Monthly report of registered emails that opt-in for marketing communications	  	Monthly	  	Active	  	TR, HNWeb	  	Health Net
							
	Web	  	 AON Microsite
 <NEW>
	  	Monthly activity report for the AON Hewitt microsite	  	Monthly	  	Active	  	Adobe Site Catalyst	  	Health Net
							
	Web	  	 AZ_HOSPITAL_
GROUP_WEBUSAGE.JU

N2014.xlsx
	  	Monthly activity report on AZ Hospitals	  	Monthly	  	Active	  	Adobe Site Catalyst, HNWeb	  	Health Net
							
	Web	  	CA_PrisonStaff_
ProviderSearch
_JUL2014.xlsx	  	Monthly Provider Search activity report for CA Prisons	  	Monthly	  	Active	  	Adobe Site Catalyst, HNWeb	  	Health Net
							
	Web	  	bkr_BookOfBusiness.
<DATE>.xlsx	  	Monthly activity report on Broker Book of Business	  	Monthly	  	Active	  	Adobe Site Catalyst, HNWeb	  	Health Net
							
	Web	  	Broker Book of Business - Broker Detail	  	Monthly detailed activity report on Broker Book of Business broken out by Broker	  	Monthly	  	Active	  	Adobe Site Catalyst, HNWeb,TR	  	Health Net
							
	Web	  	CMS CTM Form	  	Monthly report on activity of CMS-CTM form	  	Monthly	  	Active	  	Adobe Site Catalyst	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-24	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	Web	  	WebAuthRqst Rpt.<DATE>.xlsx	  	Monthly activity report on Web authorization request	  	Monthly	  	Active	  	HNWeb	  	Health Net
							
	Web	  	Mobile Apps	  	Activity report on broker mobile apps usage	  	Monthly	  	Active	  	Adobe Site Catalyst, HNWeb	  	Health Net
							
	Web	  	QI Medicare Advantage Email List	  	Monthly report of MA email addresses	  	Monthly	  	Active	  	HNWeb, TR	  	Health Net
							
	Web	  	CCC_EMailOp tin_<DATA>.xls	  	Monthly report of members with email opt-in	  	Monthly	  	Active	  	HNWeb, TR	  	Health Net
							
	Web	  	Duals MediConnect Enroll & Registration	  	Weekly list of enrolled Duals members, month to date registrations. Year-to-Date registrations produced monthly	  	Weekly, Monthly	  	Active	  	HNWeb, TR	  	Health Net
							
	Web	  	 QA AZ
 Medicaid email list
	  	Monthly list of AZ Medicaid email opt-ins	  	Monthly	  	Active	  	HNWeb, TR	  	Health Net
							
	Web	  	IEX email list	  	ACA member email list by region	  	Monthly	  	Active	  	HNWeb, TR	  	Health Net
							
	Web	  	 QI PDF
 downloads
	  	Monthly report of al QI pdf’s that were downloaded	  	Monthly	  	Active	  	Adobe Site Catalyst	  	Health Net
							
	Web	  	PMR - CA SHP	  	Monthly metrics provided for PMRs	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb, ODW	  	Health Net
							
	Web	  	 PMR -
 Commercial
	  	Monthly metrics provided for PMRs	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb, ODW	  	Health Net
							
	Web	  	 PMR -
 Medicare
	  	Monthly metrics provided for PMRs	  	Monthly	  	Active	  	Adobe Site Catalyst, TR, HNWeb, ODW	  	Health Net
							
	Change Management	  	Infrastructure Significant Risk Changes	  	Provides a schedule of (high) risk changes	  	Weekly	  	Active	  	Manual	  	HNT

  

					
	Schedule G-3 (Management Reports)	  	G-3-25	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	Change Management	  	CAB (Change Advisory Board) Report	  	Lists all upcoming changes of impact/risk. Used for Change Review Meeting	  	Twice-a- week (Fri/Wed)	  	Active	  	Remedy	  	HNT
							
	Change Management	  	Change Report	  	Lists all scheduled changes for next 24 (Mon-Thu) or 72 (Fri) hours	  	Daily	  	Active	  	Remedy	  	HNT
							
	Change Management	  	Change Management Activity Metrics	  	Provides change management performance against KPI’s	  	Monthly	  	Active	  	Remedy	  	HNT
							
	Change Management	  	Urgent Changes	  	Provides a list of Urgent Changes (Unplanned and Emergency) over past 24 (Tue - Fri) or 72 (Mon) hours	  	Daily	  	Active	  	Remedy	  	HNT
							
	Change Management	  	System Availability Matrix	  	Provides a list of services and any scheduled unavailability for the weekend	  	Weekly	  	Active	  	Manual	  	HNT
							
	Change Management	  	Servers, Services, Sites, and Databases	  	Provides inventory and (change management) related attributes for services, servers, sites, and databases	  	Monthly	  	Active	  	Manual	  	HNT
							
	ITG QA	  	QA Daily Dashboard, Issues Log, Catch-Up Plans	  	All projects being tested by QA or UAT provide status, deviation, defects, etc.	  	Daily	  	Active	  	Quality Center	  	Supplier
							
	ITG QA	  	Readiness Tracker	  	All projects with approved WO or SR to provide status of pre QA artifact readiness to know if testing can start	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	Assignment Tracker	  	All approved projects assigned to member of the HNQA team, along with key milestones and endorsements	  	Daily	  	Active	  	Excel	  	Health Net
							
	ITG QA	  	Enterprise Project Listing (EPL)	  	All known projects in the enterprise	  	Weekly	  	Active	  	PlanView	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-26	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	ITG QA	  	Health Net Enterprise Release Portfolio	  	All approved projects along with release mgt key milestones and states	  	Weekly	  	Active	  	PlanView, Access DB	  	Health Net
							
	ITG QA	  	Monthly Deployment Report	  	All portfolio projects released into production during the month	  	Weekly	  	Active	  	PlanView, Access DB	  	Health Net
							
	ITG QA	  	Remedy Ticket Report	  	All production defects found during the week attributable to portfolio work (warranty defects)	  	Weekly	  	Active	  	Remedy	  	Health Net
							
	ITG QA	  	Pre-WO (work order) Report	  	All approved portfolio projects that don’t yet have an approved WO from Supplier, to track progress towards WO	  	Daily	  	Active	  	PlanView, Excel	  	Supplier
							
	ITG QA	  	Performance tracker	  	All projects with approved WO that have performance testing, to track progress	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	Defect Cause Analysis (DCA)	  	All post-QA defects closed during previous week to analyze to understand how QA missed them and how to correct/prevent in the future	  	Weekly	  	Active	  	Quality Center	  	Supplier
							
	ITG QA	  	QA Metrics Report	  	Report for all projects that went live the previous month including all QA SLAs and KPIs	  	Monthly	  	Active	  	Quality Center, PlanView, QA Trackers and Dashboards	  	Supplier
							
	ITG QA	  	QA Monthly Governance Report	  	Summarizes the TCOE performance for the previous month, including metrics, DCA status and strategic initiative progress	  	Monthly	  	Active	  	Quality Center, PlanView, QA Trackers and Dashboards	  	Supplier
							
	ITG QA	  	QA Quarterly Executive Governance Report	  	Summarizes the TCOE performance for the previous quarter including metrics, DCA status and strategic initiative progress	  	Quarterly	  	Active	  	Quality Center, PlanView, QA Trackers and	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-27	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	ITG QA	  	QA Strategic Initiatives Reports	  	Status for each strategic initiative	  	Weekly	  	Active	  		  	Supplier
							
	ITG QA	  	QCOE Exec Dashboard	  	Executive view of QA activities	  	Daily	  	Active	  	QA Trackers and Dashboards	  	Health Net
							
	ITG QA	  	CR Tracker	  	Logs key information about all CRs that impact testing for all in-flight projects	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	Schedule Delay tracker	  	Logs key information about non-Supplier delays that impact performance - used to calc metrics	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	 QA/UAT
 overlap tracker
	  	Coordinates testing between QA and UAT teams when those phases overlap	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	Walk Through tracker	  	Logs each walk through required to achieve artifact endorsement—used for metrics	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	 QA
 Endorsement tracker
	  	Tracks all endorsements needed for each artifact to ensure readiness for QA approval	  	Daily	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	Exception Tracker (list of PIDs where process/waiver exceptions have been made)	  	Log of all exceptions granted to TCOE to not follow process along with justification	  	Daily	  	Active	  	Excel	  	Health Net
							
	ITG QA	  	Resource Capacity Tracker	  	Used to track number of projects assigned to team for demand capacity analysis	  	Weekly	  	Active	  	Excel	  	Health Net
							
	ITG QA	  	Defect Report	  	All open defects in QA	  	Daily	  	Active	  	Quality Center	  	Supplier

  

					
	Schedule G-3 (Management Reports)	  	G-3-28	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	ITG QA	  	External Capital Labor (ECL) Report	  	All costs associated with QA labor	  	Monthly	  	Active	  	PlanView	  	Supplier
							
	ITG QA	  	 Web Preview
 & Release Calendar
	  	Prep for web monthly release	  	Monthly	  	Active	  		  	Health Net
							
	ITG QA	  	Action Item tracker	  	Governance tracker to keep management teams apprised of all commitments and progress	  	Weekly	  	Active	  	Excel	  	Supplier
							
	ITG QA	  	MOV file report	  	Used to determine the contents of the move file, and if the gen # is the correct one	  	Weekly	  	Active	  		  	Supplier
							
	Production Support	  	Daily Report Card	  	List of daily PP1/P2 tickets, excluding Job Failures	  	Daily	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	Weekly Report Card	  	List of P1/P2 Tickets for major outages	  	Weekly	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	Weekly Ticket Statistics	  	Ticket Trending Reports and charts	  	Weekly	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	Monthly Ticket Statistics	  	Ticket Trending Reports and charts	  	Monthly	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	All Open Tickets Report	  	List of all currently open tickets as of the day it is run	  	Daily	  	Active	  	Remedy	  	Supplier
							
	Production Support	  	Aged Tickets Report	  	List of all open tickets ages as of day it is run	  	Daily	  	Active	  	Remedy	  	Supplier
							
	Production Support	  	HNFS Weekly Service Review	  	List of P1/P2 Tickets for major outages—HNFS	  	Weekly	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	Daily Operations Review Report	  	List of P1/P2 tickets from the last 24 hours for review during 7:30 meeting	  	Daily	  	Active	  	Remedy	  	IBM
							
	Production Support	  	Weekly Problem Management Report	  	List of open problems requiring root cause and/or follow-up Management Report	  	Weekly	  	Active	  	Lotus Notes Action Item DB	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-29	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	Production Support	  	Daily Patrol Reports	  	List of ticket used to determine and track new problems	  	Daily	  	Active	  	Remedy	  	Health Net
							
	Production Support	  	Care Radius Exec Report	  	Weekly status to Executives on Care Radius performance/availability, issues, Mes, Open tickets	  	Weekly	  	Active	  	Remedy	  	Health Net/Supplier
							
	Production Support	  	Care Radius Working Group Report	  	Weekly status to working group on Care Radius performance/availability, issues, Mes, Open tickets	  	Weekly	  	Active	  	Remedy	  	Health Net/Supplier
							
	Production Support	  	IW070	  	 Federal Services Contract Deliverable - 95% of all calls to IT Help Desk from Government customer users resolved in accordance with IT Issue
Resolution Guidelines.
  
 Specification control managed by HNFS Access to Data
owner
	  	Monthly / Quarterly	  	Active	  	Remedy, final report submitted to HNFS IW via controlled upload by FS Domain associate	  	Jimmie K Ramos
							
	Production Support	  	IW010	  	 Federal Services Contract Deliverable - Federal services Data Warehouse accessible during at least 99% of all available hours (7 am-9pm ET
Monday-Saturday) except periods of scheduled, non-routine maintenance (minimum 24-hour notice).
  

Specification control managed by HNFS Access to Data owner
	  	Monthly / Quarterly	  	Active	  	Remedy, Keynote, final report submitted to HNFS IW via controlled upload by FS Domain associate	  	Jimmie K Ramos

  

					
	Schedule G-3 (Management Reports)	  	G-3-30	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	Production Support	  	IW020	  	 Federal Services Contract Deliverable—The agreed upon access interface for Government users (www.hnfs.com) will be accessible during at
least 99% of all available hours 24 X 7 except periods of scheduled maintenance (minimum 24-hour notice).
  

Specification control managed by HNFS Access to Data owner
	  	Monthly / Quarterly	  	Active	  	Remedy, Keynote, final report submitted to HNFS IW via controlled upload by FS Domain associate	  	Jimmie K Ramos
							
	Production Support	  	Federal Services Standards - Ticket Acknowledgem ent and resolution SLA	  	Simple report used to prepare IW070	  	Ad hoc	  	Active	  	Remedy	  	Health Net user via Remedy
							
	Production Support	  	Aged Tickets Report	  	List of Tickets older than 7 days, including breakdown by month and by resolver group	  	Daily	  	Active	  	Remedy	  	Offshore Staff Aug (Supplier)
							
	Production Support	  	All Open Tickets All Queues	  	List of All Open Tickets, including break down by month, vendor, and by rsolver group	  	Daily	  	Active	  	Remedy	  	Offshore Staff Aug (Supplier)
							
	Production Support	  	All Open Tickets with Pend Reason	  	List of All Open Tickets in Pending Status and Pend Reason	  	Daily	  	Active	  	Remedy	  	Offshore Staff Aug (Supplier)
							
	Production Support	  	H0007	  	Annual Disaster Recovery Test Report for Health Net Federal Services TRICARE	  	Annually	  	Active	  	Generated as a Word document by the owner and submitted to HNFS Government contracts NLT ten days after completion of the annual DR test	  	Jimmie K Ramos

  

					
	Schedule G-3 (Management Reports)	  	G-3-31	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Production Support	  	HI007	  	Annual Disaster Recovery Test Report for PGBA LLC	  	Annually	  	Active	  	Generated as a Word document by the owner and submitted to HNFS Government contracts NLT ten days after completion of the annual DR test	  	PGBA IS
							
	Access Administration	  	Health Net Monthly Capitation SOX Reporting	  	 Privilege access reports based on system:

PRVCAPU
 PRVRPTU

PRV_CAP_AUTH
 SPCAP
	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	Health Net Monthly Claims SOX Reporting	  	CLMEXAM, CLMQC, CLMSR, CLMACC, PAYPARMNT, VENINQ1, VENINQ2, VENINQ3, VENINQ4, CLOVRSUP, REFOVRPRC, CLMPDR. PAYHSTMNT, COBMNT, COBHNMNT, VCOBHNINQ, COBHNINQ, VHNCLMINQ, HNCLMINQ, HNCLMEXAM	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	 Health Net Monthly PDM
 & Config SOX
Reporting
	  	CLPRVUPD, PHYINFOU, PRVINFOU, NPISRCHU, CLSUFX2, PRVNCPU, CLMODUPD, CLSCHUPD, CLMCLK	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	 Health Net Monthly Policy
 & Benefit Reporting
ABS
	  	CLSVCRES, CLTRMAPU, ELIG_ADDL, CARRY_4THQTR, BENVRDEF, BENLSDEF, CLSVMAPU, MED_BENEFIT, POS_BENEFITS	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	 Health Net Monthly Policy
 & Benefit Reporting
SysGem
	  	 HSI_DB_DELETE and BEN_VAR_LMT_UPDATE
 Agent/Group:
ALPHA PRD
	  	Monthly	  	Active	  		  	IBM -Access Admin

  

					
	Schedule G-3 (Management Reports)	  	G-3-32	  	Health Net / Cognizant Confidential

 Final 

													
	 Department

Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Access Administration	  	 Health Net Monthly SOP VMS
 Reporting
SysGem
	  	 Report identifiers: SOP_CREATOR and SOP_READ_ONLY

Agent/Group: ALPHA PRD, DEV, DEVI64, DSS, EDIAXP, FTP, ODS, PCMRC2, UAT AMBERS, WOOKIE
	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	Health Net Monthly User Master Listing SOX Reporting	  	USER_MASTER_EXP_FLAT_FILE	  	Monthly	  	Active	  		  	IBM -Access Admin
							
	Access Administration	  	Health Net Weekly SOX Reporting	  	 PMGCNM, PMGCNDM, PMGCMAINT, CLSCM, CLFNPLM, PCSLUPD, PROMUPD, NFEEUPD, CLMEXAM,

Sandy Hess - SOX monthly and quarterly revalidation
	  	Weekly	  	Active	  		  	IBM -Access Admin
							
	PSOTS	  	Oracle Governance Deck	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Bi-Monthly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	Oracle Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	 SQL
 Governance Deck
	  	IBM DECs for Covernance Call(Overall health of the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)	  	Bi-Monthly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	SQL Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	SQL Tower Governance	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Weekly	  	Active	  	HPSE, SAN Team, SRM	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-33	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	Daily Trend Report	  	SQL Server Capacity Report	  	Monthly	  	Active	  	SRM	  	IBM
							
	PSOTS	  	Database Last Access	  	List of databases not written to or read from for over 30 days	  	Monthly	  	Active	  	http://bld-poc-sp01:85/	  	Health Net
							
	PSOTS	  	Database Instance Overview	  	Displays SGA information and non-default initialization parameters for an Oracle Database.	  	Monthly	  	Active	  	OEM 12c	  	Health Net
							
	PSOTS	  	Database Software Summary	  	Displays software summary across all Oracle Databases.	  	Monthly	  	Active	  	OEM 12c	  	Health Net
							
	PSOTS	  	Database by Server	  	This report provides a list of SQL servers with a count of databases hosted by them.	  	As needed	  	Active	  	Altiris	  	Health Net
							
	PSOTS	  	SQL Server Cluster Configuration Summary	  	Summary information of SQL Server and associated SQL Instances participating in a Microsoft Cluster by Node.	  	As needed	  	Active	  	Altiris	  	Health Net
							
	PSOTS	  	Oracle Database Tablespace Monthly Space Usage	  	Oracle Database Tablespace Monthly Space Usage	  	Monthly	  	Active	  	OEM 12c	  	Health Net
							
	PSOTS	  	Daily Backup Report	  	TSM daily/monthly backup failure	  	Daily	  	Active	  	BUR	  	IBM
							
	PSOTS	  	 BUR
 Governance Deck
	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Weekly	  	Active	  	 SRM, Project Logs, ME Logs, TSM,
 Remedy
	  	IBM
							
	PSOTS	  	BUR Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	 SRM, Project Logs, ME Logs, TSM,
 Remedy
	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-34	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	SAN Tower Governance	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	SAN Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	Health Net BUR Monthly Capacity Reporting	  	Month backup capacity	  	Monthly	  	Active	  	TSM	  	IBM
							
	PSOTS	  	Organic Storage Growth	  	Organic Growth request	  	Weekly	  	Active	  	SAN	  	IBM
							
	PSOTS	  	Array Centric Report - NetApp	  	Capacity of Netapp	  	Weekly	  	Active	  	HPSE	  	IBM
							
	PSOTS	  	Array Centric Report - IBM SVC	  	Capacity of SVC	  	Weekly	  	Active	  	HPSE	  	IBM
							
	PSOTS	  	Storage Capacity Detail	  	Capacity of HP XP arrays	  	Weekly	  	Active	  	HPSE	  	IBM
							
	PSOTS	  	SVR_IBM_He althNet	  	HP service value monthly report of cases with HP	  	Monthly	  	Active	  	SAN/VMS	  	HP
							
	PSOTS	  	System Listing	  	List of all HealthNet SAN/VMS equipment from HP	  	Monthly	  	Active	  	SAN/VMS	  	HP
							
	PSOTS	  	ISP Project Management Plan SAN	  	SAN ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM
							
	PSOTS	  	 ISP WS BURR PP
 Deliverables
	  	BUR ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-35	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	ISP Project Management Plan Capacity	  	Capacity ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM
							
	PSOTS	  	ISP Project Management Plan Oracle	  	Oracle ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM
							
	PSOTS	  	ISP Project Management Plan SQL	  	SQL ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM
							
	PSOTS	  	ISP Project Management Plan Citrix	  	Citrix ISP Initiatives	  	Weekly	  	Active	  	Various sources, manual input	  	IBM
							
	PSOTS	  	 UNIX
 Governance Deck
	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, TSM, Remedy	  	IBM
							
	PSOTS	  	UNIX Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, TSM, Remedy	  	IBM
							
	PSOTS	  	Single Trusted Source	  	Inventory Report of all Servers	  	Monthly	  	Active	  	Manual	  	IBM
							
	PSOTS	  	Wintel/VMWar e/Citrix Governance Deck	  	 IBM DECs for Covernance Call
 (Overall health of
the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments, etc.)
	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	Wintel Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	VMWare Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-36	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	Citrix Cadence Tracker	  	IBM Tracker for Capacity Issues, Performance Issues, Others Issues, Risks, Projects, Systems Stability Checks, etc.	  	Weekly	  	Active	  	SRM, Project Logs, ME Logs, Remedy	  	IBM
							
	PSOTS	  	Citrix XenDesktops Monthly Utilization Forecast_Begin MonthYear - EndMonthYear	  	6-month rolling utilization forecasts of XenDesktops	  	Monthly	  	Active	  	Manual	  	IBM, Supplier, HP Health Net consolidates
							
	PSOTS	  	Citrix XenDesktops Monthly RU Counts	  	Monthly RU Counts by XenApp Pools	  	Monthly	  	Active	  	Manual	  	 IBM
 Health Net Consolidates

							
	PSOTS	  	Citrix XenDesktop Monthly New User Report	  	List of New XenDektop Users	  	Monthly	  	Active	  	Manual	  	IBMHN Consolidates
							
	PSOTS	  	Network Governance Deck	  	Tower overview, Risk Mitigation, Tower Reports/Metrics, Reviewed major incidents, RCA Review, Issues, Accomplishments	  	Bi-Monthly	  	Active	  	 AT&T
 (NetQOs/VitalNet/etc.)
	  	IBM/AT&T
							
	PSOTS	  	HealthNet Monthly Traffic Report	  	Monthly traffic report	  	Monthly	  	Active	  	 AT&T
 (NetQOs/VitalNet/etc.)
	  	AT&T
							
	PSOTS	  	Data Network Availability Report	  	Monthly availability report	  	Monthly	  	Active	  	 AT&T
 (NetQOs/VitalNet/etc.)
	  	AT&T
							
	PSOTS	  	HealthNet Monthly Device Report	  	Monthly device report	  	Monthly	  	Active	  	 AT&T
 (NetQOs/VitalNet/etc.)
	  	AT&T

  

					
	Schedule G-3 (Management Reports)	  	G-3-37	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	 HealthNet Monthly
 Network Performance

Analysis
	  	Monthly network performance report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 HealthNet Monthly Performance
 Exception
Report
	  	Monthly exception report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 Network Device
 Inventory (Routers

Switches Other)
	  	Device inventory	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 IMAC
 Activity
	  		  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
		  		  		  		  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	
							
	PSOTS	  	 OP142- ACD_Total_Voice_
 Availability
	  	OP142 ACD total voice availability report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 HNFS_Aspect_ ACD- Total_Voice_

Availability
	  	HNFS Aspect ACD total voice availability report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	IMAC Monthly Totals 2013	  	IMAC Monthly Totals 2014	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T

  

					
	Schedule G-3 (Management Reports)	  	G-3-38	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	NORTEL Agent	  	NORTEL Agent	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	NORTEL PBX RU COUNT	  	NORTEL PBX RU COUNT	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 OP141- PBX_Total_
 Voice_Availability
	  	OP141 PBX total voice availability report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 COMPLETED
 RUs
	  	COMPLETED RUs	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	Rockwell ACD Agents by location	  	Rockwell ACD Agents by location	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 SL032- Total_Voice_
 Availability
	  	SL032 total voice availability	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 Aspect_ACD- Total_Voice_
 Availability
	  	Aspect ACD total voice availability report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	 Symposium_A CD-Total_Voice_
 Availability
	  	Symposium ACD total voice availability report	  	Monthly	  	Active	  	AT&T (NetQOs/VitalNet/etc.)	  	AT&T
							
	PSOTS	  	MiddleWare/E mail Services/ETC Governance Deck	  	Overall health of the infrastructure tower including metrics, aging tickets, risk mitigations, accomplishments	  	Bi-Monthly	  	Active	  	SRM, Project Logs, ME Logs, TSM	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-39	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	UNIX Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	Wintel/VMWare Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	Citrix Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	Oracle Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	SQL Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	 SAN/BUR
 Road Map Prioritization/Tracker
	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	MiddleWare Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM & Health Net
							
	PSOTS	  	Network Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net, AT&T

  

					
	Schedule G-3 (Management Reports)	  	G-3-40	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	UNIX Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	PSOTS	  	Wintel/VMWar e Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	PSOTS	  	Oracle Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	PSOTS	  	SQL Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	PSOTS	  	 SAN/BUR
 Systems Stability Checks Findings and
Remediations
	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	PSOTS	  	MiddleWare Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-41	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	PSOTS	  	Network Systems Stability Checks Findings and Remediations	  	Quarterly Findings& Monthly Tracker for Systems Stability Remediations	  	Monthly	  	Active	  	Various sources, manual input	  	IBM, Health Net
							
	ECPM	  	Capacity Road Map Prioritization/Tracker	  	Monthly Tracker for Road Map initiatives progress	  	Monthly	  	Active	  	Various sources, manual input	  	IBM
							
	ECPM	  	Treesize	  	Current size of all Commercial File & Print servers	  	Daily	  	Active	  	Wintel	  	IBM
							
	ECPM	  	File share diskstatus- Health Net- (Date)	  	Current amount of usable free space on all Commercial servers	  	Weekly	  	Active	  	Wintel	  	IBM
							
	ECPM	  	File share diskstatus- HNFS-(Date)	  	Current amount of usable free space on all Federal servers	  	Weekly	  	Active	  	Wintel	  	IBM
							
	ECPM	  	HealthNet Weekly Red Server Analysis WE(date)	  	Those servers that are experiencing concerns with a number of issues . Some of which are Lack of collection, High Paging, High Utilization and others.	  	Weekly	  	Active	  	SRM	  	IBM
							
	ECPM	  	Health_NET Inc.-SRM Collection Status Final (Date)	  	Those servers that are experiencing concerns with collection	  	Weekly	  	Active	  	SRM	  	IBM
							
	ECPM	  	Small organic Storage tracker (date)	  	In Progress request concerning organic growth	  	Weekly	  	Active	  	email attachment - process has not been completed	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-42	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	ECPM	  	HealthnetFederal Distributed Systems Capacity planning monthly Report - (date)	  	This report is designed to provide a capacity status summary for Federal distributed systems based upon monthly average utilization of CPU, Memory and Disk related metrics.	  	Monthly	  	Active	  	SRM	  	IBM
							
	ECPM	  	Healthnet Commercial Distributed Systems Capacity planning monthly Report - (date)	  	This report is organized by Commercial or Federal and is separated by Unix or intel for Server Utilization, Capacity Utilization, FileSystem Utilization, LPAR Processor Utilization, LPAR Memory Utilization, LPAR Disk Utilization,
SRM Threshold Metrics, SRM Metric Definitions	  	Monthly	  	Active	  	SRM	  	IBM
							
	ECPM	  	Healthnet Mainframel Distributed Systems Capacity planning monthly Report - (date)	  	Mainframe Capacity Report	  	Monthly	  	Active	  	Resource Management Facility Tivoli Data Warehouse	  	IBM
							
	ECPM	  	PROD and DSS - Performance Graphs (various reports) - RED5, PRD_CLUSTE R, PRD_Online, PRD_Other, PROD_Batch, DSS_Weekends, DSS_Weekday s, CLUSTER, CAPWeekend_ TopQ_Vol	  	ABS/VMS Capacity Report	  	Monthly	  	Active	  	HP Performance Advisor	  	IBM

  

					
	Schedule G-3 (Management Reports)	  	G-3-43	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	ECPM	  	 ECPM -
 Infrastructure Capacity Demand
Forecast
	  	High-level Infrastructure Capacity Forecast (12 month rolling forecast)	  	Monthly	  	Active	  	HP Performance Advisor	  	IBM
							
	ECPM	  	 ECPM -
 Infrastructure Capacity Demand Forecast by
PID
	  	High-level infrastructure Capacity Assessment	  	As Needed	  	Active	  	Manual	  	IBM
							
	PSOTS & ECPM	  	RFS Log - IBM	  	current RFS work and status	  	Monthly	  	Active	  	Manual	  	IBM
							
	Release management	  	HleathNet Enterprise Release Portfolio	  	Enterprise Project portfolio. Reviewed on the weekly PMO and Release Mngm meeting	  	Weekly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Release Approvers	  	Confirming accuracy of information	  	Ad hoc	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Business checkout resources	  	Confirming accuracy of information	  	Ad hoc	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Web Release projects for Merge	  	List of projects, Mes and QCs for Web release	  	Bi Weekly	  	Active	  	Release Mngm MS Access application	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-44	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Release management	  	Web Release projects Confirmed	  	List of projects, Mes and QCs for Web release	  	Bi Weekly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Release Summary projects deployed	  	List of projects deployed for Project Inrtake department	  	Bi Weekly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Release Sizzle	  	Public announcement for projects deployed	  	Monthly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Projects deployed by date	  	Projects deployed by date	  	Monthly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	WO Review and Confirmation Agenda	  	Agenda for WO review meeting	  	Weekly	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Projects at Risk	  	Part of the agenda for twice a week meeting	  	Twice a week	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Warranty Remedy tickets for Release	  	Posted on intranet report about warranty remedy tickets	  	Daily	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Release Metrics	  	Posted on intranet report about standart and project related metrics	  	Daily	  	Active	  	Release Mngm MS Access application	  	Health Net
							
	Release management	  	Business Communication Plan	  	Business Communication plan for deployment weekend	  	Monthly	  	Active	  	Manually compiled	  	Health Net
							
	Release management	  	Go Readiness presentation	  	Go Readiness presentation for approval to proceed with the release	  	Monthly	  	Active	  	Manually compiled	  	Health Net
							
	Release management	  	Go Live presentation	  	Go Live presentation for approval to proceed with the release	  	Monthly	  	Active	  	Manually compiled	  	Health Net

  

					
	Schedule G-3 (Management Reports)	  	G-3-45	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Release management	  	Go Live presentation	  	Go Live presentation for approval to proceed with the release	  	Monthly	  	Active	  	Manually compiled	  	Health Net
							
	Release management	  	Release Calendar	  	Release Calendar	  	Annually	  	Active	  	Manually compiled	  	Health Net
							
	Release management	  	Web Release Calendar	  	Web Release Calendar	  	Annually	  	Active	  	Manually compiled	  	Health Net
							
	QA-A&G	  	A&G BKB Accuracy Data (Processor)	  	Monthly Appeals and Grievances Accuracy Result Report (Processor)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	A&G BKB Accuracy Trends (Auditor)	  	Monthly Appeals and Grievances Accuracy Trends Report (Auditor)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	A&G BKB Accuracy Trends (Drilldown- Element)	  	Monthly Appeals and Grievances Accuracy Trends Report (Drilldown-Element)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	A&G BKB Accuracy Trends (Drilldown- Met Not Met)	  	Monthly Appeals and Grievances Accuracy Trends Report (Drilldown-Met Not Met)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	A&G BKB Accuracy Trends (Drilldown-Not Met)	  	Monthly Appeals and Grievances Accuracy Trends Report (Drilldown-Not Met)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	A&G BKB Accuracy Trends (Drilldown-Top N)	  	Monthly Appeals and Grievances Accuracy Trends Report (Drilldown-Top N)	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-46	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Drilldown- Work
Type)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Drilldown-Work Type)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Element)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Element)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Element-Top
3)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Element-Top 3)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Element-Top
N)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Element-Top N)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Processor)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Processor)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (State- Market
Segment)
	  	Monthly Appeals and Grievances Accuracy Trends Report (State-Market Segment)	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-47	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System
(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

							
	QA-A&G	  	 A&G BKB
 Accuracy Trends (Work Type)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Work Type)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Audit Data
	  	Monthly Appeals and Grievances All BKB Audit Data	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB AZ
 DOI Accuracy Trends
(Element)
	  	Monthly Appeals and Grievances Accuracy Trends Report (Element)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Error Detail (Element)
	  	Monthly Appeals and Grievances Error Detail Report (Element)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Regulatory Accuracy Trends
(Drilldown-Not Met)
	  	Monthly Appeals and Grievances Regulatory Accuracy Trends (Drilldown-Not Met)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 A&G BKB
 Regulatory Error Detail
(Drilldown-Not Met)
	  	Monthly Appeals and Grievances Regulatory Error Detail (Drilldown-Not Met)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	AZ - Pre-Post- Exp Appeals (HMO) Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	AZ Medicaid ACCESS Cases Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-48	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-A&G	  	BKB Sample	  	BKB Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 CA - External Review (HMO- POS-ELECT- PPO-MHN)

Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	CA Commercial POS (Pre, Post, Exp) Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 CA POS
 Appeals Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 CA PPO
 Exchange Appeals Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	CA-AZ-OR NCQA	  	Monthly NCQA Accuracy Report for Call Center (CA/AZ/OR)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 CA-Pre-Post- Exp (HMO)
 Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	CA-Pre-Post- Exp (Part C & Part D) Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 CA-Pre-Post- Exp (PPO -
 Behavior

Health) Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-49	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-A&G	  	 CA-Pre-Post- Exp (PPO -
 Non Behavior Health)
Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 Health Net
 SOX - IPC

Checklist_3869
	  	SOX In formation Prepared by Company Control Checklist - 3869	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	OR Medicare NCQA	  	Monthly Medicare Accuracy Report for Call Center (OR)	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 OR POS
 Exchange Appeals Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 OR/WA
 Commercial PRIME Sample
	  	OR/WA Commercial PRIME Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 OR/WA
 Commercial Sample
	  	OR/WA Commercial Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	 OR-WA - Pre-
 Post-Exp (Commercial)
Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	 OR-WA - Pre-
 Post-Exp (Part C & D)
Sample
	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-50	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-A&G	  	PBC Report	  	PBC report sent out to SOX	  	Yearly	  	Active	  		  	
							
	QA-A&G	  	Provider Dispute Sample	  	Provider Dispute Sample Created by the Monthly File Receive from MHN	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	SHP (Pre-Post- Exp) Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	SHP Medi-Cal Behavioral Cases Sample	  	NCQA Sample Created by the Monthly File Receive from A&G	  	Quarterly	  	Active	  		  	
							
	QA-A&G	  	SHP Prime Sample	  	SHP Prime Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	SHP Sample	  	SHP Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	Triage OR Commercial Prime Sample	  	BKB Sample Created by the Monthly File Receive from A&G	  	Monthly	  	Active	  		  	
							
	QA-A&G	  	Triage Sample	  	Triage Sample Created by the Monthly File Obtained From Maccess	  	Monthly	  	Active	  		  	
							
	 QA-A&G,
 Claims, Contact Center

& Medicare
	  	PMR Metrics	  	Metrics for Claims, A&G, Contact Center & Medicare	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-51	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 122839374
 Claims TAT Book of Business
Report
	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	2550.Adjudicat e and Settle Claims.Metrics	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	2550.Adjudicat e and Settle Claims.Populat ion Report	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	2550.Adjudicat e and Settle Claims.Screens hots	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	 3416
 Supporting Screenshots.docx
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 A&G BKB OR
 OID Accuracy Trends
(Element).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	AHCCCS_Clai msDashboardT emplate_201405.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 ATA BKB &
 PG Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-52	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	AZ - Part C Non-Par Provider Appeals_Dispu te_Dismissals Audit (PDRs) June2014_sam ples.xslsx	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 AZ DOI
 Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	AZPI Samples	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	CA - Part C Non-Par Provider Appeals_Dispu te_Dismissals Audit (PDRs) June2014_sam ples.xslsx	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 CA DMHC
 Commercial Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-QA	  	Claims ATA AZ	  	Claims ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-QA	  	Claims ATA CA OR MCL	  	Claims ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-53	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

							
	QA-QA	  	Claims ATA Grid	  	Claims ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-QA	  	Claims ATA PG	  	Claims ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Auto Error Data (Payment).xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Auto Error Data (Payment).xlsx	  	Claims QA Weekly Results Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	Claims Auto Error Data (Procedural).xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Auto Error Data (Procedural).xlsx	  	Claims QA Weekly Result Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Accuracy Trends (Mkt-Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Accuracy Trends (Mkt-Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims BKB AZ Accuracy Trends

(Processor).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-54	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB AZ Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ CS2 Error Data Year.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ CS2 Error Trends (Mkt- Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Supplier Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Supplier Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Supplier Audit Data Month.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Supplier Error Trends Payment.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-55	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health Net/IBM/
CTS)

							
	QA-Claims	  	Claims BKB AZ
Supplier Error
Trends
Procedural.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Supplier
Preliminary
Accuracy
Trends(Product).pdf	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Supplier
Preliminary Audit
Data.xlsx	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Error Data
(Payment).xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Error Detail
(Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Error Detail
(Payment-
Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ
Error Detail
(Payment-Top
10).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-56	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB AZ Error Detail (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Error Detail (Procedural- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Error Trends (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB AZ Error Trends (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Accuracy Trends (Mkt- Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-57	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims BKB CA
 Commercial Accuracy Trends (Comm
and HF).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Audit Data Month.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Error Trends Payment.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Error Trends Procedural.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Supplier Preliminary Accuracy Trends (Product).pdf	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-58	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB CA Supplier Preliminary Audit Data.xlsx	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Detail (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Detail (Payment- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Detail (Payment-Top 10).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Detail (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Detail (Procedural- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-59	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB CA Error Trends (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA Error Trends (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims BKB CA SHP
 Accuracy Trends
(Product).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA SHP Error Detail (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB CA SHP Error Detail (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB Commercial Accuracy Trends (State).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Accuracy Trends (Mkt- Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-60	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB OR Accuracy Trends (Mkt- Seg).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Audit Data Month.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-61	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB OR Supplier Error Trends Payment.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Error Trends Procedural.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Preliminary Accuracy Trends(Product ).pdf	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Supplier Preliminary Audit Data.xlsx	  	Claims QA Supplier Preliminary Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Detail (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Detail (Payment- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Detail (Payment-Top 10).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-62	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims BKB OR Error Detail (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Detail (Procedural- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Trends (Payment).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims BKB OR Error Trends (Procedural).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Error Data (Payment).xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI
 Accuracy Trends
(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ DOI Error Detail (Worksheet).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-63	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims Focus AZ Doi Error Trends (Worksheet).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Adjustment Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Adjustment Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Ambulance Non Contracted
Paid Denied Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Ambulance Non Contracted
Paid Denied Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Clean Claims Paid
Audit
 ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-64	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Clean Claims Paid Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 ER Denied Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 ER Denied Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 ER OON Paid Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 ER OON Paid Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Unclean Claims Denied
Audit
 ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-65	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department

Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	
IT Only -  System
(Data Resides)
	  	 IT Only - Who
Generates Report
(Health
Net/IBM/
CTS)

							
	QA-Claims	  	 Claims Focus AZ DOI HMO
 Unclean Claims Denied
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO
 Adjustment Audit
ATAt.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO
 Adjustment Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO
 Ambulance Non
Contracted Paid Denied Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO
 Ambulance Non
Contracted Paid Denied Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-66	  	 Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus AZ DOI POS
 PPO Clean Claims Paid
Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS
 PPO Clean Claims Paid
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO ER
 Denied Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS PPO ER
 Denied Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ DOI POS
 PPO Unclean Claims Denied
Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-67	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus AZ DOI POS
 PPO Unclean Claims Denied
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ Medicaid Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ Medicaid Error Detail Payment (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ Medicaid Error Detail Payment.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ Medicaid Error Detail Procedural (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ Medicaid Error Detail Procedural.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus AZ PI
 Accuracy
Trends.pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-68	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims Focus AZ PI Error Detail (Worksheet).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ PI Paid Audit Extract.xlsx	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus AZ PI Universe Count.xls	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA
 Commercial Accuracy Trends
(Product).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA
 Commercial Error Detail
Payment.pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA
 Commercial Error Detail
Procedural.pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Accuracy
Trends(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-69	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus CA DMHC
 CalViva Accuracy
Trends(Worksh eet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 CalViva Error Detail
(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 CalViva Error Trends
(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial Denied Claims
Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial Denied Claims
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial Interest Late
Payments Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-70	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial Interest Late
Payments Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial PDR Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Commercial PDR Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Error Detail
(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 Error Trends
(Worksheet).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-71	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Denied Claims (CalViva)
Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Denied Claims (CalViva)
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Denied Claims Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Denied Claims Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Interest Late Payments
(CalViva) Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-72	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Interest Late Payments
(CalViva) Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Interest Late Payments
Audit ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC
 SHP Interest Late Payments
Audit Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC SHP PDR
 (CalViva) Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC SHP PDR
 (CalViva) Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-73	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Claims Focus CA DMHC SHP PDR
 Audit
ATA.xlsx
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DMHC SHP PDR
 Audit
Extract.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DOI
 Commercial Interest Late
Payments EPO PPO Audit ATA.xls
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus CA DOI
 Commercial Interest Late
Payments EPO PPO Audit Extract.xls
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus Duals Accuracy Trends (Product).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus Duals Error Detail Payment.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-74	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims Focus Duals Error Detail Procedural.pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus MCE-LIHP
 Accuracy Trends
(Product).pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus MCE-LIHP
 Error Detail
Payment.pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus MCE-LIHP
 Error Detail
Procedural.pdf
	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus OR DOI
 Commercial Interest Late
Payments Audit ATA.xls
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus OR DOI
 Commercial Interest Late
Payments Audit Extract.xls
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims Focus Regulatory Accuracy Trends (Worksheet).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-75	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims Focus Regulatory Error Detail (Worksheet).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus WA DOI
 Commercial Interest Late
Payments Audit ATA.xls
	  	Claims Focus Regulatory ATA Sample	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Claims Focus WA DOI
 Commercial Interest Late
Payments Audit Extract.xls
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Accuracy Trends (by Group).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Accuracy Trends (by Group).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-76	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims PG Commercial Accuracy Trends (Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Audit Data Month.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Error Detail (Payment-by Group).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Error Detail (Payment- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Error Detail (Procedural-by Group).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Error Detail (Procedural- Processor).pdf	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Claims PG Commercial Onshore Offshore Health Net Supplier Data.xlsx	  	Claims QA Published Results Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-77	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	Claims Recon Report	  	Claims Recon Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ AZ_Metrics.pdf	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ AZ_PBC_Scre enshots.docx	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	 Control_2598_ AZ_Population
 _Report.xlsx
	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ CA_Metrics.pdf	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ CA_PBC_Scre enshots.docx	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	 Control_2598_ CA_Population
 _Report.xlsx
	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ OR_Metrics.pdf	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2598_ OR_PBC_Scre enshots.docx	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-78	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 Control_2598_ OR_Population
 _Report.xlsx
	  	BKB SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2608_ Metrics.pdf	  	Dummy Authorization SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2608_ PBC_Screensh ots.docx	  	Dummy Authorization SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2608_ Population_Re port.xlsx	  	Dummy Authorization SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2644_ Metrics.pdf	  	Administrative Pay SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2644_ PBC_Screensh ots.docx	  	Administrative Pay SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	Control_2644_ Population_Re port.xlsx	  	Administrative Pay SOX Control Report	  	Yearly	  	Active	  		  	
							
	QA-Claims	  	 DMHC MCAL PDR CAL
 VIVA Letter
Request.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 DMHC MCAL
 PDR Letter Request.xlsx
	  	Claims Focus Regulatory Preliminary Results	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-79	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	 DMHC SHP
 Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Duals Samples	  	Claims QA Sampling	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	Dummy and Admin Quarterly Extract.xlsx	  	Sox ATA Sample	  	Quarterly	  	Active	  		  	
							
	QA-Claims	  	Focus Admin Pay Samples	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Focus AHCCCS
 Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Focus AT&T Samples	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Focus Dummy Authorization Samples	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Focus PPG Forward Samples	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 Health Net SOX - IPC
 Checklist_2550
	  	SOX Requirement	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-80	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	IPC Checklist Control 2598	  	BKB SOX Control Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	IPC Checklist Control 2608	  	Dummy Authorization SOX Control Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	IPC Checklist Control 2644	  	Administrative Pay SOX Control Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 IPC
 Screenshots 2551
	  	SOX Requirement	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	 MCE-LIHP
 Samples
	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MediCal Samples	  	Claims QA Sampling	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB Audit Data	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB Audit Error Data	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB Audit Error Data.xlsx	  	BkB Preliminary Report	  	Bi-Weekly	  	Active	  		  	
							
	QA-Claims	  	 MHN Claims BkB EX
 Accuracy Trends (Dashboard
exclude NE)
	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-81	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only -  Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims BkB EX Accuracy Trends (Dashboard)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB EX Accuracy Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB EX Accuracy Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB EX Supplier Accuracy Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB EX Supplier Accuracy Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Supplier Audit Data	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-82	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims BKB EX Supplier Error Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Supplier Error Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Detail (Payment - Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Detail (Payment)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Detail (Procedural - Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Detail (Procedural)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-83	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims BKB EX Error Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB EX Error Trends (Top 10)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB SOX Accuracy Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BkB SOX Accuracy Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Detail (Payment - Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Detail (Payment)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Detail (Procedural - Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-84	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims BKB SOX Error Detail (Procedural)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Trends (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims BKB SOX Error Trends (Top 10)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data (Month- Group)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data (Month- Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data Month (Medicaid Expansion- Duals)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-85	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims EX Accuracy Data YTD (Group)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data YTD (Group)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data YTD (Medicaid Expansion- Duals)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data YTD (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Accuracy Data YTD (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Audit Error Data	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Preliminary Accuracy Data (Group)	  	BkB Preliminary Report	  	Bi-Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Preliminary Accuracy Data (Group)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-86	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims EX Preliminary Accuracy Data (Processor)	  	BkB Preliminary Report	  	Bi-Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims EX Preliminary Accuracy Data (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Accuracy Data (Month- Group)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Accuracy Data (Month- Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Accuracy Data YTD (Group)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Accuracy Data YTD (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Audit Error Data	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-87	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Claims	  	MHN Claims SOX Preliminary Accuracy Data (Group)	  	BkB Preliminary Report	  	Bi-Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims SOX Preliminary Accuracy Data (Processor)	  	BkB Preliminary Report	  	Bi-Weekly	  	Active	  		  	
							
	QA-Claims	  	MHN Claims Weekly sample	  	BkB Audit Sample	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	OR - Part C Non-Par Provider Appeals_Dispu te_Dismissals Audit (PDRs) June 2014_sam ples.xslsx	  	Claims QA Sampling	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	Total EX Claims Audited by Examiner	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Claims	  	Total EX Claims Audited by Group	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2182.Develop and Maintain Benefits.Metrics	  	SOX Requirement	  	Yearly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-88	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	2182.Develop and Maintain Benefits.Population Report	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2182.Develop and Maintain Benefits.Sample	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2182.Develop and Maintain Benefits.Screen shots	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2195.Develop and Maintain Benefits.Metrics	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2195.Develop and Maintain Benefits.Population Report	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	2195.Develop and Maintain Benefits.Screen shots	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	3853.Manage Provider Master Files.Metrics	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	3853.Manage Provider Master Files.Population Report	  	SOX Requirement	  	Yearly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-89	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	3853.Manage Provider Master Files.Sample	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	3853.Manage Provider Master Files.Screenshots	  	SOX Requirement	  	Yearly	  	Active	  		  	
							
	 QA-
 Configuration
	  	ACA SBC Weekly sample	  	BkB Audit Sample	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	ACA Summary of Benefits and Coverage BKB Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	ACA Summary of Benefits and Coverage BKB Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	ACA Summary of Benefits and Coverage BKB Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-90	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Benefit Claims sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Claims Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Claims Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Claims Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Load Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Load Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Benefit Configuration BkB Load Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-91	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Benefit Load Sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Claims sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Configuration BkB Claims Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Configuration BkB Claims Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Configuration BkB Claims Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Configuration BkB Load Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Configuration BkB Load Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-92	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Contract Configuration BkB Load Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Contract Load Sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	CR-SAP Errors	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	DOFR Configuration BkB Load Accuracy Trend (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	DOFR Configuration BkB Load Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	DOFR Configuration BkB Load Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	DOFR sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Health Net SOX - IPC Checklist_2182	  	SOX Requirement	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-93	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Health Net SOX - IPC Checklist_2195	  	SOX Requirement	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Health Net SOX - IPC Checklist_3853	  	SOX Requirement	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Metrics	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	 MHN
 Accounting sample
	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	MHN Benefit Load sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	 MHN
 Configuration Accuracy Trends (LOB-
Region-Work Type)
	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	MHN Configuration Accuracy Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	MHN Configuration Audit Accuracy	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-94	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	 MHN
 Configuration Error Trends (Region-Work
Type)
	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	MHN Group Load sample	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	PMR Data - Configuration BkB Universe Counts	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider AST Weekly sample	  	BkB Audit Sample	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Config Focus Sample	  	Focus Audit Sample	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Config Results Extract	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Accuracy Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Accuracy Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-95	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Provider Configuration BkB Error Detail (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Error Detail (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Error Trends (Processor)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Error Trends (State)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Preliminary Accuracy Trends (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration BkB Preliminary Error Detail (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-96	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Provider Configuration BkB Preliminary Error Trends (Processor)	  	BkB Preliminary Report	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration Focus Accuracy Trends (Worksheet)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration Focus Error Detail (Worksheet)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration Focus Error Trends (Worksheet)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration Focus Preliminary Accuracy Trends (Worksheet)	  	Focus Preliminary Report	  	Weekly	  	Active	  		  	
							
	 QA-
 Configuration
	  	Provider Configuration Focus Preliminary Error Detail (Worksheet)	  	Focus Preliminary Report	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-97	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Configuration
	  	Provider Configuration Focus Preliminary Error Trends (Worksheet)	  	Focus Preliminary Report	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Broker/Employer)-AZ	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Broker/Employer)-CA	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Broker/Employer)-OR	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Member)-AZ (PG)	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Member)-CA (PG)	  	Tracks the percentage of calls being resolved on the first call.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Member)-OR (PG)	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-98	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	1st call resolution (Provider)-AZ	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Provider)-CA	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	1st call resolution (Provider)-OR	  	Tracks the percentage of calls being resolved on the first call	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	CA-AZ-OR NCQA	  	Report provides the detail of when incorrect benefit information was provided to the member	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Accuracy Trends (Category-State)	  	Contact Center Correspondence Commercial Accuracy scores by category (Supplier & Health Net) and state.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	 Contact Center BKB
 Correspondence Commercial
Audit
	  	Contact Center Correspondence Commercial Preliminary Audit Data extract of the months audits.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Supplier Accuracy Trends (Processor)	  	Contact Center Correspondence Commercial Supplier Accuracy scores by Supplier associates.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-99	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Supplier Error Detail (State-Supervisor)	  	Contact Center Correspondence Commercial Supplier Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Supplier Error Trends (State)	  	Contact Center Correspondence Commercial Supplier Error Trends report provides yearly Supplier error counts.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Health Net Accuracy Trends (Processor)	  	Contact Center Correspondence Commercial Health Net Accuracy scores by Health Net associates.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Health Net Error Detail (State-Supervisor)	  	Contact Center Correspondence Health Net Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-100	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BkB Correspondence Commercial Health Net Error Trends (State)	  	Contact Center Correspondence Health Net Error Trends report provides yearly Health Net error counts.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Accuracy Trends (Category-State)	  	Contact Center Correspondence Commercial Preliminary Accuracy scores by category (Supplier & Health Net) and state.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Audit Data.xls	  	Contact Center Correspondence Commercial Preliminary Audit Data extract of the months audits.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Supplier Accuracy Trends (Processor)	  	Contact Center Correspondence Commercial Preliminary Supplier Accuracy scores by Supplier associates.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Supplier Error Detail (State-Supervisor)	  	Contact Center Correspondence Commercial Supplier Preliminary Error Detail report provides monthly errors and comments.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-101	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Supplier Error Trends (State)	  	Contact Center Correspondence Commercial Supplier Preliminary Error Trends report provides yearly Supplier error counts.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Health Net Accuracy Trends (Processor)	  	Contact Center Correspondence Commercial Preliminary Health Net Accuracy scores by Health Net associates.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Health Net Error Detail (State-Supervisor)	  	Contact Center Correspondence Health Net Preliminary Error Detail report provides monthly errors and comments.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence Commercial Preliminary Health Net Error Trends (State)	  	Contact Center Correspondence Health Net Preliminary Error Trends report provides yearly Health Net error counts.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-102	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BkB Correspondence SHP Accuracy Trends (Category)	  	Contact Center Correspondence SHP Accuracy scores.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Audit Data	  	Contact Center Correspondence SHP Audit Data extract of the months audits.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence SHP Supplier Accuracy Trends (Processor)	  	Contact Center Correspondence SHP Supplier Accuracy scores by Supplier associates.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence SHP Supplier Error Detail (State-Supervisor)	  	Contact Center Correspondence SHP Supplier Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BkB Correspondence SHP Supplier Error Trends (State)	  	Contact Center Correspondence SHP Supplier Error Trends report provides yearly Supplier error counts.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-103	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Preliminary Accuracy Trends (Category)	  	Contact Center Correspondence SHP Preliminary Accuracy scores.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Preliminary Audit Data.xls	  	Contact Center Correspondence SHP Preliminary Audit Data extract of the months audits.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Preliminary Supplier Accuracy Trends (Processor)	  	Contact Center Correspondence SHP Preliminary Supplier Accuracy scores by Supplier associates.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Preliminary Supplier Error Detail (State-Supervisor)	  	Contact Center Correspondence SHP Supplier Preliminary Error Detail report provides monthly errors and comments.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-104	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Contact Center BKB Correspondence SHP Preliminary Supplier Error Trends (State)	  	Contact Center Correspondence SHP Supplier Preliminary Error Trends report provides yearly Supplier error counts.	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center Correspondence Commercial Sample	  	Contact Center Correspondence Commercial transactions (Drawn Documents)	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Contact Center Correspondence SHP Sample	  	Contact Center Correspondence SHP transactions	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Counts N Scores Monthly (All)	  	QA results and audit counts by associate for all LOB including vendors	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Counts N Scores Monthly (Health Net)	  	QA results and audit counts by associate for Health Net	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Counts N Scores Monthly (TP)	  	QA results and audit counts by associate for TP	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	CVS-PGU Reporting Trends	  	QA results by associate including overall results - raw data	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	LOB by Month	  	QA Results for all LOB’s by month	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-105	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	MHN Quality Assurance results	  	QA results by associate including overall results for the LOB	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	OR Medicare NCQA	  	Report provides the detail of when incorrect benefit information was provided to the member	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Performance Group and CVS Quality Assurance results	  	QA results by associate including overall results	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Performance Standards	  	Detailed breakdown of the QA results for each PCSE audit scoring component	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality (Employer/Broker)-AZ	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality (Employer/Broker)-CA	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality (Employer/Broker)-OR	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality (Member/Provider)-AZ (PG)	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality (Member/Provider)-CA (PG)	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-106	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Contact Center	  	Quality (Member/ Provider)-OR (PG)	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality Assurance reports by Supervisor	  	Provide QA results to Supervisors who are not able to access the Database	  	Weekly	  	Active	  		  	
							
	QA-Contact Center	  	Quality MHN	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Quality Score	  	The average score of all quality monitors performed during the month	  	Monthly	  	Active	  		  	
							
	QA-Contact Center	  	Sykes Focus Audits Report	  	Provide daily results of the focus audits including an overview of the results	  	Daily	  	Active	  		  	
							
	QA-Contact Center	  	TP ACA Audit Coaching Log	  	Create and review report to identify gaps/opportunities in coaching provided	  	Daily	  	Active	  		  	
							
	QA-Contact Center	  	TP Focus Audits Report	  	Provide daily results of the focus audits including an overview of the results	  	Daily	  	Active	  		  	
							
	QA-Contact Center	  	TP Focus Audits Trending Report	  	Provides the trends of the opportunities and coaching provided to the associate	  	Daily	  	Active	  		  	
							
	QA-Contact Center	  	 TP HIPAA
 Violations Report
	  	Provides the violations for the day and date coaching provided	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-107	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	A&G CMS AZ Marketing Universe 2014_07	  	Marketing Audit - A&G all AZ universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	A&G CMS CA Marketing Universe 2014_07	  	Marketing Audit - A&G all CA universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	A&G CMS Internal Audit Summary.xlsx	  	CMS Element scores - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	A&G CMS IRE Marketing Universe 2014_07	  	Marketing Audit - A&G all IRE universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	A&G CMS OR Marketing Universe 2014_07	  	Marketing Audit - A&G all OR universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	A&G CMS WR Marketing Universe 2014_07	  	Marketing Audit - A&G all WR universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Claims CMS AZ Marketing Universe 2014_07	  	Marketing Audit - Claims all AZ universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Claims CMS CA Marketing Universe 2014_07	  	Marketing Audit - Claims all CA universes	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-108	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	Claims CMS Internal Audit Summary.xlsx	  	CMS Element scores - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Claims CMS OR Marketing Universe 2014_07	  	Marketing Audit - Claims all OR universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	CMS Internal Audit Summary.xlsx	  	CMS Element scores - A&G, Claims & Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	CMS Metrics ABS.xlsx	  	Failed Elements with Finding and CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	CMS Metrics MC400.xlsx	  	Failed Elements with Finding and CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	CMS Metrics PDP.xlsx	  	Failed Elements with Finding and CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 EDR_Submission_
 TEMPLATE_Data
AbrahamG.xlsx
	  	PMR - Commercial, Medicare, SHP & Duals metrics	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part Claims.xlsx	  	CMS Findings - sent to Claims for CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D A&G (Audit Findings).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-109	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	Internal Audit Report MA and Part D A&G (Elements).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D A&G.xlsx	  	CMS Findings - sent to A&G for CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D Claims (Audit Findings).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D Claims (Elements).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D Membership (Audit Findings).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Internal Audit Report MA and Part D Membership (Elements).pdf	  	CMS Final report sent to compliance	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-110	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	Internal Audit Report MA and Part Membership.xlsx	  	CMS Findings - sent to Membership for CAP’s	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Membership CMS AZ Marketing Universe 2014_07	  	Marketing Audit - Membership all AZ universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Membership CMS CA Marketing Universe 2014_07	  	Marketing Audit - Membership all CA universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Membership CMS Internal Audit Summary.xlsx	  	CMS Element scores - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Membership CMS OR Marketing Universe 2014_07	  	Marketing Audit - Membership all OR universes	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Prelim - Internal Audit Report MA and Part Claims.xlsx	  	CMS Prelim / Recon sent to the QA audit team when audit is complete	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	Prelim - Internal Audit Report MA and Part D A&G.xlsx	  	CMS Prelim / Recon sent to the QA audit team when audit is complete	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-111	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	Prelim - Internal Audit Report MA and Part Membership.xlsx	  	CMS Prelim / Recon sent to the QA audit team when audit is complete	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_AZ Claims_Universe Denied - Sample.xlsx	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_AZ Claims_ Universe Paid - Sample.xlsx	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_Calif_ Claims_ Universe Denied - Sample.xlsx	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_Calif_ Claims_ Universe Paid - Sample.xlsx	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_DNR1 June Processing - Sample.xlsx	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	WS_DNR1 Worksheet.xlsx	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-112	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_DNR2
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR2
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR3
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR4
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR4
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR5
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_DNR5
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR1
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-113	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_ENR1
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR10
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR2
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR2
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR3
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR4
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR6
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR6
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-114	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only -  System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_ENR8
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR8
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_ENR9
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_D_ HNAZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_D_ HNAZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_D_ WR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_D_ WR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_HN AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_HN AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-115	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_GV1_HN CA -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_HN CA
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_HN OR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_GV1_HN OR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE1 -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE1
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE1_D -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE1_D
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE2 -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE2 -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-116	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_IRE2
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE2
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE3 -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE3
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE3_D -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_IRE3_D
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_LEP1
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_LEP1A
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_LEP1B
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-117	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	WS_LEP2 June Processing - Sample.xlsx	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_LEP2
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_OR
 Claims_Universe Denied -
Sample.xlsx
	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_OR
 Claims_Universe Paid - Sample.xlsx
	  	CMS Claims sample from universe received from Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_PRM1
 June Processing - Sample.xlsx
	  	CMS Membership sample from universe received from Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_PRM1
 Worksheet.xlsx
	  	Completed Audit db extract - Membership	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC1_HN
AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC1_HN
AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC2_HN
AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-118	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_RC2_HN
AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC2_HN
CA -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC2_HN
CA
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC2_HN
OR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RC2_HN
OR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE1_D_H
NAZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE1_D_H NAZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE1_D_
WR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE1_D_
WR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE2_D_H NAZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-119	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_RE2_D_H NAZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE2_D_
WR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE2_D_
WR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE3_D_H NAZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE3_D_H NAZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE3_D_
WR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RE3_D_
WR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP1_HN
AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP1_HN
AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP1_HNC
A -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-120	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_RP1_HNC
A
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP1_HN
OR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP1_HN
OR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP2_HN
AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP2_HN
AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP2_HN
OR -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP2_HN
OR
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP3_HN
AZ -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP3_HN
AZ
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS_RP3_HNC
A -
 Sample.xlsx
	  	CMS A&G sample from universe received from A&G	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-121	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	QA-Medicare	  	 WS_RP3_HNC
A
 Worksheet.xlsx
	  	Completed Audit db extract - A&G	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC1
 AZ.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC1
 CA.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC1
 OR.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC2
 AZ.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC2
 CA.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	QA-Medicare	  	 WS-OC2
 OR.xlsx
	  	Completed Audit db extract - Claims	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	0722.Manage the Selling Process IPC	  	IPC checklist for control 0722	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	0722.Manage the Selling Process PBC	  	PBC for control 0722	  	Yearly	  	Active	  		  	
							
	 QA-
 Membership
	  	2656.Administ er Groups and Contracts IPC	  	IPC checklist for control 2656	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-122	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Membership
	  	2656.Administer Groups and Contracts PBC	  	PBC for control 2656	  	Yearly	  	Active	  		  	
							
	 QA-
 Membership
	  	2746.Enroll and Maintain Members IPC	  	IPC checklist for control 2746	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	2746.Enroll and Maintain Members PBC	  	PBC for control 2746	  	Yearly	  	Active	  		  	
							
	 QA-
 Membership
	  	3440.Monitor Health Net AR IPC	  	IPC checklist for control 3440	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	3440.Monitor Health Net AR PBC	  	PBC for control 3440	  	Yearly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Accuracy Trends (Drilldown- Processor)	  	Membership Accuracy scores by work type/ supervisor/associate.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Accuracy Trends (Work Type)	  	Membership Accuracy scores by work type (AR, Broker, Eligibility, Group).	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Accuracy Trends (Work Type-Manager)	  	 Membership Accuracy scores by work type
 &
manager.
	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB ATA
 Sample
	  	Membership Audit the Auditor process	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-123	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Membership
	  	Membership BKB Auditor Trends	  	Membership BKB Auditor Trends provides auditor accuracy scores based on overturned and rescinded audits.	  	Daily	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB AZ
 Allocations Sample
	  	Membership AZ Allocations (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB AZ
 Eligibility Sample
	  	AZ Membership Eligibility transactions (Queue Contents)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB AZ
 Group Sample
	  	Membership AZ Group transactions (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB AZ
 Manual Adjustments
Sample
	  	Membership AZ Manual Adjustments (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB AZ
 Medicaid Sample
	  	Membership AZ Medicaid transactions (Base)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Error Trending	  	Membership Broker extract of month audits that contained an error for trending purposes	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Accuracy Trends (Contract-Broker)	  	Membership BKB Broker Accuracy scores by Contract/Broker	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-124	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Accuracy Trends (Contract- Category	  	Membership BKB Broker Accuracy scores by Contract/Category	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Accuracy Trends (Processor)	  	Membership Broker Accuracy scores by Processor	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Error Detail (Processor)	  	Membership BKB Broker Error Detail (Processor)provides monthly errors and comments by processor.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Error Detail (Question)	  	Membership BKB Broker Error Detail (Question) provides monthly errors and comments grouped by question that did not meet.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Error Trends (Contract)	  	Membership BKB Broker Medicare Error Trends (Contract) report provides yearly error counts by contract.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-125	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	 QA-
 Membership
	  	Membership BKB Broker Medicare Error Trends (Processor)	  	Membership BKB Broker Medicare Error Trends (Processor) report provides yearly error counts by processor.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Allocations Sample
	  	Membership CA Allocations (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Eligibility Sample (CA
Membership)
	  	CA Membership Eligibility transactions (Drawn Documents CA Membership dept)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Eligibility Sample (Cobra DP
RC)
	  	CA Membership Eligibility transactions (Drawn Documents Cobra DP dept)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Eligibility Sample (ELIG
RC)
	  	CA Membership Eligibility transactions (Drawn Documents CA ELIG RC dept)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Eligibility Sample (ENR
Supplier)
	  	CA Membership Eligibility transactions (Drawn Documents CA ENR Supplier dept)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Eligibility Sample (ENR
RC)
	  	CA Membership Eligibility transactions (Drawn Documents CA ENR RC dept)	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-126	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	 Membership BKB CA LRG
 Group Sample
	  	Membership CA Large Group transactions (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA
 Manual Adjustments
Sample
	  	Membership CA Manual Adjustments (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB CA SBG
 Group Sample
	  	Membership CA Small Group transactions (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Call Accuracy Trends	  	Membership Call Accuracy scores	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Call Accuracy Trends (Processor)	  	Membership Call Accuracy scores by processor	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Call Error Detail	  	Membership Call Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Call Error Trends	  	Membership Call Error Trends report provides yearly error counts by work type.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-127	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	Membership BKB Supplier Accuracy Trends (Drilldown- Processor)	  	Membership Supplier Accuracy scores by work type/ supervisor/associate.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Accuracy Trends (Work Type)	  	Membership Supplier Accuracy scores by work type (AR, Eligibility, Group).	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Accuracy Trends (Work Type-Manager)	  	Membership Supplier Accuracy scores by work type & manager.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Audit Data	  	Membership Supplier Audit Data extract of the months audits.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Error Detail (Work Type)	  	Membership Supplier Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Error Trends (Drilldown- Processor)	  	Membership Supplier Error Trends (Drilldown-Processor)report provides yearly error counts by work type/supervisor/associate.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Error Trends (Work Type)	  	Membership Supplier Error Trends (Work Type)report provides yearly error counts by work type.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-128	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	Membership BKB Supplier Error Trends (Work Type- Supervisor)	  	Membership Supplier Error Trends (Work Type-Supervisor) report provides yearly error counts by work type/supervisor.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Accuracy Trends (Drilldown- Processor)	  	Membership Supplier Preliminary Accuracy scores by work type/ supervisor/associate.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Accuracy Trends (Work Type)	  	Membership Supplier Preliminary Accuracy scores by work type (AR, Eligibility, Group).	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Accuracy Trends (Work Type-Manager)	  	Membership Supplier Preliminary Accuracy scores by work type & manager.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Audit Data.xls	  	Membership Supplier Audit Data extract of the months audits.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Error Detail (Work Type)	  	Membership Supplier Preliminary Error Detail report provides monthly errors and comments.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-129	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Error Trends (Drilldown- Processor)	  	Membership Supplier Preliminary Error Trends (Drilldown-Processor)report provides yearly error counts by work type/supervisor/associate.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Error Trends (Work Type)	  	Membership Supplier Preliminary Error Trends (Work Type)report provides yearly error counts by work type.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Supplier Preliminary Error Trends (Work Type- Supervisor)	  	Membership Supplier Preliminary Error Trends (Work Type-Supervisor) report provides yearly error counts by work type/supervisor.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Error Detail (Aging)	  	Membership BKB Error Detail (Aging) provide the clients with detail of audits with an error that are outstanding and need to be acknowledged.	  	Daily	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Error Detail (Work Type)	  	Membership Error Detail report provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Error Trending	  	Membership extract of month audits that contained an error for trending purposes	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Error Trends (Drilldown- Processor)	  	Membership Error Trends (Drilldown- Processor)report provides yearly error counts by work type/supervisor/associate.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-130	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	Membership BKB Error Trends (Work Type)	  	Membership Error Trends (Work Type)report provides yearly error counts by work type.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Error Trends (Work Type- Supervisor)	  	Membership Error Trends (Work Type- Supervisor) report provides yearly error counts by work type/supervisor.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership BKB Medicare Broker Sample	  	Membership BKB Medicare Broker transaction (ABS)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB OR
 Allocations

Sample
	  	Membership OR Allocations (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB OR
 Eligibility Sample (CA
Membership)
	  	OR Membership Eligibility transactions (Drawn Documents CA Membership dept)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB OR
 Group Sample
	  	Membership OR Group transactions (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB OR
 Manual Adjustments
Sample
	  	Membership OR Manual Adjustments (Kbase)	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB
 Production

Drilldown
	  	Membership BKB Production Drilldown provides audits completed by auditor and audit type on a daily basis.	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-131	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	 Membership BKB
 Production Summary
	  	Membership BKB Production Summary provides audits completed by audit type, market segment, transaction type, and product on a daily basis.	  	Daily	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership BKB Top 3
 Results
	  	Membership BKB Top 3 provides the months 3 most frequent errors by audit type along with detail	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership Critical Fields Report	  	CA Membership Eligibility Critical Fields report provides monthly score based on critical fields not met.	  	Yearly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership Focus SBG ATA Accuracy Trends	  	Membership Focus SBG ATA Accuracy Trends provides accuracy scores of Supplier audit the auditor process focusing on SBG Eligibility.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership Focus SBG ATA Error Detail	  	Membership Focus SBG ATA Error Detail provides monthly errors and comments.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership Focus SBG ATA Error Trends	  	Membership Focus SBG ATA Error Trends provides yearly error counts.	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership Focus SBG ATA
 Preliminary Accuracy
Trends
	  	Membership Focus SBG ATA Preliminary Accuracy Trends provides accuracy scores of Supplier audit the auditor process focusing on SBG Eligibility.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-132	  	 Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Membership
	  	 Membership Focus SBG ATA
 Preliminary Error
Detail
	  	Membership Focus SBG ATA Preliminary Error Detail provides monthly errors and comments.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	 Membership Focus SBG ATA
 Preliminary Error
Trends
	  	Membership Focus SBG ATA Preliminary Error Trends provides yearly error counts.	  	Weekly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership Focus SBG ATA Sample	  	Membership Focus SBG Audit the Auditor process	  	Monthly	  	Active	  		  	
							
	 QA-
 Membership
	  	Membership PMR Universe Counts	  	Membership Eligibility and Group Universe counts	  	Monthly	  	Active	  		  	
							
	QA	  	BA Metrics	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	QA	  	 MHN ATA
 sample
	  	BkB Audit Sample	  	Monthly	  	Active	  		  	
							
	QA	  	 QA&T CS
 Report
	  	Monthly Dashboard/Extract	  	Monthly	  	Active	  		  	
							
	Training	  	Training Dashboard (Actual)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	Training	  	Training Dashboard (Projected)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-133	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	Training Dashboard Detail (Actual)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	Training	  	Training Dashboard Detail (Projected)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	Training	  	Training Dashboard Detail (Variance)	  	BkB Monthly Report	  	Monthly	  	Active	  		  	
							
	QA-Claims	  	DMHC Results Summary	  	Monthly DMHC regulatory audit results with recap of errors for failed elements and departmental corrective action plans.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	QA-Claims	  	 AZ DOI
 Summary
	  	Monthly AZ DOI regulatory audit results with recap of errors for failed elements and departmental corrective action plans.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	QA-Claims	  	 CA/OR/WA
 Results Summary
	  	Monthly CA/OR/WA DOI regulatory audit results with recap of errors for failed elements and departmental corrective action plans.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	QA-Claims	  	Monthly Error Trend Details	  	Monthly BKB error trend details and root cause analysis report for AZ, CA, OR book of business audits.	  	Monthly	  	 Active report, last month
 reported June
2014
	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-134	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-
 Claims/Membership/ A&G –
	  	 Health Net MA_PDP
 Marketing Audit Perform
Indicator Report
	  	CMS Marketing Materials audit results for Claims, Membership and A&G detail and corrective action plan report.	  	Report submitted to Compliance currently Quarterly, but will be changing to Monthly submission by end of Q3.	  	Active report, last quarter reported Q2 2014	  		  	
							
	 QA-CCC –
 Commercial Correspondence
	  	Correspondence Top 3 Error Trends	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned and recommendations on how to prevent the processing errors. It also provides a view of year
to date trends by audit question, along with monthly increase or decrease of accuracy scores.	  	Monthly	  	Active report, last month reported July 2014	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-135	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 QA-CCC –
 Commercial Correspondence
	  	Correspondence Top 3 Error Trends	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned and recommendations on how to prevent the processing errors. It also provides a view of year
to date trends by audit question, along with monthly increase or decrease of accuracy scores.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	 QA-
 Membership Accounting & Eligibility
– BKB
	  	 Membership BKB Top 3
 Error Trends
	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned and recommendations on how to prevent the processing errors. It also provides a view of year
to date trends by audit question, along with monthly increase or decrease of accuracy scores.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	QA-Supplier – Membership Accounting & Eligibility - BKB	  	 Membership BKB Top 3
 Error Trends
	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned and recommendations on how to prevent the processing errors. It also provides a view of year
to date trends by audit question, along with monthly increase or decrease of accuracy scores.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	 QA-
 Membership Accounting & Eligibility
- Medicare Broker
	  	Medicare Broker BKB Top 3 Error Trends	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned and recommendations on how to prevent the processing errors. It also provides a view of year
to date trends by audit question, along with monthly increase or decrease of accuracy scores.	  	Monthly	  	Active report, last month reported July 2014	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-136	  	 Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	QA-Medicare Membership Accounting & Eligibility	  	Membership CMS Trends	  	Report drills down on the highest identified error trends during the audit cycle. It provides further detail on why the error was assigned. It also provides a view of year to date trends by audit element, along with the client CAP
response to each of the findings that caused a failed element.	  	Monthly	  	Active report, last month reported July 2014	  		  	
							
	 QA-
 Membership Acctng & Elig.
	  	Aged Error Report	  	The report is an up to date listing of all audits that have not been acknowledged for the current audit month. The report advises that the reports are needed for return to ensure that the month end score are reported
accurately.	  	Weekly & then Daily	  	Active	  		  	
							
	 - Supervisors
 & Managers
	  		  		  	Weekly for the first 3 weeks of the month	  		  		  	
							
		  		  		  	- Daily the first 5 bus. days of the month, for the previous month’s audits	  		  		  	
							
	 QA-
 Membership Acctng & Elig.
Medicare
	  	CMS Missing Document Report	  	Log of missing documentation that is identified while auditing cases. These receipt of these missing items have an impact on the completion of the audit, as well as the audit results. So, the log is sent to give the Client an
opportunity to provide the data needed to complete the audit.	  	Twice daily	  	Active	  		  	
							
	- various	  		  		  		  		  		  	
							
	QA / A&G	  	 CMS A&G
 Trend Report
	  	Prior month CMS reported error trend with identifying error element and coordinator	  	Monthly	  	 CMS
 A&G Error

Trend Report submitted for processed date May 2014
	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-137	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

	QA / A&G	  	 BKB A&G
 Commercial Trend Report for all
Regions
	  	Prior month Commercial and SHP A&G error trend	  	Monthly	  	 BKB
 A&G Commercial Error Trend report
submitted for June 2014
	  		  	
							
	QA / A&G	  	BKB Medicare A&G Trend Report for all Regions	  	Prior month Medicare A&G error trend	  	Monthly	  	 BKB
 A&G Medicare Error Trend report submitted
for June 2014
	  		  	
							
	QA / A&G	  	 CMS A&G
 Internal Audit Report MA and Part D
Audit Findings
	  	CMS A&G audit review month error findings with description	  	Monthly	  	 BKB
 A&G Medicare Error Trend report submitted
for June 2014
	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-138	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	Master Training Calendar - 1	  	Training Planning document. Captures all planned and delivered training classes for Membership Commercial (MA&E), Membership Medicare, Claims (SHP, Government, Medi-cal, & MHN), Market Facing initiatives, System Releases and
Enterprise offerings.	  	Bi-Monthly or as requested	  	Active	  		  	
							
		  		  	 ·Captures Training Operational Metrics
	  		  	 External
 / Internal Report. Source
file for other external reports.
	  		  	
							
	Training	  	Master Training Calendar - 2	  	Training Planning document. Captures all planned and delivered training classes for the Health Net Contact Center, Appeals and Grievances, State Health Plan, Commercial, Medi-Cal, Medicare, Market Facing Initiatives, system
releases, and Omni Releases.	  	Bi-Monthly or as requested	  	Active	  		  	
							
		  		  	 ·Captures Training Operational Metrics
	  		  	Internal Report.	  		  	
							
		  		  		  		  	Source file for other external reports.	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-139	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	 BST
 Performance Metrics
	  	Documents overall Training Department’s performance on key metrics. Report highlights monthly statistics which include, #of Classes delivered, # of associates passing the required proficiency scores by class, graduation
percentages, # class hours, number of materials produced by type and their cumulative lean cycle time.	  	Wkly/Monthly	  	Active	  		  	
							
		  		  	·Captures Training Operational Metrics	  		  	Internal Report.	  		  	
							
		  		  		  		  	Source file for other external reports.	  		  	
							
		  		  		  		  	 Depende nt on data found in the Master Calendar 1, TMDB

and Learning Manage ment System
	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-140	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	Learning Management System	  	Official Training records/ transcripts for all courses and classes planned and delivered. Official training records are compiled from this source for regulatory inquiries. As required by various departments and regulatory agencies,
ad hoc reports / training records are compiled to provide evidence of completed training.	  	Wkly / On Demand	  	 Active Internal and External. Source

for official training records.
	  		  	
							
		  		  	·Outcome based reports specific to Compliance Requirements	  		  		  		  	
							
		  		  	·Captures Training Operational Metrics	  		  		  		  	
							
	Training	  	Allocation Database & Report	  	Captures and identifies time spent on delivering training, developing materials or work on special projects. Captures data at the individual level, team level and department level. Final reports are created by Training
Department’s Business Analyst.	  	Wkly/ Monthly	  	Active	  		  	
		  	  	  		  	Internal Report.	  		  	
		  	  	  		  	Source file for other external reports.	  		  	
		  		  	  		  		  		  	
							
	Training	  	Training Material Database (TMDB) and Weekly Inventory Report	  	Captures and identifies all material development items, providing tracking information by work team, work type, development phase, and cycle time. Reports are generated by department, by work teams, and by
individual.	  	Daily / Weekly / Monthly /	  	Active	  		  	
		  	  	  	  	  		  	
		  	  	  
 ·Captures Training Operational Metrics
	  	  
 On Demand
	  	  
 Internal Report.
	  		  	
		  	  		  		  	Source file for the Department Metrics Report	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-141	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	Rollup Report	  	Captures a monthly narrative of courses (delivered, ongoing, and upcoming), large scale material development projects, and system releases.	  	Monthly	  	Active	  		  	
		  		  	  		  	External Report.	  		  	
		  		  	  		  	Shared at the Director level with client groups supported by BST	  		  	
							
	Training	  	Mirror Report	  	Captures monthly course data (delivered, ongoing, and upcoming) and a YTD summary of course completion metrics.	  	Monthly	  	Active	  		  	
	  	  	  	  	External Report.	  		  	
	  	  	  	  	Shared at the Director level with client groups supported by BST	  		  	
							
	Training	  	PMR Report	  	Captures a monthly narrative of high level accomplishments in each of three lines of business: Medicare, SHP and Commercial	  	Monthly	  	Active	  		  	
		  		  	  		  	Internal Report.	  		  	
		  		  	  		  	Used by the BST Director	  		  	
							
		  		  		  		  		  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-142	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	ETP Report	  	Captures course completion data at the class and student level for all training classes attended by associates in California.	  	Monthly	  	 Active
  

External Report.
  

Shared with Health Net’s ETP Consultant for ETP funding
	  		  	
							
	Training	  	Monthly Variance Report	  	Provides a comparison of projected and actual expenses incurred by cost center. Comments for discrepancies are entered into the report at the GL account level	  	Monthly	  	 Active
  

Internal Report.
	  		  	
							
	Training	  	Project Plan Report – Elearning Activities	  	Captures and identifies all Elearning projects. Monitors project status, key project data, milestones and cycle times.	  	Weekly	  	 Active
  

Internal Report.
  

Source file for other external reports.
	  		  	
							
	Training	  	 Project Plan Report – MFI / Other
	  	Captures and identifies all Market Facing Initiatives (MFI) and non- MFI projects. Monitors project status, key project data, milestones and cycle times.	  	Weekly	  	 Active
  

Internal Report.
  

Source file for other external reports.
	  		  	
		  		  		  		  	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-143	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Training	  	Knowledge Base System Reports	  	Used to identify which training materials require annual review. Data and progress is tracked through the Training Material Database.	  	Monthly	  	 Active
  

Internal Report.
  

Received from Knowledge Base Administrators
	  		  	
							
	Training	  	Ad Hoc Reports	  	Data requests as needs are identified.	  	Ad Hoc	  	 Internal
 / External
Reports.
	  		  	
							
	Claims	  	Cap Deduct Over 50K	  	Identify Cap Deduct claims over $50K Net Diff.	  	Monthly	  	Active	  		  	
							
	Claims	  	Pay & Recover Monthly Summary	  	Show monthly receipts, rework, and reconciliation summary of Pay & Recover claims off-book projects.	  	Monthly	  	Active	  		  	
							
	Claims	  	Pay & Recover Inventory	  	Show month-end inventory for Pay & Recover claims off-book inventory.	  	Monthly	  	Active	  		  	
							
	Claims	  	PMPM Report	  	Shows the Calculated Per Member Per Month Received Claims Counts by Region and Product using total Membership counts.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-143	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

	Claims	  	ACA Report	  	Shows the ACA Receipts, AA Rate, Paid $ Incurred Triangle, and Inventory Billed $ Incurred Triangle for On-Exchange Members in ABS, and LIHP & Expansion members in QCare.	  	Monthly	  	Active	  		  	
							
	Claims	  	PDR, Reper & Special Proj. Summary	  		  	Monthly	  	Active	  		  	
							
	Claims	  	Health Net Life Insurance	  		  	Monthly	  	Active	  		  	
							
	Claims	  	NY HCRA	  		  	Monthly	  	Active	  		  	
							
	Claims	  	Southern CA Edison (Annual)	  		  	Yearly	  	Active	  		  	
							
	Claims	  	EIS Daily Tracking	  	Shows certain daily checkpoints from EIS and ACA Expansion Inventory that have high-level Claims Goals, or are important to Senior Leadership & Actuarial.	  	Daily	  	Active	  		  	
							
	Claims	  	High-Dollar Claims new to Inventory	  	Any new receipts to inventory that are considered high-dollar (there is a matrix of age & $ combinations that is used to determine these) are identified, researched & reported. Report includes information on any differences
between what shows in inventory and the actual claim image, expected pay amount (if any), and expected release date. Any anomalies found are identified and handled through business processes (PNM, Remedy tickets, COB, etc.).	  	Daily	  	Active	  		  	
							
	Claims	  	QCare Receipts/Production Trending	  	Provides charts of QCare inventory, production & receipts for the past 2 months.	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-145	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims	  	QCare AA%	  	Provides Auto-Adjudication rate for Fac, Pro & Overall QCare claims for each week and month.	  	Weekly	  	Active	  		  	
							
	Claims	  	 PMG
 Reinsurance Inventory Analysis
	  	Tracks the submissions from the 2013 Incurred Professional Stop-Loss submissions received in bulk in late April 2014. This shows the progress of each PPG project, including analysis of current payments and revised estimates of total
payout	  	Weekly	  	Active	  		  	
							
	Claims	  	High-Dollar Special Projects Tracking	  	Any Special Projects with a Billed $ value over $1M are tracked weekly to show the progress of the project, including analysis of current payments and revised estimates of total payout.	  	Weekly	  	Active	  		  	
							
	Claims – Medi-Cal	  	 AB1455 SHP
 Timeliness Report – Health
Net
	  	Claims Timeliness Report prepared by the Medi-Cal Claims team providing various measures of TAT for the Medi-Cal claims that are Health Net responsibility.	  	Monthly	  	Active	  		  	
							
	Claims – Medi-Cal	  	 AB1455 SHP
 Timeliness Report –
CalViva
	  	Claims Timeliness Report prepared by the Medi-Cal Claims team providing various measures of TAT for the Medi-Cal claims that are CalViva responsibility.	  	Monthly	  	Active	  		  	
							
	Claims – Medi-Cal	  	 AB1455 SHP
 Timeliness Report – Cal
Optima
	  	Claims Timeliness Report prepared by the Medi-Cal Claims team providing various measures of TAT for the Medi-Cal claims that are Cal Optima responsibility.	  	Monthly	  	Active	  		  	
							
	Claims – Medi-Cal	  	 AB1455 SHP
 Timeliness Report –
Molina
	  	Claims Timeliness Report prepared by the Medi-Cal Claims team providing various measures of TAT for the Medi-Cal claims that are Molina responsibility.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-146	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	 QCare SOX3833
 Report
	  	SOX compliance reporting	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Hi$ Ready-to-Pay	  	Pre Pay audit for QCare high dollar claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Mary Medical Inc Claims	  	Claims for Mary Medical	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Transportation Claims	  	Transportation Specific Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare 100K Billed	  	Claims at or over 100K billed	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare CBAS Claims	  	CBAS Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Vitas Healthcare Claims	  	Vitas Healthcare Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare USCF TINs Claims	  	UCSF Claims	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-147	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report

(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare APR DRG Payment Review	  	Claims with APR DRG	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare MediCal A+ List of Provider Claims	  	Large list of A+ Providers claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Hi$ Pends	  	Pended for High Dollar	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare EHS Cap Hosp. Pends	  	Pended for EHS Cap	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Behavioral Health	  	QCare MHN report	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare CalOptima Pends	  	Pended Cal Optima Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Molina Pends	  	Pended Molina Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare CalViva Pends	  	Pended CalViva Claims	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-148	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare MRU Queues Aged Pends	  	Aged Pends in MRU Queues	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Non- MRU Queues Aged Pends	  	Aged Pends in non-MRU Queues	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	 QCare CPT 21032, 21034
 and 26410 Claims
	  	Any claims with specified CPT Codes	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	Non-QCare EHS Report	  	EHS Claims that were Routed Out	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	Pacific Hosp of Long Beach Non-QCare Report	  	Run out claims check	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Daily Inventory	  	Daily inventory numbers for QCare	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare BillType 130 TIN 953527031	  	Check to see if this provider bills with TOB 130-QCare	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare EHS NQC Routed Claims	  	EHS Routed out claims	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-149	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare Claims Rprts - P25 pends	  	QCare pended with P25	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare P80 pends	  	QCare pended with P80	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Not in Filenet	  	QCare claims not found in Filenet	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Aging Reports	  	QCare reports list currently 30 - 60 days old	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Aging Reports	  	QCare reports list currently 60 - 90 days old	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Aging Reports	  	QCare reports list currently over 90 days old	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Prov & Member Update	  	Local for our team - update ref tables	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare MaxiMed CapDed (Wed)	  	QCare CapDeduct review for MaxiMed	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-150	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare CPT 21034 Report (Thurs)	  	Claims paid with CPT 21034	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare EOC I51 Report (Thurs)	  	Claims paid with EOC I51	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare BL5HOSP	  	5 Specific Hosp Report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare BLINTPD	  	Paid Interest Report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare BLHIDLR	  	High Dollar Report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Levy Provider Claims	  	Report on Levy Providers	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare DME EOC I51	  	DME Claims with EOC I51	  	Weekly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare EDI IP EOC 035	  	EDI IP Claims with EOX 035	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-151	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare CBAS Summary	  	QCare CBAS Report and routed out Cbas	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Safety Net Report **	  	Safety net catch all report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Month-End Pends >= 100K	  	End of Month pending claims over 100K billed	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Family Healthcare Network	  	Family Healthcare provider monthly production report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare & ABS AA%	  	Auto Adjudication rates for abs and QCare	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	“QCare SPD Audit Universe	  		  		  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-152	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	& MCE-LIHP”	  	SPD Reports	  	MONTHLY	  	Abraham Guizar, Kenneth Lock, Hugo Sotelo, Wendy Davila, Robery Tonoyan	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Inventory Categorization	  	QCare specific categories in inventory	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare & ABS Paid & Denied Summaries (SIU)	  	Special Investigations Unit report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Timeliness Summary	  	Copy of a pagecenter report- screen shot	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare Incurred by MOS Report	  	Count of incurred claims over 13 months	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	 QCare SHP35 PPC HAC &
 OPPCs Report
	  	PPC HAC & OOPC Report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-153	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	QCare DMHC Schedule G-3	  	DMHC inventory reports	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare CV ER Meds Audit Report	  	Check to see if ER patients later picked up their prescriptions.	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	QCare LADHS Quarterly Report	  	LADHS Paid Report	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	Contested Claims over 100K Billed (QCare)	  	Contested claims that are billed >100K	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	LADHS	  	LADHS denied report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	 LADHS Non-
 QCare
	  	LADHS Routed Out report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	Lisa Medi-Cal Production	  	Supplier and Rancho QCare production report	  	Daily	  	Active	  		  	
							
	Claims Reporting - QCare (Rancho)	  	Daily LADHS LACO037 TO LACO042	  	LA DHS CLAIMS	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-154	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - QCare (Rancho)	  	Multi Pends Report	  	QCare Pended P80, P90, P96, or P98	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Daily Inventory Report (MC400)	  	Daily Inventory Report of claims in MC400 system	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	NE/AZ High Dollar Update	  	High Dollar Claims Report- (MC400)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	NE/AZ First Health / Viant Inpatient Claims	  	Report on First health / Viant inpatient claims (MC400)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	NE/AZ NonPar Funnel Pricing Over 10 Days	  	NonPar Funnel claims over 10 days (MC400)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Catch-All Queue Volume	  	Report of Catch-All Queues with their volumes - used to monitor Macess	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ DOI CAP
 Multiplan Claims >=18 Days
	  	AZ DOI CAP Multiplan Claims >=18 Days (MC400)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Macess SF Aging Reports	  	Report on aged service forms from Macess for claims department	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	NE/AZ Non-MP Vendor Pends	  	NE/AZ non-multiplan related vendor pends (MC400)	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-155	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Macess SSRS Morning Reports	  	Variety of Macess reports sent to new day claims teams to monitor queues and production tracking	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Macess SSRS Morning Reports (PERFORMA NCE TEAMS)	  	Variety of Macess reports sent to new day claims teams to monitor queues and production tracking	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR Open SF Sent To Report	  	Report on Open SF sent to PDR team	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	ADJ Open SF Sent To Report	  	Report on Open SF Sent to ADJ team	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	High Dollar Inventory	  	High Dollar Claims Report for Erik Granada	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	DUALS Daily Inventory Detail	  	Claims summaries and details for Cal Mediconnect	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR Open SF Sent TO Report	  	Open SF For PDR	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	DHS Claims	  	Report on DHS Medicaid Reclamation claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Over 30 day Pivots	  	Claims aged over 30 days	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-156	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Performance and IND/OOS Claims Pended for MRU	  	Claims for performance groups as well as Indemnity and OOS pending with MRU	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 PAUC,POUC, PCUC,PHOM, PSUT,PHCM,P
 CMC
Reports
	  	Claims pivot and detail reports for each pend code listed	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	All Claims In Suffix Status	  	All claims in suffix status (Adela report)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Performance Claims	  	Various slices of non-finalized performance claims details	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Performance PAPR,PSCR,P FCI,PRFC,PHI G,PADJ,PADH

Pended Claims
	  	Claims details of claims pending with each pend code listed	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CSP & SP2
 Claims in AUDIT Status
	  	Medicare claims in Audit	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	High Dollar Over 100K	  	All High Dollar Claims over 100K Billed	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZPCP & BANNER MC400 + ABS SUMMARY	  	Report specific to AZPCP and BANNER claims across both systems	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Today’s On Hand Summary By Region	  	Report of On-Hand Claims including ABS and MC400 all regions	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-157	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Claims for Commercial All Products in AUDIT Status	  	Commercial Claims in AUDIT	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CALPERS
 Claims
	  	CALPERS claims in inventory	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Aged Claims Summary 28 Days or Over - Rolling 5 Days	  	Claims over 28 days age by supervisor including previous business days	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Claims Paid at 96% of Billed Charges	  	Claims paid at or over 96% of billed charges	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ AHCCCS
 Duals Claims
	  	AZ AHCCCS Claims - captures processed primary claims where secondary claim still needs to be finalized	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	MA Pend Report	  	Pend Report for Medicare Advantage Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	MACESS vs ABS PMDR (ALL)	  	Links All Claims with Macess to see if SF was created	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Performance Group Queue Contents at or over 10 days	  	Performance Group queue contents where claim is over 10 days	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Supplier Aborts Report	  	Finds claims that may have been aborted out of in ABS as compared to Macess	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-158	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Macess Examiner Production	  	Examiner Production based on Macess completed claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Macess DOFR Queue	  	Checks if there are claims in the Macess DOFR queue	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Dignity Commercial	  	AZ Claims for Dignity Providers in Inventory - Commercial Claims only	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Dignity AHCCCS	  	AZ Claims for Dignity Providers in Inventory - AHCCCS Claims only	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Risk Code	  	Risk Code claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Stuck_4day_pend	  	Funnel claims stuck in Pend 4 days or more	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Stuck_FC_4day
_pend	  	First Choice claims stuck in Pend 4 day or more	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Stuck_7day_pend	  	Funnel claims stuck in Pend 7 day or more	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Latino WIP claims	  	Latino WIP claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Audit Que Sip	  	Claims in audit with Paid Amt of $25000 or more	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-159	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Daily DOFR SCCID Change	  	DOFR SCC Id change	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Adjustments	  	appends daily adjustments processed to adj database	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR count	  	appends daily PDRs processed to PDR database	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	High $	  	Daily report on high dollar claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Reper	  	Daily report on Repers	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR	  	Daily report on PDRs	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ PDRs	  	current open AZ PDRs	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR report	  	PDR report for Susie O’Mohundro	  	Daily	  	Active	  		  	
							
		  		  		  		  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Denied ACS Paper Claims with Attachments	  	Captures all prior business day denied ACS claims with attachments for all LOBs	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-160	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Outpatient Multi Days	  	Captures prior day outpatient multi day claim billings	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Inventory Deletes	  	Captures all prior day claims deletes	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 High Dollar over $50k Billed Charges
 - Jim
Woys
	  	Captures all ABS Prior Day and On hand claims with billed charges over $50k.	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Pend PPDR Report	  	Captures all claims currently pended with code PPDR	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Code 78 Report	  	Oregon Denials -DISALLOW CODE 78	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PERR Report	  	PERR Pends with AGE	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PCON Report	  	PCON Pends	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PCRP Report	  	PCRP Pends	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PCSP Report	  	PCSP Pends	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-161	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 Top 100
 Claims Over 30 Days by Manager
	  	# of Pended Claims over 30 days under each Supervisor	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Daily AA Rate Report	  	Auto Adjudicated vs Manual	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	IEX Tribal Group Report	  	Paid and denied POS and HMO claims that belong to a list of specified groups	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS CAP
 Report
	  	Non contracted claims for selected RMC codes from the Daily3 file	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	On and Off Exchange RMC Report	  	Paid and denied POS and HMO claims by selected RMC codes	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AB1455 Report	  	Report of selected disallow codes by selected vendors	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	EDI vs Paper Report	  	25 random claims for both Professional and Institutional showing claim source	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	CA Over 100K Report	  	Calif denied claims with billed amount greater than or equal to 100K	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ OR WA
 Incoming PDRs Report
	  	Detailed PDR by service form for OR, WA and AZ	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Incomping PDRs Report	  	Detailed PDR by AZ AHCCCS and AZ CSP Non Par	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-162	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 AZ AHCCCS COB
 Membership Report
	  	AZ AHCCCS Membership report for members who have COB Coverage	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Suffixing (Sherman)	  	Report on current and last 5 days suffixing volumes	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Daily Performance Groups (Sherman)	  	Report on current and last 5 days of performance claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Daily Performance Groups Suffix Report Sherman)	  	Report on current and last 5 days performance claims in suffixing	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Daily Suffix Queue No Performance Groups Report	  	Report on current and last 5 days suffixing queue volumes excluding performance claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Oregon Suffix Queue (Sherman)	  	Report on current items in Oregon Suffixing queue	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Arizona Suffix Queue	  	Report on current items in Arizona Suffixing queue	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 OR
 Adjustments and Appeals - Open Macess
SF’s
	  	Report on open service forms for OR Adjustments and Appeals team	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-163	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

							
	Claims Reporting - ABS (WH)	  	AZ PI Open Macess SF	  	Report on open service forms for AZ PI team	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ AHCCCS
 Daily Report
	  	Report on AZ AHCCCS claims processed on the previous business day	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ AHCCCS
 Claims Summary
	  	Report on historical and current volumes for AZ AHCCCS Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Trizetto Scrub Report	  	Report on Trizetto Scrub description for PATI pended claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Pharmacy Inventory Report	  	Report on Pharmacy Related Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 MHN
 Inventory Report
	  	Report on MHN Related Claims	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AHCCCS
 Daily Varnish Screening Report
	  	Report on HMO paid/denied/inventory AZ procedure codes D1206 and 96110.	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Claims Paid at 96% of Billed Charges Report (AZ Medicaid)	  	Claims paid at or over 96% of billed charges (Medicaid)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Delinquent Premium	  	Delinquent Premium	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-164	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Daily_CA_
CSP	  	Closed CSP Previous day with Disallow 8 or 10	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Daily_Pended_ CSP	  	Currently Pended CSP for certain CPT codes	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Pend PNCB CDI Report	  	Claims currently pended for PNCB	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 ABS BillType 130 TIN
 953527031
	  	Check to see if this provider bills with TOB 130-ABS	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Daily PPG Report	  	PPG 6554 and 6555 Report	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Denied CSP Letter Codes 11 & 52	  	Denied with letter code 0011 or 0052	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	CQI Database Report	  	CQI Audits Database Reports	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Audit TAT And Interest	  	CQI Audits turnaround time and interest incurred	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Disallow 08 CDI Claims	  	Claims processed with disallow 8	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	CSP Claims Inventory	  	CSP Inventory Report	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-165	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Non-Standard Claims in Inventory	  	Bounce from a report delivered to us daily	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	AZ Com. Non- Par Ambulance Inv.	  	Arizona Amb Report for non pars	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Daily Write-off Databse	  	Update Only: Outstanding recoveries for write-off database	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Audit Spreadsheet	  	Update Only - For use with Monthly Recover Audit Rpt	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Medicare Advantage Denials	  	CSP Denied Report	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Compliance PMED Pends	  	Claims pended with PMED	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Audits Daily Released Report	  	Daily processed claims released from Audits	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Adjustments Over 25K Net Diff Summary	  	Claims that adjusted over 25K	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Supplier Audits Database Production	  	Audits Database Production report	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	CSP Disallow 18 - Non Par Claims	  	Non Par Claims with Disallow 18	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-166	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	 AHCCCS -
 Denial Letter 5297 Report
	  	AZ AHCCCS Claims denied with letter code 5297	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Daily Disallow 57	  	Claims disallowed with Disallow 57	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Duals Denied Report	  	Medi-Conect Duals Denied Report (disallow specific)	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 ASH
 Contracted Providers Aged 5 Days or
More
	  	Reports all ASH contracted providers where claim age is 5 days or greater	  	Daily	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	E&M Open Service Forms	  	Report of open service forms in Macess for E&M box	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Medicare Advantage Development Audits	  	Weekly Report on MA Claims to Audit development process	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Chiro Report(Lilit)	  	Weekly report on Chiro related claims	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Healthy Family Fee Key Report	  	Report on Healthy Families Claims including Fee Key Info	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	ICD9 Report (Kenia)	  	Report on specific ICD9 codes as provided by requester	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-167	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Oregon Day 3 reports	  	OR Paid, Inventory, Denied claims for the week	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 DOFR ER
 NewDay Report
	  	ER DOFR claims	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	UC,Boeing & Verizon Adjustments	  	Adjustments processed by Supplier	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Denied Clams with Payable DOFR	  		  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Weekly PDR	  	Tracks PDRs proc & TAT for the previous week (DMHC & DOI)	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Weekly CMS PDR	  	Tracks CMS PDRs proc & TAT for the previous week	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Weekly OR/WA PDRs	  	Tracks OR/WA PDRs processed for the previous week	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Supplier - Dashboard	  	NE/AZ current month to date stats	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 ACA -
 Womens Prev Care
	  	Weekly claims processed for specific srv codes and diag codes	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	ACA - Prev Care	  	Weekly claims processed for specific srv codes and diag codes	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-168	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Stater Bros - Accumulator	  	Accumulative OOPM & Deductible report for specific group	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 UCLA
 Anesthesia Paid Claims Report
	  	Paid claims by tax ID	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Saddleback Orangecoast Report	  	Inventory Report by selected tax ID and rev codes	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	HSA Database Load	  	Using Business Objects to capture HSA data and load files	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Validate Weekly Supplier	  	Upon request from Heidi	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Sarbanes 3538 Report (New)	  	SOX Specific Report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Member Pay Adjustments	  	Adjusted claims based on Member Payment	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Disallow 28 Report	  	Claims disallowed with disallow 28	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	DRG Report (Wednesdays)	  	DRG specific report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Sutter Mod 26/TC	  	Sutter claims priced with modifiers 26 or TC	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-169	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Recovery ML TPL Letter Report	  	Volume or TPL letters	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery ML TPL Load Cases	  	Load new TPL cases from DHCS and Cal Viva	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery ML TPL Aged Report	  	Volume of TPL age	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 Recovery TPL CFW-DHCS
 (Wed)
	  	Encrypted TPL DHCS specific report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery TPL CFW-CalViva (Wed)	  	Encrypted TPL CalViva specific report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery COB Not Taken Update (Wed)	  	Update COB data in COB Not Taken DB	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 ABS
 MaxiMed Cap Deduct (Fri)
	  	ABS CapDeduct review for MaxiMed	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	MedCap Report (Mon)	  	MedCap Check number report	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	AZ Provider Collections - Zero Balance Report	  	Arizona Collections tracking	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	99397 iHealth Disallow	  	iHealth disallows with cpt 99397	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-170	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	 Oregon Medicare Dsallow 179 or
 181
	  	Oregon Medicare claims with specific disallow codes	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Claims paid at 96% of Billed Charges for Oregon and Washington	  	only Oregon and Washington claims, paid at 96% of billed	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Adjusted Claims	  	Captures all adjusted claims for CA and OR regions for prior week	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Admit Diff Report	  	Captures all institutional claims for prior week where admit date is different than service date	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 DOFR
 Category 5 WIP and History
	  	Captures all DOFR WIP and History Status claims for prior week processed with Claims Categ 5	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Inventory Roll up	  	Production & Receipts	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Daily CA & OR & AZ
 Supplier
Report
	  	Production on new day & adjusted claims	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Bi-Weekly Report on tax id#03-0378442
 & 26-
1440485B
	  	all processed claims under this tax id#	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-171	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	TAT Report	  	Turnaround time report on all products including DMHC for CA & OR	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Various Denials Report- Medicare Advantage	  	# of CSP Various Denial	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Various Denials Report	  	 Disallow codes on 10 Or 46 Or 61 Or 62 Or
 78 Or
132 Or 133 Or 153
	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Special Provider Paid at 96 Perc - OR_WA	  	Special Provider (list) Paid at 96 Perc - OR_WA	  	Weekly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	First Choice	  	Report on First Choice claims	  	EVERY TWO WEEKS	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Supplier Production - MC400	  	Monthly MC400 Report for claims processed during the previous month	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Supplier Dashboard - MC400	  	Dashboard Report for claims processed and service forms on MC400	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Performance TAT	  	MC400 Performance Claims TAT for previous month	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CalPERS
 Claims Processed Previous month
	  	Report on all CalPERS group claims processed in the previous month	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-172	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 PMR Metrics for CPD’s 105,106, 691,
 692,
708, 709
	  	Monthly PMR Metrics Reports for Lisa Brickey	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PMR Metrics for Cal MediConnect claims - TAT 30, 45 days	  	PMR Metric results for Cal MediConnect (Hugo / James Lee)	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	CMC Report Card	  	Report card for Cal MediConnect service forms and adjustments	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Massachusetts Paid Claims	  	Tracks checks paid to Massachusetts providers (Out of State PPO/Indemnity)	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Outstanding checks	  	Track current outstanding checks	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Performance Standards	  	Performance results for TAT, Financial, Payment & Procedural accuracy	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	OR metrics	  	OR TAT & Adjustment percentage	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	OR EDI	  	volume of EDI/Paper claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PDR - Check Write TAT	  	TAT between Proc date & check date	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-173	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	Dream Report	  	Monthly adjustments processed for all regions	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Medicare Part C - appeals disputes & dismissals	  	Report monthly PDRs/ADJs processed for specific adj codes	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	MEMB SOX	  	Walt’s	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Abortion Funds	  	Report monthly claims processed for specific abortion procedure codes	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Monthly HNS	  	Captures all current Viant Providers for each month who have not yet terminated their contracts	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 ABS
 Adjustments by Examiner
	  	Captures a subset of adjusted claims for prior month by specific examiners	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 UCLA ER
 claims
	  	Captures all ER claims billed by UCLA and paid by Health Net for prior month	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	OR and WA New Day TAT Claims	  	Captures all new day claims for OR and WA and identifies those processed within TAT of 30 days and over. (CPD-111, CPD-112, CPD-104)	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Monthly Sef Bill Reports	  	Captures all CA and AZ HMO and POS claims that went through the vendor pricing funnel for prior month and identifies the Health Net savings for each record	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-174	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report
Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	AZ DOI Report	  	Captures all AZ Commercial Paid and Denied clean and unclean claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Med Supp	  	Captures all claims activity for prior month for AZ Med Supp members	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	TP Claims Report	  	Captures all transplant related claims for prior month	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ AHCCCS
 Dashboard
	  	Captures all prior month AZ AHCCCS claims with the various volume and TAT metrics	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Anesthesia Report with unit greater than 1	  	All anesthesia svcs when unit values are greater than 1	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Pain Management Report	  	based on specific cpt codes	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Monthly Interest Report	  	Interest applied on new day & adjusted claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Supplier Dream Report on CA
 & OR &
AZ
	  	provide the reason why the claim was adjusted	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Supplier Performance Metrics/Recove ry Report CA

& OR & AZ
	  	Monthly STATs production, receipts, TAT, Pends etc (used to reimburse Supplier)	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-175	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 PMR-CPD#81 PPO/EPO TAT
 Report
	  	TAT	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 PMR- CPD#690 AZ HMO/PPO TAT
 Acknowledge Letter
Report
	  	TAT	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Hospice Report	  	Report on Hospice related claims by membership report for Rachel Valine	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Admin Pymnts & ABS Admin Pymnts	  	AZ admin pymnts by Associate, ABS admin pymnts CC by claim , A & G admin pymnts by claim	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Dream Report	  	Dream Report for NE, CT Adjust Reports(2), Bucket Review, and Broad Specific Category Report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ Dream Report	  	Dream report is run for AZ with tabs breakingout products	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Denials	  	Line count by reason code	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 COB
 Dashboard
	  	Monthly, quarterly and YTD COB for NE and AZ	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 SOX
 Production Control
	  	BEING DISCONTINUED - waiting for decision	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-176	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 WC COB
 Audit
	  	For MC400 COB updates	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Oregon Ambulance	  	Paid and denied Oregon Ambulance claims for POS, HMO and IND	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Saddleback and Orangecoast	  	Monthly version of the weekly report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	SIMNSA	  	Incorrect claim payments for specific medical group and provider network in Mexico	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	SIMNSA PPG 3037	  	Incorrect claim payments for specific medical group and provider network in Mexico for PPG 3037 only	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AZ DOI
 Reports
	  	6 statistical AZ MC400 reports	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 AHCCCS
 Processed Offshore
	  	Report of all AZ AHCCCS Claims that were processed by an offshore examiner	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Hospice Report	  	Medicare hospice paid claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	ATA Sampling for Claims Audit	  	Audit the Auditor sample report for additional audits	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Contested Claims over 100K Billed (ABS)	  	Contested claims that are billed >100K	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-177	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	PnP Report (CA, AZ, OR)	  	All region Policy and Procedure report from Lotus	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 CA, OR/WA &
 AZ Retro Term
	  	All Region Retro Terms	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 Sutter Enrollment
 *Discontinued 8/2014*
	  	Monthly count of Sutter members	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	120-103 Viant Reports	  	Claims priced by viant	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	CVS Caremark	  	CVS Specific report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Raytheon (Sunset)	  	Raytheon Specific report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Examiner Data	  	Detail on specific examiners	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Mod 80 Report	  	Claims priced with Modifier 80	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 HNCA “Q5”
 Recovery Report
	  	Claims recovery processed with Q5	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 Tier 2-3
 Disallow 8 AA Claims
	  	Auto Adjud with Disallow 8	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-178	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Org Chart & PageCenter	  	SOX reports from Org Chart and PageCenter	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Hoffman Report	  	Provider specific report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 CSP IP DOS
 Outside Mbr Eligibility
	  	IP claims processed with mbr not eligible	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	CMS Mock Audit	  	CMS mock audit readiness report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Vaden Students	  	Vaden College specific report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	ABS Possible Duplicates	  	check for paid duplicate claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	AZ AA Claims	  	Auto Adjudicated AZ claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 PPO CDI
 Claims Disallow 18
	  	PPO claims processed with disallow 18	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 ASHP
 Disallow 78
	  	ASHP claims processed with disallow 78	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 ICD9 EVM
 Claims CSP Report
	  	EVM specific claims, include ICD9	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-179	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	 CDI
 Adjustment Report
	  	CDI Specific Adjustment Report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	ADI Report	  	ADI Specific Adjustment Report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 Autism Claims
 - Comm 54
	  	Autism Claims	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Medical Records Reimbursement	  		  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	AA Claims Later Adjusted	  	Auto Adjud claims that required adjustment	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Prof Paid Claims w/Modifier 50 Report	  	Claims processed using Modifier 50	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery ML TPL Closed	  	Closed ML TPL cases	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery ML Outstanding by Prov (OP Requests)	  	Provider summary outstanding cases	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Adjustment Report	  	Recovery adjustment report	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-180	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Recovery COBRA over 65	  	Members over 65 cobra specific report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Performance Metrics	  	Full Claims Metrics	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 WA
 Acknowledgem ents
	  	Washington claims acknowledged age	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Refund Reconciliation	  	Refund Report	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery HMS Reports	  	HMS Recoveries reports	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 AZ PPG Cap
 Deduct Detail
	  	AZ PCP PPG Cap Deduct	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Data iSight	  	Claims repriced by Data iSight	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Claims Leakage- Interest prevention	  	Claims with large interest payments	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Claims Leakage-Paid > Billed	  	Claims paid over billed charges	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Audit Reports	  	Recovery claims being sent for auditing	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-181	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Monthly Other COB Paid	  	Summary of Other COB amounts paid per region	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Failed to COB Report	  	Claims with Failed to COB adj codes	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Reper Based on Adjustments	  	Claims identified as reper	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Possible Reper	  	Claims that could possibly return as repers	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	 UC ACO Re-
 imbursement Report
	  	Medical record reimbursement requests	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Beginning ABS Pre-Pay Audit Inventory by MOS	  	ABS Pre-Pay Audit inventory at start of each month	  	Monthly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	University of California Quarterly Results	  	Quarterly performance	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Boeing adjustments	  	Percentage of adjustments for the qtr	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CVS
 adjustments
	  	Percentage of adjustments for the qtr	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-182	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	UC Postdocs adjustments	  	Percentage of adjustments for the qtr	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 UC
 adjustments
	  	Percentage of adjustments for the qtr	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Bank of America - DMHC
 timeline
	  	Stats on 45 day TAT	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 Boeing - DMHC
 timeline
	  	Stats on 45 day TAT	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	DMHC	  	Qtrly number for DMHC RMCs	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	BOB & Perf Group Stats	  	Qtrly stats (TAT and financial, procedural & payment accuracy)	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	TOP 5	  	Walt’s	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Apria Leakage Report	  	Paid claims for specific CPT codes and Tax ID	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	PODs Reports	  	POD Report	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery MSP Overlap	  	COB Overlap based on multiple received MSP spreadsheets	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-183	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (Rancho)	  	Recovery Coll Vend Plcmnt - CR	  	Encrypt - Vendor placement collections report	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Coll Vend Plcmnt - GBC	  	Encrypt - Vendor placement collections report	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Coll Vend Plcmnt - SRI	  	Encrypt - Vendor placement collections report	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (Rancho)	  	Recovery Vendor Analysis	  	Recovery Vendor total collected summary	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Cedar Sinai Monthly PPG reports	  	Captures all claims activity for Cedar Sinai PPG members for previous month	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Monthly DME Leakage Report	  	Captures all DME claims for HMO and CSP products for prior month	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Monthly Home Health Leakage Report	  	Captures all Home Health claims for HMO and CSP products for prior month	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	CMS Medicare Part C-Org Determ Reports	  	Captures all CA, OR, and AZ Medicare claims according to CMS requirements for prior quarter	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS MMP -
 Org Determ Report
	  	Captures all CA Duals MMP claims according to CMS requirements for prior quarter	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	Health Net_STAT	  	ASO Plan, RMC PN & GN, Aging Pending Inventory Report	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-184	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Claims Reporting - ABS (WH)	  	 CMS Incentive Bonus Payment
 - PCIP
	  	Quarterly CMS Incentive payment project	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS Incentive Bonus Payment
 - HPSA
	  	Quarterly CMS Incentive payment project	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS Incentive Bonus Payment
 - HPSI
	  	Quarterly CMS Incentive payment project	  	Quarterly	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	AZ DOI	  	Report of AZ commercial and medicare by month (Note: Jan-Dec due Apr 1, and Jan - Jun Due Oct 1)	  	TWICE YEARLY	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS MMP
 LTSS Reports
	  	Captures all CA Duals MMP LTSS (Long-Term Services and Supplies) claims - includes LTS and CBAS (Note: Jan-Jun due in July, and Jul-Dec due in Jan)	  	TWICE YEARLY	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	University of California Year End Results	  	Year end performance	  	YEARLY	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	PBGH	  	Year end performance	  	YEARLY	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS Incentive Bonus Payment
 - PQRS
	  	Annual CMS Incentive payment project	  	YEARLY	  	Active	  		  	
							
	Claims Reporting - ABS (WH)	  	 CMS Incentive Bonus Payment
 - XXXX
	  	Annual CMS Incentive payment project	  	YEARLY	  	Active	  		  	
							
	 PDR (from CC)
 Commercial/Medicare
	  	Late Cases	  	Lead runs report daily/monthly to capture late forwarded cases (>6 days from receipt and not yet forwarded to Claims)	  	Daily & Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-185	  	Health Net / Cognizant Confidential

 Final 

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 PDR-SHP
 (Medi-Cal)
	  	 Reconciliation report for Claims (all MMA

overturned cases).
	  	Reconciliation report of appeals sent from PDR, excel format. This is for all MMA overturn cases that Claims Department needs to pay.	  	Daily	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Reconciliation report for Medical Management (all MMA cases that need review)	  	Reconciliation report of appeals sent from PDR, excel format	  	Daily	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Reconciliation report for Claims (all MA9R cases that need review)	  	Reconciliation report of appeals sent from PDR, excel format	  	Daily	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Supplier Reconciliation and TAT report	  	Report showing the aging of the cases pending to be processed and cases needing correction. The agreed TAT is 6 working day.	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-186	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 PDR-SHP
 (Medi-Cal)
	  	Weekly PDR Compliance Reports : Health Net, CalViva, Cal-Optima, Molina (four separate excel reports)	  	PDR status for the week this report is sent to upper management from: Compliance, Claims, MRU, Medical Management.	  	Weekly	  	Active	  		  	
							
	 PDR-Arizona AHCCCS
 (Medicaid)
	  	Arizona Weekly PDR Compliance Report	  	PDR status for the week this report is sent to upper management from: Compliance, Claims, MRU, Medical Management.	  	Weekly	  	In Development	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Weekly PDR Status Report for Claims	  	Compliance report listing all the cases by age. This report was designed to help claims/medical management work appeals from oldest to newest and help stay within compliance guidelines per AB1455	  	Weekly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Weekly PDR Escalation Report for Claims	  	Report showing all cases that will be due per AB1455 guidelines within the next 7 days. Escalation report for claims/ medical management to prioritize the cases listed and closed within timely guidelines	  	Weekly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Weekly PDR Status Report for Medical Management	  	Compliance report listing all the cases by age. This report was designed to help claims/medical management work appeals from oldest to newest and help stay within compliance guidelines per AB1455.	  	Weekly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Weekly PDR Escalation Report for Medical Management	  	Report showing all cases that will be due per AB1455 guidelines within the next 7 days. Escalation report for claims/ medical management to prioritize the cases listed and closed within timely guidelines	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-187	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 PDR-SHP
 (Medi-Cal)
	  	Supplier Weekly Closure Report	  	All cases that are returned from Claims because they were paid or denied using EOC 901 or 902. A list is pulled from the Access database, saved in the Supplier share drive. Supplier on Wednesday reviews each claim, line by line to
ensure the cases were paid or denied correctly. If they were correctly process they close the Access Database with the check date.	  	Weekly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Monthly PDR Compliance Report: HNT, CalVival, Cal-Optima, Molina	  	Monthly report sent to upper management from; Compliance, Claims, MRU, Medical Management, and the VP’s. This report is sent for the previous month, due before the 15th	  	Monthly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	PMRU Report	  	Percentage and numbers (Out of Compliance and Compliant) taken from the Monthly Reports	  	Monthly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	DMHC Mock Audit Report/data pull	  	Report showing all the closed true appeal cases for the previous month. The Data is used by Compliance: Abraham Guizar for the mock DMHC audit. To ensure HNT is within compliance guidelines by the DMHC. Report due 1st of every month
& data is combined for HNT, CalViva, Cal-Optima & Molina. It excludes any cases processed by Onshore. Onshore processes DMHC/DHCS, Legal/Meet & Confer cases which are not counted in the DMHC reportable universe.	  	Monthly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Medical Management Monthly Report	  	Report showing a breakdown of all cases processed by Medical Management according to outcome: upheld, overturned, partial, etc.	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-188	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 PDR-SHP
 (Medi-Cal)
	  	Productivity Report	  	Report showing previous months stats on: DMHC/DHCS cases or any cases worked as if they were DMHC (in order avoid DMHC filings)	  	Monthly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Supplier/Supplier Monthly Production Report	  	Production report for all cases processed by Supplier. This report is sent to Renne A DeStefano for invoicing and payment to Supplier.	  	Monthly	  	Active	  		  	
							
	 PDR-Arizona AHCCCS
 (Medicaid)
	  	 Arizona Monthly PDR AHCCCS
 Report
	  	ABS & MACESS Data showing what is received, pending and closed	  	Monthly	  	Active	  		  	
							
	 PDR-Arizona AHCCCS
 (Medicaid)
	  	Arizona Monthly PMR Report	  	Cam Ha send template to fill out. Template captures: 1)Number of disputes were acknowledged at 5 days; 2) Number of disputes closed at 30 business days or older; 3) Number of overturned disputes paid in manner consistent within 15
business days of the date of the Decision; 4) Number of Provider State Fair Hearings submitted with 5 business days of receipt, submitted to the Office of Administrative Legal Services (AHCCCS)	  	Monthly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Quarterly Compliance reports: HNT, CalViva, Cal-Optima, HNT	  	Separate report for each Plan to show the compliance percentage for the quarter.	  	Quarterly	  	Active	  		  	
							
	 PDR-SHP
 (Medi-Cal)
	  	Annual Compliance reports: HNT, CalViva, Cal-Optima, HNT	  	Separate report for each Plan to show the compliance percentage for the year.	  	YEARLY	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-189	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	 PDR-SHP
 (Medi-Cal)
	  	CalViva Quarterly breakdown or receipts during the reporting period	  	Excel format show, all received cases during the reporting period	  	Quarterly	  	Active	  		  	
							
	Prior Auth	  	PEGA Mars outbox report	  	This report should include daily inventory for all regions. The information should include volumes of open items to be processed, by date received, region and request priority	  	Daily	  	Active	  		  	
							
	Prior Auth	  	PEGA Mars outbox report	  	This report should include total number of items processed for the timeframe of the report. (daily or monthly).	  	Daily & Monthly	  	Active	  		  	
							
	Prior Auth	  	PEGA Mars outbox report	  	Report should reflect total number of requests received per month by line of business, region, request priority.	  	Monthly	  	Active	  		  	
							
	Prior Auth	  	Service Level Agreements	  	Tracking of Service Levels as indicated in the Service Level Agreement Document for all lines of business. Provide root cause and corrective action plan for any service level not met.	  	Monthly	  	No	  		  	
							
		  		  	Report to measure turnaround time of Urgent Concurrent requests. Measured start from request received date and time and measure stop time from completion of request or date and time submitted to clinical team for review.	  		  		  		  	
							
		  		  	Notification timeliness - Report to measure 100% of cases requiring notification are completed within regulatory timeframes.	  		  		  		  	
							
		  		  	Phone calls – Average Speed to Answer within <45 seconds and <5% abandonment rate.	  		  		  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-190	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Prior Auth	  	Compliance Monitoring	  	Address any service failure that did not meet compliance TAT. Provide root cause and provide Corrective Action Plan for each case.	  	Monthly	  	No	  		  	
							
	MRU	  	Macess Inventory report (6995)	  	This report should include daily inventory for all regions. The information should include volumes of open items to be processed, by date received, region	  	Daily	  	Active	  		  	
							
	MRU	  	MRU Reports for Production	  	This report should include total number of items processed for the timeframe of the report. (daily or monthly).	  	Daily & Monthly	  	Active	  		  	
							
	MRU	  	Macess Inventory report (6995)	  	Report should reflect total number of requests received per month by line of business, region	  	Monthly	  	Active	  		  	
							
	MRU	  	Service Level Agreements	  	Tracking of Service Levels as indicated in the Service Level Agreement Document for all lines of business. Provide root cause and corrective action plan for any service level not met.	  	Monthly	  	No	  		  	
							
		  		  	Report on TAT of cases requiring Health Net review are routed within 4 business hours.	  		  		  		  	
							
		  		  	Report on escalated cases from claims are processed <=24 hours.	  		  		  		  	
							
		  		  	Report on All post service requests are <=9 calendar days.	  		  		  		  	
							
	MRU	  	Compliance Monitoring	  	Address any service failure that did not meet compliance TAT. Provide root cause and provide Corrective Action Plan for each case.	  	Monthly	  	No	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-191	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	HNU	  	Inventory Volume	  	This report should include daily inventory for all regions. The information should include volumes of open items to be processed, by date received, region	  	Daily	  	Active - Manual	  		  	
							
	HNU	  	Medical Management Productivity Report	  	This report should include total number of items processed for the timeframe of the report. (daily or monthly).	  	Daily & Monthly	  	Active	  		  	
							
	HNU	  	KPI reporting	  	Report should reflect total number of requests received per month by line of business, region	  	Monthly	  	Active	  		  	
							
	HNU	  	Service Level Agreements	  	Tracking of Service Levels as indicated in the Service Level Agreement Document for all lines of business. Provide root cause and corrective action plan for any service level not met.	  	Monthly	  	No	  		  	
							
		  		  	Report 99% of cases prepared, documented and routine in Med Mgme within 4 hours of receipt.	  		  		  		  	
							
		  		  	Phone calls – Average Speed to Answer within <45 seconds and <5% abandonment rate.	  		  		  		  	
							
	HNU	  	Compliance Monitoring	  	Address any service failure that did not meet compliance TAT. Provide root cause and provide Corrective Action Plan for each case.	  	Monthly	  	Active	  		  	
							
	CCR UMC	  	Hospital Admit Aging Report (7039)	  	This report should include daily inventory for all regions. The information should include volumes of open items to be processed, by date received, region	  	Daily	  	Active	  		  	
							
		  	 AZ/OR
 Inpatient Worklist
	  		  		  		  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-192	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	CCR UMC	  	Production Report	  	This report should include total number of items processed for the timeframe of the report. (daily or monthly).	  	Daily & Monthly	  	Active	  		  	
							
	CCR UMC	  	Hospital Admit Aging Report (7039)	  	Report should reflect total number of requests received per month by line of business, region	  	Monthly	  	Active	  		  	
							
	CCR UMC	  	Service Level Agreements	  	Tracking of Service Levels as indicated in the Service Level Agreement Document for all lines of business. Provide root cause and corrective action plan for any service level not met.	  	Monthly	  	No	  		  	
							
		  		  	100% of cases completed or routed within 4 business hours. Report to include turnaround times for this process.	  		  		  		  	
							
		  		  	100% of cases needing RN escalation routed within 2 business hours.	  		  		  		  	
							
		  		  	100% of cases prepared for updates within 4 business hours of request.	  		  		  		  	
							
	CCR UMC	  	Compliance Monitoring	  	Address any service failure that did not meet compliance TAT. Provide root cause and provide Corrective Action Plan for each case.	  	Monthly	  	Active	  		  	
							
	Config/Capitation/PDM	  	Quality and TAT Metrics Reports	  	Monthly production reports provided to Health Care Analytics for Commercial PMR	  	Monthly	  	Active	  		  	
							
	Provider Data Management	  	Reject Quality Report	  	Report provided to Provider Network Management identifying PNM errors in all work types provided from PNM to PDM	  	Monthly	  	Active	  		  	
							
	Provider Data Management	  	AHCCCS Provider ID’s	  	Batch Report to AHCCCS identifying AHCCCS assigned Provider ID’s needed for claims processing	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-193	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Provider Data Management	  	Debarrment	  	Sent to Network Management for contracted providers	  	As debarment information is received	  	Active	  		  	
							
	Provider Data Management	  	HEDIS	  	Questionnaire sent to PDM from Health Net HEDIS reporting group.	  	Annual	  	Active	  		  	
							
	Capitation	  	MLR Report	  	Identifies Capitation health care expenditures for determining Medical Loss Ratios. Sent to Network Management	  	Annual	  	Active	  		  	
							
	Capitation	  	PPG/Hospital terms	  	Identifies deficit/liabilities for hospitals/PPG’s who have termed. Sent to Actuarial, Provider5 Network Management and Finance	  	Quarterly	  	Active	  		  	
							
	Capitation	  	Monthly Financial Report	  	Provided to Divisional Accounting to identify G/L debit, credits	  	Monthly	  	Active	  		  	
							
	Capitation	  	CAP Payment and Eligibility	  	Activity, eligibility, CAP detail and employee group ID reports sent to PPG/Hospitals	  	Monthly or Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Daily A&G Dashboard	  	Summary of all A&G cases daily, including Out of Compliance (OOC) cases and if a Corrective Action Plan (CAP) would be needed. All Lines of Business (LOBs)	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Medicare Error Report	  	Report of A&G cases reporting errors. LOB: Medicare	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	MAXIMUS Website Reconciliation Report	  	Reconciliation Report used to reconcile our reports to the MAXIMUS website. LOB: Medicare	  	Daily	  	Active, requires coordination with the MAXIM US Federal Services website	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-194	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	Cases Due Today & Cases Closed Yesterday	  	A&G Cases that were due today and cases that were closed yesterday. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	 Medicare CA, AZ, OR
 Exempt Grievance Detail
Report
	  	Medicare Oral Grievances. LOB: Medicare	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	 Commercial CA, AZ, OR
 Exempt Grievance Detail
Report
	  	Commercial Exempt Grievances. LOB: Commercial	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	AZ Medicaid (Maces Cases)	  	Listing of all cases created for AZ Arizona Health Care Cost containment System (AHCCCS). LOB: AZ State Health Plan (SHP)	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G Cases - Claims Reprocessing	  	A&G Cases that need Claims Reprocessing. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G Cases - Claims Verification	  	A&G Cases that need Claims Verification. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Cases Closed Report	  	Cases Closed. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Cases Coded Report	  	Cases Coded. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Cases Due following week	  	Following week Cases Due. All LOBs	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-195	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	Cases Due this week - Case #	  	Case #‘s for Cases Due this week. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Cases Not Coded Report	  	Cases Not Coded. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Compliance report - MTD	  	Month to Date (MTD) Daily Compliance report. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Performance Guarantee Open Cases - A&G	  	A&G Daily Open Cases Performance Guarantee. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Performance Guarantee Open Cases - Inquiries	  	Daily Performance Guarantee Open Cases Inquiries for Performance Guarantee. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	OOC Reports - Daily	  	Daily Report for Out of Compliance A&G cases. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Open Ack Compliance - All regions	  	Open Ack Compliance. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	 SHP &
 Medsupp - Reporting
	  	SHP & Medsupp providing the A&G team with production data open cases, received cases, closed cases along with summaries to be used on the dashboard. LOB: SHP	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-196	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	A&G PRIME Daily Dashboard - OR/WA	  	Summary of A&G Cases daily, including OOC cases and if a CAP would be needed. LOB: OR/WA Commercial	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G PRIME Daily Production - OR/WA	  	Daily Report providing the A&G team with production data. LOB: OR/WA Commercial	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G PRIME Daily Dashboard - SHP	  	Summary of A&G Cases daily, including OOC cases and if a CAP would be needed. LOB: SHP	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G PRIME Daily Production - SHP	  	Daily Report providing the A&G team with production data. LOB: SHP	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	A&G Clinical TAT Reporting	  	A&G Clinical Turn Around Time (TAT) Reporting. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Medicare Compliance Report	  	Report with Medicare compliance metrics. LOB: Medicare	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Magic Data Issue Queries Daily	  	Report of all Magic data issues. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Daily Maximus Report	  	MAXIMUS case detail, OOC cases, and compliance metrics. LOB: Medicare	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Open Cases Queries Daily	  	All A&G open cases. All LOBs	  	Daily	  	Active	  		  	
							
	Appeals and Grievances	  	Preventable Reporting	  	Preventable Report. All LOBs	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-197	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	Regulatory Reporting	  	All Department of Insurance (DOI) cases. LOB: Commercial	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Weekly Expedited Report	  	Weekly Expedited Case summary and detail. All LOBs	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Weekly Member Packet Report	  	Member Packet Report. All LOBs	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	SHP QOS vs QOC Clinical Report	  	SHP Quality Of Service (QOS) vs Quality Of Care (QOC) Clinical Report. LOB: SHP	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Weekly SHP TAT Report	  	Weekly SHP Turn Around Time Report. LOB: SHP	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Weekly CAP Report	  	Weekly Corrective Action Plan Report. All LOBs	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Weekly Performance Report	  	Weekly Performance Report. All LOBs	  	Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	A&G SOX Weekly Reporting	  	A&G SOX cases weekly. LOB: Medicare	  	Bi-Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	Biweekly A&G report	  	All the cases filed against PPG/PCP for Comm/MCR and SHP. All LOBs	  	Bi-Weekly	  	Active	  		  	
							
	Appeals and Grievances	  	CTM Weekly Report	  	Complaint Tracking Module (CTM) Root Cause Report. All LOBs	  	Weekly/ Monthly	  	Active, requires coordination with Complaint Tracking Module (CTM) Team	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-198	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	PMR	  	Programs Management Review data. All LOBs	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Medicare Compliance Dashboard	  	Report of Medicare compliance metrics. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Medicare Universe	  	Medicare Appeals and Grievances. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Monthly STARs	  	General STARs report for compliance that outlines CTMs C32 and C33. LOB: Medicare	  	Monthly	  	 Active, requires coordination with Pharmacy Department and CTM

Team
	  		  	
							
	Appeals and Grievances	  	Final Letter Audit	  	Top 5 Misses by % and Category. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Letter Review A&G	  	Letters Not Entered in the Database Report. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Monthly Oregon Report Card	  	A&G Oregon Report Card. LOB: OR Commercial	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Monthly BOB Audit Universe	  	Monthly Book Of Business (BOB) Audit Universe - Appeals and Grievances. LOB: Medicare/Commercial	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-199	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	Monthly CMS Mock Audit Universe	  	Monthly Centers for Medicare and Medicaid Services (CMS) Mock Audit Universe - Appeals and Grievances. LOB: Medicare/Commercial	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Oregon EMT	  	A written evaluation of Health Net Oregon’s (HNOR) member appeals and grievances is provided to the Plan’s Executive Management Team to review identified trends of Commercial and Medicare appeals and grievance. LOB: OR
Commercial	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	A&G Compliance Report	  	A&G Compliance metrics. All LOBs	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Mail Order A&G Detail Report / Complaints	  	A&G Mail Order Detail Report / Complaints. All LOBs	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Maximus Withdrawal Trending Reports	  	Report of MAXIMUS withdraws trends. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Oral Grievance Universe	  	Part C and Part D oral grievances for AZ, CA and OR Medicare. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Administrative payment trend report	  	Admin payment trend report. All LOBs	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	NCQA Monthly Report	  	Monthly report that captures (Quality Assurance) QA scores for medical and pharmacy benefits. All LOBs	  	Monthly	  	Active	  		  	
							
	Appeals and Grievances	  	Prime Reports	  	New portfolio of Prime reports to replace Macess reports	  	TBD	  	New	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-200	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Appeals and Grievances	  	Trend Reports	  	Report on trends of issues to share cross-functionally to drive down complaints and appeals	  	TBD	  	New	  		  	
							
	Health Net Contact Center	  	Daily Operational Workbook	  	Workbook with call stats for all Lines of Business (LOBs)	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	MHN Headcount	  	Reports that tracks the number of FTE. Line Of Business (LOB): Managed Health Network (MHN)	  	As Needed	  	Active	  		  	
							
	Health Net Contact Center	  	SOPs	  	Standards of Performance - Call Center. All Lines Of Business(LOBs)	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	SHP A&G Detail Report	  	SHP A&G Details. LOB: State Health Plan (SHP)	  	Daily	  	Active, requires coordination with Members hip	  		  	
							
	Health Net Contact Center	  	SHP Exempt Grievance Detail Report	  	SHP Exempt Grievances. LOB: SHP	  	Daily	  	Active, requires coordination with Members hip	  		  	
							
	Health Net Contact Center	  	Cal Medi Connect Daily Cases (OMNI / Macess)	  	Listing of all cases created for CalMedi Connect (CMC). LOB: CMC	  	Daily	  	Active, requires coordination with Members hip	  		  	
							
	Health Net Contact Center	  	AZ Medicaid (OMNI Cases)	  	Listing of all cases created for AZ Arizona Health Care Cost containment System (AHCCCS). LOB Medicaid	  	Daily	  	Active, requires coordination with Membership	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-201	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	SBC Report	  	Summary of Benefits request (Macess ). All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Performance Group (PG) Open Cases Report	  	PG Cases for review LOB: Commercial/Medicare	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Exempt Grievance - Macess	  	All Exempt Grievances cases for review LOB: Commercial/Medicare	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Open Cases Report - Macess / OMNI	  	Open Cases in OMNI and Macess. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	OR Continuation Report	  	Membership Continuation. LOB: Commercial	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	WA Claims sent for Adjustment Report	  	Claims sent for Adjustment. LOB: Commercial	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	National Rep Inventory Report	  	Rep Inventory Report. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Mcare OOA Daily Closed/Opened Cases	  	Medicare Out of Area Daily Closed/Opened Cases. LOB: Medicare	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	AZ Medicaid Case Details - CCC	  	Call Center AZ Medicaid Case Detail. LOB: SHP	  	Daily	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-202	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	CalMedi Connect Duals Daily Reporting	  	CalMediConnect Duals Daily Reporting. LOB: CMC	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Daily Workbook	  	Call center metrics. Service level, Average Handle Time, Average Talk Time, Hold time etc. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Service Level	  	Report of service level. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	MTD SL Goal Projection	  	Month to date (MTD) service level goal projections. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Health Net Absenteeism Report	  	Health Net Absenteeism Report. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Longest Delay Report	  	Report that contains each day the oldest call waiting. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	 11AM & 3PM
 SL Update Report
	  	11AM & 3PM Service Level (SL) Update Report. All LOBs	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Solution Team Daily Inventory Report	  	Solution Team daily inventory report. LOB: AZ Commercial	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Resolution Team Daily Inventory Report	  	Resolution Team daily inventory report. LOB: AZ Commercial	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Daily Action Report	  	A daily activity report per user. LOB: MHN	  	Daily	  	Active	  		  	
							
	Health Net Contact Center	  	Temp Staff Weekly Report	  	Current active temporary staff and hours they have currently worked. All LOBs	  	Weekly	  	Active, requires coordination with the Finance Department	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-203	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	Weekly Temp Conversion Report	  	Temporary to Permanent. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Weekly Reconciliation Report	  	Reconciled Organization Chart with the Associate Database. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	AZ Escalation Dashboard	  	Listing of AZ cases escalated to escalation team. LOB: AZ Commercial	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Schedule Activity Report	  	Review Schedule Call backs. LOB: Commercial/Medicare	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Call Center Cases Open in Other Dept.	  	Listing of open cases in other departments. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Case Count by member	  	Number of cases created for each member. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Outstanding Open CSFs	  	Outstanding Open (Health Net Service Form (CSF)s. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Agent Performance	  	Report of agent performance. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	NR Codes	  	A report that tracks the agents NR time. LOB: MHN	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Clinical Skillset Volumes	  	Report used to report out on the number of calls per skillset for clinical. LOB: MHN	  	Weekly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-204	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	Clinical Hotkey Volumes	  	Report used to report out on the number of calls per Hot Key. LOB: MHN	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	RCA - Root Cause Analysis	  	The report contains any P1 or P2 ticket open for any LOB that reports to Larry. All LOBs	  	Weekly	  	Active	  		  	
							
	Health Net Contact Center	  	Staffing Report	  	Total Staff - FTE, Temp, Vend. All LOBs	  	Weekly/ Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Transfer Report	  	Call Transfer Report for all LOBs. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	PMR	  	Programs Management Review (PMR). All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	1% PMPM Report	  	Per member per month monthly report 1% improvement from last year. LOB: SHP	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	10 Minute Report	  	Department of Managed Health Care (DMHC) calls over 10 min report. LOB: Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Internet Response Report	  	List of cases created from Emails. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	PMR	  	First Day Resolution. LOB: Commercial/Medicare	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	PMR ACA	  	Email Response TAT. LOB: ACA	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Cal Pers	  	Cal Pers cases, summary. LOB Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Case to Call	  	List Call count vs Case count by Rep. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Performance Group Reports	  	First Day Resolution for each Performance Group. LOB: Commercial/Medicare	  	Monthly	  	Active, requires coordination with Membership	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-205	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	ASU Email Report	  	Account Services emails TAT. All LOBs.	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	SBC Compliance Report	  	Send compliance results for Summary of Benefits Coverage (SBC) requests. LOB: Commercial/Medicare	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Hot topic Report - PSEQ / ACA	  	Listing of Hot Topics created. LOB: Affordable Care Act (ACA)	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Trending Reports Macess / OMNI	  	Reason Types	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Cases sent to all mailboxes A&G Report	  	All Cases sent to A&G via Macess. LOB: Commercial/Medicare	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Provider Sequestration Calls Report	  	Provider Sequestration Calls. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Call Center Case Production Dashboard	  	A dashboard of call center case production metrics. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Medicare Compliance Dashboard	  	Report of Medicare compliance metrics. LOB: Medicare	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Service Level (SL) Dashboard	  	Reports all the Month to Date (MTD) SL achieved for each of the LOB within MHN. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Map-Quality vs AHT	  	Use within Call Center - Compared Quality against AHT. LOB: MHN	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-206	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	Year-end Volume Stats MHN	  	MHN Call Volume Report. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Arizona Department of Insurance (ADOI) Report	  	A report that tracks data for the AZ State. LOB: Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	CalPERS	  	A report to track the overall performance of CalPers - Call Center. LOB: Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Agent Activity Report	  	Report that reflects short calls dropped calls, call work, etc. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Administrative (Admin) payment trend report	  	Admin payment trend report. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Covered California	  	A report that provides call center performance on Service CA. LOB: ACA	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Provider Transfer Unit Inventory Report	  	Provider Transfer Unit inventory report. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Chat inventory report	  	Chat inventory report. LOB: Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Automatic Call Distribution (ACD) Utilization Reports	  	ACD utilization reports. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Occupancy data - ( 3 Reports)	  	Reports used to populate the Occupancy Report. LOB: MHN	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-207	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	Monthly Occupancy & SL Report	  	Used within the call center to monitor performance. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Supervisor Scorecard	  	Reports out the indicators per supervisor on a monthly basis. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Met Life Stats	  	Monthly met life stats. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Agent Scorecard Dbase	  	Report the list the agents’ indicators such as AHT, QA, ACW, etc... LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Top and Bottom AHT & SC’s	  	Report that list the top and bottom agent performance. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Variance - C/S	  	Report that compares the agents against department trend. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Variance- Clinical	  	Report that compares the clinical rep against department trend. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Summary	  	Report that provides an overview of data within call center. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Quadrant Report	  	Report that compares Quality Assurance (QA) and Average Handle Time (AHT). LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Telecom Report	  	Report out call volume per each line of business. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Rolling Quarterly Telecom Report	  	Rolling up the Telephony data quarterly. LOB: MHN	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-208	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	CVS Monthly Report	  	Monthly CVS Report. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Performance Guarantee Report - MHN	  	MHN performance guarantees report. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Metlife Monthly Report	  	Client report for Metlife. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	PG & Membership Update	  	Performance guarantee & membership update. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Attrition Report	  	Attrition Report. All LOBs	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Team Quality Scores	  	Reports track Quality Scores for each of the Reps. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Agent Quality Scores	  	Monthly Agent Quality Score. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Evaluator Productivity	  	Monthly Evaluator Productivity. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Monthly Audit by Scores	  	Monthly Audit by Scores. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Medi Cal Report	  	Report that contains the volume of Medi Cal calls handled by MHN. LOB: SHP/MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Symposium Report - Active	  	A list of active participants within Symposium. LOB: MHN	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Quarterly Volume Stats MHN	  	MHN Call Volume Report. LOB: MHN	  	Monthly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-209	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	AZ Medicaid Report	  	Report that contains Vendor and Health Net overview of SL Stats for State of AZ. LOB: AZ SHP	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Health Net Performance Guarantee Report	  	Report the monitors the performance of Health Net Performance Guarantees. All Commercial	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	Avg Score by Manager	  	Average Score by Manager. LOB: MHN	  	Monthly/Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	Avg Score by Team Member	  	Average Score by Team Member. LOB: MHN	  	Monthly/Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	UC Report	  	Call Stats, Reason Types. LOB: Commercial/Medicare	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	Boeing Report	  	Call Stats, Reason Types. LOB: Commercial	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	EG Access to Care	  	Exempt Grievances related to Access to Care. All LOBs	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	Open Cases Greater than 60 days	  	Open Cases Greater than 60 days. All LOBs	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	Qtrly Met Life Stats	  	Quarterly met life stats. LOB: MHN	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	MIP Numbers for both Supervisors/Management	  	MIP Numbers for both Sups/Mgmt. All LOBs	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	HNAZ/HNOR/ HNNE/HNCA	  	Reports that reflect out call volume for CA/AZ/OR states. All LOBs	  	Quarterly	  	Active	  		  	
							
	Health Net Contact Center	  	 MHN
 Quarterly Volume Stats
	  	MHN Quarterly Volume Stats. LOB: MHN	  	Quarterly	  	Active	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-210	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	NCQA Report New Member Understanding	  	Report on call types , trended data to share with cross functional depts to drive down calls	  	Monthly	  	Active	  		  	
							
	Health Net Contact Center	  	NCQA Report Accuracy of Benefit Information 2014	  	Report used to determine if our members have plan and benefits information available to them through our Health Net Contact Center and having a process in place to respond to member inquires within the first contact.	  	Annually	  	Active	  		  	
							
		  		  	Ensure members have the ability to determine their financial responsibility for a drug based on their pharmacy benefit, which include, ordering a refill for an existing or unexpired mail order prescription. This also includes
ensuring members have the ability to initiate the exception process when applicable, locate a in-network pharmacy, and determine a potential drug interaction, side-effects and have the ability to find a generic substitute when needed.	  		  		  		  	
							
		  		  	Health Net uses these findings of member inquiries to identify opportunities for improvement and actively implements corrective action plans based on those opportunities.	  		  		  		  	
							
	Health Net Contact Center	  	NCQA Report Accuracy of Benefit Information 2015	  	Report used to determine if our members have plan and benefits information available to them through our Health Net Contact Center and having a process in place to respond to member inquires within the first contact.	  	Annually	  		  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-211	  	Health Net / Cognizant Confidential

 Final 
  

													
	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

		  		  	Ensure members have the ability to determine their financial responsibility for a drug based on their pharmacy benefit, which include, ordering a refill for an existing or unexpired mail order prescription. This also includes
ensuring members have the ability to initiate the exception process when applicable, locate a in-network pharmacy, and determine a potential drug interaction, side-effects and have the ability to find a generic substitute when needed.	  		  		  		  	
							
		  		  	Health Net uses these findings of member inquiries to identify opportunities for improvement and actively implements corrective action plans based on those opportunities.	  		  		  		  	
							
	Health Net Contact Center	  	NCQA Report Accuracy of Benefit Information on Web	  		  	Annually	  	Active	  		  	
							
		  		  	This report presents an annual review of contacts received by Health Net’s Health Net Contact Center (CCC) from members via Health Net’s website for physician changes and ID card requests.	  		  		  		  	
							
		  		  	Health Net uses these findings of member inquiries to identify opportunities for improvement and actively implements corrective action plans based on those opportunities.	  		  		  		  	
							
	Health Net Contact Center	  	Omni Reports	  	Portfolio of Omni reports to replace Macess reports	  	TBD	  	New	  		  	
							
	Health Net Contact Center	  	First Call Resolution	  	Report that measures first call resolution systematically	  	TBD	  	New; need to solve for Omni fields issue and establish report	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-212	  	Health Net / Cognizant Confidential

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	 Department
Area
	  	 Report Title
	  	 Report Description
	  	 Frequency
	  	 Current
Report
	  	 IT Only - System

(Data Resides)
	  	 IT Only - Who
Generates Report
(Health

Net/IBM/CTS)

	Health Net Contact Center	  	Repeat Callers	  	Report that measures repeat callers systematically	  	TBD	  	New; need to solve for Omni fields issue and establish report	  		  	
							
	Health Net Contact Center	  	Call Types and Trends	  	Report on call types and issues to trend and share cross functionally	  	TBD	  	New; need to solve for Omni fields issue and establish report	  		  	
							
	Health Net Contact Center	  	Aging Reports	  	Report aging of cases	  	TBD	  	New; need to solve for Omni fields issue and establish report	  		  	

  

					
	Schedule G-3 (Management Reports)	  	G-3-213	  	Health Net / Cognizant Confidential

 Final 

SCHEDULE H 
 CHANGE
CONTROL PROCESS 

  

					
	Schedule H		 		Health Net / Cognizant Confidential

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SCHEDULE H 
 CHANGE
CONTROL PROCESS 
 This Schedule H (Change Control Process) sets forth the Change Control Process as defined in Section 17.5 (Change
Control) of the Terms and Conditions. 
  

	1.	CHANGE CONTROL PROCESS 

 Within 60 days of the Effective Date, Health Net and Supplier
will jointly establish a detailed operating level Change Control Process, not inconsistent with the following terms, to include designated Change tracking logs, Change review meetings, Change review boards including definition of applicable Change
Control roles and responsibilities, and Change management timeframes. 
  

	1.1	Right to Request and Completing a CN 

 Either Party may request a Change by submitting to
the other Party’s duly authorized representative a written change notice in substantially the form attached as Schedule H-1 (Sample Change Notice (CN)) to this Schedule H (a “Change Notice” or
“CN”), specifying in detail the proposed Change in accordance with the following procedure: 
  

	 	(a)	Section A of a CN will be executed by the duly authorized representative of the Party that requests the Change, who will act as the CN sponsor throughout the Change Control Process, and who will complete Part A of the
CN and submit it to the other Party for its review and approval. Numbering of Changes will be of this format: XCCYY####, where X is S for Supplier initiated Changes, Health Netis for Health Net Initiated Changes, CCYY is the four digit Year, and
#### is a sequential increasing number for the Change. 

  

	 	(b)	Part B of the CN will be completed by Supplier regardless of who requests the Change. For Supplier-requested Changes, Supplier shall complete Part B concurrently with Part A, and submit it to Health Net for review and
approval. For Health Net-requested Changes, Supplier shall complete Part B and submit it back to Health Net within three (3) Business Days after Supplier’s receipt of the CN from Health Net (or such other period of time as may be agreed by
the Parties based on the nature and extent of the Change requested). In completing Part B of the CN form, Supplier will provide as appropriate: 

  

	 	(i)	a description of the Change and whether Supplier considers the Change to be a New Service or a change to an existing Service; 

  

	 	(ii)	a description of the activities necessary to plan and carry out the Change and to operate and maintain it following its implementation; 

 

	 	(iii)	the projected impact of the Change on the existing Services; 

  

	 	(iv)	Supplier’s proposed charges to make and implement the Change and, if applicable, to operate and maintain it after its implementation; 

 

	 	(v)	information supporting any applicable proposed Charges or changes to Charges, including a brief description of any incremental new or additional Functions that would be required of Supplier, together with a good faith
projection of the 

  

					
	Schedule H		H-1		Health Net / Cognizant Confidential

 Final 

resulting additional resources and associated additional Supplier Charges, if any, that would be attributable to them and, if applicable, a
brief description of any Functions then being performed by Supplier in rendering the existing Services affected by the Change or New Service that would no longer need to be performed or which could be performed at a reduced volume level as a result
of the Change or New Service, together with a good faith projection of the resulting reductions in Supplier resources and associated reductions in Supplier’s Charges, if any; 

 

	 	(vi)	a list of Deliverables (if any) required to implement the Change; 

  

	 	(vii)	a timetable for implementing the Change; 

  

	 	(viii)	any relevant Acceptance criteria and details of how the Change will be subjected to Acceptance testing; 

  

	 	(ix)	an assessment of the added value of the proposed Change to Health Net; 

  

	 	(x)	an assessment of any potential adverse impacts or risks of the proposed Change on Health Net and Supplier’s proposal for mitigating them; 

 

	 	(xi)	proposed amendments to the Agreement in accordance with Section 25.3 (Contract Amendments and Modifications) of the Terms and Conditions, as required, including a brief explanation of why they are needed to effect
the Change; and 

  

	 	(xii)	such other information as Health Net may reasonably request. 

  

	1.2	Review of Changes 

 Health Net and Supplier will review and revise the proposed Change
until they reach agreement on all aspects of the proposed Change, which agreement shall not be unreasonably withheld by either Party. Such review and revision cycles will be conducted in a timely manner so as to avoid negatively impacting
performance of the Services or either Party. 
  

	1.3	Approval of Changes 

 Following agreement on all aspects of the proposed Change between
Health Net and Supplier, Part C of the CN shall be signed by the duly authorized representatives of the Parties appointed for that purpose (such executed CN a “Change Order”). For purposes of this Change Control Process, the
duly authorized representative of Health Net will be designated for each Change Order in accordance with Health Net policy and procedures, and the duly authorized representative of Supplier is the Supplier Client Partner. No Change can be
implemented without the prior authorization of Health Net in accordance with this Section 1.3. All Change Orders must be executed by both Parties before the Change becomes effective. 

  

					
	Schedule H		H-2		Health Net / Cognizant Confidential

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	1.4	Implementation and Management of Changes 

  

	 	(a)	Supplier shall implement all Health Net-approved Changes in accordance with the Agreement (including Section 17.5 (Change Control) of the Terms and Conditions and any and all change management provisions set
forth in Schedule A or any SOW), applicable Laws and Health Net Policies. 

  

	 	(b)	Supplier shall provide monthly reporting on status and target completion dates for open Change Orders. 

  

	2	. EMERGENCY CHANGES 

  

	 	(a)	“Emergency Change” means a Change of a critical business nature that must be implemented immediately to avoid severe adverse impacts, failure to be in compliance with Laws, and/or unintended
significant disruptions to Health Net’s business or Members or Providers. Supplier will make reasonable efforts (given the circumstances) to obtain Health Net’s prior written approval for any Emergency Change. Notwithstanding any other
procedures in this Schedule H, if Health Net requests or approves an Emergency Change, Supplier will promptly implement the Change in accordance with Health Net’s written instructions, and the Parties will prepare the appropriate CN documenting
the Change in parallel with Supplier carrying out the Change. If Supplier makes an Emergency Change without the approval of Health Net, at Health Net’s written request Supplier shall back out such Change as soon as practicable after the
emergency is over or has been otherwise abated, until such time as Health Net approves such Change in accordance with this Schedule H. If Health Net believes that any Change requested by Health Net is an Emergency Change, it will so inform Supplier.

  

	 	(b)	If the Parties are unable to agree on Supplier’s charges (if any) for carrying out an Emergency Change, the matter will be referred to the dispute resolution process. In no event will a dispute over such charges
constitute grounds for Supplier to refuse to carry out or to delay in carrying out an Emergency Change, and in no event will Health Net’s payment of any portion of Supplier’s proposed charges for an Emergency Change constitute a waiver of
Health Net’s right to dispute the validity or amount of such charges. 

  

	 	(c)	Health Net requests for Emergency Changes will be subject to the Change Control Process so as to ensure they are carried out in a controlled and disciplined manner, but Supplier may not refuse to enter into an
appropriate form of Change Order for, or to otherwise carry out, an Emergency Change as directed by Health Net. Health Net may, in its discretion, require Supplier to implement an Emergency Change on an expedited basis where Health Net reasonably
believes that expedited implementation of the Emergency Change is necessary to limit Health Net’s compliance risk or to otherwise mitigate potential adverse consequences to Health Net or its Affiliates. 

  

					
	Schedule H		H-3		Health Net / Cognizant Confidential

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Schedule H-1 
 Sample
Change Notice (CN) 
 CN No. 
 This CN is
made and entered by and between Health Net and Supplier pursuant to Schedule H (Change Control Process) of the Master Services Agreement between Health Net and Supplier dated November 2, 2014. 

Part A (To be completed by the Party requesting the Change) 

Submitted by: 
 Date: 

Detailed Description of Change Requested (if New Services, provide description of such New Services): 

Part B (To be completed by Supplier as applicable to the specific Change) 

Timetable: 
 Project Plan (activities necessary to develop and
implement the Change and to operate and maintain it following its implementation): 
 Projected impact of the Change on the existing Services; 

Supplier’s proposed charges to make and implement the Change and, if applicable, to operate and maintain it after its implementation: 

Information supporting any applicable proposed Charges or changes in Charges: 

Added Value of a Proposed Change to Health Net : 
 Potential
adverse impacts (and risks) of a proposed Change on Health Net and Supplier’s proposals to mitigate them: 
 Deliverables: 

Relevant Acceptance Criteria and Details of Acceptance Testing: 

Proposed Changes to the Agreement as Required (list specific sections and explain why the change is needed): 

Changes to the Procedures Manual: 
 Other information required
by Health Net: 

  

					
	Schedule H-1		H-1-1		Health Net / Cognizant Confidential

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Part C (Each Party to complete and sign where indicated) 

Health Net’s Approval for Supplier to Proceed with the Change As Described Above (Including Applicable changes to Supplier’s Charges as specified
above: 
  

					
	Approved:    		Not Approved:    		

  

			
	Supplier:
		
	By:		 
	Name:		 
	Title:		 
	Date:		 

  

			
	Health Net:
		
	By:		 
	Name:		 
	Title:		 
	Date:		 

 Additional Information Required: 

  

					
	Schedule H-1		H-1-2		Health Net / Cognizant Confidential

 Final 

SCHEDULE I 
 SUPPLIER
INSURANCE 
  

  

					
	Schedule I		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE I 
 SUPPLIER
INSURANCE 
  

	1.	INTRODUCTION 

 With reference to Section 22 (Insurance) of the Terms and Conditions
of this Agreement, this Schedule I (Supplier Insurance) sets forth the requirements for insurance to be maintained by Supplier and its Subcontractors in connection with this Agreement. 

 

	2.	TYPES AND AMOUNTS OF COVERAGE 

 Supplier represents that as of the Effective Date it will
have, and agrees that during the Term it will maintain in force, at least the following types and amounts of insurance: 
  

	 	(a)	Worker’s Compensation Insurance in the form prescribed by statutory law and with limits as required by applicable statute(s), and Employer’s Liability Insurance with minimum limits of not less than $1,000,000
per accident, $1,000,000 per employee – disease, and $1,000,000 per employee – policy limit. 

  

	 	(b)	Commercial General Liability Insurance written on a form at least as broad as Insurance Services Office (“ISO”) commercial general liability coverage form CG 00 01, or another
“occurrence” form providing equivalent coverage and approved in writing by Health Net, including Products, Completed Operations, Premises Operations, Bodily Injury, Property Damage, Personal and Advertising Injury, and Contractual
Liability (Insured Contract) coverages. The amount of required insurance shall be the greater of (i) the limits set forth in Supplier’s Commercial General Liability policy, or (ii) $1,000,000 per occurrence, $1,000,000 personal and
advertising injury, and $2,000,000 general aggregate. This coverage will be endorsed to name Health Net and its Affiliates as additional insureds. 

  

	 	(c)	All-Risk Commercial Property Insurance, including Extra Expense and Business Income coverage, for risks of physical loss of or damage (including as a result of flood or earthquake) to Health Net business personal
property or other personal property that is in the care, custody or control of Supplier pursuant to the Agreement. Such insurance will have a limit adequate to cover risks on a replacement cost basis. This coverage will include Health Net and its
Affiliates as loss payees, as their interest may appear. 

  

	 	(d)	Commercial Auto Liability Insurance issued on a form at least as broad as ISO business auto coverage form CA 00 01, or other form providing equivalent coverage and approved in writing by Health Net, covering use of all
owned, non-owned and hired automobiles for bodily injury, property damage liability with a minimum combined single limit per accident of $1,000,000 or the minimum limit required by law, whichever limit is greater. This coverage will be endorsed to
name Health Net and its Affiliates as additional insureds. 

  

	 	(e)	Commercial Crime Insurance, including coverage for employee dishonesty and computer fraud, for loss or damage arising out of or in connection with fraudulent or dishonest acts (including theft or mysterious
disappearance) committed by the employees of Supplier, acting alone or in collusion with others, including an endorsement or insuring agreement specifying that such personnel theft coverage extends to Health Net’s property and funds and of
others in their care, custody or control, with a minimum limit per occurrence of $10,000,000. This coverage will include a customer’s property and will include Health Net and its Affiliates as joint loss payees. 

  

					
	Schedule I		I-1		Health Net / Cognizant Confidential

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	 	(f)	Professional Liability Insurance / Errors and Omissions Insurance covering liability for loss or damage due to an act, error, omission or negligence, with a per claim limit of $7,000,000, and a limit of $7,000,000 in
the aggregate. This coverage shall be maintained for a minimum of two (2) years following termination or completion of Supplier’s work pursuant to the Agreement. 

 

	 	(g)	Privacy Liability and Network Security Insurance, covering liability and expenses incurred as a result of acts, errors, and omissions in connection with performance of the Services under this Agreement. Such insurance
shall, at a minimum, cover: 

  

	 	(i)	data security breaches (including, without limitation, unauthorized loss, access, use or theft of Protected Health Information, or Health Net Confidential Information); 

 

	 	(ii)	violation of Laws relating to the care, custody, control, or use of Protected Health Information or Health Net Confidential Information, or the privacy or security of such information; 

 

	 	(iii)	data damage, destruction, or corruption; or 

  

	 	(iv)	any act, omission or failure to act that results in a failure of network security (including unauthorized access to, unauthorized use of, a denial of service attack by a third party against, or transmission of a Virus
or other type of malicious code to Health Net’s computer systems). 

 The insurance shall cover Health Net for all
expenses for which Supplier is liable under this Agreement (including reasonable legal expenses) that Health Net incurs as a result of any such actual or alleged event, including costs of defending, settling and paying judgments resulting from
claims, costs of responding to regulatory or administrative investigations and legal advice therefor, regulatory fines, and costs of computer forensic analysis and investigation, notification of impacted individuals, public relations, call center
services, fraud consulting services, credit monitoring and protection services, and identity restoration services. The foregoing insurance shall (x) have a minimum limit of $10,000,000 per claim and in the aggregate; (y) address all of the
foregoing without limitation if caused by an employee of Supplier or an independent contractor working on behalf of Supplier in connection with the Agreement; and (z) provide coverage for wrongful acts, claims, and lawsuits anywhere in the
world. Supplier will maintain the foregoing policy in force during the Term of the Agreement, and for a period of five years after the termination or expiration of this Agreement (either as a policy in force or extended reporting period). Primary
insurance shall be provided to Health Net as it relates to Supplier’s Services, and shall not include an insured versus insured exclusion applicable to claims against Health Net. 

 

	 	(h)	Umbrella or Excess Liability Insurance with minimum limits equal to the greater of (i) the limits set forth in Supplier’s umbrella liability policy; or (ii) $5,000,000, and following the form of, and in excess
of, the insurance required under Paragraphs (b) and (d) above. 

  

					
	Schedule I		I-2		Health Net / Cognizant Confidential

 Final 
  

	3.	TERMS OF COVERAGE 

  

	 	(a)	The insurance coverages, including, without limitation, additional insured coverages, described above will be primary, and all coverage will be non-contributing with respect to any other insurance or self-insurance that
may be maintained by Health Net. Supplier will be responsible for all deductibles and retentions with regard to such insurance. All coverage described above (with the exception of Commercial Crime insurance for waiver of subrogation) will include a
waiver of subrogation and a waiver of any insured-versus-insured exclusion regarding Health Net and its Affiliates. Notwithstanding any insurance coverages of Supplier, nothing in this Schedule I (Supplier Insurance) shall be deemed to limit or
nullify Supplier’s indemnification obligations under the Agreement Supplier agrees that it shall work solely at Supplier’s risk. To the extent any coverage is written on a claims-made basis, it will have a retroactive date no earlier than
the Effective Date and, notwithstanding the termination of the Agreement, either directly or through ‘tail’ coverage will allow for reporting of claims until the applicable limitation of actions period has expired. 

 

	 	(b)	Prior to the initiation of work, Supplier shall provide Health Net’s designated representative with certificates of insurance on ACORD forms (or such other forms approved in writing by Health Net) and copies of any
applicable endorsements evidencing (i) the coverages required to be carried by Supplier as set forth in this Agreement; (ii) the additional insureds’ status; and (iii) that not less than thirty (30) days prior written notice
will be given to Health Net and submitted to the Health Net Strategic Sourcing representative prior to any cancellation of any of the policies. Upon Health Net’s request made at any time prior to five (5) years following completion or
earlier termination of the Services, Health Net may request and Supplier shall promptly deliver updated certificates of insurance, policy declarations pages (with premium and other exposure or Supplier specific information redacted) and policy
endorsements indicating the required coverages. All insurance policies maintained to provide the coverages required herein shall be issued by insurance companies authorized to do business in the state in which work is performed, and by companies
rated, at a minimum, “A-IX” by A.M. Best, or, if such ratings are no longer available, with a comparable rating from a recognized insurance rating agency. Health Net shall be endorsed as an additional insured on all policies required under
the Commercial General Liability and Umbrella or Excess Liability Insurance required hereunder, and shall be evidenced on the certificate of insurance. The insurance afforded to each additional insured shall be at least as broad as that afforded to
the first named insured under each policy. 

  

	 	(c)	In the case of loss or damage or other event that requires notice or other action under the terms of any insurance coverage described above, Supplier will be solely responsible for taking such action. Supplier will
provide Health Net with contemporaneous notice and with such other information as Health Net may request regarding the event. 

  

	 	(d)	The Parties do not intend to shift all risk of loss to insurance. Supplier’s obligation to maintain insurance coverage in specified amounts will not act as a limitation on any other liability or obligation which
Supplier would otherwise have under the Agreement. Similarly, the naming of Health Net and its Affiliates as additional insureds is not intended to be a limitation of Supplier’s liability under the Agreement and will in no event be deemed to,
or serve to, limit Supplier’s liability to Health Net to available insurance coverage or to the policy limits specified in this Schedule I, nor to limit Health Net’s rights to exercise any and all remedies available to Health Net under the
Agreement, at law or in equity. 

  

					
	Schedule I		I-3		Health Net / Cognizant Confidential

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	 	(e)	Supplier will ensure that all Subcontractors, if any, maintain insurance coverages described above including naming Supplier as an additional insured or loss payee where relevant or Supplier will ensure that all
Subcontractors, if any, are included as additional insureds on Supplier’s insurance described above. If any Subcontractor’s coverage does not comply with the provisions herein, Supplier shall indemnify and hold Health Net harmless of and
from any damage, loss, cost or expense, including attorneys’ fees, incurred by Health Net as a result thereof. 

  

					
	Schedule I		I-4		Health Net / Cognizant Confidential

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SCHEDULE J 
 PROJECT
FRAMEWORK 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 
  

  

					
	Schedule J		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE J-1 
 DELIVERABLE
ACCEPTANCE PROCEDURES 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 
  

  

					
	Schedule J-1		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE J-2 
 FORM OF
WORK ORDER 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 
  

  

					
	Schedule J-2		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE J-3 
 PROJECT
ESTIMATION MODEL 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 
  

  

					
	Schedule J-3		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE K 
 REGULATORY
COMPLIANCE ADDENDUM 
  

  

					
	Schedule K		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE K 
 REGULATORY
COMPLIANCE ADDENDUM 
 Supplier acknowledges that Health Net, as a Medicare Advantage Organization under Medicare Part C (Medicare Advantage) and/or
Medicare Part D (Voluntary Prescription Drug Benefit) and as a Medicaid organization (Medicare Parts C and D and Medicaid are collectively, “Government Programs”), is required to include certain terms and conditions in its
contract with Supplier. To the extent that the terms and conditions of the Agreement directly conflict with or contradict any terms and conditions set forth in this Medicare and Medicaid Compliance Addendum, (“Addendum,”) the
terms and conditions of this Addendum shall control. 
  

	1.	Health Net and its first tier entities, downstream and related entities (as defined by 42 CFR § 422.2) paid by Health Net to fulfill obligations under a Government Programs contract, are subject to certain laws
that are applicable to individuals and entities receiving federal and state funds. Supplier, as a first tier entity, acknowledges that payments it receives are, in whole or in part, from federal and state funds in performing services under a
Government Programs contract. 

  

	2.	The Parties acknowledge and agree that Health Net oversees and is accountable to: (i) the Centers for Medicare and Medicaid Services, (“CMS”) for any functions or responsibilities described
in the Medicare Advantage Part C and Part D regulations; and (ii) CMS, the Department of Health Care Services (“DHCS”) and the Arizona Health Care Cost Containment System (“AHCCCS”) for any
functions or responsibilities described in Medicaid regulations. The Parties agree that Health Net maintains ultimate responsibility for adhering to and otherwise fully complying with all terms and conditions of Health Net’s Government Programs
contracts. 

  

	3.	Supplier shall comply with all applicable local, state and federal laws, regulations, guidance and instructions from the Regulators, now or hereafter in effect, to the extent that they directly or indirectly affect
Health Net, Supplier, and/or Supplier’s subcontractors, and bear upon the subject matter of the Agreement, the Addendum, and/or the subject matter of the Government Programs contract. 

 

	4.	The Parties agree that Supplier and Supplier’s downstream and related entities (“subcontractors”) will support and adopt any corrective action plans imposed upon Health Net by the Department of Health and
Human Services (“HHS”), the Comptroller General, CMS, the Department of Justice (“DOJ”), DHCS, AHCCCS, and any and all other governmental agencies with regulatory oversight of Health Net or each of the designees of these
regulatory agencies (collectively, “Regulators”). In turn, Health Net shall, on an ongoing basis, monitor Supplier’s performance and may impose corrective action as necessary. 

 

	5.	Supplier agrees that the Regulators have the right to inspect, evaluate, copy and audit any of Supplier’s pertinent books, records, and contracts, including its Agreement with Health Net, and Supplier’s
agreements with any subcontractors, financial records, computer or other electronic systems, medical records and documentation related to Health Net’s Government Programs contract(s). Further, the Regulators’ right to inspect, evaluate,
copy and audit any pertinent information for any particular contract period exists through ten (10) years from the final date of the contract period or from the date of completion of any audit, whichever is later, and in certain instances, as
referenced in 42 CFR 422.504(e), periods in excess of ten (10) years. Supplier agrees that it will maintain the above-described materials at the Supplier’s place of business, or at such other mutually agreeable location, and upon Health
Net’s or the Regulator’s request, Supplier will provide copies of and/or make available for inspection, evaluation, copying and/or auditing by Health Net or the Regulators, all of Supplier’s above-described materials. Supplier further
agrees that HHS, the Comptroller General or their designees have the right to audit, evaluate, collect, and inspect any records described in the preceding sentence directly from Supplier. 

  

					
	Schedule K		K-1		Health Net / Cognizant Confidential

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	6.	Supplier agrees: (i) to cooperate, assist and provide information as requested for audits, evaluations, reporting requirements and inspections performed in connection with Health Net’s Government Programs
contracts; (ii) that it will cooperate, assist and provide such information within a reasonable time period so that Health Net may meet the reporting requirements of the Regulators and/or applicable law; and (iii) to produce to Health Net
or directly to any Regulator upon such Regulator’s request, any books, contracts, records, including medical records and documentation of Supplier’s or its subcontractors’ performance related to Health Net’s Government Program
contract(s). 

  

	7.	Supplier agrees that upon Health Net’s or the Regulator’s request that it will complete and submit to Health Net, Health Net’s Medicare Attestation, which documents Supplier’s actions regarding its
performance as it relates to Health Net’s Government Programs contracts. In particular, Supplier agrees to monitor and audit: (i) its operations to ensure compliance with applicable laws, regulations and compliance program requirements;
and (ii) its subcontractors to ensure compliance with applicable laws, regulations and compliance program requirements. Supplier further agrees to: (i) create corrective action plans as needed for itself and its subcontractors;
(ii) share those corrective action plan results with Health Net; (iii) provide follow-up documentation to Health Net upon request; and (iv) to retain downstream monitoring and auditing records for a ten (10) year period.

  

	8.	Supplier will comply with the confidentiality and enrollee record accuracy requirements for each Health Net Member who has enrolled in a Medicare or Medicaid benefit program, including: (i) abide by all federal and
state laws regarding confidentiality and disclosure of medical records and other health and enrollment information; (ii) ensure that medical information is released only in accordance with applicable federal and state law, or pursuant to court
orders or subpoenas; (iii) maintain the records and information in an accurate and timely manner; (iv) ensure timely access by enrollees to the records and information that pertain to them; (v) refrain from accessing Member
information not required by Supplier and/or subcontractor to perform its services for Health Net; and (vi) adhere to all other confidentiality requirements established by the Government Programs Regulators. 

 

	9.	Supplier and/or its subcontractors will not process, transfer or release Health Net Members’ protected health information (“PHI”), as defined in 45 C.F.R. § 160.103, outside of the
United States or one of the United States Territories, without the prior written express approval of Health Net. Supplier and its subcontractors agree to comply with all CMS Offshore Attestation requirements (as set forth in Schedule K-2 (CMS
Offshore Attestation Requirements), including submission of an Attestation and supporting documents as requested. For purposes of this Addendum, offshore means outside of the United States and the United States territories. 

 

	10.	Supplier agrees to provide annual training on Supplier’s privacy and security obligations to its employees and subcontractors who create, receive process, transfer, and/or access PHI of Health Net Members who are
enrolled with Health Net under a Government Program contract. 

  

	11.	Supplier agrees that in no event, including, but not limited to Health Net’s nonpayment, insolvency or breach of this Agreement, shall Supplier and/or its subcontractor bill, charge, collect a deposit from, seek
compensation, remuneration or reimbursement from, or have any recourse against a Member or other person, including the State, acting on a Member’s behalf, for payments that are the financial responsibility of Health Net under the Agreement.
This provision survives the termination of the Agreement and relates only to services performed under the Agreement. 

  

	12.	The Parties agree that Health Net may delegate activities or functions including, but not limited to, quality improvement functions, to Supplier, but only in a manner consistent with requirements of the Government
Programs. The delegation agreement shall specify Supplier’s delegated activities and reporting responsibilities and Health Net may revoke delegation of the activities and reporting responsibilities in instances when a Regulator and/or Health
Net determines that Supplier has not performed satisfactorily. 

  

					
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	13.	Supplier agrees that the services or other activity performed by it under this Agreement shall be consistent and comply with Health Net’s contractual obligations to CMS, DHCS, and AHCCCS under its Government
Programs contracts, and Health Net shall modify this Addendum from time to time to include such other terms and conditions as CMS, DHCS and AHCCCS may direct. 

  

	14.	To the extent that Supplier performs its obligations through subcontractors, such subcontractors shall be subject to the: (i) prior approval of Health Net; and/or (ii) prior written approval of the Regulators
in those instances where prior approval is required by the Regulators. 

  

	15.	Supplier agrees to incorporate the terms of this Addendum into its contractual arrangements with subcontractors. 

  

	16.	Supplier agrees to include a timely payment provision in its written agreement with each subcontractor. 

  

	17.	Supplier agrees to comply with policies and procedures of Health Net that have been disclosed to Supplier. Supplier agrees to: (i) review and distribute to its employees and subcontractors Health Net’s
compliance policies found on Health Net’s website, including but not limited to the Medicare Compliance Plan, Standards/Code of Conduct, Code of Business Conduct and Ethics, within 90 days of hire, annually, and when notified in writing by
Health Net that the policies are updated (see Schedule K-1 (Supplemental Regulatory Detail)); and (ii) provide proof of review and distribution upon request. 

 

	18.	Supplier represents and warrants that, to the best of its knowledge, none of its employees, subcontractors or agents who will perform services for Health Net have been excluded, debarred or suspended from participating
in the Medicare program or any state health care program under 42 U.S.C. Section 1320-7 and there are no pending or threatened exclusion actions against any such personnel. Supplier will screen personnel and downstream entities prior to hiring
or contracting, and monthly thereafter. Supplier agrees to review the U.S. Department of Health and Human Services Office of the Inspector General (OIG), List of Excluded Individuals/Entities (LEIE) and the General Services Administration System for
Award Managements, Exclusions Extract Data Package (EEDP) in order to determine if any of its personnel who perform services for Health Net have been excluded, debarred or suspended. If Supplier becomes aware that such personnel have been excluded,
debarred or suspended from participating in the Medicare program or any state health care program, Supplier shall promptly remove any personnel from performing services for the Health Net Government Programs contract(s). Supplier will retain records
related to these screening efforts for a period of ten (10) years. 

  

	19.	Supplier will cooperate with Health Net, and Regulators in protecting against fraud, waste and abuse (“FWA”). Supplier agrees to have all employees, volunteers, consultants, governing body
members, and subcontractors who perform services under Health Net’s Government Programs contracts to complete and document FWA training within 90 days of hire and annually thereafter and to maintain attendance records related to such FWA
training for a period of ten (10) years. Health Net’s FWA training requirement is further described in Schedule K-1. Notwithstanding the foregoing, Health Net and Supplier acknowledge and agree that, effective January 1, 2016,
Supplier’s training obligation shall be to complete the training module made available by CMS. Health Net shall accept the certificate of completion of the CMS training as satisfaction of the training requirement. 

 

	20.	Supplier represents, warrants and covenants to Health Net that Supplier has and will maintain a written corporate compliance program at all times during the term of this Agreement. That program will (i) designate a
senior-level individual to be responsible for the implementation of Supplier’s compliance program; (ii) educate Supplier’s and subcontractor’s personnel providing services under a Government Programs contract on legal and ethical
obligations under a Government Programs contract; (iii) monitor for and remediate any failure of Supplier and/or subcontractor to comply with 

  

					
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legal, ethical and contractual obligations under a Government Programs contract; (iv) provide for prompt notification to Health Net of any
such failure; (v) document the corrective actions taken to remediate any such failure; (vi) retain such documentation for a period of ten (10) years; (vii) include non-intimidation and non-retaliation policies, and
(viii) include a hotline for employees and subcontractors to report non-compliance with the compliance program. 
  

	21.	Supplier agrees that training attestations, excluded entity reviews, disciplinary actions, training and education documents and their distribution records, monitoring events, compliance program requirements, and
documentation of non-compliance that are pertinent and related to Health Net’s Government contracts, including those related to subcontractors under the Government Programs contracts, are also subject to the Regulators’ right of
inspection, evaluation, copying and auditing as set forth above and will be maintained for a minimum of ten (10) years from the final date of the contract period or from the completion date of any audit, whichever is later. 

  

					
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SCHEDULE K-1 

SUPPLEMENTAL REGULATORY DETAIL 
  

  

					
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SCHEDULE K-1 

SUPPLEMENTAL REGULATORY DETAIL 
 Dear
Health Net Medicare Business Partner: 
 First tier, downstream, and related entities (“FDR’s”) are required to operate in
compliance with applicable law and regulatory guidance, including regulations set forth in Title 42 of the Code of Federal Regulations, Parts 422 and 423 and sub-regulatory guidance published in both, Medicare Prescription Drug Benefit Manual,
Chapter 9, and in, Medicare Managed Care Manual, Chapter 21. 
  

	1.	ABOUT THIS DOCUMENT 

 This document is intended to provide supplemental information
regarding the core Medicare compliance program requirements contained within the Medicare Compliance Addendum; it is not intended to replace, reduce, or supersede any/all contractual obligations. Your organization may be subject to additional
requirements that have been established in your contract with Health Net and not discussed in this document. Your organization is receiving this document as you have been identified as a Health Net first tier entity. As a Health Net first tier
entity you must operate in compliance with applicable law and regulatory guidance specifically outlined in your contractual agreements with Health Net, including compliance with all applicable federal, state and CMS Medicare Advantage Part C and
Part D requirements. This document provides a summary of the core Medicare program compliance requirements of first tier entities, their downstream entities and related entities, including citations on where to locate additional information on
Medicare’s regulatory requirements and Health Net’s compliance policies and required training. As part of Health Net’s first tier entity monitoring and oversight activities, your organization will be subject to: submission of periodic
compliance attestations, submission of evidence of compliance, and periodic audit by Health Net to validate that your organization is compliant. 

Health Net strongly recommends that you share this document/information with your downstream entities so that they understand what is expected
and how to meet their compliance program obligations. The periodic compliance attestations referenced above require you to certify that you have instituted internal controls (e.g., periodic attestations, monitoring, auditing) to ensure that your
downstream entities are complying with these compliance program requirements. 
 Additional information on Health Net’s Medicare
compliance policies and procedures and training can be found on Health Net’s website under working with Health Net > Medicare Compliance Regulations at: https://www.healthnet.com/portal/provider/home.ndo. If you have any questions
about the compliance requirements contained in this communication, please contact the Vendor Management Office at vendormanagementoffice@healthnet.com. We appreciate your cooperation and partnership in complying with these important requirements.

  

	2.	WHAT ARE FDRS? 

 CMS defines these terms as follows: 

“FDR” means “First Tier Entity”, “Downstream
Entity” or “Related Entity”. 
 First Tier Entity: Any party
that enters into a written arrangement with an MA organization to provide administrative services or health care services for a Medicare eligible individual under the MA program. 

  

					
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Downstream Entity: Any party that enters into a written arrangement with persons or entities involved with the MA benefit, below
the level of the arrangement between an MA organization and a first tier entity. These written arrangements continue down to the level of the ultimate provider of both health and administrative services. 

Related Entity: Any entity that is related to an MAO or Part D sponsor by common ownership or control and
(1) performs some of the MAO or Part D plan sponsor’s management functions under contract or delegation; (2) Furnishes services to Medicare enrollees under an oral or written agreement; or (3) Leases real property or sells
materials to the MAO or Part D plan sponsor at a cost of more than $2,500 during a contract period. (See, 42 C.F.R. §423.501). 

Overview of Core Medicare Compliance Program Requirements (applies to your employees, board members, subcontractors, downstream entities or
agents, collectively, “personnel”): 
  

			
		
	 1.      Compliance Program Requirement:

Code of Conduct and Business Ethics
		Your Compliance Obligation
		
	 Health Net’s Code of Business Conduct Standard and Ethics establishes the standards that reflect Health Net’s reputation as an
ethical company and describes our expectations that all personnel conduct themselves in an ethical manner; that issues of noncompliance and potential fraud, waste, and abuse (FWA) are reported through the appropriate mechanisms outlined; that there
will be protections against intimidation and retaliation for good faith reporting and that reported issues will be addressed and corrected. Health Net’s Code of Business Conduct and Ethics is available on our website accessible through the
Health Net provider portal.
  
 You have the option to follow Health Net’s Code of
Business Conduct and Ethics or ensure that your organization has a code of conduct that meets CMS requirements that clearly communicate compliance expectations and implement mechanisms for ensuring personnel abide by these expectations.
		 Ensuring personnel receive the code of conduct/business ethics within ninety (90) days of hire/appointment and annually thereafter (or when
any updates are provided to you).
  
 Attest that this requirement was met and retain
evidence (email message, electronic certifications, attestations) this document was distributed within the timeframes stated above.

		
	 2.      Compliance Program Requirement:

General Compliance Information and

Expectations
		Your Compliance Obligation
		
	The general compliance policies and procedures, on our website, communicate Health Net compliance information and expectations for our employees and first tier entities. For example, you will find specific information such as the
Medicare Compliance Officer’s contact information, information about our anonymous and confidential hotlines for reporting compliance concerns and		 Ensure that all personnel receive and review compliance policies and procedures, have access to the compliance information and comply with
the expectations outlined.
  
 Provide evidence of distribution upon
request.

  

					
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	suspected fraud, waste and abuse, our policies for non-retaliation for reporting concerns, and specific policies related to the requirements to report and escalate certain issues within prescribed timeframes.		
		
	 3.      Compliance Program Requirement: Fraud, Waste and Abuse (FWA) Training and
Education
		Your Compliance Obligation
		
	 FDRs will cooperate with Health Net, its partners and Regulators in protecting against fraud, waste and abuse (FWA). All first tier entities
must, at a minimum, ensure their personnel receive FWA training.
  
 These requirements
can be met by completing the CMS Fraud, Waste and Abuse training and education module that is available through the CMS Medicare Learning Network (MLN) website at www.cms.gov/MLNProducts.

 
 Please note that CMS allows for certain individuals or entities to be
“deemed” to have met the FWA training and education requirements due to their enrollment into Medicare Parts A or B, or through accreditation as a supplier of durable medical equipment, prosthetics, orthotics, and supplies
(DMEPOS).
		 Ensure that personnel and your downstream entities have fulfilled the FWA training requirements within ninety (90) days of initial hiring and
annually thereafter.
  
 Attest that these requirements were met and retain evidence such
as training certifications.

		
	 4.      Compliance Program Requirement: Lines of Communications and Reporting Obligations
		Your Compliance Obligation
		
	 Health Net has adopted processes to receive, record and respond to compliance questions, reports of potential or actual noncompliance, and
FWA from contractors, agents, directors, enrollees, and first tier entities. Health Net maintains confidentiality to the extent possible, allows callers to remain anonymous if desired and ensures
non-retaliation against those who report suspected misconduct.
  

To report suspected fraud, waste or abuse, contact Health Net as listed below:
  

Health Net, Inc. Special Investigations Unit
 PO Box 2048

Rancho Cordova, CA 95741-2048
  

Health Net’s Fraud Hotline: (800) 977-3565
		 Establish a culture that requires all employees to report compliance concerns and suspected or actual violations.

 
 Establish a 24 hour user friendly and hot-line reporting service.

 
 Ensure that all personnel receive the reporting information, understand reporting
timeframes and are complying with the expectations outlined.
  
 Attest that this
requirement was met and retain evidence (email message, electronic certifications, attestations) this information was distributed to personnel.

  

					
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	 To report potential or actual noncompliance or ethical concerns, contact Health Net as listed below:

 
 Health Net Medicare Compliance Officer

Gay Ann Williams

Mail Stop: CA-102-22-07

21650 Oxnard Street

Woodland Hills, CA 91367
  

Health Net’s Integrity Line: (888) 866-1366
		
		
	 5.      Compliance Program Requirement: Well Publicized Disciplinary Standards
		Your Compliance Obligation
		
	Health Net’s disciplinary standards are incorporated into several compliance policies which are located on our website. The policies include specific information such as our anonymous and confidential hotlines for reporting
compliance concerns, non-retaliation for reporting concerns, appropriate disciplinary actions, compliance with Corrective Action Plans and specific information related to the requirements to report and
escalate certain issues within prescribed timeframes.		 Ensure communication to personnel of disciplinary standards.
  

Ability to demonstrate that there was timely, consistent and effective disciplining actions for violations, etc.

 
 Attest that this requirement was met (email message, electronic certifications,
attestations).
  
 Maintenance of documentation of disciplinary actions for a period of
ten (10) years.

		
	 6.      Compliance Program Requirement: Monitoring and Auditing
		Your Compliance Obligation
		
	Health Net’s monitoring and auditing policy is available on our website. This policy provides specific information regarding the auditing and monitoring requirements for personnel who perform services to help fulfill Health
Net’s Medicare Part C and/or Part D contract requirements.		 Establish and implement an effective system for routine monitoring and the identification of compliance risks, which includes internal
monitoring and auditing and external audits to ensure program compliance.
  
 Monitoring
and auditing of downstream entities compliance with applicable Medicare requirements.
  

Attest that this requirement was met and retain evidence including but not limited to; monitoring outcomes, summary of the audit work plan, and audit results
including appropriate and timely correction of deficiencies.

		
	 7.      Compliance Program Requirement Excluded Entity Screenings
		Your Compliance Obligation
		
	Medicare payment may not be made for items or services furnished or prescribed by an excluded entity. Federal funds shall not be used to pay for services, equipment or drugs prescribed or provided by a provider, supplier, employee
or FDR		 To have a process for demonstrating compliance with excluded entity screening, including:

 
 Confirmation that personnel are screened against the OIG (LEIE) and GSA (EEDP) exclusion
lists prior to hire/contracting and monthly thereafter.

  

					
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	excluded by the DHHS OIG or GSA. First tier entities and their downstream entities must review; (i) the U.S. Department of Health and Human Services Office of the Inspector General (OIG), List of Excluded Individuals/Entities
(LEIE), and (ii) the General Services Administration System(GSA) for Award Managements, Exclusions Extract Data Package (EEDP).		  
 Prompt removal of any personnel from services for Health Net when it is
identified that such personnel have been excluded, debarred or suspended from participating in the Medicare program.
  

Attest that this requirement was met and retain evidence including but not limited to; monthly reports, disciplinary actions, and policies and
procedures.

		
	 8.      Compliance Program Requirement: Prompt Response to Detected Offenses
		Your Compliance Obligation
		
	Health Net’s compliance issues policy establishes the process and procedure for promptly responding to compliance issues as they are raised, investigating potential compliance problems as identified in the course of
self-evaluations and audits, correcting such problems promptly and thoroughly to reduce the potential for recurrence, and ensure ongoing compliance with CMS requirements.		 To have a process for demonstrating the methods used to report or respond to detected offenses, including:

 
 Maintenance of documentation of all deficiencies identified for a period of ten (10)
years.
  
 Assurance of appropriate corrective actions taken when deficiencies are
detected.
  
 Monitoring corrective actions of personnel after implementation to ensure
actions are effective and prevent recurrence.
  
 A process which indicates whether and
when potential non-compliance incidences should be reported to the client.

		
	 9.      Compliance Program Requirement: Record Retention
		Your Compliance Obligation
		
	Books, records, documents, and other evidence of accounting procedures and practices that are related but not limited too; training records, disciplinary records, records for audit and inspection, and required access to records, are
subject to the CMS ten (10) year record retention requirement. Examples of documents include, but are not limited too; records that relate to CMS program requirements (e.g., code of conduct, audit and monitoring reports, hotline reports, etc.),
OIG GSA/SAM screenings and background checks including records of detected exclusions and follow-up actions, disciplinary records, including date reported violation description, date of investigation, summary of findings, disciplinary action and the
date the action was taken, and records that relate to completion of specialized compliance and/or FWA training.		 To have a process for demonstrating record retention compliance, including:

 
 Attest annually that this requirement is being fulfilled.

  

					
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	 10.    Compliance Program Requirement:

OffshoreSubcontracting Attestation
		Your Compliance Obligation
		
	 All Health Net FDRs who use offshore subcontractors to process, handle or access Health Net MA member PHI in oral, written or electronic
form, must submit an offshore attestation, including supporting documentation, to Health Net (obtain from your Health Net representative).
 Member data is
not allowed to be stored offshore. Offshore entities may access data through onshore entities located in the United States. Information on the CMS Offshore Attestation requirement can be found at http://www.healthnet.com/provider >
Contractual and Clinical Resources > Medicare Compliance Regulations > Offshore Subcontracting Attestation.
		 To have a process for demonstrating compliance with Offshore Subcontracting requirements including:

 
 Submission of the attestation form and supporting documentation for each offshore
subcontractor engaged to perform Medicare-related work.
  
 Providing, as requested,
supporting documentation (for example contracts minus proprietary information), policies and procedures, and auditing results).
  

Retain documents for a ten (10)-year period.

  

					
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SCHEDULE K-2 
 CMS
OFFHSORE ATTESTATION REQUIREMENTS 
  

  

					
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SCHEDULE K-2 
 CMS
OFFHSORE ATTESTATION REQUIREMENTS 
  

	1.	OFFSHORE SUBCONTRACT INFORMATION AND ATTESTATION (CY 20XX & CY 20XX) 

 Annual
Reporting- (Month, Day, Year) New/Changes (Due within xx days) 
  

	1.1	Part I. Medicare Part C Organization and Part D Plan Sponsor Information 

  

	 	(a)	Provide legal name of MAO or PDP sponsor; and [Name of parent company if different] 

  

	 	(b)	Identify MAO or PDP sponsor contracts or prospective contracts (e.g., H1234 or S1234). [This is to completed by Health Net] 

  

	1.2	Part II. Offshore Subcontractor Information 

  

	 	(a)	Provide offshore subcontractor name; 

  

	 	(i)	Provide offshore subcontractor country 

  

	 	(ii)	Provide offshore subcontractor address; 

  

	 	(b)	Describe offshore subcontractor functions (narrative discussion) 

  

	 	(c)	State proposed or actual effective date for offshore subcontract. 

  

	1.3	Part III. Precautions for Protected Health Information (PHI) 

  

	 	(a)	Describe the PHI that will be provided to the offshore subcontractor; 

  

	 	(b)	Discuss why providing PHI is necessary to accomplish the offshore subcontractor’s objectives; and 

  

	 	(c)	Describe alternatives considered to avoid providing PHI, and why each alternative was rejected. 

  

	2.	OFFSHORE 

  

	2.1	Part I. Attestation of Safeguards to Protect Beneficiary Information in the Offshore Subcontract 

  

					
	 	  	 Yes or No
	  	 Attestation

	 I.1.
	  		  	Offshore subcontracting arrangement has policies and procedures in place to ensure that PHI and other personal information remains secure.
	 I.2.
	  		  	Offshore subcontracting arrangement prohibits subcontractor’s access to Medicare data not associated with the sponsor’s contracts.

  

					
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	 	  	 Yes or No
	  	 Attestation

	 I.3.
	  		  	Offshore subcontracting arrangement has policies and procedures in place that allow for immediate termination of the subcontract upon discovery of a significant security breach.
	 I.4.
	  		  	Offshore subcontracting arrangement includes all required Medicare Part C and D language (e.g., record retention requirements, compliance with all Medicare Part C and D requirements, etc.)

  

	2.2	Part II. Attestation of Audit Requirements to Ensure Protection of PHI 

  

					
	 	  	 Yes or No
	  	 Attestation

	 II.1.
	  		  	Organization will conduct an annual audit of the offshore subcontractor.
	 II.2.
	  		  	Audit results will be used by the Organization to evaluate the continuation of its relationship with the offshore subcontractor.
	 II.3.
	  		  	Organization agrees to share offshore subcontractor’s audit results with CMS, upon request.

  

	
	   

	[SIGNATURE OF INDIVIDUAL AUTHORIZED TO SIGN ON BEHALF OF ORGANIZATION]
	
	   

	[TITLE]
	
	   

	[DATE]

  

					
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SCHEDULE K-3 
 AHCCCS
SUBCONTRACT 
  

  

					
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SCHEDULE K-3 
 AHCCCS
SUBCONTRACT 
 Supplier acknowledges that Health Net’s subsidiary, Health Net Access, Inc. (“Health Net Access”) is a party to the
Arizona Health Care Cost Containment System (“AHCCCS”) Contract which requires that certain terms and conditions be included in contracts with subcontracting entities such as Supplier that deliver services as a subcontractor to the AHCCCS
Contract. This Schedule K-3 sets forth such requirements, which are in addition those requirements set forth elsewhere in the Master Services Agreement (“Agreement”), and are applicable to services provided by Supplier under the AHCCCS
Contract. 
  

	 	1.	Definitions: Defined terms used in this Schedule K-3 shall have the same meaning as in the Agreement unless otherwise specifically defined herein. 

 

	 	2.	Supplier shall comply with the terms and conditions of the attached. 

  

	 	3.	Supplier acknowledges and agrees that in the event of any conflict between this Agreement and state and federal laws, rules and regulations to which Health Net or Supplier is subject, or the contract between Health Net
and AHCCCS, such state and federal laws, rules and regulations shall control. 

  

	 	4.	This Schedule K-3 incorporates and requires compliance with the Minimum Subcontract Provisions of AHCCCS, available at http://www.azahcccs.gov/commercial/MinimumSubcontractProvisions.aspx. 

 

	 	5.	Supplier’s compliance and performance of this Agreement shall be monitored by Health Net periodically and is subject to formal review according to a schedule approved by AHCCCS. Deficiencies in Supplier’s
performance identified in such periodic reviews and monitoring shall be communicated to the Supplier and a corrective action plan developed and provided to Supplier. Health Net may revoke the continued participation by Supplier as a subcontractor
under the AHCCCS Contract or impose other sanctions if Supplier’s performance is determined by Health Net to be inadequate. 

  

	 	6.	Supplier shall cooperate, as applicable, with quality assurance programs and comply with the utilization control and review procedures specified in 42 CFR Part 456, as specified in the AHCCCS Medical Provider Manual
(“AMPM”). 

  

	 	7.	Supplier shall be fully responsible for all tax obligations, worker’s compensations insurance and all other applicable insurance coverage obligations which arise under this Agreement for itself and its employees,
and AHCCCS shall have no responsibility or liability for any such taxes or insurance coverage. 

  

	 	8.	Health Net may suspend, deny, refuse to renew or terminate this Agreement in accordance with the terms of the Agreement and applicable law and regulation. 

  

					
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	 	9.	If Supplier is performing any utilization management and concurrent review activities pursuant to this Agreement, Supplier may not structure compensation to individuals or entities that conduct utilization management
and concurrent review activities so as to provide incentives for the individual or entity to deny, limit or discontinue medically necessary services to any enrollee (42 CFR 438.210(e)). 

 

	 	10.	Supplier shall verify the eligibility and enrollment of a Beneficiary in AHCCCS and assigned to Health Net by accessing the AHCCCS website or contacting Health Net. Supplier, if applicable, shall comply with all AHCCCS
enrollment and disenrollment procedures for Medicaid Beneficiaries and acknowledges that Medicaid Beneficiaries are enrolled and disenrolled by AHCCCS. 

  

	 	11.	Supplier may provide Health Net Access Beneficiaries with factual information, but is prohibited from recommending or steering a Beneficiary in his/her selection of an AHCCCS Program Contractor. 

 

	 	12.	Supplier, if applicable, shall identify Medicare and other third party liability coverage and seek such Medicare or third party liability payment before submitting claims to Health Net. 

 

	 	13.	Supplier, if applicable, shall comply with Health Net and AHCCCS encounter reporting and claims submission requirements. 

  

	 	14.	Supplier, if applicable, shall comply with any necessary authorization from Health Net or AHCCCS for services provided to an eligible and/or enrolled Health Net Access Beneficiary. 

 

	 	15.	Before entering into this Agreement which delegates duties or responsibilities to Supplier, Health Net has evaluated Supplier’s ability to perform the activities to be delegated hereunder. The delegated duties and
reporting responsibilities are specified under the Agreement. Health Net Access’ Chief Executive Officer retains the authority to direct and prioritize any delegated contract requirements for services delivered pursuant to the AHCCCS Contract.

  

	 	16.	The Agreement incorporates by reference the terms and conditions of the AHCCCS Medicaid contract. 

  

	 	17.	A merger, reorganization or change in ownership of Supplier shall require a contract amendment and prior approval of AHCCCS. 

  

	 	18.	This Schedule K-3 incorporates and requires Supplier’s compliance with the Disclosure of Ownership and Control and Disclosure of Information on Persons Convicted of Crimes requirements as outlined in contract and
42 CFR 455.101 through 106, 42 CFR 436 and SMDL09-001. 

  

	 	19.	Supplier shall require that all Beneficiary communications furnished by the Supplier include Health Net’s name. 

  

					
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SCHEDULE L 
 DISENGAGEMENT
ASSISTANCE 
  

  

					
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TABLE OF CONTENTS 
  

									
	 1.
		 INTRODUCTION
		 	1	  
			
	 2.
		 DEFINITIONS
		 	1	  
				
			2.1		CERTAIN DEFINITIONS		 	1	  
			2.2		OTHER DEFINED TERMS		 	3	  
			
	 3.
		GENERAL TERMS		 	3	  
				
			3.1		OVERVIEW OF DISENGAGEMENT ASSISTANCE		 	3	  
			3.2		SURVIVAL OF AGREEMENT		 	3	  
			
	 4.
		REVERSE TRANSITION PLANNING		 	3	  
				
			4.1		REVERSE TRANSITION DEFINED		 	3	  
			4.2		REVERSE TRANSITION PLAN		 	4	  
			
	 5.
		RESOURCE TRANSITION		 	4	  
				
			5.1		GENERAL TERMS		 	4	  
			5.2		OWNED EQUIPMENT		 	7	  
			5.3		LEASED EQUIPMENT		 	8	  
			5.4		THIRD PARTY AGREEMENTS		 	8	  
			5.5		TELEPHONE NUMBERS		 	9	  
			5.6		SOFTWARE AND DELIVERABLES		 	9	  
			5.7		UNIDENTIFIED ASSETS		 	9	  
			5.8		HUMAN RESOURCES		 	10	  
			
	 6.
		REVERSE TRANSITION ASSISTANCE		 	10	  
				
			6.1		GENERAL SUPPORT FOR REVERSE TRANSITION IMPLEMENTATION		 	10	  
			6.2		SUPPLIER REVERSE TRANSITION TEAM		 	10	  
			6.3		OPERATIONAL TRANSITION		 	10	  
			6.4		ORGANIZATIONAL TRANSITION		 	14	  
			6.5		BUSINESS CONTINUITY TRANSITION		 	14	  
			6.6		KNOWLEDGE TRANSFER		 	15	  
			6.7		FINANCIAL TRANSITION		 	16	  

  

					
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	1.	INTRODUCTION 

 This Schedule L (Disengagement Assistance) further describes
certain Disengagement Assistance and sets forth other terms relating to the provision of Disengagement Assistance. The general purpose of Disengagement Assistance, and Supplier’s goal in providing it, shall be (a) to enable Health Net to
obtain from another service provider or to provide for itself and other Service Recipients, each in an efficient manner without adverse effect on the continuity of operations or otherwise, services to substitute for or replace the Services, and
(b) to minimize any adverse effect of transferring responsibility for providing the Services to Health Net or to a new provider or providers selected by Health Net. 
  

	2.	DEFINITIONS 

  

	 	2.1	Certain Definitions 

 The following terms, when used in this Schedule L (Disengagement
Assistance), have the meanings given them in this Section 2.1: 
  

	 	(a)	“Affected Supplier Personnel” has the meaning given in Section 5.8(a)(i). 

  

	 	(b)	“Affected Services” has the meaning given in the Terms and Conditions. 

  

	 	(c)	“Commercially Reasonable Efforts” has the meaning given in the Terms and Conditions. 

  

	 	(d)	“Confidential Information” has the meaning given in the Terms and Conditions. 

  

	 	(e)	“Cutover Date” means, for any Affected Services, the corresponding effective date of the cessation of, or the termination or expiration (as applicable) of Supplier’s obligation under the
Agreement to provide, such Affected Services (as such effective date may be extended pursuant to the Terms and Conditions). 

  

	 	(f)	“Dedicated” solely for purposes of this Section 2.1, shall mean Supplier Personnel who spend at least *** of their time in the performance of the Affected Services. 

 

	 	(g)	“Dedicated BPO Personnel” means any business process operation Supplier Personnel Dedicated to the performance of the Affected Services (it being understood that any Dedicated Supplier Personnel
that are not within the category of Dedicated IT Personnel shall default into this category regardless of the role such individual performs in connection with the Affected Services). 

 

	 	(h)	“Dedicated IT Personnel” means any information technology Supplier Personnel Dedicated to the performance of the Affected Services. 

 

	 	(i)	“Dedicated Personnel” means Dedicated BPO Personnel and Dedicated IT Personnel. 

  

	 	(j)	“Discovery Notice” has the meaning given in Section 5.7(a). 

  

	 	(k)	“Disengagement Assistance” has the meaning given in the Terms and Conditions. 

  

	 	(l)	“Equipment” has the meaning given in the Terms and Conditions. 

  

	 	(m)	“Financial Reconciliation Period” has the meaning given in Section 6.7. 

  

	 	(n)	“Health Net Data” has the meaning given in the Terms and Conditions. 

  

					
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	 	(o)	“Health Net Facilities” has the meaning given in the Terms and Conditions. 

	 	(p)	“Knowledge Transfer Plan” has the meaning given in Section 6.6(b). 

  

	 	(q)	“Leased Equipment” has the meaning given in Section 5.3(a). 

  

	 	(r)	“Non-BPaaS Owned Equipment” means Owned Equipment used in connection with the Non-BPaaS IT Services. 

 

	 	(s)	“Out-of-Pocket Expenses” has the meaning given in the Terms and Conditions. 

  

	 	(t)	“Owned Equipment” has the meaning given in Section 5.2(a). 

  

	 	(u)	“Procedures Manual” has the meaning given in the Terms and Conditions. 

  

	 	(v)	“Required Consent” has the meaning given in the Terms and Conditions. 

  

	 	(w)	“Remaining Rebadged BPO Personnel” means any business process operation Transitioned Employees who (a) are still employed by Supplier or its Subcontractors, and (b) who are Dedicated to
the performance of the Affected Services (it being understood that any Transitioned Employees that are Dedicated to the performance of the Affected Services and who are not within the category of Remaining Rebadged IT Personnel shall default into
this category regardless of the role such individual performs in connection with such Affected Services. 

  

	 	(x)	“Remaining Rebadged IT Personnel” means any information technology Transitioned Employees who (a) are still employed by Supplier or its Subcontractors, and (b) who are Dedicated to the
performance of the Affected Services. 

  

	 	(y)	“Resources” has the meaning given in Section 5.1(a)(i). 

  

	 	(z)	“Reverse Transition” has the meaning given in Section 4.1. 

  

	 	(aa)	“Reverse Transition Plan” has the meaning given in Section 4.2. 

  

	 	(bb)	“Service Levels” has the meaning given in Schedule B (Service Levels). 

  

	 	(cc)	“Service Recipients” has the meaning given in the Terms and Conditions. 

  

	 	(dd)	“Services” has the meaning given in the Terms and Conditions. 

  

	 	(ee)	“Source Code” has the meaning given in the Terms and Conditions. 

  

	 	(ff)	“Subcontractor” has the meaning given in the Terms and Conditions. 

  

	 	(gg)	“Successor Supplier” means any third-party vendor to whom Health Net directs that (i) any Disengagement Assistance be provided, or (ii) Resources be transferred in accordance with this
Schedule L (Disengagement Assistance). 

  

	 	(hh)	“Supplier Non-Personnel Resource Obligations” has the meaning given in Section 5.1(c)(iii). 

  

	 	(ii)	“Supplier Personnel” has the meaning given in the Terms and Conditions. 

  

	 	(jj)	“Supplier Personnel Information” has the meaning given in Section 5.8(a). 

  

	 	(kk)	“Supplier Personnel Resource Obligations” has the meaning given in Section 5.1(c)(iv). 

  

	 	(ll)	“Supplier Procured IT Asset Charge” has the meaning given in Schedule C (Charges). 

  

					
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	 	(mm)	“Supplier Reverse Transition Lead” has the meaning given in Section 6.2(a). 

  

	 	(nn)	“Third Party Agreement” has the meaning given in Section 5.4(a). 

  

	 	(oo)	“Transitioned Employee” has the meaning given in Schedule E (Transitioned Employees). 

  

	 	(pp)	“Unidentified Asset” has the meaning given in Section 5.7(a). 

  

	 	(qq)	“Use” has the meaning given in the Terms and Conditions. 

  

	 	2.2	Other Defined Terms 

 Other terms used in this Schedule L (Disengagement
Assistance) are either defined in the context in which they are used or are defined elsewhere in the Agreement, and in each case shall have the meanings there indicated. 
  

	3.	GENERAL TERMS 

  

	 	3.1	Overview of Disengagement Assistance 

  

	 	(a)	In accordance with Section 16.6 (Disengagement Assistance) of the Terms and Conditions, Supplier will provide Disengagement Assistance with respect to the Services as Health Net may reasonably request. In addition
to the terms and conditions set forth in this Schedule L (Disengagement Assistance), Disengagement Assistance shall include the Supplier obligations set forth in Section 16.6 (Disengagement Assistance) of the Terms and Conditions
and the provision of bid assistance as set forth in Section 16.8 (Bid Assistance) of the Terms and Conditions. 

  

	 	(b)	Disengagement Assistance shall be deemed to be Services, and shall be provided in accordance with this Agreement, including the terms of this Schedule L (Disengagement Assistance). Disengagement Assistance will
be provided by Supplier as requested by Health Net, and pursuant to a plan specified by Health Net or its designee, with input from Supplier (including as provided in Section 4 of this Schedule L (Disengagement Assistance)).

  

	 	(c)	To the extent that Supplier has delegated its obligation to provide Affected Services to a Subcontractor, Supplier shall cause such Subcontractor to comply with Supplier’s obligation to provide Disengagement
Assistance with respect to such Affected Services, and with the terms of this Schedule L (Disengagement Assistance). 

  

	 	3.2	Survival of Agreement 

 Disengagement Assistance will be deemed to be governed by
the Terms and Conditions of the Agreement notwithstanding its earlier termination or expiration. 
  

	4.	REVERSE TRANSITION PLANNING 

  

	 	4.1	Reverse Transition Defined 

 Supplier shall support and cooperate with the transition
from Supplier to Health Net or one or more of Health Net’s designees of Supplier’s responsibility for performing the Affected Services (such transition collectively the “Reverse Transition”). The Reverse Transition
shall include (a) the migration of the corresponding operations to one or more of such entities, (b) to the extent set forth herein and requested by Health Net, the transfer of the corresponding employees and contractor personnel to one or
more of such entities 

  

					
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and (c) to the extent set forth herein and requested by Health Net, the transfer of the corresponding assets to one or more of such
entities, each of (a) through (c) in accordance with the terms of this Schedule L (Disengagement Assistance) and the Agreement. 
  

	 	4.2	Reverse Transition Plan 

 Health Net or its designee will be responsible
for planning and managing the Reverse Transition. For any Affected Services, Supplier will assist Health Net or its designee in preparing and subsequently revising a plan for the Reverse Transition of such Affected Services to Health Net or its
designee, which may include major transition activities, schedules, and milestones that are aligned with Health Net’s requirements and the rights outlined in this Schedule L (any such plan a “Reverse Transition Plan”).
Without limiting the generality of the foregoing, such assistance shall include: 
  

	 	(a)	preparing input for the Reverse Transition Plan detailing how Supplier will perform, during the Reverse Transition, its responsibilities to provide (i) the corresponding Affected Services before the corresponding
Cutover Date(s), and (ii) Disengagement Assistance with respect to the Affected Services; 

  

	 	(b)	reviewing draft versions of the Reverse Transition Plan and subsequent revisions, identifying to Health Net (i) risks associated with Health Net’s proposed plans for Reverse Transition insofar as those plans
involve the Affected Services (including any potential disruption in the Affected Services before the corresponding Cutover Date(s)), and suggested means by which such risks may be mitigated; and (ii) operational constraints that may conflict
with Health Net’s proposed plans; and 

  

	 	(c)	providing other information regarding the Affected Services or Supplier’s performance of Disengagement Assistance with respect to the Affected Services that may be reasonably requested by Health Net in connection
with the preparation or subsequent revision of the Reverse Transition Plan. 

  

	5.	RESOURCE TRANSITION 

  

	 	5.1	General Terms 

  

	 	(a)	Access to Resources. 

  

	 	(i)	Supplier shall provide to Health Net or its designee reasonable and timely access to and use of Equipment, Software, personnel, third parties (including Subcontractors), third party contracts (including leases, licenses
and contracts), documentation and other materials or resources that are used to provide such Affected Services (collectively the “Resources”) for the purpose of transitioning responsibility for such Affected Services to
Health Net or its designee. 

  

	 	(ii)	Supplier shall also provide Health Net or its designee with information concerning the Resources as reasonably requested by Health Net (subject to the confidentiality obligations (A) with third parties, (B) of
the Terms and Conditions and (C) any applicable Laws). 

  

	 	(b)	Management of Resources. 

  

	 	(i)	If and to the extent reasonably requested in writing by Health Net in connection with Disengagement Assistance for any Affected Services, Supplier shall obtain Health Net’s prior written approval before
(A) taking any action or actions with respect to the removal, reassignment, transfer, disabling or disposal of any corresponding Resources, or (B) amending, terminating or extending the terms of (or entering into new) agreements governing
such Resources. 

  

					
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	 	(ii)	Without limiting the generality of the foregoing, with respect to personnel Resources, if and to the extent requested by Health Net in connection with Disengagement Assistance for any Affected Services, Supplier will
not, without the prior written consent of Health Net: 

  

	 	(A)	Terminate or materially vary, or purport or promise to vary, the terms or conditions of employment, engagement, or service of any Supplier Personnel performing Affected Services; 

 

	 	(B)	Terminate (or give notice to terminate) the employment or engagement of any Dedicated Personnel other than lawfully for cause; or 

  

	 	(C)	Prevent, restrict or hinder any Dedicated Personnel from working for Health Net or any of its designees (including a Successor Supplier). 

 

	 	(c)	Transfer of Resources. 

  

	 	(i)	Supplier shall provide all reasonable assistance required for, and shall take all reasonable actions (including by executing documents) necessary to effect the transfer of Resources as contemplated in this
Section 5. Health Net shall reasonably cooperate with Supplier in effecting such transfer of Resources, and shall use Commercially Reasonable Efforts to cause any Successor Supplier to do the same, in each case with due consideration given to
minimizing the costs to Supplier and Health Net associated with such transfer of Resources. Supplier shall use Commercially Reasonable Efforts to minimize the costs associated with the transfer of, or assumption of responsibility for, Resources
pursuant to this Section 5. 

  

	 	(ii)	Unless otherwise requested by Health Net, the effective date of any transfer of Resources pursuant to this Section 5 shall be the Cutover Date for the corresponding Affected Services. 

 

	 	(iii)	Health Net will not assume, and shall not be liable for, any of Supplier’s or any of its Subcontractor’s obligations to any third party with respect to any non-personnel Resource owned, leased, licensed, or
contracted for by Supplier or any of its Subcontractors (such obligations collectively the “Supplier Non-Personnel Resource Obligations”), and Supplier shall be responsible for performing such Supplier Non-Personnel Resource
Obligations; provided, however, that for any such Resource transferred to Health Net or its designee pursuant to this Section 5, Health Net shall be responsible for such obligations to the limited extent such obligations (A) arise under a
contract that is assigned to Health Net or its designee under this Section 5, and (B) arise after the effective date of assignment of such contract under this Section 5. 

 

	 	(iv)	Health Net will not assume, and shall not be liable for, any claims, obligations, or liabilities of any kind or nature with respect to any personnel Resource that arise out of (A) Supplier’s relationship as
the 

  

					
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employer of such person, or (B) a contractual arrangement with such person (such obligations collectively “Supplier Personnel
Resource Obligations”), and Supplier shall be responsible for performing such Supplier Personnel Resource Obligations; provided, however, that for any personnel Resource transferred to Health Net or its designee pursuant to
Section 5.7, Health Net shall be responsible for such claims, obligations and liabilities to the limited extent such obligations are either (1) asserted, or result from, facts or circumstances occurring after the date on which such person
commences employment with Health Net or its designee (in the case of personnel hired by Health Net or its designee) or the date the corresponding contract is assigned to Health Net or its designee (in the case of contractor personnel), or
(2) caused by Health Net or its designee (including by their respective acts and omissions in connection with the selection, recruitment and employment of such persons, if applicable). 

 

	 	(d)	Required Consents. 

  

	 	(i)	Software and associated maintenance and support agreements. Supplier shall be financially and administratively responsible (with the cooperation of Health Net) for obtaining the Required Consents for any Software
(and associated maintenance and support agreements) for which Supplier is obligated to provide a license to Health Net pursuant to Section 12.3 (Health Net Rights to Certain Software) or Section 15.1(b) of the Terms and Conditions,
or any other section of the Agreement. Health Net shall be financially responsible and Supplier shall be administratively responsible (with the cooperation of Health Net) for obtaining a Required Consent necessary to assign a Software license (and
associated maintenance and support agreements) for any Software not covered by the prior sentence. 

  

	 	(ii)	Equipment Leases and Third Party Service Contracts. If Health Net requests Supplier to assign any leased Equipment in accordance with Section 5.3, or if Health Net requests Supplier to assign any third party
service contract in accordance with Section 5.4 below, then the Party which is obligated to procure the Required Consent for such Equipment lease or third party service contract shall be as follows: 

 

	 	(A)	if at the time of acquisition of such leased Equipment or third party service contract, (1) Supplier used Commercially Reasonable Efforts to obtain the right to assign the asset to Health Net, but (2) despite
such efforts Supplier was unable to obtain such rights, and (3) Supplier so notified Health Net, and (4) Supplier explored any alternatives and provided such information to Health Net, including any ramifications to the Services that may arise
out of using alternatives, and (5) Health Net agreed that Supplier could acquire such asset to utilize in providing the Services notwithstanding not having such right to assign, then Health Net shall be financially obligated to procure such
Required Consent and Supplier shall be administratively responsible for procuring such Required Consent (with the cooperation of Health Net); 

  

					
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	 	(B)	For any scenario not covered by Section 5.1(d)(ii)(A) above, Supplier shall be financially and administratively obligated to procure such Required Consent (with the cooperation of Health Net); and 

 

	 	(iii)	For clarity, maintenance and support agreements for Software are covered by Section 5.1(d)(i) above and not Section 5.1(d)(ii). 

  

	 	(e)	Relationship of Asset Purchase Prices to Termination Charges. 

 As a general principle,
it is understood and agreed by the Parties that Health Net is not, in any circumstances, obliged to compensate Supplier twice for the acquisition cost of an item of Software, Equipment, or any other tangible Resource acquired by Health Net from
Supplier pursuant to this Section 5. Accordingly, to the extent that any Termination Charges payable by Health Net include an allowance or allocation for the expected net book value, residual value or other value of the categories of Resources that
Health Net is entitled to acquire from Supplier in connection with the termination, the following shall apply: 
  

	 	(i)	If Health Net pays Supplier a purchase price for any Resources, such payment shall be deemed to also constitute payment of a Termination Charge in an identical amount, and Schedule C-10 (Termination Charges)
shall be amended (or deemed amended) to reduce the amount of the remaining Termination Charges by such amount; or 

  

	 	(ii)	If Health Net pays Supplier a Termination Charge that includes an allowance or allocation for the expected net book value, residual value or other value of the categories of Resources that may be acquired by Health Net
from Supplier in connection with such termination, the payment of such charge shall be deemed to constitute Health Net’s payment to Supplier of the purchase price of the Resources Health Net is entitled to acquire from Supplier in connection
with the termination. 

  

	 	5.2	Owned Equipment 

  

	 	(a)	At Health Net’s request, Supplier will provide information to Health Net or its designee concerning the Equipment owned by Supplier (or any of its Subcontractors) that is used to perform the Affected Services
(collectively the “Owned Equipment”), which shall include a complete inventory of such Owned Equipment (in MS Excel format) specifying make, model, serial number, the corresponding Affected Services such Owned Equipment is
used to provide, location, purchase date and other reasonable information requested by Health Net. Health Net may audit the accuracy of such information in accordance with Section 18 (Audits and Records) of the Terms and Conditions.

  

	 	(b)	As and to the extent directed by Health Net, Supplier will offer to sell, or will use Commercially Reasonable Efforts to cause the corresponding Subcontractor to offer to sell, to Health Net or its designee some or all
(as designated by Health Net) of (i) the Owned Equipment used exclusively to provide the Affected Services that are BPaaS Services, at a purchase price equal to its then-current residual book value, (ii) the Supplier Procured IT Assets
owned by Supplier at a purchase price equal to the remaining Supplier Procured IT Asset Charges (if any) for such Equipment less the administrative fee and any maintenance costs and other costs included in the Supplier Procured IT Asset Charges that
can be avoided following a transfer of ownership to Health Net. Supplier will convey, 

  

					
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or will use Commercially Reasonable Efforts to cause the corresponding Subcontractor to convey, such Owned Equipment and Supplier Procured IT
Assets to Health Net or its designee, along with any associated equipment warranties that Supplier (or the applicable Subcontractor) is permitted to pass on to the purchaser and with all available user and other documentation. Supplier will execute,
or shall use Commercially Reasonable Efforts to cause the corresponding Subcontractor to execute, a bill of sale to evidence the conveyance. Conveyance shall be without warranties, other than a warranty of good title, and shall be set out in the
bill of sale. 
  

	 	5.3	Leased Equipment 

  

	 	(a)	At Health Net’s request, Supplier will provide information to Health Net or its designee concerning the Equipment leased by Supplier (or any of its Subcontractors) that is used to perform the Affected Services
(collectively the “Leased Equipment”), which shall include a complete inventory of such Leased Equipment (in MS Excel format) specifying make, model, serial number, the corresponding Services such Leased Equipment is used to
provide, location, lease start date and lease term, and other reasonable information requested by Health Net. Health Net may audit the accuracy of such information in accordance with Section 18 (Audits and Records) of the Terms and
Conditions. 

  

	 	(b)	As and to the extent directed by Health Net, Supplier will (i) provide, or will use Commercially Reasonable Efforts to cause the corresponding Subcontractor to provide, to Health Net or its designee a copy of the
current leases pertaining to (A) the Leased Equipment that is used exclusively to provide the Affected Services that are BPaaS Services and (B) the Supplier Procured IT Assets leased by Supplier, and (ii) assign, or will use Commercially
Reasonable Efforts to cause the corresponding Subcontractor to offer to assign, to Health Net or its designee the leases for some or all (as designated by Health Net) of such Equipment; or if and to the extent permitted by the applicable leases and
if requested and fully paid for by Health Net for any such Leased Equipment and Supplier Procured IT Assets, Supplier will buy out (or will cause the corresponding Subcontractor to buy out) some or all (as designated by Health Net) of the leases and
purchase such Leased Equipment from the lessor, in which case Supplier shall convey to Health Net Supplier’s interest in such Equipment. The assignee will assume the assigning party’s obligations under any assigned lease relating to
periods after the date of assignment. 

  

	 	5.4	Third Party Agreements 

  

	 	(a)	At Health Net’s request, Supplier will provide information to Health Net or its designee concerning the third party contracts and licenses in Supplier’s (or any of its Subcontractor’s) name that are used
to perform the Affected Services (excluding Equipment leases, which are governed by Section 5.3 above, but including any third party maintenance and support services agreements for Equipment) (collectively the “Third Party
Agreements”), which shall include a complete inventory of such contracts (in MS Excel format) specifying the third party, the nature of the contract (e.g., equipment maintenance contract), the corresponding Services such contract is
used to provide, term and expiration date, and other reasonable information requested by Health Net. Health Net may audit the accuracy of such information in accordance with Section 18 (Audits and Records) of the Terms and Conditions.

  

					
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	 	(b)	Subject to Supplier’s or Subcontractor’s existing confidentiality restrictions with relevant third parties, as and to the extent directed by Health Net, Supplier will (i) provide, or will use Commercially
Reasonable Efforts to cause the corresponding Subcontractor to provide, to Health Net or its designee a copy of the Third Party Agreements that are primarily used to provide the Affected Services and (ii) use Commercially Reasonable Efforts to
assign, or cause the corresponding Subcontractor to assign, to Health Net or its designee some or all (as designed by Health Net) of any such Third Party Agreements. The assignee will assume the assigning party’s obligations under any such
contract assigned relating to periods after the date of assignment. 

  

	 	5.5	Telephone Numbers 

  

	 	(a)	At Health Net’s request, Supplier will provide information to Health Net or its designee concerning any telephone numbers (i) for which Supplier or a Subcontractor is the customer of record, and (ii) that
are used for the provision of the Affected Services (e.g., help desk numbers), which shall include a complete inventory of such numbers (in MS Excel format), the corresponding Services each of such numbers is used to provide, the corresponding
network provider and country of origin, and other reasonable information requested by Health Net. Health Net may audit the accuracy of such information in accordance with Section 18 (Audits and Records) of the Terms and Conditions. For
avoidance of doubt, this Section 5.5(a) shall not require Supplier to provide the individual telephone number for any specific Supplier employee (personal or otherwise), or the personal telephone number of any Subcontractor. 

 

	 	(b)	At Health Net’s request, Supplier shall use Commercially Reasonable Efforts to cause each of the telephone numbers described in Section 5.5(a) that are used primarily for the provision of the Affected Services
to be ported to Health Net or its designee as of the corresponding Cutover Date(s), thereby making Health Net or its designee the customer of record for such numbers. 

 

	 	5.6	Software and Deliverables 

  

	 	(a)	Supplier shall comply with its obligations under Sections 12 (Resource Acquisitions During the Term) and 15 (Intellectual Property Rights) of the Terms and Conditions with respect to Software and
Deliverables and Section 4 of Annex 1 (Supplemental Terms and Conditions for BPaaS Services). 

  

	 	(b)	Supplier shall comply with its obligations under Section 10.5(f) (Transfer of Ownership) of Schedule C (Charges) with respect to any Software that is a Supplier Procured IT Asset. 

 

	 	5.7	Unidentified Assets 

  

	 	(a)	For any Affected Services, if after the corresponding Cutover Date, any Owned Equipment, Leased Equipment, Third Party Agreement, or telephone number described in Section 5.5(a) is discovered that was not
identified by Supplier pursuant to Sections 5.2 through 5.6 and would have been transferable to Health Net if discovered prior to the Cutover Date (each, an “Unidentified Asset”), Supplier shall provide Health Net or its
designee with notice of such discovery (such notice for any such Unidentified Asset a “Discovery Notice” for such asset), which notice shall provide a description of the corresponding Unidentified Asset which includes the
information described in Sections 5.2(a), 5.3(a), 5.4(a), and 5.5(a), as applicable. 

  

					
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	 	(b)	As of the Cutover Date, Supplier hereby grants to Health Net and its designees, at no additional charge, to the greatest extent possible given Supplier’s existing rights, perpetual, irrevocable rights of access to,
and use of the Unidentified Assets at the rates (if any) calculated pursuant to Sections 5.2 through 5.6; provided, however, that with respect to any Unidentified Asset that is Leased Equipment or a Third Party Agreement, Supplier may terminate the
lease or agreement corresponding to such Unidentified Asset at Supplier’s expense, but only after: (i) Supplier has provided Health Net with a Discovery Notice for such Unidentified Asset, (ii) Supplier has presented Health Net with a
complete copy of the corresponding agreement and has provided Health Net with the opportunity to exercise its rights pursuant to Sections 5.3(b) and 5.4(b); and (iii) Health Net has notified Supplier that it does not wish to exercise its rights
pursuant to Sections 5.3(b) or 5.4(b). For any such Unidentified Asset that is Leased Equipment or a Third Party Agreement, Health Net shall provide the notification as to whether it wishes to accept assignment of the corresponding lease or
agreement within thirty (30) days after Supplier’s delivery of the corresponding agreement to Health Net pursuant to clause (ii) of this Section 5.7(b). 

 

	 	5.8	Human Resources 

 (i)*** 

 

	6.	REVERSE TRANSITION ASSISTANCE 

  

	 	6.1	General Support for Reverse Transition Implementation 

  

	 	(a)	Supplier shall support the implementation of the Reverse Transition Plan by performing its responsibilities relating to the Reverse Transition (including performing any requested Disengagement Assistance relating to the
Reverse Transition, and performing Supplier’s responsibilities described in the Reverse Transition Plan) in accordance with the Reverse Transition Plan. 

  

	 	(b)	During the Reverse Transition, to the extent that Health Net requests Disengagement Assistance beyond that which is set forth in the Reverse Transition Plan, Health Net will consult and coordinate with Supplier, so as
to minimize the possibility of disrupting Supplier’s provision of Services. 

  

	 	6.2	Supplier Reverse Transition Team 

  

	 	(a)	Until the completion of the Reverse Transition, Supplier will assign an individual to serve on a dedicated, full-time basis to manage and oversee Supplier’s support of Reverse Transition activities (such position
the “Supplier Reverse Transition Lead”). The individual serving as the Supplier Reverse Transition Lead shall be subject to Health Net’s prior approval. The Supplier Reverse Transition Lead will meet with his or her
Health Net counterparts on a weekly basis (or more frequently if requested by Health Net), and will serve as an escalation point for issues relating to the Reverse Transition. 

 

	 	(b)	Supplier will assign other individuals to the Reverse Transition team as reasonably necessary to support Reverse Transition and map to Health Net’s or its designee’s Reverse Transition organization (e.g., by
region or functional area). 

  

					
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	 	6.3	Operational Transition 

 Supplier shall perform activities required to facilitate the
orderly migration and transition of operational responsibility for the Affected Services without interruption or adverse effect from Supplier’s operating environment(s) to the replacement operating environment(s) of Health Net or its designee,
as directed by Health Net, and in accordance with Supplier’s responsibilities under the Reverse Transition Plan and this Schedule L (Disengagement Assistance). These shall include, as requested by Health Net: 

 

	 	(a)	Providing to Health Net or its designee, as directed by Health Net, machine-readable source code (to the extent required of Supplier under this Agreement) and object code, data base, file, record layouts and field
descriptions with respect to the Health Net Software (and other Software, to the extent Health Net is entitled to a license to the same), along with the documentation and associated program execution statements , and other similar information
necessary for the designee to execute Software for Health Net’s benefit; 

  

	 	(b)	To the extent used to provide the Services and subject to Section 5.6, documenting and delivering program materials, including source and object libraries, reference files, interface definitions, specifications,
implementation procedures relative to Health Net’s technical environment, and embedded software; 

  

	 	(c)	Delivering then-existing systems support profiles, change logs including enhancement and maintenance, history, problem tracking/resolution documentation, scale, functional and complexity assessment analyses, and status
reports associated with the Services; 

  

	 	(d)	Providing work volumes, staffing requirements, demand backlog and information on historical performance for the Service Levels, and to the extent available for each Equipment component or system, over the preceding
twelve (12) months; 

  

	 	(e)	Identifying and documenting the demarcation points for each portion of the Affected Services, including any operating level agreements with other Health Net or Supplier groups at those demarcation points and information
regarding the physical and virtual locations affected by the Reverse Transition; 

  

	 	(f)	Providing copies of all Health Net Data with the respective data bases and files on electronic media as specified by Health Net or its designee; 

 

	 	(g)	Identifying work and projects expected to be in progress as of the corresponding Cutover Date(s) for the Affected Services, and with respect to such work, documenting current status (including project budget
information), stabilizing for continuity during transition, and providing any reasonably required training to qualified personnel to achieve transfer of responsibility; 

 

	 	(h)	Providing the following services before the corresponding Cutover Date(s): 

  

	 	(i)	Provide documentation used by Supplier to provide the Affected Services, including documentation necessary to provide continuity of service during transition, in hard-copy or electronic media as indicated by Health Net;

  

	 	(ii)	Provide Health Net with any help desk or service request tickets and problem logs it does not already have, reporting back at least two (2) years prior to the Cutover Date (but no earlier than the Effective Date);

  

	 	(iii)	Identify, record and provide change control historical records including release and maintenance levels for Systems Software; 

  

					
	Schedule L		L-11		Health Net / Cognizant Confidential

 Final 
  

	 	(iv)	After consultation with Health Net, discontinue all discretionary Software changes, other than with respect to the Services or other modifications necessary to address processing problems; 

 

	 	(v)	Provide and coordinate assistance in notifying outside vendors of the procedures to be followed during the Reverse Transition; 

  

	 	(vi)	Review the organization, structure use and contents of all Software libraries including those utilized for test, staging and production with Health Net’s or its designee’s operations staff; 

 

	 	(vii)	Assist Health Net or its designee in the analysis of the direct access storage capacity required to accommodate Software libraries and Health Net’s data files; 

 

	 	(viii)	Provide reasonable assistance to Health Net or its designee in establishing or transferring operational standards including naming and addressing conventions; 

 

	 	(ix)	Subject to Section 5.6, document and deliver all tools and databases used to provide the Services, including those for tracking projects and service information requests, and those used for knowledge transfer;

  

	 	(x)	Subject to Section 5.6, and as provided in Sections 12.3 and 15 of the Terms and Conditions or expressly provided in any other section of the Agreement, generate and provide the Source Code for the Software to
which Health Net has a license under Sections 12.3 and 15 of the Terms and Conditions or such other express provision of the Agreement in a form reasonably requested, and deliver such Source Code, technical specifications and materials, and user
documentation for the Software to Health Net or its designee as and to the extent provided for in Section 12.3 and 15 of the Terms and Conditions or such other express provision of the Agreement; 

 

	 	(xi)	At Health Net’s request and to the extent applicable, deliver the materials required to cause and control program execution and associated appropriate program execution documentation and procedures to Health Net or
its designee; 

  

	 	(xii)	Make arrangements for any physical de-installation, transportation, and relocation of Equipment and physical assets to be performed as part of the Reverse Transition; 

 

	 	(xiii)	Provide documentation and diagrams for the voice, data, video, and other communications capabilities, including asset information and configuration settings (including configurations, router tables, IP addressing
schema, managed device thresholds) for all configurable items (including media access, media, routing, bridging and switching devices and other equipment and software providing communications service delivery and management functions); and

  

	 	(xiv)	Provide interim Health Net Data, in such format and on such media as reasonably requested by Health Net; and 

  

	 	(xv)	Cooperate and assist Health Net and its designees in achieving a state of operational readiness before the applicable Cutover Date(s), as such readiness is reasonably defined in the Reverse Transition Plan.

  

					
	Schedule L		 L-12
		Health Net / Cognizant Confidential

 Final 
  

	 	(i)	Providing the following services on or before the corresponding Cutover Date(s): 

  

	 	(i)	Copy and deliver to Health Net all requested Health Net Data files and other Health Net Confidential Information (including content listings and with respect to control file information, printouts of the same), and
subject to Section 5.6 and as provided in Sections 12.2 and 12.3 of the Terms and Conditions, copy and deliver Source Code listings for the Software to which Health Net has a license to the extent provided for under Section 15 of the Terms
and Conditions; 

  

	 	(ii)	In conjunction with Health Net or its designee, conduct a rehearsal of any migration that is part of the Reverse Transition prior to the Cutover Date as scheduled by Health Net, and provide any required corrective
action identified during the rehearsal; 

  

	 	(iii)	Provide reasonable assistance to Health Net or its designee in making Health Net Data files available on the storage devices of the new environment; 

 

	 	(iv)	Provide reasonable assistance to Health Net or its designee with the transmission or movement of data from then-existing databases to the new environment; 

 

	 	(v)	Provide an image copy (and mirrored DASD volumes if available) of each operating system environment (in dump/restore or image mode, as applicable to the operating system platform); 

 

	 	(vi)	Allow and assist in the installation and operation of such software, equipment or communications capabilities that may be necessary to allow for the synchronous or asynchronous replication of Health Net Data from
Supplier facilities to the facilities of Health Net or its designee; 

  

	 	(vii)	Provide reasonable assistance to Health Net or its designee with the turnover of operations and the execution of parallel testing and parallel operations; 

 

	 	(viii)	Assist Health Net or its designee in the identification and removal of security access credentials for Supplier employees, agents and designees from reverse transitioned computing communications devices and associated
software; and 

  

	 	(ix)	Transfer responsibility to Health Net or its designee for off-site media and document storage; and 

  

	 	(j)	Providing, after the corresponding Cutover Date(s), additional assistance requested by Health Net, including: 

  

	 	(i)	Returning to Health Net (or if requested by Health Net destroying) at no additional charge any remaining Health Net property in Supplier’s possession or under Supplier’s control, including remaining reports,
data and Health Net Data or Health Net Confidential Information; and 

  

	 	(ii)	Vacating Health Net Facilities in a timely manner at no additional charge. 

  

					
	Schedule L		L-13		Health Net / Cognizant Confidential

 Final 
  

	 	6.4	Organizational Transition 

 Supplier shall provide all reasonable assistance required to
adequately transfer, in accordance with the Reverse Transition Plan, the organizational information developed during the Term to support the delivery of the Affected Services. Supplier’s responsibilities shall include, as requested by Health
Net: 
  

	 	(a)	Documenting, updating, and providing functional organization charts, operating level agreements with third-party contractors, phone trees, contact lists, and standard operating procedures; 

 

	 	(b)	Transferring physical and logical security processes and tools, including cataloguing and tendering all badges and keys, documenting ownership and access levels for all passwords, and instructing Health Net or its
designee in the use and operation of security controls; and 

  

	 	(c)	Protecting against security breaches of Supplier Personnel during the Reverse Transition by revoking Supplier Personnel access to Health Net Facilities (or secure locations within such facilities), Health Net Data,
Health Net Confidential Information, Equipment, Software and other systems, processes and tools, as such Supplier Personnel are transitioned away from Health Net’s account or as the functions performed by such Supplier Personnel are
transitioned away from Supplier, and accordingly, corresponding access to such items is no longer required. 

  

	 	6.5	Business Continuity Transition 

 Supplier shall provide, in accordance with the Reverse
Transition Plan, reasonable assistance to support Health Net’s requirements for business continuity for the Affected Services during the Reverse Transition and, to the extent business continuity Services are among the Affected Services, to
transfer responsibility to enable Health Net or its designee to provide similar services as part of the Reverse Transition. Supplier’s responsibilities shall include, as requested by Health Net: 

 

	 	(a)	Updating and supplying documentation used by Supplier to provide Business Continuity and Disaster Recovery Services with respect to the Affected Services, including the business continuity plans, testing procedures and
frequencies including the reports of the results of such tests, redundancy diagrams and other plans; 

  

	 	(b)	Training and informing Health Net or its designee of then-current policies and procedures with regard to backup and business continuity for the Affected Services; 

 

	 	(c)	Providing for additional overlapping coverage or support through the Reverse Transition to minimize disruption in the event of an outage during that period; 

 

	 	(d)	As requested by Health Net, participate in a reasonable amount of business continuity testing in connection with the Reverse Transition until a successful test of the recovery arrangements has been accomplished; and

  

	 	(e)	To the extent Health Net Data corresponding to the Affected Services is replicated to another facility, then Supplier shall transfer such data to Health Net or its designee, and upon Health Net’s request, Supplier
shall provide reasonable assistance to Health Net in developing equipment and other requirements for relocating such data. 

  

					
	Schedule L		L-14		Health Net / Cognizant Confidential

 Final 
  

	 	6.6	Knowledge Transfer 

  

	 	(a)	Supplier will provide for a transfer of knowledge regarding the Affected Services, Health Net’s requirements, and related topics, so as to facilitate the provision of the Affected Services by Health Net or its
designee. Supplier’s responsibilities shall include, as requested by Health Net: 

  

	 	(i)	Providing Health Net and its designee with information regarding the Affected Services that is necessary to implement the Reverse Transition Plan, and providing such information regarding Services as necessary for
Health Net or its designee to assume responsibility for continued performance of the Affected Services in an orderly manner so as to minimize disruption in operations. Information that Supplier is obligated to provide under this Section 6.6 shall
include: (A) relevant documentation; (B) the Procedures Manual; (C) schedules, frequencies, work product and related information for activities and deliverables as reasonably requested by Health Net; (D) operating level
arrangements with third-party vendors of goods and services to the extent relevant to the Affected Services; (E) security plans and procedures; and (F) key support contacts (names and phone numbers) of Health Net and third-party personnel,
and of Supplier Personnel during the Reverse Transition; 

  

	 	(ii)	Providing reasonable training to Health Net’s or its designee’s personnel in the performance of those Services that are to be transferred, including in the management of the third-party vendors of goods and
services used to perform the Affected Services; 

  

	 	(iii)	Explaining the particular Supplier implementation of the processes enumerated in Schedule A (Cross Functional Services) of the Agreement and each SOW, and the human, procedural and technical interfaces to and
interactions with Health Net (including the Procedures Manual) to Health Net or its designee’s operations staff; 

  

	 	(iv)	Responding to inquiries from Health Net regarding the Affected Services, including by providing reasonable access (e.g., by telephone) for a period of at least six (6) months after the corresponding Cutover Date(s)
to Supplier Personnel who were performing such Affected Services before the Cutover Date(s); and 

  

	 	(v)	Providing contact listings of potential alternate sources of resources, including skilled labor and spare Equipment parts. 

  

	 	(b)	Supplier’s performance of the obligations described in Section 6.6(a) shall be in accordance with a knowledge transfer plan for the Affected Services (each such plan a “Knowledge Transfer
Plan”). Each Knowledge Transfer Plan will be aligned with the Reverse Transition Plan, and shall, at a minimum, describe the overall knowledge transfer process, including: (i) Supplier’s overall approach; (ii) major activities
and schedules for the knowledge transfer; (iii) the Supplier Personnel who will participate in the knowledge transfer; (iv) a detailed description of the documentation that Supplier will provide in connection with the knowledge transfer;
and (v) designation of resources required of Health Net and associated schedules. Each Knowledge Transfer Plan shall be provided to Health Net for its review, comment, and approval. The reasonable comments or suggestions of Health Net will be
incorporated as applicable into each such Knowledge Transfer Plan and Health Net’s final approval will be obtained prior to implementation of the Knowledge Transfer Plan. 

  

					
	Schedule L		L-15		Health Net / Cognizant Confidential

 Final 
  

	 	6.7	Financial Transition 

 As of the Cutover Date for any Affected Services, and continuing
for a period of six (6) months thereafter (each such period a “Financial Reconciliation Period”), Supplier will reasonably cooperate with and support Health Net, at no additional charge, to achieve a final reconciliation
with respect to the areas identified in this Section 6.7. 
  

	 	(a)	Supplier Invoicing. Supplier shall submit its invoice for all charges and credits applicable to the Affected Services through the corresponding Cutover Date, which shall be payable in accordance with Schedule C.
Effective as of the Cutover Date for any Affected Services, each Party will submit to the other reconciliation information (including as reasonably requested by the other Party) to reconcile any outstanding charges or credits, and each Party shall
work diligently and in good faith to achieve a final reconciliation of such charges and credits by the end of the Financial Reconciliation Period. 

  

	 	(i)	The Parties acknowledge the possibility that invoices for third-party contracts (e.g., Third Party Agreements or Equipment leases) used to provide the Affected Services and transferred to Health Net or its designees
pursuant to Section 5 may be misdirected by third-party vendors after the effective date of transfer, and provided to Supplier instead of Health Net or its designee. Supplier shall provide any such invoices in their original form to Health Net
in a timely manner. 

  

	 	(ii)	Supplier shall reimburse Health Net for third party products or services, if any, for which Supplier is financially responsible, and that are used to provide the Affected Services before the Cutover Date but invoiced to
Health Net or its designee. 

  

	 	(iii)	On or before the Cutover Date, Supplier shall provide Health Net with information reasonably requested by Health Net regarding any third party contracts used to provide the Affected Services such that Health Net can
reasonably validate that the corresponding third party vendor has invoiced, and Supplier has paid, any charges arising under such contracts before the Cutover Date. 

 

	 	(b)	Asset Acquisitions. Sections 5.2 through 5.4 describe terms pursuant to which Health Net or its designee may acquire certain resources used to provide the Affected Services. Each Party shall work diligently and
in good faith to achieve, by the end of the Financial Reconciliation Period, a final reconciliation of the financial issues arising from any transfer of such resources to Health Net or its designee under such provisions. 

 

	 	6.8	Risk Mitigation. 

 The Parties will at all times work together in good faith during the
disengagement to minimize any risk to or interference with the Services (including the Service Levels and the Reverse Transition). 

  

					
	Schedule L		L-16		Health Net / Cognizant Confidential

 Final 

SCHEDULE M 
 SUPPLIER
COMPETITORS 
  

  

					
	Schedule M		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE M 
 SUPPLIER
COMPETITORS 
 The following is a complete list of Supplier Competitors for purposes of the definition in Section 2.1 of the Terms and Conditions.
Supplier Competitors shall also include all successors and Affiliates of any of the following: 
 *** 

In addition, Supplier may add to this Schedule M entities not existing as of the Effective Date but coming into existence thereafter, that engage in the
business of providing services that are the same as or comparable to the Services provided by Supplier under the Agreement, by giving Health Net written notice of Supplier’s proposed addition and obtaining Health Net’s prior written
approval of such additional entity. 

  

					
	Schedule M		M-1		Health Net / Cognizant Confidential

 Final 

SCHEDULE N 

NON-DISCLOSURE AGREEMENT 
  

  

					
	Schedule N		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE N 

NON-DISCLOSURE AGREEMENT 

This Confidentiality Agreement (this “Agreement”), dated as of the      day of
         20    , by and between                     , a
                     having offices at (“Recipient”), Health Net, Inc., a Delaware corporation, with its principal
offices at 21650 Oxnard Street, Woodland Hills, California 91367 (collectively with its affiliates, “Health Net”) and Cognizant Technology Solutions U.S. Corporation, a Delaware corporation, with its principal offices at 500
Frank W. Burr Blvd., Teaneck, New Jersey 07666, (collectively with its affiliates, “Cognizant”) (all parties hereto collectively referred to as the “Parties” and individually as a
“Party”). 
 Recitals: 

WHEREAS, Health Net and Cognizant are parties to that certain Master Services Agreement dated November 2, 2014 (“Master
Services Agreement”), pursuant to which Cognizant will perform certain business process outsourcing services for Health Net; 

WHEREAS, Health Net and Recipient have entered into or are contemplating a business relationship wherein Recipient will perform certain
services for Health Net which may require Recipient’s use of certain confidential information of both Health Net and Cognizant (the “Services”); 

WHEREAS, Recipient and Health Net have entered into a confidentiality or other agreement that governs the use and protection of their
respective confidential information that is exchanged between them; and 
 WHEREAS, the Parties now desire to enter into a separate
agreement to govern the use and protection of Cognizant’s Confidential Information (as defined below) that may be disclosed to Recipient by either Health Net or Cognizant for the purpose of enabling Recipient to perform the Services. 

NOW THEREFORE, in consideration of the above premises the Parties mutually agree as follows: 

1. Definition. “Confidential Information” shall mean any and all information disclosed to Recipient, or
otherwise acquired or observed by Recipient from Cognizant or Health Net and their affiliated companies, relating to the business of Cognizant, whether communicated in writing, orally, electronically, photographically, or in recorded or any other
form, including, but not limited to, all customers lists, client contracts, sales and operating information, existing and potential business and marketing plans and strategies, financial information, cost and pricing information, data media,
know-how, designs, drawings, specifications, software, tools, methodologies, source codes, technical information, concepts, reports, methods, processes, techniques, operations, devices, and the like, whether or not the foregoing information is
patented, tested, reduced to practice, or subject to copyright. The term “Confidential Information” does not include information which (i) becomes generally available to the public other than as a result of disclosure by Recipient in
breach of this Agreement; (ii) was available to Recipient on a non-confidential basis as shown in written records prior to its disclosure to Recipient by Cognizant or Health Net; (iii) becomes available to Recipient on a non-confidential
basis from a source other than Cognizant or Health Net; provided that such source is not bound by a confidentiality agreement with Cognizant or is otherwise prohibited from transferring the information to Recipient by a contractual, legal or
fiduciary obligation; or (iv) is independently developed by Recipient without any use of or benefit from the Confidential Information and such independent development can be documented by Recipient with written records. 

  

					
	Schedule N		N-1		Health Net / Cognizant Confidential

 Final 

2. Non-disclosure. In consideration for the receipt of Confidential Information, Recipient shall hold all Confidential Information in
confidence and with the same degree of care it uses to keep its own similar information confidential, but in no event shall it use less than a reasonable degree of care; and shall not, without the prior written consent of both Cognizant and Health
Net, disclose such information to any person for any reason at any time. The term “person” as used in this letter shall be broadly interpreted to include, without limitation, any corporation, company, partnership or individual. 

3. Use. Recipient shall not use any Confidential Information for any reason or purpose other than as necessary in regard to the
Services. Recipient agrees to make no other use of the Confidential Information or to incorporate any Confidential Information into any work or product except as permitted under the Master Services Agreement. In addition, Recipient shall not use the
Confidential Information for purposes of reverse engineering, decompiling, unbundling or separating for use as a stand-alone product, or preparing derivative works of such Confidential Information, except to the same extent Health Net would itself
be permitted to do so under the Master Services Agreement. 
 4. Ownership. Recipient recognizes that all tangible information
derived from Confidential Information (but not information owned by Health Net), including notes, reports and other documents prepared by Recipient in connection with the Services, including all copies thereof, (collectively “Derived
Materials”) are and shall be the sole property of Cognizant, and Recipient shall keep the same at all times in its custody and subject to Recipient’s control. The Recipient does not hereby and shall not acquire by implication or
otherwise pursuant to this Agreement any right in or title to or license in respect of the Confidential Information disclosed to it by Cognizant or Health Net. 

5. Compelled Disclosure. In the event that Recipient is requested or required (by oral questions, interrogatories, requests for
information or documents, subpoena, civil investigative demand or similar process) to disclose any of the Confidential Information, it is agreed that Recipient or such Recipient’s Representative, as the case may be, will provide Cognizant and
Health Net with prompt notice of such request(s) so that Cognizant or Health Net may seek an appropriate protective order or other appropriate remedy. In the event that such protective order or other remedy is not obtained, Recipient or such
Recipient’s Representative may furnish that portion (and only that portion) of the Confidential Information which Recipient is legally compelled to disclose and will exercise reasonable best efforts to obtain reliable assurance that
confidential treatment will be accorded any Confidential Information so furnished. 
 6. Return of Confidential Information. Promptly
following the earlier of (i) the termination of this Agreement by Health Net or Cognizant pursuant to Section 10, and (ii) the written request of Health Net, Recipient will deliver to the Party from which Recipient received the
Confidential Information all documents or other materials furnished by Cognizant or Health Net to Recipient constituting Confidential Information or Derived Materials, together with all copies thereof, including computer disks in the possession of
Recipient. In the event of such request, all other documents or other materials constituting Confidential Information, together with all copies thereof in the possession of Recipient, will be destroyed with any such destruction confirmed by
Recipient in writing to Cognizant and Health Net. 
 7. No Warranties. Neither Cognizant nor Health Net makes any representation or
warranty as to the accuracy or completeness of the Confidential Information. 
 8. No Obligation. No Party shall make any commitment
or incur any expense or charge for or in the name of any other Party. No Party has any obligation by virtue of this Agreement to procure any products or services from any other Party. Neither execution nor performance of this Agreement shall be
construed or deemed to have established any joint venture or partnership or have created the relationship of principal and agent between the Parties. 

  

					
	Schedule N		N-2		Health Net / Cognizant Confidential

 Final 

9. Remedies. Recipient acknowledges that money damages would be both incalculable and an insufficient remedy for any breach of this
agreement by Recipient and that any such breach would cause Cognizant and Health Net irreparable harm. Accordingly, Recipient also agrees that, in the event of any breach or threatened breach of this Agreement, each of Cognizant and Health Net, in
addition to any other remedies at law or in equity they may have, shall be entitled, without the requirement of posting a bond or other security, to equitable relief, including injunctive relief and specific performance. 

10. Scope; Termination. This Agreement is intended to cover Confidential Information disclosed to Recipient by Cognizant and Health Net
both prior and subsequent to the date hereof. This Agreement may be terminated (A) by Health Net upon written notice to Recipient, and (B) by Cognizant upon the breach by Recipient of its obligation to not disclose Confidential
Information, or use by Recipient of Confidential Information other than is permitted under this Agreement; provided, however, that, notwithstanding anything herein to the contrary, Recipient’s obligations with respect to each item
of Confidential Information will survive for a period of five (5) years following the disclosure of the applicable Confidential Information. 

11. Governing Law. This Agreement shall be governed by and interpreted in accordance with the laws of the State of California
applicable to agreements entered into and performed wholly within the State of California, and without regard to its conflict of law principles. 

12. Amendments. This Agreement may not be and shall not be deemed or construed to have been modified, amended, rescinded or canceled in
whole or in part, except by written instrument signed by the Parties hereto which makes specific reference to this Agreement and which specifies that this Agreement is being modified, amended, rescinded or canceled. 

13. Severability. If any provision of this Agreement shall be declared invalid or illegal for any reason whatsoever, then,
notwithstanding such invalidity or illegality, the remaining terms and provisions of this Agreement shall remain in full force and effect in the same manner as if the invalid or illegal provision had not been contained herein. 

14. Waivers. No failure on the part of any Party to exercise, and no delay in exercising, any right or remedy hereunder shall operate
as a waiver thereof, nor shall any single or partial exercise of any right or remedy hereunder preclude any other or a future exercise thereof or the exercise of any other right or remedy granted hereby, or by any related document, or by law. Any
failure of a Party to comply with any obligation contained in this Agreement may be waived by the Party entitled to the benefit thereof only by a written instrument duly executed and delivered by the Party granting such waiver, which instrument
makes specific reference to this Agreement and the provision to which it relates and describes the right or obligation consented to, waived or purported to be violated. 

15. Entire Agreement; No Assignment; Counterparts. This Agreement contains the entire agreement and understanding between the Parties
hereto relating to the subject matter hereof and supersedes all other prior agreements and understandings, both written and oral, between the Parties with respect to the subject matter hereof. This Agreement may not be assigned by Recipient by
operation of law or otherwise without the written consent of both Cognizant and Health Net, which consent shall not be unreasonably withheld or delayed. This Agreement may be executed in several counterparts, each of which will be deemed an
original, and all of which taken together will constitute one single Agreement between the parties with the same effect as if all the signatures were upon the same instrument. 

  

					
	Schedule N		N-3		Health Net / Cognizant Confidential

 Final 

IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed by their duly authorized representatives effective as of the
date and year first above written. 
  

			
	[COMPANY NAME]
		
	By:	 	 
	Name:
	Title:

  

			
	COGNIZANT TECHNOLOGY SOLUTIONS U.S. CORPORATION
		
	By:	 	 
	Name:
	Title:

  

			
	HEALTH NET, INC.
		
	By:	 	 
	Name:
	Title:

  

					
	Schedule N	  	N-4	  	Health Net / Cognizant Confidential

 MSA Schedule O 

SCHEDULE O 
 HEALTH NET
PROVIDED RESOURCES 
 *** 

[Represents 24 pages of material pursuant to a request for confidential treatment under Rule 24b- 2 of the Securities Exchange Act of 1934 which has been
filed separately with the Securities and Exchange Commission] 

 Final 

SCHEDULE P 
 HEALTH NET
POLICIES 

  

					
	Schedule P		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE P 
 HEALTH NET
POLICIES 
  

	1.	INTRODUCTION 

 Supplier shall have ninety (90) calendar days from the Effective Date
to raise any concerns about the Health Net Policies listed in this Schedule P (Health Net Policies), provided that any concerns raised by Supplier shall not result in any increase to the Charges or a diminution in the Service Levels. 

 

	2.	HEALTH NET POLICIES NOT LOADED INTO THE NATIONAL POLICY LIBRARY 

 Listed below are the
Health Net Policies not loaded into Health Net’s national policy library, which the Parties acknowledge have been disclosed to Supplier by Health Net prior to the Effective Date. 

 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Claims - QA	  	Claims Processing & Provider Support G8_Claim Audit	  	Arizona AHCCCS Audit Process	  	AZ AHCCCS	  	Common 06\QA (Share Drive)
					
	Claims - QA	  	Administrative Payment Audit_Claims_Revised 12-02-13	  	Administrative Payment audit process	  	All	  	Common 06\QA (Share Drive)
					
	Claims - QA	  	Quality Assurance General Book Of Business Audit_Claims_Revised 12_20_12	  	QA’s general audit policy	  	All	  	Common 06\QA (Share Drive)
					
	Claims - QA	  	Quality Assurance DMHC Claim Audits_Revised 10-9-2012	  	General audit policy for the Monthly DMHC Regulatory audits	  	Commercial HMO and POS	  	Common 06\QA (Share Drive)
					
	Claims - QA	  	Medicare Compliance Sampling Revised 12_20_12	  	This document describes the monthly sampling of the QA department universes for Health Net’s Medicare line of business.	  	Medicare	  	Common 06\QA (Share Drive)
					
	A&G - QA	  	Quality Assurance Medicare Compliance Auditing_A&G_Revised 12_20_12	  	This document describes QA’s Medicare Compliance Auditing for A&G	  	Medicare	  	Common 06\QA (Share Drive)

  

					
	Schedule P	  	P-1	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Claims - QA	  	Quality Assurance Medicare Compliance Auditing_Claims_Revised 12_20_2012	  	This document describes QA’s Medicare Compliance Auditing for Membership	  	Medicare	  	Common 06\QA (Share Drive)
					
	Claims, Membership and A&G - QA	  	Quality Assurance Medicare Compliance Auditing_Marketing Material Revised 12_20_12	  	This document describes QA’s Medicare Marketing Materials Audit process for Claims, Membership and A&G	  	Medicare	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Correspondence Audit	  	This document describes a method by which the correspondence intake transactions are reviewed and measured, as well as, how the results are shared.	  	 California Commercial Correspondence
  

Oregon Commercial Correspondence
  

California SHP Correspondence
	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Broker Commissions Audit	  	This document describes a method by which broker commission transactions are reviewed and measured, as well as, how the results are shared.	  	 Commercial
  

Medicare
	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Call Audit Service Standards	  	The Quality Assurance measurement form and guidelines were designed to support the mission and purpose of this process.	  	Commercial	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Eligibility Audit	  	This document describes a method by which member enrollment transactions are reviewed and measured, as well as, how the results are shared.	  	 Special Accounts
  

Labor and Trust
  

Regional
  

Individual Family Plan
  

Small Business
  

Medicare
 Supplemental

 
 COBRA DP / Small Business Cal-COBRA / AB1401 Cal-COBRA Extension
	  	Common 06\QA (Share Drive)

  

					
	Schedule P	  	P-2	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership - QA	  	QA Membership Group Audit	  	This document describes a method by which group transactions are reviewed and measured, as well as, how the results are shared.	  	Commercial	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Medicaid Access AHCCCS Audit	  	This document describes a method by which the Medicaid Access transactions are reviewed and measured, as well as, how the results are shared.	  	Arizona AHCCCS	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Medicare Broker Commissions Audit	  	This document describes a method by which the Medicare broker commission transactions are reviewed and measured, as well as, how the results are shared.	  	Medicare	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Medicare Compliance Auditing	  	This document describes QA’s monitoring process for compliance with Health Net’s Medicare enrollment and disenrollment procedures.	  	Medicare	  	Common 06\QA (Share Drive)
					
	Membership - QA	  	QA Membership Premium Billing Audit	  	This document describes a method by which premium billing transactions are reviewed and measured, as well as, how the results are shared.	  	 Special Accounts
  

Labor and Trust
  

Regional
  

Individual Family Plan
  

Small Business
  

Medicare
  

COBRA DP / Small Business
  

Cal-COBRA / AB1401 Cal-COBRA Extension
	  	Common 06\QA (Share Drive)

  

					
	Schedule P	  	P-3	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	A&G - QA	  	Quality Assurance_A&G Audit Policy_ Revised 2012_07_05	  	This document describes QA’s monthly review process of Appeals & Grievance case files processed and closed by both Health Net Associates and Supplier.	  	All	  	Common 06\QA (Share Drive)
					
	Configurati on – QA	  	Business Solutions - ACA SBC Audit P&P	  	SBC Audit Process	  	All	  	Common 06\QA (Share Drive)
					
	Configurati on – QA	  	Business Solutions - Benefit Load Audit P&P	  	Benefits Configuration Audit Process	  	All	  	Common 06\QA (Share Drive)
					
	Configurati on – QA	  	Business Solutions - Contracts Load Audit P&P	  	Contracts Configuration Audit Process	  	All	  	Common 06\QA (Share Drive)
					
	Configurati on – QA	  	Business Solutions - Provider Configuration Audit P&P	  	Provider Configuration Audit Process	  	All	  	Common 06\QA (Share Drive)
					
	Training	  	Privacy Compliance Department Protocol	  	This document outlines the Training Staff’s responsibilities whenever they are delivering a class that involves the demonstration of Protected Health Information.	  	All LOB	  	OPSTraining Drive, Management Dashboard
					
	Training	  	TRN-002.2 - PHI Training Materials	  	This document outlines the Training Staff’s responsibilities regarding Protected Health Information (PHI) or Personal Identification Information (PII) when developing training materials.	  	All LOB	  	OPSTraining Drive, Management Dashboard
					
	Training	  	TRN-002 - Claims Pended during Training	  	This document outlines the process to follow while a trainer has an ongoing class and it is necessary to ‘pend’ and claim for further clarification.	  	All LOB	  	OPSTraining Drive, Management

  

					
	Schedule P	  	P-4	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Training	  	TRN-003 - Cal MedConnect Training Policy	  	This document outlines how Training will be delivered and Tracked for Membership and Claims associates that process Cal MediConnect work.	  	Cal Medi-Connect	  	OPSTraining Drive, Management
					
	Training	  	TRN-003.01 - AZ HN Access Training Policy	  	This document outlines how Training will be delivered and Tracked for Membership and Claims associates that process AHCCCS work.	  	AHCCCS	  	OPSTraining Drive, Management
					
	Training	  	Travel and Expense Department Protocal	  	 This document outlines the protocols training staff will follow when submitting expense reports related to company business trips.

This document is a supplement item to all corporate travel policies.
	  	ALL LOB	  	OPSTraining Drive, Management
					
	Training	  	SOX Protocol - Membership	  	This document outlines the process training staff must follow prior to processing any live work for the membership department.	  	ALL LOB	  	OPSTraining Drive, Management
					
	Training	  	SOX Protocol - Claims	  	 This document outlines the process training staff must follow prior to processing any live work for the claims department that exceeds

$0.01.
	  	ALL LOB	  	OPSTraining Drive, Management
					
	Training	  	TRN-ADMIN_001 - Adding an Assistant to Concur	  	This document outlines the process training staff must follow in order to add an assistant to Concur.	  	ALL LOB	  	OPSTraining Drive, Management
					
	Training	  	BST Orientation and Performance Standards	  	This document outlines the department’s operations and expectations for all training staff members.	  	ALL LOB	  	OPSTraining Drive, Management

  

					
	Schedule P	  	P-5	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN A&G	  	Online Submission of Member Grievances	  	To ensure that all members with plans for which MHN is delegated appeals and complaints are able to register grievances confidentially online.	  	All MHN Lines	  	Lotus Notes database
					
	MHN A&G	  	Member Appeals - Urgent	  	To provide an expedited process for urgent appeals by members (or their representatives) who request re-evaluation of a decision to deny authorization of payment for urgent care claims.	  	All MHN Lines	  	Lotus Notes database
					
	MHN A&G	  	Member Appeals - PreService/Concurrent	  	To provide a pre-service appeal by members or their representatives who request re-evaluation of a decision to deny authorization of payment for pre-service care claims.	  	All MHN Lines	  	Lotus Notes database
					
	MHN A&G	  	Member Appeals - Post Service	  	To provide a process for appeal by members or their representatives who request re-evaluation of the decision to deny authorization of payment for services, or who are dissatisfied with the resolution of a complaint filed with
MHN.	  	All MHN Lines	  	Lotus Notes database
					
	MHN A&G	  	Provider Disputes	  	A provider dispute resolution process has been established to insure, for both individual practitioner and facility providers, consistent, timely, and effective de novo review of an issue that has not been satisfactorily resolved
through our regular provider customer service channels.	  	All MHN Lines	  	Lotus Notes database
					
	MHN A&G	  	Provider Disputes - CalViva	  	In order to assure that all provider disputes administered by CalViva Health (“CalViva” or the “Plan”) are addressed in a fair and timely manner, CalViva has established this policy,
which specifies how provider disputes are to be handled from inception to resolution.	  	CalViva	  	Lotus Notes database

  

					
	Schedule P	  	P-6	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN A&G	  	Language Assistance Program	  	To ensure that MHN is in compliance with the Department of Managed Health Care and California Department of Insurance regulations regarding language assistance requirements. To ensure that MHN provides enrollees with appropriate
linguistic assistance to ensure quality clinical care, and to disclose to enrollees the availability of the Language Assistance Program (LAP) in efforts to reduce health care disparities.	  	All California/DMHC Lines	  	Lotus Notes database
					
	MHN A&G	  	Written Translation Services	  	The purpose of this policy and procedure is to ensure that MHN’s customer service and utilization management teams are in compliance with all state and federal regulations regarding written notification and translation of
applicable MHN documents.	  	All Lines	  	Lotus Notes database
					
	MHN A&G	  	MediCare and Cal MediConnect Hospital Discharge Appeal Process	  	To establish a consistent process for informing Medicare and Cal MediConnect members of appeal rights when member is not in agreement with the planned discharge date.	  	All Medicare	  	Lotus Notes database
					
	MHN A&G	  	Medi-Cal Behavioral Health Responsibility-MHN and California County Speciality Mental Health Plans	  	To explain MHN (also referred to as the managed care plan, or MCP) responsibilities in the provision of medically necessary outpatient mental health services for MHN Medi-Cal members; differentiate MHN’s responsibilities from
County Specialty Mental Health Plan (MHP) responsibilities; and describe care coordination between MHN and the County Specialty MHP.	  	MediCal	  	Lotus Notes database
					
	MHN A&G	  	MHN Compliance Incident Reporting-Medicare	  	MHN Services (MHN) must ensure accurate and timely reporting of Medicare compliance issues.	  	All Medicare	  	Lotus Notes database

  

					
	Schedule P	  	P-7	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN A&G	  	MOON PDR	  	A Medicare required provider dispute resolution process has been established to ensure (for both non-contracted individual practitioners and non-contracted facility providers) compliant, consistent, timely, and effective review of
specific dispute types.	  	Medicare	  	Lotus Notes database
					
	MHN A&G	  	MOON Appeal	  	To define the basic responsibilities for the handling of the non-contracted provider appeal resolution process, ensuring a compliant, consistent, timely, and effective Medicare-required review for these specific provider
appeals.	  	Medicare	  	Lotus Notes database
					
	A&G	  	A&G Transfer Process to Resolution Team for Explanation of Benefit (EOB) Reconciliation	  	This P&P Outlines how A&G would work to resolve a MOOP Complaint due to MED 128.	  	Medicare A&G	  	N/A
					
	CCC	  	Business Checkout Communication Procedure	  	P&P to outline communicating Business Checkout with the CCC floor.	  	AR - AP	  	N/A
					
	A&G/CCC	  	Pharmacy Authorization Requests	  	P&P covers new prior auth forms as a result of COMM 49	  	CA Comm	  	N/A
					
	MHN CCC	  	Authorization of Out-of-State Care For Members Who Only Have In-State Benefits	  	To establish a process for authorizing medically necessary out-of-state care for members who do not have an out-of-state benefit, but the medically necessary service is not available in the member’s state.	  	All MHN Lines	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Compliance with Health Net, Inc. Exempt Grievance Policies and Procedures	  	To ensure that MHN associates follow all Health Net Inc. Exempt Grievance policies and procedures for accounts regulated by the California Department of Managed Health Care (DMHC).	  	 EAP, HMO,
 Commercial Managed Care
	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-8	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Flexing of Benefits	  	To define which exceptions to the standard benefit policy may be approved for a member. To describe the process for implementing such exceptions. To delineate procedural guidelines to ensure equal and consistent policy application
for all members to whom it applies.	  	HMO, Commercial Managed Care	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Investigation and Review of Quality Issues with Potential Quality Indicators (PQI)	  	To ensure that the MHN Clinical Quality Management Department (CQMD) identifies, reviews, and takes action on issues that may pose potential harm to a member while in treatment as a result of lack of clinical quality of care. The
CQMD Department will review all filed cases of member’s grievances, as well as internal staff concerns presenting clinical issues. Lack of quality of care is defined as not meeting professionally recognized standard of care (for details, see
the list of Potential Quality Indicators below) and/or not being compliant with MHN clinical standards.	  	 Commercial Managed Care, Cal MediConnect, EAP, EPO, HMO,

Medi-Cal (including CalViva), Medicare, PPO
	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Medi-Cal Behavioral Health Responsibility: MHN and California County Specialty Mental Health Plans	  	To explain MHN (also referred to as the managed care plan, or MCP) responsibilities in the provision of medically necessary outpatient mental health services for MHN Medi-Cal members; differentiate MHN’s responsibilities from
County Specialty Mental Health Plan (MHP) responsibilities; and describe care coordination between MHN and the County Specialty MHP.	  	Medi-Cal (including CalViva)	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	MHN Compliance Incident Reporting (Medicare)	  	MHN Services (MHN) must ensure accurate and timely reporting of Medicare compliance issues.	  	Medicare	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-9	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Most Valued Provider Program (MVP)	  	To describe the Most Valued Provider (MVP) program protocol and to ensure that MHN’s customer service and utilization management service teams are in compliance with the MVP procedures as outlined in this document.	  	 All MHN Lines of Business (Exceptions- Healthy Families, CHIPA, BHA, Cardinal Care

/ Vaden Health Center & CVS accounts)
	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Request For Information Regarding Utilization Management Review Procedures	  	To establish guidelines for informing patients, hospitals, physicians, other health professionals, and the public who request to know MHN’s review procedures for authorization of payment for clinical services.	  	Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Second Opinions	  	To establish clear guidelines for obtaining second opinions	  	All MHN Lines	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Untoward Events	  	To ensure that major significant adverse events involving MHN members are reviewed to identify problem areas.	  	 Commercial Managed Care, Cal MediConnect, EAP, EPO, HMO, Medi-

Cal (including CalViva), Medicare, PPO
	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Administration of the California Parity Benefit	  	To ensure that California members receive services and benefits consistent with California regulations.	  	HMO, Commercial Managed Care	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Administration of the Oregon Parity Benefit	  	To ensure that members receive services and benefits consistent with Oregon regulations.	  	Commercial Managed Care, EPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Behavioral Health Care Coordination and Interface with Primary Care and other	  	To define and describe possible coordination and support for members who may receive	  	Cal MediConnect, Commercial	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-10	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

		  	Medical Providers	  	some level of behavioral health intervention and/or services from a primary care physician (PCP) or other medical doctor.	  	Managed Care, All MHN Lines of Business, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	
					
	 MHN CCC
 and MHN A&G
	  	Benefit Waiver: Benefit Exception	  	To establish a standardized protocol to give guidance to all MHN associates to meet the needs of a client company and its employees. MHN commitment to service design includes, but is not limited to, providing services outside of the
benefit design of the client company.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Crisis Intervention - Urgent and Emergent Service Access and Referrals	  	To standardize the process by which MHN staff handle callers needing urgent or emergent services, consistent with MHN’s level of care criteria. To provide guidelines for timely service delivery in accordance with MHN protocols
for crisis stabilization, and to assure that the needed services were provided. To assist MHN staff in organizing efficient and effective response to crisis situations presented on the telephone.	  	Cal Medi-Connect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	EAP, Behavioral Health Care, and Community Resource Coordination	  	To define how care managers will utilize all available resources when MHN Employee Assistance Program (EAP) and behavioral health members need more assistance than can be offered by accessing their benefits.	  	Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Emergency Room Services	  	To ensure that MHN and its delegates provide, arrange for, or otherwise facilitate all needed emergency room services for behavioral health emergencies, including appropriate coverage of costs.	  	Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-11	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Initial Eligibility Verification Process For Customer Service Representatives and Care Managers	  	To standardize the eligibility verification processes when members request access to benefits or services, but do not appear eligible in the care management system.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Language Interpretation and Hearing Impaired Services	  	To ensure that all members and providers have prompt and efficient access to MHN services, in order to sustain a high level of patient care, customer service and satisfaction.	  	Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Out of Network Exceptions	  	MHN has an extensive network of facilities and providers to meet the needs of our members. However, at times there will be unique situations that require treatment that is not available within the allowable network for that member.
In these unique situations MHN has developed this policy to address specific requests of members who believe that the network within their benefit plan does not meet the requirements of treatment.	  	HMO, Commercial Managed Care, Medicare	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Referral, EAP Authorization, and Managed Care Registration for Accounts with EAP Services Plus Managed Care Benefits	  	 To standardize procedures for determining whether Employee Assistance Program (EAP) services or behavioral health benefits should be used at
the time of initial referral, authorization, or registration.
 To ensure accurate account reporting when EAP services and/or behavioral health benefits are
accessed by members.
 To ensure accurate claims processing when a member has both EAP services plus managed care benefits with MHN.
	  	EAP, Commercial Managed Care, as Applicable	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-12	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Routine EAP Service Referrals	  	To establish procedures for completing Employee Assistance Program (EAP) referrals and authorizations.	  	EAP	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Routine Outpatient Service Referrals	  	To establish procedures for completing outpatient service referrals.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Special Handling for Clinical Referrals	  	To define and establish protocol for Special Handling of clinical referrals, separate from the account specific provider availability check (PAC) process.	  	 EAP, HMO,
 Commercial Managed Care,
Medicaid
	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Special Handling for Repetitive Callers	  	To assist MHN staff in organizing efficient, effective, and clinically appropriate responses to repetitive callers who are unable or unwilling to accept referrals or help.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Telehealth Guidelines for Behavioral Health Service Delivery	  	To document and outline MHN’s operational protocol for telehealth services (web audio-video) for behavioral health outpatient treatment. This behavioral health policy is separate and distinct from MHN’s EAP policy,
Telephonic/Web-video EAP Services - Service Delivery.	  	Medi-Cal (including CalViva)	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Telephone Access Standards	  	To ensure that members and providers have prompt and efficient access to MHN services, and thereby sustain a high level of patient care, customer service and satisfaction.	  	Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Telephone Transfer Protocol: Customer Service Representative to Care Manager	  	To establish a clear internal telephone transfer protocol to ensure member safety and appropriate access to clinical assessment.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-13	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Telephonic/Web-video EAP Services - Service Delivery	  	To standardize and describe member access, scheduling, and provision of individual telephonic/web-video Employee Assistance Program (EAP) services. To provide standard protocols that can be effectively and efficiently implemented to
provide telephonic/web-video services as a core EAP service.	  	EAP	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Transition of Care Process (New Members)	  	To establish a process for authorizing continued services in a timely and appropriate fashion for new members who are in a current episode of treatment with a non-network practitioner.	  	Cal MediConnect, Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	The purpose of this policy and procedure is to ensure that MHN’s customer service and utilization management teams are in compliance with all state and federal regulations regarding written notification and translation of
applicable MHN documents.	  	Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Authorization for Transcranial Magnetic Stimulation (TMS)	  	To ensure appropriate coverage of requests for authorization of transcranial magnetic stimulation (TMS).	  	Cal MediConnect, Commercial Managed Care, EPO, HMO, Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Documentation Requirements for Outpatient Care Management for New Jersey Psychologists	  	To ensure consistent standards of documentation for outpatient care management for cases treated by New Jersey Psychologists in compliance with the New Jersey Independent Professional Review Committee Law (NJ Law NJSA 45:14B-31-
46)	  	All MHN Lines of Business	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-14	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Psychological and Neuropsychological Testing	  	To ensure appropriate and consistent application of criteria for requests for authorization of psychological testing.	  	Cal MediConnect, Commercial Managed Care, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	After Hours Higher Level of Care Determinations	  	To define a consistent practice for processing requests for higher level of care (HLOC) services in the MHN After Hours department. After Hours only authorizes for acute Level of Care inpatient behavioral health services (i.e.,
inpatient mental health, inpatient detoxification and inpatient rehabilitation).	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Managing Higher Level of Care Cases When MHN is Secondary Coverage	  	To establish guidelines for managing cases when the member has primary coverage through a different managed behavioral health care carrier.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Pre-Service Requests for Higher Levels of Care Authorization	  	To define a consistent practice for processing pre-service requests for authorization.	  	Cal MediConnect, Commercial Managed Care, EPO, HMO, Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Requests for Authorization of Initial Psychiatric Consultations in Non-Psychiatric 24-Hour Medical/Surgical Settings	  	To ensure appropriate coverage for requests for authorization for psychiatric consultations and behavioral health evaluations in a non- psychiatric 24-hour medical/surgical setting (inpatient, skilled nursing facility, nursing
home).	  	 Cal MediConnect, Commercial Managed Care, EPO, HMO,

Medi-Cal (including CalViva), Medicare, PPO
	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-15	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Urgent Pre-Service Requests for Higher Levels Of Care Authorization	  	To establish a process for urgent requests for authorization for higher levels of care (HLOC).	  	Cal MediConnect, Commercial Managed Care, EPO, HMO, Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN A&G	  	External Appeal Review	  	To provide an external appeal review of MHN’s final determination to deny authorization of payment for pre-service, concurrent, or post-service claims for MHN Commercial and Health Plan accounts as delegated and
contracted.	  	HMO, Commercial Managed Care	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Independent Medical Review (IMR) Appeals - California ONLY	  	To provide for members of California Department of Managed Health Care regulated plans or a Health Net Life Stand Alone plan regulated by the California Department of Insurance an external appeal review of MHN’s final
determination to deny authorization of payment for delayed or modified services, determinations of medical necessity, payment for emergency or urgently needed services, or determinations that a treatment is experimental or investigational.	  	Commercial Managed Care, California Knox- Keene	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Medicare Post Service Appeals for Non-contracted Providers	  	To define the basic responsibilities for the handling of the non-contracted provider appeal resolution process, ensuring a compliant, consistent, timely, and effective Medicare-required review for these specific provider
appeals.	  	Medicare	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Medicare Provider Payment Dispute Process (for Non-contracted Providers Only)	  	A Medicare required provider dispute resolution process has been established to ensure (for both non-contracted individual practitioners and non-contracted facility providers) compliant, consistent, timely, and effective review of
specific dispute types.	  	Medicare	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-16	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN A&G	  	Online Submission of Member Grievances	  	To ensure that all members with plans for which MHN is delegated appeals and complaints are able to register grievances confidentially online.	  	EAP, Commercial Managed Care, California Knox- Keene	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Post-Service Member Appeals	  	To provide a process for appeal by members or their representatives who request re-evaluation of the decision to deny authorization of payment for services, or who are dissatisfied with the resolution of a complaint filed with
MHN.	  	Commercial Managed Care, EPO, HMO, PPO	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Pre-Service/Concurrent Member Appeals	  	To provide a pre-service appeal by members or their representatives who request re-evaluation of a decision to deny authorization of payment for pre-service care claims.	  	Commercial Managed Care, EPO, HMO, PPO	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Provider Dispute Resolution Process	  	A provider dispute resolution process has been established to insure, for both individual practitioner and facility providers, consistent, timely, and effective de novo review of an issue that has not been satisfactorily resolved
through our regular provider customer service channels.	  	All MHN Lines of Business, including Medicare	  	MHN Policy and Procedure Database
					
	MHN A&G	  	Urgent Member Appeals	  	To provide an expedited process for urgent appeals by members (or their representatives) who request re-evaluation of a decision to deny authorization of payment for urgent care claims.	  	Commercial Managed Care, EPO, HMO, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Associate / Board Member Confidentiality Agreement	  	To ensure that all MHN associates and Board of Directors members have read and agreed to comply with all MHN Clinical Services policies and procedures regarding confidentiality of patient information.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-17	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	 MHN CCC
 and MHN A&G
	  	Authorization for Disclosure /Authorization of Representative and Medical Records	  	 · To ensure compliance with all MHN standards and applicable state and federal statutes regarding the disclosure of confidential
patient information;
 · To ensure the rights of qualified individuals to access confidential patient information;

· To allow members to assign a representative to act on their behalf, and

· To protect the security of confidential patient information.
	  	Cal Medi-Connect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Collection and Maintenance of Member Specific Information and Non-Telephonic Communication and Records	  	To ensure the appropriate collection, protection, and maintenance of confidential member specific records, information and non-telephonic communication.	  	All MHN Lines of Business	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Compliance With Health Net Inc. HIPAA Policies and Procedures	  	To ensure compliance with Health Net Inc. HIPAA policies and procedures	  	Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Confidentiality of Member Specific Information With Inbound and Outbound Calls	  	To enure the confidentiality of member-specific information relative to its communication to and from members, callers and/or entities outside MHN.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN
	  	Confidentiality of Provider Specific Information	  	To assure the confidentiality of provider-specific information, relative to its	  	Cal MediConnect, Commercial	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-18	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	A&G	  		  	distribution to entities outside Managed Health Network.	  	 Managed Care, EAP, EPO, HMO, Medi-
 Cal
(including CalViva), Medicare, PPO
	  	
					
	MHN CCC	  	Consent Requirements for Minors Able to Consent to Services (California-specific)	  	To ensure proper consideration of the rights of members who are minors and are able to consent to health care services without required notification to parents or guardians.	  	 CALIFORNIA
 ONLY: Commercial Managed Care, EPO,
HMO, Medi-Cal (including CalViva), PPO
	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Consent Requirements for Minors or Adults Unable to Give Consent	  	To ensure proper consideration of the rights of members who are minors or adults who are unable to give consent.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Disclosure of Confidential Member Information to Parents	  	To provide for appropriate disclosure of confidential member information to parents.	  	Cal Medi-Connect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	MHN CCC	  	Duty to Warn: Exceptions to Confidentiality	  	To delineate mandatory reporting procedures for situations involving reports of potential danger to self or others	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database

  

					
	Schedule P	  	P-19	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	MHN CCC	  	Mandatory Child/Elder Abuse Reporting – Exceptions to Confidentiality	  	To delineate mandatory reporting procedures for child, elder and dependent adult abuse.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	 MHN CCC
 and MHN A&G
	  	Visitor Guidelines and Confidentiality Agreement	  	To establish a process that safeguards confidential patient specific and/or proprietary company information by only allowing access to company premises handling Protected Health Information (PHI) to authorized visitors who have
signed a Business Associate Agreement (BAA) with Health Net and requiring these visitors to always wear a company-authorized identification badge and sign in at the main lobby on a visitor log with privacy language clearly printed on each page.	  	Cal MediConnect, Commercial Managed Care, EAP, EPO, HMO, Medi-Cal (including CalViva), Medicare, PPO	  	MHN Policy and Procedure Database
					
	CCC and A&G	  	Customer Contact Center and Appeals & Grievances Policy & Procedure: Member Issues, Complaints and Appeals (Note- In process and will be added to NPL after updates)	  	Policy for use by other dept. to assist in where appeals and/or grievances should be sent for timely processing	  	All regions, All products	  	 GENERAL COMPLAINT P&P vl 061614;

Z:\WH\Common10\MemServ2\Policies Procedures - VL\!Melissa

					
	Membership	  	61.68 GINA (HR 493)	  	It is the policy of Health Net to be compliant with Federal legislation HR493, GINA (Genetic Information Nondiscrimination Act) that was signed into law on May 21, 2008, with Sections 101, 102 and 104 relating to health insurers
taking effect by May 2009. The objective is to describe Health Net’s requirements to ensure that subscribers are not discriminated against because of genetic testing results that may affect their health.	  	ALL	  	54703/Knowledgebase

  

					
	Schedule P	  	P-20	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	CHIP - HR 2	  	It is the purpose of the Act (H.R. 2) to provide dependable and stable funding for children’s health insurance under CHIP in order to enroll the six million uninsured children who are eligible, but not enrolled, for
coverage.	  	ALL	  	54748/Knowledgebase
					
	Membership	  	Gender Identification - AB1586	  	Health Net may not discriminate on the basis of an insured’s or prospective insured’s actual or perceived gender identity, or on the basis that the insured or prospective insured is a transgender person.	  	ALL CA & OR	  	54749/Knowledgebase
					
	Membership	  	GINA (HR 493)	  	 It is the policy of Health Net to be compliant with Federal legislation HR493, GINA (Genetic Information Nondiscrimination Act) that was
signed into law on May 21, 2008, with Sections 101, 102 and 104 relating to health insurers taking effect by May 2009.
 The objective is to describe Health
Net’s requirements to ensure that subscribers are not discriminated against because of genetic testing results that may affect their health.
	  	ALL	  	54750/Knowledgebase
					
	Membership	  	1111.02 CA IFP Enrollment w/o Underwriting (Policy Statement)	  	 It is the policy of the CA IFP Unit to coordinate with Sales in the review and processing of IFP applications. CA IFP plans provide health
care coverage for individuals and families who are not provided coverage by their employer, Covered CA or a government-financed health plan (e.g.
 Medicare
or other state/federal funded program). The objective is to define eligibility requirements, type of products offered and payment options.
	  	CA IFP	  	56393/Knowledgebase

  

					
	Schedule P	  	P-21	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	OR IFP Enrollment (Includes Quick Net) - SOX Control 2734	  	It is the policy of the OR IFP Unit to coordinate with Sales in the review and processing of IFP applications. OR IFP plans provide health care coverage for individuals and families who are not provided coverage by their employer,
through Cover Oregon or a government-financed health plan (e.g. Medicare or other state/federal funded program). The objective is to define eligibility requirements, type of products offered and payment options.	  	OR IFP	  	56395/Knowledgebase
					
	Membership	  	Cal-COBRA AB1401	  	AB1401 signed on September 22, 2002, pursuant to Health and Safety Codes and Insurance Codes Sections amends those sections to comply with California legislation regarding Cal-COBRA coverage. This bill revises certain
provisions of Cal-COBRA and other existing laws that require plans and insurers to offer health benefit coverage to certain individuals. To comply with the revised coverage requirements for converted policies, and to offer specified individuals who
begin receiving continuation coverage, and who have exhausted their continuation coverage under federal continuation coverage provisions, an opportunity to extend the term of their coverage to 36 months.	  	CA COBRA	  	56772/Knowledgebase
					
	Membership	  	COBRA Premium Assistance Under ARRA	  	On February 17, 2009 the President signed into law the American Recovery and Reinvestment Act (ARRA). The objective of this legislation is to provide premium assistance for eligible beneficiaries electing COBRA coverage, as defined
under ARRA and its extensions.	  	ALL COBRA	  	56773/Knowledgebase

  

					
	Schedule P	  	P-22	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	Collection Unit - General Ledger AR Adjustments & Collections - SOX Ctl 1761, 2765 & 2767	  	 Management reviews Aged A/R Report quarterly, and after comparison of Aged A/R Report to the General Ledger may approve A/R Adjustment to
General Ledger.
 Management may approve additional allowances to the G/L within a Quarter to reflect updated Aged A/R Reports.

Additionally, the review of the Aged A/R Report identifies potential problem groups and lines of business, enabling Management to create a proactive approach
to address and target these accounts.
	  	ALL	  	56774/Knowledgebase
					
	Membership	  	Cash Unit - Payment Processing - SOX Ctl 1767, 2777 & 2778	  	Cash Unit processes the payments received via mail, interoffice, hand delivered and overnight courier that were not sent directly to the lockbox address daily. Checks not processed on the day received are placed in department’s
safe for processing the following business day.	  	ALL	  	56775/Knowledgebase
					
	Membership	  	DMHC Language Assistance - SB853	  	SB853 effective January 1, 2009, amended and added to the Health & Safety Codes and the Insurance Codes that health plans must comply with the requirement to develop and implement language assistance programs for Californians
with limited or no English-speaking ability, the translation of materials into a language that they speak and can comprehend.	  	ALL	  	56776/Knowledgebase
					
	Membership	  	KB 57239 Registered Domestic Partners AB 2208\SB 651	  	It is the policy of Health Net to comply with California legislation relating to Registered Domestic Partners, which require that insurers providing coverage for employee spouses must provide equal coverage to the registered
domestic partner of an employee. This law,	  	CA ALL	  	57239/Knowledgebase

  

					
	Schedule P	  	P-23	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

		  		  	known as California Insurance Equality Act, applies to health care service plans and health insurance policies for registered domestic partners in California.	  		  	
					
	Membership	  	9911.02 Same Gender Marriage/Partnership Enrollment	  	The objective of both the US Supreme Court and the state of Washington is to provide same gender couples with the same rights, protections, and benefits, and to be subject to the same responsibilities, obligations, and duties under
the law. This includes but is not limited to, health coverage under a spouse or same gender partner; requiring health plans to process and enroll spouses/partners of same gender marriages/partnerships.	  	All CA & WA	  	57240/Knowledgebase
					
	Membership	  	Military and Veterans Benefits - AB 2884	  	AB2884 extends to reservist ordered to active duty on or after January 1, 2007 reinstatement of coverage without any waiting periods or exclusion of coverage for pre-existing condition.	  	CA ALL	  	57241/Knowledgebase
					
	Membership	  	Processing Refunds - AB1043	  	 AB 1043 effective October 2005 amended Section 481.5 and repealed Section 393 of the Insurance Codes regarding the reduction or termination
of coverage resulting in unearned premium income for the insurer. The unearned premium shall be processed and returned to the beneficiary within twenty-five (25) business days after receiving notice of the reduction or termination of coverage. If
refund not processed within the twenty-five
 (25) business days the member is entitled to 10% interest per annum from the date on which the refund was to be
paid, until the date it is processed.
	  	CA ALL	  	57242/Knowledgebase

  

					
	Schedule P	  	P-24	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	Overage Dependent - Early Enrollment	  	It is the policy of Health Net for Membership Accounting to review dependent coverage to ensure that Health Net is compliant with all Federal and/or State Legislation. The Patient Protection and Affordable Care Act (HR 3590),
effective September 23, 2010, requires health plans and insurers, offering group or individual health insurance coverage for dependent children, to continue to make such coverage available until the child turns 26 years of age. This act will be
effective on the group’s next renewal on or after September 23, 2010. Health Net, in advance of HR 3590 implementation date, is providing employer groups and individual beneficiaries who opt-in early, to continue currently enrolled
dependents coverage until their 26th birthday effective May 1, 2010.	  	ALL	  	57370/Knowledgebase
					
	Membership	  	HIPAA Compliance	  	Health Net ensures compliance with HIPAA by providing its associates with guidelines on the use and disclosure of Protected Health Information (PHI) and members’ personal information as mandated by applicable Federal and State
laws.	  	ALL	  	57938/Knowledgebase
					
	Membership	  	Member Returned and Undeliverable Mail	  	It is the policy of Health Net to update in ABS, and related Health Net systems, returned and undeliverable mail if determinable from USPS notification or by contact with member. The objective is to ensure that Health Net systems
maintain the current address of all members, for accurate delivery of mailed correspondence to member.	  	ALL	  	57984/Knowledgebase

  

					
	Schedule P	  	P-25	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	Overage and Disabled Dependent Children	  	It is the policy of Health Net for Membership Accounting to review dependent coverage for dependents turning 26 years of age to ensure compliance with all Federal and/or State Legislation. Additionally, to ensure that CA disabled
subscribers are provided coverage as applicable under AB 910, and to verify new group eligibility requirements as defined in the group’s EOC relating to disabled dependent.	  	CA ALL	  	58111/Knowledgebase
					
	Membership	  	Retroactive Approval - SOX Control 2752	  	It is the policy of Health Net to accurately process retroactive enrollments and terminations to conform to DMHC regulations.	  	CA ALL	  	59123/Knowledgebase
					
	Membership	  	30 Day Grace Period (AB 2470)	  	 AB 2470 (2010), effective January 1, 2011, amended the following: Pursuant to California DMHC Section 1365(a) and CDI Section

10273.4 prohibiting health plans and insurers from rescinding or canceling coverage, except under specified circumstances. AB 2470 (2011) modifies the ability
to cancel or not renew a contract or policy for non-payment of premiums by requiring a thirty (30) day grace period from the date of notification from the plan or insurer.
	  	CA ALL	  	61553/Knowledgebase
					
	Membership	  	60 Day Rate Change Notification SB 1163	  	SB 1163 requires notice of an increase to the premium rate to be provided to member at least 60 days prior to the effective date of the change.	  	CA ALL	  	62914/Knowledgebase
					
	Membership	  	Enrollments of Newborns Policy	  	It is the policy of Health Net to enroll eligible newborn beneficiaries for the first thirty (30) days of life without an enrollment form/request. In order for coverage to	  	CA ALL	  	71050/Knowledgebase

  

					
	Schedule P	  	P-26	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

		  		  	continue beyond thirty (30) days, the newborn must be enrolled through the employer within thirty (30) days of birth. Newborns must be assigned to the same PPG as the mother or subscriber. Dependent children from age 1 month up to
age 3 years must be assigned to the same PPG as the mother or subscriber, unless the subscriber self designates a PPG.	  		  	
					
	Membership	  	MLR Database Solution	  	 In accordance with the Affordable Care Act, provide the Statutory Reporting department with part six of the annual Medical Loss Ratio Rebate
Filing Form to complete the MLR reporting annually by June 1. Produce rebate checks and rebate notifications (with interest if late) for eligible subscribers and policyholders for the MLR reporting year.

Provide Customer Distribution Services (CDS) rebate check and rebate notification files to mail annually no later than August 1. Retain and insure access to
MLR related data with the capability of meeting reporting requirements in accordance with the retention policies.
	  	ALL	  	72962/Knowledgebase
					
	Membership	  	SB853 P & Policy Statement	  	In 2003, the California legislature passed Senate Bill 853 mandating that all health plans in the state provide limited English speaking enrollees with language assistance services	  	CA ALL	  	78497/Knowledgebase
					
	Membership	  	1111.01 IFP and IFP Child Only Notifications	  	 The objective of this policy statement is to provide guidance to MA&E regarding the following notifications: (a) 2013 CA portfolio
Off-Exchange IFP Child Only plans, and (b) all other IFP Off-Exchange plans.
 These notifications are intended to provide
	  	CA IFP	  	80599/Knowledgebase

  

					
	Schedule P	  	P-27	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

		  		  	IFP applicants with information related to the California individual exchange, including that lower cost coverage may be available through the California individual exchange.	  		  	
					
	Membership	  	9911.07 Effective Dates for Open Enrollment	  	This policy describes Health Net’s procedures for compliance with required regulations related to Open Enrollment on and off the Exchanges. The objective is to ensure compliance when enrolling members within the appropriate
timeframes.	  	ALL	  	80622/Knowledgebase
					
	Membership	  	9911.04 Special Enrollment Periods	  	It is the policy of Health Net, Inc. to comply with Federal Regulations allowing enrollments outside of the Annual Enrollment period under certain conditions known as Qualifying Events. Applicants may apply within 60 days (IFP and
CA or WA SBG) or 30 days (Large Group and AZ or OR SBG) after a Qualifying event occurs. If applicant is without coverage and did not apply during the initial open enrollment period, proof of the qualifying event may be required	  	ALL	  	80626/Knowledgebase
					
	Membership	  	9911.05 Records Retention	  	 Health Net, Inc. policy requires that all books, records and accounts be maintained accurately and that no fund, asset, liability, revenue or
expense be concealed or incompletely recorded for any purpose.
 Furthermore, all entries must be supported by documentation adequate to permit the books and
records to be verified by audit.
	  	ALL	  	80627/Knowledgebase
					
	Membership	  	9911.08 ACA Group Probationary Periods	  	The objective of this Policy Statement is to provide clear communication regarding the responsibilities pertaining to Probationary Periods as defined in the Affordable Care Act.	  	All SBG & SHOP	  	83331/Knowledgebase

  

					
	Schedule P	  	P-28	  	 Health Net / Cognizant Confidential

 
  
  

 

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	Membership	  	9411.01 Policy Statement Bulletin #4 Enrollee Initiated Terminations	  	Enrollees have the right to terminate their coverage in a Qualified Health Plan (QHP) provided they give adequate notice to both the Marketplace and the QHP. Regulatory requirements at 45 CFR § 155.430(1) require the
Marketplace to permit enrollees to terminate coverage in a QHP.	  	AZ IEX & SHOP	  	84757/Knowledgebase
					
	Membership	  	9411.02 Policy Statement Bulletin #5 Flexibility During Initial OE to Change Plans Offered by the Same Issuer at the Same Metal Level	  	CMS will now allow enrollees to change plans during the Initial Open Enrollment Period after the effective date of their enrollment under certain, discrete circumstances.	  	AZ IEX & SHOP	  	84779/Knowledgebase
					
	Membership	  	9941.01 Exchange Payment Processing	  	In accordance with Federal Regulation, it is Health Net, Inc.’s policy to provide consumers with the ability to easily remit payment towards initial and subsequent monthly premiums by equally presenting numerous payment
options.	  	All IEX & SHOP	  	85128/Knowledgebase
					
	Membership	  	CMS Bulletin#3 SEP Effective Dates and Processes	  	Several categories of special enrollment periods (SEPs) exist that allow a consumer to enroll in a Qualified Health Plan (QHP) with accelerated effective dates or to change their QHP selection.	  	AZ IEX & SHOP	  	85252/Knowledgebase
					
	Membership	  	CMS Bulletin #2 Functionality for Consumer-Initiated Application and Enrollment Changes	  	New functionality on healthcare.gov allows consumers to report changes directly through the Federally – facilitated Marketplace (FFM).	  	AZ IEX & SHOP	  	85253/Knowledgebase
					
	IT - Release Management	  	Group Mailbox Set-Up Instructions	  		  	All	  	\\Hncorp\dfs- common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P

  

					
	Schedule P	  	P-29	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Release Management	  	HN Change Management CMR Review and Approval Archive_Updating	  		  	All	  	\\Hncorp\dfs- common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	Health Net Change Management Release Requirements	  		  	All	  	\\Hncorp\dfs- common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	How to Change Access Controls lists in group mailboxes	  		  	All	  	\\Hncorp\dfs- common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	ISP Metrics	  		  	All	  	\\Hncorp\dfs- common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	ITG Release Management Business Communication Plan Procedure	  		  	All	  	 http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/822C66D83A9D5C1 588257B6C006EB90F?

OpenDocument

					
	IT - Release Management	  	ITG Release Management DB Refresh Procedure	  		  	All	  	 http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/4E548321AC2E0B6 C88257CE7007E1AFB?

OpenDocument

  

					
	Schedule P	  	P-30	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Release Management	  	ITG Release Management Project Information Collection	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/B8420F788362814F 88257CE50061CCED?OpenDocument
					
	IT - Release Management	  	ITG Release Management SIT & UAT At Risk Report	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/8ECA57261D15543 588257B67005ABC27?OpenDocument
					
	IT - Release Management	  	ITG Release Scheduling Policy & Guidelines	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/2DB97F7C546398E 988257B21007BF76E?OpenDocument
					
	IT - Release Management	  	PostImplementationMetrics Template	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-003-03_Procedure_@Risk_mgt_prep	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-004-01_Procedure_Implementation_GOLIVE	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-005-01_Procedure_Remedy_PostDepl_reporting	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P

  

					
	Schedule P	  	P-31	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Release Management	  	PRD-007-01_Weekend Implementation Activities	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-008-01_Imp Readiness Procedure	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-009-01_Procedure_RMDB_Maintenance	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-010-01_RM High Level Process	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	PRD-011-01_Work Order Review Meeting	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	ProjInfo-xxxx-xxxxx-Template-6-25-14	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P

  

					
	Schedule P	  	P-32	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Release Management	  	RCA Template	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	Release Management Training Checklist	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	Release Policies Procedures	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	RM Process Write up- Confirmation Process	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	WCOE RM Process	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Release Management	  	Weekend Checklist	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P

  

					
	Schedule P	  	P-33	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Release Management	  	WO Review - PM Guidelines	  		  	All	  	\\Hncorp\dfs-common\WH\Common04\SystemsConsolidation\Releases\Dashboard\Enterprise Release Communication\Process\RM P&P
					
	IT - Records Management	  	Non-Production Systems Data Recovery for Electronic Media	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all
/94933ACDF596DC A988257D2B005DB22D?OpenDocument
					
	IT - Mobile Device	  	WiFi Acceptable Use Policy	  		  	All	  	https://hnc.healthnet.com/sites/default/files/documents/
departments/itg/pol icies_and_guidelines/
wifi_device_use_policy_472014.pdf
					
	IT - Mobile Device	  	Mobile Device BYOD Q&A 5/19/2014	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/
sys_all/0C39DBB75CBF21 3E88257D0E007BBEDC?OpenDocument
					
	IT - Mobile Device	  	Mobile Device Policy aka Associate Policy in NPL	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/
sys_all/0C39DBB75CBF21 3E88257D0E007BBEDC?OpenDocument
					
	IT - Mobile Device	  	Mobile Device Policy for IT Testing Devices aka Associate Policy in NPL	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/
sys_all/5E942FAF521A3EA 888257D200062D889?OpenDocument
					
	IT - Mobile Device	  	Mobile Device Request Process	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/
sys_all/03E438A9DC7F02C 088257D19006EE211?OpenDocument

  

					
	Schedule P	  	P-34	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Mobile Device	  	Mobile Device Usage aka Associate Policy in NPL	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/
5D07E1E3B9A4854 F88257D200060D3CA?OpenDocument
					
	IT - Minor Enhancements	  	CTS ME and Locking Down Monthly Release Meeting Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/minor_enhancements/
cts/process_guidelines/cts_me_and_locking_down_
monthly_release_meeting_guidelines.pdf
					
	IT - Minor Enhancements	  	CTS ME EPSS Minor Enhancements Mailbox Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/minor_enhancements/
cts/process_guidelines/cts_me_epss_minor_
enhancements_mailbox_guidelines.pdf
					
	IT - Minor Enhancements	  	CTS ME Intake & Implementation Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/minor_enhancements/cts/
process_guidelines/cts_me_intake_
implementation_guidelines.p df
					
	IT - Minor Enhancements	  	CTS ME Monthly Capacity per Application	  		  	All	  	https://hnc.healthnet.com/sites/defaul t/files/documents/
groups/itg_infrastructure_project_group/minor_enhancements/cts/
process_guidelines/cts_me_monthly_
capacity_per_application. pdf
					
	IT - Minor Enhancements	  	CTS ME Process Flowchart	  		  	All	  	https://hnc.healthnet.com/sites/defaul t/files/documents/
groups/itg_infrastructure_project_group/minor_enhancements/
cts/process_workflows/cts_me_process_flowchart.pdf

  

					
	Schedule P	  	P-35	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Minor Enhancements	  	Current ME Listing and CTS Release Lock Down Schedule Post	  		  	All	  	 notes://SacDom70/88257593005C2B6C/
626E6035EADBB4CD85256499 006B15A6/A71957299F4CF473882

57B4B0020B7DC

					
	IT - Minor Enhancements	  	IBM ME Bi Weelky Mtg Participation	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/
ibm_me_bi_weekly_mtg_participation_
guidelines_v2_20131203.pdf
					
	IT - Minor Enhancements	  	IBM ME Closure Process Flow	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/process_work_flows/ibm_ me_
closure_process_v2_20130404.pdf
					
	IT - Minor Enhancements	  	IBM ME Guidelines for Closing a Completed IBM ME Project in Planview	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/
guidelines_for_closing_completed_
ibm_me_projects_in_planview_v2_2
0130409.pdf
					
	IT - Minor Enhancements	  	IBM ME Guidelines for Closing Denied IBM ME Projects in Planview	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/
guidelines_for_closing_denied_ibm _me_
projects_in_planview_v1_2013
0412.pdf

  

					
	Schedule P	  	P-36	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Minor Enhancements	  	IBM ME Intake Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/ itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ibm_
me_intake_guidelines_v2_201 31203.pdf
					
	IT - Minor Enhancements	  	IBM ME Log Clean Up Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/ itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ibm_
me_log_clean_up_v1_201304 18.pdf
					
	IT - Minor Enhancements	  	IBM ME Mailbox Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/ itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ibm_
minor_enhancements_mailbox _guidelines_v1_20130326.pdf
					
	IT - Minor Enhancements	  	IBM ME Process Flow	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/ itg_infrastructure_project_group/
minor_enhancements/ibm/ process_work_flows/visio _ibm_
me_procees_flow_2014_05_22.pdf
					
	IT - Minor Enhancements	  	IBM ME Requirements Review Meeting Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/ itg_infrastructure_project_group/minor_enhancements/ibm/
guidelines_and_workflows/ibm_me_requirement_
review_meeting_ guidelines_v4_201301203.pdf
					
	IT - Minor Enhancements	  	IBM ME Weekly IBM Project Remediation Work Session Guidelines	  		  	All	  	 https://hnc.healthnet.com/sites/default/
files/documents/groups/

itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ mtg_
participation_guidelines_for_ ibm_hn_proj_remediation_
wrk_
sessions_v1_20130326.pdf

  

					
	Schedule P	  	P-37	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Minor Enhancements	  	IBM ME Weekly Reporting Schedule Guidelines	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ibm_
me_weekly_rptng_schd_guide lines_v4_20131203.pdf
					
	IT - Minor Enhancements	  	IBM ME Weekly Reporting Schedule Process Flow	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/process_work_flows/ibm_
me_weekly_reporting_schedule_v5_ process_flow_20131203.pdf
					
	IT - Minor Enhancements	  	IBM ME Weekly Work Order Log Procedures	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/guidelines_and_workflows/ibm_
minor_enhancement_weekly_ work_order_log_procedures_v2.pdf
					
	IT - Minor Enhancements	  	IBM Time Reporting Process Flow	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_group/
minor_enhancements/ibm/process_work_flows/visio_
ibm_time_reporting_process_flow.pdf
					
	IT - Governance	  	Asset Management	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL

  

					
	Schedule P	  	P-38	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	Baseline process to add new or adjust AO services through a Change Notice	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Change Notice Procedure	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Colorado Use Tax Apportionment (SW Renewals)	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Creating a C-ID	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Creating New PO for AO Fixed Bid Efforts	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	CTS AO PO Closure Process	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	CTS CSAT SLA Process v1.3_final	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS HN Service Level Management Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - Amount at Risk Tracking Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - Communication Link Availability Validation Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - Earn Back Period Tracking Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - Functional Defect Removal Effectiveness (DRE) Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final

  

					
	Schedule P	  	P-39	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	CTS SA SLA - Internal Financial Communication Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - QA Cost Percentage Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - QA Schedule Variance Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	CTS SA SLA - Reports Validation Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	DAD and DND Documents	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	External Government Remedy User Profile	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Fixed Bid AO Project Work Order/Change Request/Assessments	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	hCentive Process Document	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	HN IT Asset Management Equipment Return, Replace, Retain Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	How to order PCs from Compucom	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	HSC Calculations	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures

  

					
	Schedule P	  	P-40	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	IBM Desktop Ongoing Physical Equipment Maintenance Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	IBM HN Service Level Management Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IBM RU Invoice Process	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Information Technology Service Level Process Manual	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/39CECB0688AE634 588257C740068B6DF?OpenDocument
					
	IT - Governance	  	Invoice Review - InterCall’s Reservationless-Plus Validation of monthly charges	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	IO Project Work Orders	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	IO svc tower RU #30 VPN User Count Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IO svc tower RU#1 Tape Gigabyte usage	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IO svc tower RU#15 Databases-SQL Billing Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IO svc tower RU#18 Billing Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IO svc tower RU#21 Lotus Notes Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final

  

					
	Schedule P	  	P-41	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	IO svc tower RU#22 Help Desk Services Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IO svc tower RU#31-36 IMAC Activity LAN-WAN Firewall Validation	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	ISR_Special Access Request Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	IT Asset Management E-Waste Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	IT Physical Hardware Inventory Reconciliation Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	IT Quarterly Physical Equipment Review Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	IT Quarterly Telephone Hardware and Software Inventory Audit Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	IT Server Hardware Inventory Reconciliation Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL

  

					
	Schedule P	  	P-42	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	IT Service Level Metric Team Ad Hoc Report Request Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/BCF0E21C6BB2FD 0288257A21005F5EE9?OpenDocument
					
	IT - Governance	  	IT Service Level Metric TeamCross Vendor (HN, CTS & IBM)Ticket Ownership Dispute Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/0AA1B5CBEA2731 2E88257A29006009BD?OpenDocument
					
	IT - Governance	  	ITAM HN-IBM Server Software Compliancy Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	ITAM PIM - Health NetProcess Interface ManualAsset Management	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/E3308D2D7DD7BC C288257B5000756163?OpenDocument
					
	IT - Governance	  	ITAM Quarterly Remote Site Physical Equipment Degauss and Un-Encryption Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	ITAM Software Naming Standard Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/02890079054346AA 88257B7B00505A2E?OpenDocument
					
	IT - Governance	  	ITAM Work Order Software Check	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	ITAMP-020-Monthly Voice IMAC Activity Validation_draft	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final

  

					
	Schedule P	  	P-43	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	ITG SLM Team - Audit Procedure for Month-End Reporting	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Cognizant Application Availability Minutes Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Create Service Request Document Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - GSA (General System Availability) Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - How to Add an Application to the Database for Metrics Processing	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - How to Populate the IBM Monthly Scorecard	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - How to Remove an Application to the Database for Metrics Processing	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - How to Run Monthly Application Availability Reports Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - How to Run the Response Time Z/OS CICS Region Performance Report Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SLA Ticket Scrub Review Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SLA Waiver Request Process	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final

  

					
	Schedule P	  	P-44	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	ITG SLM Team - JP Morgan Quarterly Metrics Reporting Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Metrics Access Database Application Update Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Metrics Access Database Department Update Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Metrics Access Database Site Update Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Populating Monthly MOR & Quarterly Scorecard Data	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Remedy and SRM Group Add/Update Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Remedy Client Impacted Tab Add Application Affected Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - Remedy Client Impacted Tab Obsolete Application Affected Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - University of CA Metrics Reporting Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL001 Annual Customer Satisfaction Survey Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL002 End User Services Customer Satisfaction Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final

  

					
	Schedule P	  	P-45	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	ITG SLM Team - IBM SL003 Help Desk Satisfaction Survey Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL004 General System Availability Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL005/SL006
 SAN/NAS
Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL007 Data
 Network
Availability Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL008 SL011
 Problem Priority
1 & 2 Response-Resolution Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL012-SL015
 Incident
Priority 1 & 2 Response-Resolution Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL016 First Call Resolution (FCR) Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL018 IMACs
 Deskside Support
Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL021-SL024
 Incident
Priority 3 & 4 Response-Resolution Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL025-SL028
 Problem Priority
3 & 4 Response-Resolution Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	 ITG SLM Team - IBM SL032 Voice
 Availability
Validation Procedure
	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final

  

					
	Schedule P	  	P-46	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	ITG SLM Team - IBM SL033-SL037 Service Request Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL038-SL039 & SL045-SL046 Server Availability Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SL050 Production Batch Application Availability Validation Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SLA54-55 Audit and Compliance - PARC Preliminary Report Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - IBM SLA56 How to Calculate Access Admin ‘Business as Usual’ Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	ITG SLM Team - ITG Problem P1/P2 Morning Ticket Review and Follow-up Procedure	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	MAPT Expenses	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Monthly PDA Validation Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	Product Batch Availability Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	Product Work Orders	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures

  

					
	Schedule P	  	P-47	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	Project & Product Work Orders	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Project Stop Work Orders	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Quest Analytics Annual Release Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	Resource Units 37-38 IT Monthly VOIP Port and PBX Port Validation Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	Resource Units 41 - 45 Monthly Voice IMAC Activity Validation Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Governance	  	Retained Expenses	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Service Request Process	  		  	All	  	H:\IT Governance\Service Levels\Procedures\Final
					
	IT - Governance	  	Site Point of Contact (SPOC) Process	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/EAD18816BBDD6B 96882579FA006166BC?OpenDocument
					
	IT - Governance	  	SLA Initiation Process	  		  	All	  	H:\IT Governance\Service Levels\
Procedures\Final
					
	IT - Governance	  	SLA Measurement Desktop Procedure_DRAFT	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Dave s Blog\Process & Procedures

  

					
	Schedule P	  	P-48	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Governance	  	T&M AO Project Work Order/Change Request/Assessments Procedure	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Third Party Vendor Management Guide	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Governance	  	Tracking/Ordering Software for CTS	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - EPSS	  	EPSS ID_003 Sponsoring Projects	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/DCB8AA2943695A E188257B9C00619F31?OpenDocument
					
	IT - EPSS	  	EPSS ID_013 Special Projects	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/F87CB628C080E11 888257BA200800759?OpenDocument
					
	IT - EPSS	  	EPSS ID_017 Report Status	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/9DB8C988B985C89 388257BA4007D5F03?OpenDocument
					
	IT - EPSS	  	EPSS ID_020 Daily Operations Review Meeting	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/E7FE8248DDD1614 C88257B9D0065B0C3?OpenDocument
					
	IT - EPSS	  	EPSS ID_023 Initiate SWAT Bridges for Severe Outages	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/601EF931BAD2EC E188257B49006C041B?OpenDocument

  

					
	Schedule P	  	P-49	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	 	 Policy Name
	  	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - EPSS	 	EPSS ID_024 Contact Service Delivery Manager	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/8596926DCF0E64C F88257D33005F121F?OpenDocument
					
	IT - EPSS	 	EPSS ID_025 Service Delivery Manager Engagement	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/D2AF605080BDA5 7688257D33005A696D?OpenDocument
					
	IT - EPSS	 	EPSS ID_029 Formal Communication of Outages	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/C584FC73883AAD 6688257B790083B2F1?OpenDocument
					
	IT - EPSS	 	EPSS ID_030 Attend SWAT Calls	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/54A6D6C903C545D 888257B7F00833FDB?OpenDocument
					
	IT - EPSS	 	EPSS ID_031 Formal Resolution of Production System Availability & Response Issues	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/976763C361C24A6 188257B96007050B4?OpenDocument
					
	IT - EPSS	 	EPSS ID_032 Sending G2 Notifications	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/52B3C57BA129D6 C688257B94007FF549?OpenDocument
					
	IT - EPSS	 	EPSS ID_040 Turnover Transition to On Call SDM	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/E2C414531C29C2B 488257B9500790C2C?OpenDocument
					
	IT - EPSS	 	EPSS ID_044 Weekend On Call Duties	  		 	All	 	http://sacdom50.healthnet.com/npl/
NPL.NSF/sys_all/5D80DB6DD54DB D9388257B95007C75AB?OpenDocument

  

					
	Schedule P	  	P-50	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	 	 Policy Name
	  	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - EPSS	 	EPSS ID_095 Telephone Tree	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/EF780E5D8329281 E88257B9800739EE3?OpenDocument
					
	IT - EPSS	 	EPSS ID_096 Use of Pending in Remedy Tickets	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/707366EDAC48C6 DA88257D3300731E97?OpenDocument
					
	IT - EPSS	 	EPSS Weekly Report Card Procedure	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/D6F7A81FC25A0E A188257D2400134659?OpenDocument
					
	IT - EPSS	 	EPSS Weekly Ticket Stats Procedure	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/9F66C16F15189501 88257D24001790EA?OpenDocument
					
	IT - EPSS	 	SWAT Management Process Flow (diagram)	  		 	All	 	\\hncorp\dfs-common\datacenter\commom03\pss\ procedures\job description procedures
					
	IT - ECPM	 	ECP - Project Brief Creation	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/1D7DB65789C8B46 E88257CEB00746C75?OpenDocument
					
	IT - ECPM	 	ECP Wintel Storage Management Process	  		 	All	 	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/DDFF13159A5EAD BA88257CEC005A67C9?OpenDocument

  

					
	Schedule P	  	P-51	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	 	 Policy Name
	  	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - ECPM	 	ECPM – Inftrastructure Capacity Demand Forecast	  		 	All	 	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/enterprise_
capacity_planning/policies_procedures/ecpm_
infrastructure_capacity_demand_forecast_11.pdf
					
	IT - ECPM	 	ECPM - Project Brief Creation	  		 	All	 	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/enterprise_
capacity_planning/policies_procedures/ecpm_
project_brief_creation_v20_0.pdf
					
	IT - ECPM	 	PSOTS - 2nd Tier Production Support	  		 	All	 	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/technical_
services/policies_procedures/01_general/psots_
2nd_tier_production_support_v10.pdf
					
	IT - ECPM	 	PSOTS – Database Decommission	  		 	All	 	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/technical_
services/policies_procedures/07_oracle/psots_
database_decommission_10_0.pdf
					
	IT - ECPM	 	PSOTS – Minor Enhancement Support	  		 	All	 	https://hnc.healthnet.com/documents/ groups/itg_
infrastructure_project_group/minor_enhancements/
ibm/psots_minor_enhancement_support_process
					
	IT - ECPM	 	PSOTS - Minor Enhancement Support Process	  		 	All	 	https://hnc.healthnet.com/sites/default/files/documents/
groups/itg_infrastructure_project_group/technical_
services/policies_procedures/01_general/psots_
minor_enhancement_support_v7
0.pdf

  

					
	Schedule P	  	P-52	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - ECPM	  	PSOTS – Project Support	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_
project_group/technical_services/policies_
procedures/01_general/psots_project_support_v50.pdf
					
	IT - ECPM	  	PSOTS – Storage Request Review and Approval Process	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_
project_group/technical_services/policies_
procedures/09_storage/psots_storage_request_approval_ process_v10_0.pdf
					
	IT - ECPM	  	PSOTS – Systems Stability Checks & Remediation	  		  	All	  	https://hnc.healthnet.com/sites/default
/files/documents/groups/itg_infrastructure_project_
group/technical_services/policies_procedures/01_general/
psots_system_stability_checks_ remediations.pdf
					
	IT - ECPM	  	PSOTS - XenDesktop Usage Policy	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_
group/technical_services/policies_procedures
/03_citrix_/psots_xendesktopusagepolicy_v10_0.pdf
					
	IT - ECPM	  	PSOTS - XenDesktop Utilization Audit and Demand Forecast Process	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_
group/technical_services/policies_procedures/
03_citrix_/psots_xendesktop_utilization_
audit_and_demand_forecast_process_v_14.pdf

  

					
	Schedule P	  	P-53	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - ECPM	  	Storage Organic Growth	  		  	All	  	https://hnc.healthnet.com/sites/default/
files/documents/groups/itg_infrastructure_project_
group/enterprise_capacity_planning/policies_
procedures/ecpm_storage_organic_growth.pdf
					
	IT - Disaster Recovery	  	 ITG Disaster Recovery Plan Testing Policy
 &
Procedure
	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/
sys_all/108D6AA9A8278EE288257AFD0004FFB9%3FOpenDocument%0A%0A
					
	IT - Disaster Recovery	  	ITG Disaster Recovery Program	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/
5427DF945FC33310 88257AF4006D746E%3FOpenDocument%0A%0A
					
	IT - Disaster Recovery	  	ITG Disaster Recovery Standards	  		  	All	  	http://sacdom50.healthnet.com/npl/N PL.NSF/sys_all/
8C1C92114010A29 D88257B020081151E%3FOpenDocument%0A%0A
					
	IT - Decom	  	Project Decommissioning of Equipment	  		  	All	  	 http://sacdom50/npl/NPL.NSF/sys_all/
0ECB4CC3B113CB8C88257D510

0636C44?OpenDocument

					
	 IT -
 Compliance
	  	Daily Access Process	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Daily PrivAcct Check Step 1 - Storing the files for mef3 processing	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Daily PrivAcct Check Step 2 - Copying and Modifying the Vault Inventory Report for Daily Verification	  		  	All	  	Came from IBM

  

					
	Schedule P	  	P-54	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	 IT -
 Compliance
	  	Daily PrivAcct Check Step 3 - Active Privileged Account Comparison to the Daily Scorecard and ITIM	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Daily PrivAcct Check Step 4 - Comparing the mef3s to the Daily Check using Access	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Health Net Instructions for Performing a Password Audit	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Health Net Instructions for Selecting a Random Sample for Audit	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Health Net’s Daily Score Card Review Process	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	HN PARC SLA Process	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	IBM Daily Privilege Access Recon Process	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	IBM’s 72 Hour Provisioning Reconcilation Process for Controlling Privileged Access	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	ISR Health Net Daily Scorecard Reconciliation Procedures	  		  	All	  	Came from IBM
					
	 IT -
 Compliance
	  	Manual Deprovisioning	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/85A1892F15361FE B88257B420076CAD7?OpenDocument
					
	 IT -
 Compliance
	  	Password Confirmation Policy	  		  	All	  	Came from IBM

  

					
	Schedule P	  	P-55	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	 IT -
 Compliance
	  	Scorecard Process Review	  		  	All	  	Came from IBM
					
	IT - Change Management	  	Amin Rule for Remedy	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Approval Role Profile	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Dave s Blog\Process & Procedures
					
	IT - Change Management	  	Change Approval Matrix	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Audit Procedures_Updating	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Monthly Metrics report Procedure	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Policy V3.0	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Procedure System Availability Matrix	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Process	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/1B04A1742187BB9 688257C8B000947C2?OpenDocument

  

					
	Schedule P	  	P-56	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Change Management	  	Change Management Process Interface Manual	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Quick Tips	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Report	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management SLA Validation Procedure	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Management Weekly Audit Report Metrics	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Change Meetings Information	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Cheat Sheet	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Client Notification Mailbox	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Closure Code Definition	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures

  

					
	Schedule P	  	P-57	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Change Management	  	CM00_Change Process Overview_SOP	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/45DE3C1A620D7D 0088257C8C001503DE?OpenDocument
					
	IT - Change Management	  	CM01_Initiate a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM02_Assess a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM03_Review a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM04_Authorize a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM05_Implement a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM06_Close a Change_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM11_ITG Freeze_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM12_ITG Client Notification_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures

  

					
	Schedule P	  	P-58	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Change Management	  	CM13_ITG Change Validation_SOP	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CM14_ITG CM Remedy Unavailable Process_SOP_DRAFT	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CMXX_Agent Upgrades_SOP V3_Draft	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	CMXX_CMR Guidelines_SOP V3_Draft	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Compliancy Audit Report Desktop Procedure	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Daily_Weekend Report	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Extended Sunday Availability	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Extended Sunday Availability Generic	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	How to upload the Change Review Meeting to the worksite	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures

  

					
	Schedule P	  	P-59	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Change Management	  	How to upload the DailyWkly report to the work site	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Impact and Risk	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Installing Client Notifications Mailbox	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	ITG Production Services Change Management Policy	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/20D6A6E1A7D7A8 1888257CE700729917?OpenDocument
					
	IT - Change Management	  	Monthend Metric Desktop Procedure_DRAFT	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	PIM Updates 092010	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Preparation of RAW Data for Monthend and SLA Desktop Procedure_DRAFT	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Workflow_CAB	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Workflow Definitions_Responsibilities	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures

  

					
	Schedule P	  	P-60	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Change Management	  	Workflow_Client Notifications new	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Workflow_Compliancy Audit	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Workflow_HN Change Management CMR Review and Approval	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Change Management	  	Workflow_HN Change Management Training	  		  	All	  	\\hncorp\dfs-common\datacenter\common03\Daves Blog\Process & Procedures
					
	IT - Asset Management	  	Health Net Desktop Lifecycle Workflow Methodology	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/22876B5FDD6A095 C88257B7C00510852?OpenDocument
					
	IT - Asset Management	  	Health Net Process Interface Manual Asset Management	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/9E87662B3CE8572 A88257B7B0060A67D?OpenDocument
					
	IT - Asset Management	  	Inventory Tool Update and Reporting Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/F41C4FCFA624D4 B588257B7A007163FC?OpenDocument
					
	IT - Asset Management	  	IT Admin Rights Annual Qualification Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/CB4B54B96C64959 088257B7A005973C5?OpenDocument

  

					
	Schedule P	  	P-61	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Asset Management	  	IT Asset Management Exiting Associates Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/41DE007C5C886A1 688257B7A005B8227?OpenDocument
					
	IT - Asset Management	  	IT Asset Management Group Mailbox Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/083A4D64764708F6 88257B7B0050FBAF?OpenDocument
					
	IT - Asset Management	  	IT Asset Management New Associates Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/FBB950DFDD0448 1388257B7A00734F6A?OpenDocument
					
	IT - Asset Management	  	IT Asset Management Transferring Associates Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/083A4D64764708F6 88257B7B0050FBAF?OpenDocument
					
	IT - Asset Management	  	IT Collection and Storage of Physical Software Media Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/8730A1FC929523A 388257B7A005AF250?OpenDocument
					
	IT - Asset Management	  	IT Desktop License Transfer In Compliance With License Agreement Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/8730A1FC929523A 388257B7A005AF250?OpenDocument
					
	IT - Asset Management	  	IT External Audit of Software Installation Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/4023FE5DF5320A9 E88257B7A005C06C7?OpenDocument
					
	IT - Asset Management	  	IT Internal Software Audit Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/D60FED36D94781E 488257B7A006C4F9B?OpenDocument

  

					
	Schedule P	  	P-62	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Asset Management	  	IT Service Request for Software Removal Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/91AFD1825541D0D 188257B7A0073B71A?OpenDocument
					
	IT - Asset Management	  	IT Single Trusted Source Host/Server Baseline Correction Procedure	  		  	All	  	H:\IT Governance\Asset Management\IT Software Asset Tracking\Policies & Procedures\FINAL
					
	IT - Asset Management	  	IT Software Approval and Updating of eBuyer Catalog Procedure	  		  	All	  	 http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/55ABEA2B890B12 F788257B7B004FD1B4?Open

Document

					
	IT - Asset Management	  	IT Steady State Non Lease Equipment Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/C686177E97B0EB2 288257B7A005A3E66?OpenDocument
					
	IT - Asset Management	  	ITAM Advertised Programs Package Request Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/C686177E97B0EB2 288257B7A005A3E66?OpenDocument
					
	IT - Asset Management	  	ITG Asset Management Delivery Confirmation Document Policy & Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/58DC5245B1F3380 D88257AD100745A41?OpenDocument
					
	IT - Asset Management	  	ITG Asset Management Policy & Procedure	  		  	All	  	 http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/27F72F502BFF1538

88257B0F006B0503?OpenDocument

  

					
	Schedule P	  	P-63	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Asset Management	  	Server Software Inventory Tool Update and Reporting Procedure	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/2B1BF39625018FC 088257B7A00746851?OpenDocument
					
	IT - Asset Management	  	Workstation Placement Guidelines	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/639BB60A2CB6D3 F388257B720060CD4F?OpenDocument
					
	IT - Access Admin	  	A2D - Invalid IP Address for Access to Data	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ABS - ABS Integrity Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ABS - ABS Printer Queue Management	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ABS - Cluster / Nodes Naming	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-64	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	ABS - Getting Blank Screen after launching ABS-Integrity	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	ABS - How to find a printer queue status?	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	ABS - How to resolve printer not printing from ABS or MDM?	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	ABS - Resetting A User’s Password In Sysgem	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	 Access Administration - Global Process ID
 &
Access Administration
	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Access Administration Associate Transfer Policy	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/3AF2DA42E158316 288257B7C007A5244?OpenDocument
					
	IT - Access Admin	  	Access Administration Roles and Responsibilities	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/F399ADA13AA966 98882579F3005AD57D?OpenDocument

  

					
	Schedule P	  	P-65	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Access Administration Termination Policy	  		  	All	  	http://sacdom50.healthnet.com/npl/NPL.NSF/sys_all/0F02EA852BF14CE 5882579F3005AA853?OpenDocument
					
	IT - Access Admin	  	Access To Data (A2D) - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Accutraq - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Accutraq - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ACMS - Application Control Management System Basic Description	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Acquisition Process for Misc IT Equipment	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Access Admin	  	ACS - FTP password and connectivity issues	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-66	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Active Directory - Application Support	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - Domain Account Re- Enable Process	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - Portable & removable devices policy	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - Unlocking and Resetting HNCORP/FS Domain Accounts	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - Unmanaged/Unlocked User Documentation	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - Urgent Termination process	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-67	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Active Directory - URL Filtering Exemptions	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory - What do I tell a client requesting a name or OU change?	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory No account in system	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Active Directory Temporary extension of expiration date	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Adding Funds to Existing Purchase Order(PO) for Fixed Bid Efforts	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Access Admin	  	Admin.do (Support Portal) - Account unlock	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-68	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Admin.do (Support Portal, SWP) - Website Overview	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Adobe Acrobat Access	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Adobe Flash Player	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Advertised Programs - Missing Application(s)	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	ADW - Password Reset / Unlock Procedure	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	ADW Analytical Data Warehouse Oracle Data Base	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-69	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	AgentView/SuperView - Support Info	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Alfresco - HealthNet.com Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ALGS - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ALGS - Error: Unable To Open Multiple Copies	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ALGS Letters - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Alva - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-70	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Alva Web - Help desk procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Alva Web - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	American Express Expense Manager (GERS) - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Ames - Login issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Application Name: Omni	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Argus/Argus IPNS System and contact information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-71	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	AS400 - Account Status Maintenance	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Assume Identity - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Avaya - Phone Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	AWP DRG Pricer - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	AXS One - Lotus Notes Email Archive System	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	B2B Gateway - Info and Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-72	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	BCM - Business Communication Manager Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	BlackBerry - How to order and discontinue service	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Blackberry - Password Changes	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	BlackBerry - Support Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	BlackBerry Reporting a lost or stolen device	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	BlueZone - Common Issues and Troubleshooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-73	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Burgess - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Business Object - Unexpected response from the Zabo Server	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Business Object Commercial - Account Creation & Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Business Objects - Ad Hoc Report Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Business Objects - Application Support and Account Management	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Business Objects - Password Reset and User LookUp Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-74	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Business Objects - Unexpected Response from the Zabo Server	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CAC - Common CAC Errors	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CAC - Process for access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CAC Reader - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Call Flow Diagrams	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Call Path -Ticket Procedure for P1/P2 Problems	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-75	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Care Core Terminal - How to reset password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Care Radius - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Caremark/API Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCM - Call Pop Issues or Errors	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCM - Care Coordination Management Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCM - Error: User Is Not Setup To Use INForm	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-76	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CCS - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCS - Could Not Create New Session In Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCS - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCS - Printing Issues Related to CCSCutePDFScriptX	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCS - Red Ribbon Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CCS - User is unable to login after Password Reset/Account unlock	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-77	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CCS (A2D) - Verifying External Government HNFS Client Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	C-CURE - System Unavailable Processes	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CDS - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CDS - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CHCS - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CHIPA - VPN Account issue	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-78	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CIMS - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Cisco VOIP - Surfside Telephony Support Called In By PGBA	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citirix - Slowness & ODBC Fix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - An error occured while connecting to citrix secured gateway	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Changing user from Xen4 to Xen5	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-79	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Citrix - Clearing a User’s Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Client Logon Procedure And Basic Troubleshooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Enabling Sound	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Error message local policy of this system does not allow you to work interactively	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Error: The Application’s Digital Signature Has An Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Home Computer Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-80	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Citrix - How to Clear an Commerical Citrix Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - How to Clear an FS Citrix Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - How to download Citrix reciever	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - How To get Essbase	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - IBM Support Teams Having Connection Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - ICA File Not Found	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-81	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Citrix - iMAC information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - IP Address	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Logging Out a Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Lotus Notes Troubleshooting Tips (Notes Remote Access)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - NFuse: ICA File Not Found	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Profile Drive Mappings for FS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-82	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Citrix - Resolving Digital Certificate	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Setting Up a User’s Citrix Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Troubleshooting Support For Local Printer	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix - Unable to create Screen Shots	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix Ending a Hung Session(s)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Citrix Front Line Support Trouble Shooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-83	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Citrix Xen-desktop Restart Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Civerex / Civerpsych - Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CiverPsych - Citrix group	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Civerpsych - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Civerpsych (Civerex) - Password Reset and Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Cliqbook - Travel Booking Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-84	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CLR Application - Access information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CLR/CTT - Clearly Legible Report Tracking Tool Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CMS (Centers for Medicare & Medicaid Services) Web Application - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CMS Letter Automation System - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Collage - Access Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Collage - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-85	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Collage - Editor Not Defined	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Common Drive - Error“Drive is not accessible you might not have Permission to use this network resource”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Community Solutions(HNCS) - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Compass - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Compass Routing of Slowness Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Computer Performance and Network Connectivity	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-86	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Convergence - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Convergence - Phone Panel Login	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Copier, Fax & MFD - Support Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Copier/Fax - List and Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Corporate Express - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Cresend - Symphony Backup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-87	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CSC - Application Support for CSC Pega, CSC File Net and CSC Citrix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CSI - Link Missing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CSI - Not Auto Populating or buttons not functioning	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CSI - Test Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CSI Reset/Unlock Passwords	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	CSI Troubleshooting and Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-88	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	CTO (Chief Technical Officer) - Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Custom View Director - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Data Restore - Backup and Recovery	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Desktop Malfunctioning Issues - Large Icons	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DIAL LOG C3 - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DMDC Application (DOES/DEERS) Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-89	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	DocFinity - Adding A User	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Docfinity - An Error Has Occurred Connecting to the Requested Resource	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DocFinity - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DocFinity - Could not obtain image from OD390 or File not found	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DocFinity - Error :User Not Authorized For This OD390 Object	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DocFinity - Reactivate or Reset Password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-90	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	DocFinity - Slow Document Retrieval	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DocFinity Internal Point of Contact	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DOES - FS.SOHO User Cannot Access in Citrix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Domain - User Cannot Save Files On the C Drive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Domain Controller Down	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Dreams - How to reset password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-91	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Drive Mapping on VPN	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Dropped Calls - Process/Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	DTRAQ - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Duplexing - HP 8150 printers only	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	E-Buyer - Helpful Hints and Tools	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	E-Buyer - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-92	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	EDI - Partners.Healthnet.com Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	EDI (Symphony) - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	EIS - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Enterprise Web Monitor - Creation and password reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Entrendex - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ENTRENDEX - FAQ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-93	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Entrendex Logon Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	EP Admin - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Error due to Names.nsf file missing or corrupted in Lotus notes 8.5.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Error due to Template Design in Lotus Notes 8.5	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	E-Services Website - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	E-Sourcing - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-94	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	ESSA - Account Creation Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Essbase - Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Essbase - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Evidant Probe - Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Exceed - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	EZ Pickins - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-95	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Facilities - Application Support For Site Power Outages and Wiring Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Facilities - Issues in the Raised Floor in Rancho Cordova Bldg A	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Facilities - Site Support for Facility Related Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Facilities & ITG Service Request - New Share Directory	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FARE - “Runtime error 1011” - Connection Inactive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FARE - Excel toolbars missing after install	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-96	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	FARE - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Fastrieve - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FAX Repair and Maintenance	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Fax Service Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FHP3 Password Resets (CCM and TSO)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Filemaker Pro - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-97	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	First Health - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FMRS - Contact Info	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Formulary and Benefit - Application Support for FAB	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Freedom application - Contact and Remedy information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FS - Creating an External Gov User Account on the FS-EXT.Healthnet.com Domain	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	FS Health Net - Password Requirements	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-98	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	GEMS - Contact Info	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	GEMS - system information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Gems Support - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genelco - HelpDesk no.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genelco - Unlocking and Resetting Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genelco Display User Name *=wildcard	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-99	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Genelco Display User Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genelco End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genelco Scan For User Name	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Genesis T Server - Link Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	GeoNetwork - General Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Glossary - Health Net Federal Services (HNFS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-100	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Good Application - Password reset instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Good For Enterprise - Android Installation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Good For Enterprise - iOS Installation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Good For Enterprise - Reset Network Settings	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Good Mobile - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Google Chrome	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-101	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Guardian - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hardware - Disposal of e-waste	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hardware - Printer Warranty information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hardware - Printing Configuration pages	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hardware - Support For Desktop and Printer Moves	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hardware Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-102	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Health Net - Weather Alert	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Health Net Focal number	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Health Net Service Desk Telephone Numbers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Commands	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Creating a Directory	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-103	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ABS - DEVAXP	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Emenu Approver and contact information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Flag Transplant from Auto Adjudicating	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Granting access to ABS Tables	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Granting UDMS Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - How to end a process or job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
		  		  		  		  	

  

					
	Schedule P	  	P-104	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ABS - How to find a user account?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - HSA Update	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Moving programs into production (BYPASS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - NDS (Network Data Systems)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Printer Queue Management	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-105	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ABS - R Privileges	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Reporting ABS access by user	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Reporting users by function	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Roles requiring extra work	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Sec Menu Commands	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - SEM (SPREE) Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-106	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ABS - SEM125 Table show and add	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - SPCAP approver	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Table look up	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS - Unlock a Claim or USER in ABS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS/VMS - Capitation Authorization	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ABS/VMS - Performance Flags (GRPCLM)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-107	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ABS/VMS - TARERUN/TASUP Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Access Cyber Ark	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Access Edinburgh Citrix Farm	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Access Reqeust Forms	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Access Tips	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Access Unix Server	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-108	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Healthnet - Access Admin - Access Wintel Server	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Accessing Chicago Citrix From	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Accessing Warwick/Portsmouth Socks Servers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - (FS) Creating and Disabling Training Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Access to Another associate’s Home Drive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Contractor Account Creation (HNC or FS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-109	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Device Control and Removable Media Exemption v2	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Exception Documentation (Do Not Delete List)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Granting Access to an Associates Home Drive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Granting SLU Renewals Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Group Creations	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Lockout Tool instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-110	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - MTF_Capability & App- MTFCapEditor-C	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Privileged ID creation/Activation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Regular Employee Account Creation (HNC or FS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Setting up a new user	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - SQL Server Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - System Accounts, Guidelines and Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-111	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Telecommuter returning to office	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Temp to Perm	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory - Unmanaged Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Active Directory Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Admin.do(Support Portal) - Account Creation/Modification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Admin.do(Support Portal) - Approvals	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-112	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Alfresco - How to Add users	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Aperture - Active Directory information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ARMS - BDS and Associate Database (or List)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Arrival - Pitney Bowes	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Access systems during Maintenance periods	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Account Modification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-113	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Permanent Profiles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Privileged ID creation/activation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - QUERIES Training Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - AS400 - Terminating SECOFR Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - BI Publisher (SALSA) - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-114	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - BKB - Creation, Modify, Deletion	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - BOXI - system information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Business Objects - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CASA - Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CBOC - OU in the FS-EXT domain	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-115	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - CCS - AZ Man (Access Manager)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Beneficiary EMail Contacts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Changing a role	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Developer DB Accts (CCS) & PL\SQL	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - HCSSupervisor	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Process Tracking Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-116	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - CCS - Renaming Accounts ( FTE to Temp or Temp to FTE)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - TNEX Provider Finder	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS - Web DEERS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CCS Master document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Citrix - Log In Script Problems	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Civerex / Civerpsych - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-117	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - CMS - Content Management System Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Command Line Applications - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Commercial Web Based application Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Computer Configuration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Create External Government Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CSI - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-118	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - CSI - Master Document for Access Administration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CSI - Vaden Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CTI Pop - Account creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CTO-BRCC - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - CTT - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - DOES - Procedure for Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-119	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - DREAMS - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - DSS - Cane_Shared or VMS-SAS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - EDI Archives
 -
System information
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Edinburgh Access Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - EIS - Pilot Cube information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - EIS Procedures - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-120	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	 HealthNet - Access Admin - Entrendex CA
 -
Creation, Modify, Deletion
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - Entrendex NE
 -
Creation, Modify, Deletion
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - eWFM Client
 -
Account Setup procedures
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - EXT Domain
 -
Unlocking Partners Secure Mail
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - External Government users - password reset procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FARE - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-121	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - FARE - Version 8.0.2	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Federal Web Based application Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FileNet - Creation/Deletion	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FileNet - WF Report requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Focus - Account creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Formulary and Benefits (FAB) - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-122	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Freedom Tracker - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FS - Creating an External Gov User Account on the FS.Healthnet.com Domain	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FS Domain - ISA Required Applications	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FS-EXT - Domain Administration for CCS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - FTE to Temp, Temp to FTE	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Genelco - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-123	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Genelco Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - GIQD - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Global Process Control Points	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Group Mailbox - ACL Access Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Group Mailbox - Setup Procedures (Users/Owners)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HBA - Contact Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-124	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Health Net File eXchange(HFX) - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Health Net Vendors - Approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HealthNet - Access Admin - MDM/MDR- Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HN Connect - Help Desk Utility Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HN Plan - Approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HN Unity - Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-125	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - HNC EXT Domain - Partners Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HNCap - System Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HNConnect - Provider Education Hyperlink Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HNConnect MEDLTRQ and LTRHISINQ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HNCS Windows - Force Commlog	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - HNFS-A2D \ IW External Users - (Account creation)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-126	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - HNI Review Manger - Contacts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Hyperion Essbase - Approval Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA AD groups FS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA AD groups HNC	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA AS400 systems	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA ITG Groups	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-127	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA Macess	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA ODW/BKB/ABS setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA PSA	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA RacF system	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - AA Remedy	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Admin.do	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-128	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - AS400	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Commercial Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Commercial Help Desk Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Federal Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Federal Help Desk Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - FS AD groups	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-129	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - HNC AD groups	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - iHealth	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - ITG	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Offboarding procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-130	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - Onboarding procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Password Generator	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - PGBA access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Remedy tickets to Support teams	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Requesting HealthNet Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Review Manager	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-131	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - SIR	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Siteminder	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Support Teams AD groups	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Support Teams Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - Tivoli Identity Manager Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IBM - TSO commercial	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-132	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - IBM - TSO Federal	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - iHealth - Acct Creation Level 1	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - iHealth - Terminations	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Informatica - Access Request Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Information Warehouse North / BO - Account Creation(FS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Instil - Requesting Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-133	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Interwoven - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IS Request - Change an approver	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Associate Transfer between HNC and FS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Closing the ISR / Notifying the user requester	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Move/Transfer Request Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Remedy Tickets/Email notifications to other Teams	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-134	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ISR - Verifying Correct approvals example 1	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Verifying Correct approvals example 2	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR - Verifying Correct approvals/routing for more approvals	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ISR Process flow	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - IST - Account Creation\Troubleshooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ITG - Changes to ISRs	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-135	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - ITIM - Vault Manager Roles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ITIM Change Password Rejection Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ITIM Check In Heads Up File / Outage process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - JD Edwards - MC400 environment	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - KBase - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - K-Base - Resetting Passwords for BKB	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-136	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Knowledge Base - Account Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lawson (Symphony) - Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - LOA - Reactivating accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Access to Another Associate’s Email	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - ACL rights Definitions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Approving requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-137	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Change users location	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Group E-Mail Address (Distribution List)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - ID Change in Lotus Notes for TEMP to PERM	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Name Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Requesting Notes procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-138	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Server Space availability	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - Updating an Access Control List (ACL)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Lotus Notes - What Fields Can Be Edited in the HN Corp Address Book?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Doc Flo Access Rights	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Granting Doc Flo administrator	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-139	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Macess - Group mailbox creation requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Reports/Test/Train	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Supervisor Look-down Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - Training Id requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess - User Permissions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Macess Master document for Access Administration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-140	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Magic - Creation Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Mars - Contact and system information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Master Control Doc	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - Creating (PRD) Production Account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - Creating a new role	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DDM Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-141	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DEV Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DEV Account Creation for a new Developer	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DEV Developer Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DEV Provide access to CLRPFM	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - DEV/E2E Environment Approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - MC400 - E2E
 &
DEV Authorization List Maintenance
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-142	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MC400 - E2E Single Signon	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - Naming Standards	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Add an Account to the Directory Entry Table	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Adding Keyword/System Codes to Roles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Delete Role	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-143	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD F6 Encounter, F14 Institutinal	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Modify Users Roles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Power Account Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Read Only Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD Role Owner Update	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MC400 - PRD\DEV\E2E Command line access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-144	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MC400 PRD - Rumba (New York Nurses association)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - McAfee - Data Loss Prevention Manager (DLPM) Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MFM Pro (Burgess) - Creation Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MGCS (Medi- Cal GCS) - Access Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHN - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHN - Support Portal	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-145	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MHN DataWarehouse - Creation Proccess	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHN Unity/Atlantes - Create/Modify account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHNGS - Required approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHNGS Information Warehouse - Account Creation procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - MHNGS-OP-JFSAP - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Monarch - access information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-146	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - MTM - RXcellent Care: Granting Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - 30 Day Inactivity Process / 60 day deletion	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - Access to FS shared drives	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - Associate Transfer Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - Moving a Client between Domains	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - Non - HNFS Transfer Report Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-147	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Network - Resetting Run Advertised Program Window	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network - Transfer Policy with HNFS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Network (servers) - Server Control Listing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ODW - PSAS_READ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ODW/BKB/ADW - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - One Card Admin - contact information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-148	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	 Category (LOB)
	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Opus - Creating a New Account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Opus Display User Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Opus End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Opus Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Opus Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Opus Unlocking an account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-149	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - OTRA - active directory group	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PageCenter - Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PAOS - Pharmacy Authorization Operation System	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Partner Citrix/VPN Connection - Offshore	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - Access Admin - Peregrine	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PGBA - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-150	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Pitney Bows - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Plone Access - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Prelude - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Prelude - Account Modification Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Prelude - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - Privileged IDs
 -
Master Control Doc
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-151	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	 HealthNet - Access Admin - Privileged IDs
 -
Submitting for access
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PSA Archive - Admin Utility	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PSA LPAD - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - PSAS - Provider Database	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - QA Enablement Approval Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - QA Re- Enablement Approval Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-152	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Qcare - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - ACRS for PSCICS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - QCare - Approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - FORCE COMMLOG	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - Group Descriptions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - QCare - HNCS Windows	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-153	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Qcare - MEDI-CAL GROW HN COMMUNITY	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - Molina & Universal Care Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - OFFSHORE Medi-Cal	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare - Unistar High Level Qualifiers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qcare Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Qfiniti - Creation / Troubleshooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-154	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - RacF - Approval for Special Privileged Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - Boot out, (cancel) hung session	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - Dataset Deletion in FHP1 & FHP3 (TSO)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - DATASET LOOKUP	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - EMTS(CICS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - FHP3 TWAS - OPC	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-155	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - RacF - IBM/AT&T TSO Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - IECICS(ECRS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - LPAR Naming standards	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - Privileged ID creation/activation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - Qcare, TSO, IBM ID Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - Removing Special Attribute	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-156	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - RacF - Special Authority Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - TSO Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF - TSO DataSet Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RacF Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Rate Model - Approvers, Active Directory group	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Rawlings - Contacts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-157	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - RazzaBDE - account creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RDP - Remote Desktop Connection	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - REMS - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - ResourceIQ - Administration Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Review Manager - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Risk Navigator - System Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-158	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - RNQ - Creation Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Rockwell - Convergence Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	 HealthNet - Access Admin - RTA (Aspect)
 -
Account Creation procedure
	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - RU30 VPN - Users Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SalesDataWarehouse - Active Directory group	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SAP - (ASP) Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-159	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - SAP - Deployed via Citrix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SAP - WEB Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SCCM - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Shared ID’s - IBM Employees	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Showcase - EIP Server account creation/modification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SIR - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-160	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - SIR - Admin Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SIR - Contact Information for Access Admin	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Siteminder - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Software - EZPickins	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Software - Federal requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Software - Seagate Software for the Desktop	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-161	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Software COMMERCIAL requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Spirit - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Spirit Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Splunk - Creating Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Stand Alone Applications - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Stars - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-162	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - STARS - Reactivate deleted accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - Approvers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - Confidential ID’s	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - F10 Switch Group Modification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - Role Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-163	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Symphony - Role Modification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony - User Role Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Symphony Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SysGem - ACMS issues (ACMSUDU)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - SysGem - Password reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Sysgem Account - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-164	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - TACACS Application Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Targus - Processing Requests for Security Cable Lock Combinations	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - ABS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Active Directory (FS or HNC)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Admin.do(Support Portal)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Business Objects	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-165	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - CCS Disabling External Gov User Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Commercial(HNC) Master Document for Access Administration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Entrendex(CA or NE)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Federal(FS) Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - FileNet	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - HNFS from Daily Report (OE Report)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-166	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - HNFS from IS Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - iHealth	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Macess	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - MC400 DEV Role	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - MC400 E2E environments	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - MC400 PRD Roles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-167	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - MC400 PRD, DEV, E2E	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - PageCenter (HNC or FS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Qcare	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - RacF Commercial	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - RacF Federal	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Requesting Lotus Notes Term	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-168	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Review Manager	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Saving Daily Report	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - SIR	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Spirit, Genelco, Opus, Prelude	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Symphony	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - Terming Lotus Notes Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-169	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - UNIX	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - VDI (FS and HNC)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedure - XenDesktop (FS and HNC)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Termination Procedures - Resource IQ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - TIBCO Staffware - information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Tivoli Identity Manager - Check In	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-170	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Tivoli Identity Manager - Check Out	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Tivoli Identity Manager - First Time Login	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Tivoli Identity Manager - Password Reset Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Tivoli Identity Manager - Users Account is locked or Password is invalid	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unity - approval contact	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unity - Dummy/System Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-171	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Unity - Troubleshooting Error Messages	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unity Reporting - Approver information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Account Creation / Modify	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Active Directory LDAP Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - CVS Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Error: Unable to chdir to home directory	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-172	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Unix - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Meta LDAP Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Privileged ID creation/activation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Processing secure.healthnet.com requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Pushing Keys	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Removing users from the configuration files	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-173	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Unix - Requests for servers that are not built yet	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Secure.Healthnet.com requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - SSH Key Failure Fix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - Temporary Root Access requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Unix - VI Tutorial	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - UPS II - Account Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-174	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - Valuetech - Account Creation/login Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Vault - Primary Controls	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Auto-Adjudicated Claims IDs	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Cluster Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Copying User Rights	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Creating Accounts for the clusters	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-175	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - VMS - D Account Responsibility for Access Admin	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - D Accounts, Add, List and Delete	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Forwarding Mail	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - HSI_DB_DELETE (PRD) approver	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - ID Deletions from Command Line for batches	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Master Document	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-176	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - VMS - Privileged ID creation/activation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - Service_DCL access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - setting up HNDev and HNTST (DOMENU)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - UAF display	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - UAT Enviroment Creation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VMS - UAT SYSLOG (Heckle, Jeckle)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-177	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - VMS - User ID’s for ABS / VMS PRD, DSS, DEV, DEVI64 and UAT	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VPN - User Access Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - VPN HNFS - Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Webex (1- 800-conference) - Account Creations	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - XenApp - Granting the Exceed application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - XenDesktop - Admin console	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-178	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Access Admin - XenDesktop - Admin console First Login Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - XenDesktop - Creation Process (HNC or FS)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - XenDesktop - Development Setup process flow	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Admin - Zavanta - Account Setup Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Access Administration - QA Disable Approval Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet - Disabled Active Directory Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-179	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet - Federal Dist Ops Escalation Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet - PTO Database	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet File eXchange - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet File eXchange - Filling Out the Access Request For Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet File eXchange - Overview for HFX	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HealthNet File eXchange - User Guide	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-180	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HealthNet Remedy Configuration for IBMers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet.com - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Healthnet.com and HN connect - Remedy Support groups	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Help Desk - Ticket Templates	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Accounts Payable Forms	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - First Time Logon and Registering an Associate	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-181	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HN Connect - Issues With Content or Access.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Off-shore Associate Registration Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Pop Up Blocker	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Registering a Non-Associate	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Schedule of Benefits will not Launch	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN Connect - Temporary Associate Registration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-182	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HN Connect Images not displaying	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HN INFO SEC - Routing Remedy Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNC EXT Domain - Searching for Partners (Secure Mail)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNConnect - Add Last Four of SSN (Social Security Number)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNConnect - How to find a clients cost center and Internal Order number(ION)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNConnect and HRLink - Password Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-183	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HNCS / Filenet - Common Errors	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNCS / Valutech / Filenet, Q Care, (UPS 1,2,3), Red Phone, TSO, Pagecenter, MARS, DREAMS Password reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNCS Windows - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNFS - Accessing Application Links on HN Connect	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNFS - Government IT Glossary of Business Terms	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNFS - T&M AO Project Work Order/Change Request/Assessments Procedure	  		  	All	  	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Access Admin	  	HNFS Jive / Scout - Knowledgebase Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-184	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	HNFS SPOC - Contacts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNFS.net - Website Issues and Site Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNPage - contact information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNPS Formulary System - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HNStore - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	How to change Login password on Citrix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-185	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	How to create E-mail signature	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	How to handle Work Order	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HR Link - Information and Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	HR Link (Spa users Invalid Id or Password)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Hyperion - Application and Account Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IBM - ATT Instructions for setting up RSA Token	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-186	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	IBM/ATT - RSA Token Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ICT Vendors - Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IE - Importing & Exporting Internet Favorites	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iHealth - Down Time Notification Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iHealth - Password Reset Instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IHealth - Ticket Assignment and Contacts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-187	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	iHealth - User Log-on Instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iHealth End User Guide	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iLinc Conference - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iMany CM - Supplier Contracts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Ingenix Impact Pro Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Instructions for installing updates after receiving the SCCM client on Xen Desktop.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-188	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Internet - Blocked by URL Filter Database	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet - Error” the proxy received an invalid response” while accessing a business web site	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet - How to delete cookies and temp files from Internet Browsers	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet - Internet page does not render properly	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet - Malware Detected	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet Explorer - How to set default Internet Browser to MS Explorer?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-189	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Internet Explorer - SSL Certificate Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet Explorer - Web pages not loading correctly/Loading slowly	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Internet Explorer 8 - Compatibility issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Interpost / TAO Mail - Connection information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Interqual - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Interwoven - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-190	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	IP Address Popup Box	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IP Soft Phone - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - FAQ’s	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - First approver	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - How to Check if a Ticket is done for system access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - Process to Re-activate / Re-Create Privileged Account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-191	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	ISR - SLA Time requirements	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - Status Check	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR - Temporary access creation for new hire Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ISR Escalation - For IBMer only	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IST - Individual Sales Tracking Application Support and Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ITG - Change the Approver for a Conference Room	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-192	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	ITG - FDS Work Order Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IVR - Application Support for Interactive Voice Response	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IVR - Status Critical Massage Instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	IW1 - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	iZon - Logging into Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Kbase - Password reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-193	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	KBase Password Reset (VMS Account)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Knowledge Base - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Laptop - Turning Off the Num Lock	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lawson (Symphony) - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lawson (Symphony) End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Learning Link - Password Resets and Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-194	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	LMS - Removing a user from LMS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	LMS - Triage and Troubleshooting for My Compass LMS Calls	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	LMS - Updating a users supervisor	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lockout Tool - HN Corp Domain Unlock Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Login Attempts Exceeded on Hnconnect page	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - “_Associates” Group / Distribution List Access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-195	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - “file does not exist” Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - A “Missed Alarms” dialog box keeps popping up for past events	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Access Email Via the Web	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Accessing Lotus Notes via the Web	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Account Terminated Due to Inactivity	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Application Support and Ticket Routing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-196	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Auto Reply Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Auto-Refresh Functionality	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Calendar Cleanup / Inbox Management Policy Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Calendar Not Opening	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Calendar View	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Certificate Expiring	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-197	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Changing the Password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Configuration Setup	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Context toolbar not found. Bookmark design needs updated.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Creating a Local Replica of Address Book	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Cross Certificate Notification	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Database Bookmarks	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-198	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Delayed E-mails to External Domains	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Delegating Calendar and To Do access	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Deleted Documents Reappearing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Deleted Folder	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Delivery Options Toolbar Missing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Domino Server List with IP Address	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-199	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Email Contents Displayed Incorrectly	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - E-Mail Letterhead	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Email Signature	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Emails Blocked at Firewall	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Encrypted Email Sent Without Password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error - “Unable to Initialise the VSE Engine”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-200	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Error - Specified private key Does not exist	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error Insufficient frames - frames set handles	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error Message File not found” or “Choose a server to search”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error: Cross Certificate and the Domino Directory / Unable to Load Frames Content	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error: Toolbar Config, Context Toolbar, Bookmark Design	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - error: Unable to open link or ISR	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-201	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Error: You Cannot Run the Administration Application While the Domino Server is Running”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Error: You must select an instance document to perform these actions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Execution Security Alert Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - External Attachments in format WINMAIL.DAT	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - File Does Not Exist	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Formatting a Calendar for Printing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-202	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - How can E-Mail Messages be retracted?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How do I set up a new archive in Notes 6?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How Does Roaming Work?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to access someone else’s calendar in Lotus Notes?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to archive emails settings for 6.5.4 upgrade for Lotus Notes?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to attach a file in an email?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-203	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - How To Create A Lotus Notes Link In An E-Mail To Another Internal Notes Mailbox	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to Customize the Lotus Notes Welcome Page?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to determine the size of Lotus Notes database?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How To Disable the MiniView	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to find a client’s cost center and company code	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to replace the Workspace icon if deleted	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-204	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - How to Request a Name Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to restore the Default bookmark icons to the sidebar?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to See Status of Roaming User	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - How to Setup Database Replication	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - ID File Troubleshooting / Fixing Notes.ini File	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - If You Can’t Accept A Rescheduled Meeting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-205	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Important Policy change to Quota Provided	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Inbox indicates a number that doesn’t coincide with the number of unread messages	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Inbox is not refreshing automatically even with “Automatically refresh inbox” selected.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Increase Font Size	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Instant Messaging (IM) Basic Troubleshooting and Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Instant Messaging Setup for Lotus Notes 6	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-206	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Intranet Mail Password	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Mail Encryption Instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Mail Reduction	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Mail Stop Code Change Form	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Mailbox Access and Delegation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Mails marked as Unread without opening	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-207	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Making Lotus Notes Mobile with Replication	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - MyArchive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Name Change Does Not Update	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Password Reset Procedure / ID Drop	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Policy of Forwarding HealthNet E-Mail to a Personal/Home or External E-Mail.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Printing All Meetings in R5 Scheduler	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-208	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - R5 Conference Room Scheduler	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Refresh Template Design	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Remote (Citrix) User	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Replace Template Design	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Replying To An E-Mail Client receives “File Does Not Exist”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Right Fax Via Lotus Notes	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-209	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Roaming files are still associated with old mail server.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Roaming to Another PC	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Sametime/IM Issue	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Secure E-mail Encryption	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Server Error: This database cannot be read due to an invalid on disk structure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Service Desk Troubleshooting for Common Errors and Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-210	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Signature Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Slow pasting Web content into notes/ Images showing as Red X’s in email	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Specified Private key does not exist	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Splash screen pops up and goes away	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Steps To Improve Lotus Notes Performance	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Tips to improve Lotus Notes response time	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-211	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - Troublshooting Error “File Cannot Be Created” When Opening An Email	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Unable to Load Frames Content	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - ‘Unable to load frames content. The doclink database cannot be located.’	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Unable to Open External HTML email	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Unread Marks are not correct	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Web Navigator Errors	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-212	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes - What do I tell a client requesting a new distribution group?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Why Can I See Someone Else’s Mail When I Shouldn’t Have Access?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Why Can’t I Send or Reply to Groups with the Word Associate?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - Workspace Icon Shows When Clicking on the Bookmark for ‘Databases’, ‘More Bookmarks’, ‘History’, or ‘Internet Explorer Links’	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes - ‘You have outgoing mail pending’ and cannot find the pending email?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Lotus Notes -Email Missing	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-213	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Lotus Notes- Error- “File already exists” when launching the Notes client	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macess - Betrieve Error 84	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macess - Error “Password has expired”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macess - Jukebox information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macess - Printing Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macess - Tiff viewer Registration	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-214	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Macess - Unable to Open or View TIFF Images	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macintosh Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Macintosh/Mac - Support Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Magic - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Mars - Connection Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Marx - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-215	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Marx - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Master: Outages and P1/P2 Processes	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MAT REQ - Application Support for Material Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 - Group1 Account information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 - Hours of Availability	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 - How to FTP	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-216	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MC400 - Online Password Reset Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 - Password Requirements	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 DEV - Display User Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 DEV - Enable an Account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 DEV Display user name (Wildcard Search)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 DEV End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-217	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MC400 DEV Password Resets and Unlocking Accounts	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 DEV Scan for User Name by Name or User ID	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 E2E Display user name *=wildcard	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 E2E Display User Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 E2E End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 E2E Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-218	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MC400 E2E Re-enabling an account no password change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 E2E Scan for User Name by Name or User ID	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 PRD - Display User Profile	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 PRD - Enable an Account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 PRD - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 PRD - Search for a User Name	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-219	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MC400 PRD End Interactive User Job	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MC400 PRD Scan for User Name by Name or User ID	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	McAfee - Debug Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	McAfee - Encryption Password Not Accepted After Network Password Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	McAfee - Proxy Received an Invalid Response	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	McAfee - Unlocking Hard Disk Encryption (Password Reset)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-220	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MDM - Drive mapping	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MDM Medical Data Management Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MDR - Password Change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MEDai - System information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Medi-cal FileNet - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - ContinuousMeeting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-221	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Meeting Place - Creating a User Profile For Users By the Service Desk	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Extending the Length of a Meeting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Limited Toll Free Number	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Login Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Quick Reference Card	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-222	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Meeting Place - Scheduling a Meeting for a Client	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place - Secure Meeting Quick Reference	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meeting Place Local Phone number for Rancho Cordova, CA	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Meridian Phone - Issues and Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MGCS - Application Support for Medi-Cal GCS	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MHNGS - Login issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-223	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MHNGS - Website Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Microsoft Access - Application Support for Access Databases	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Microsoft Office 2010 Upgrade	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Middleware - Neon Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Milliman (CareWeb) - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MMC 20/20 - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-224	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Molina Medical Clinic - User Troubleshooting	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Monitor - Screen Rotation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Mouse Pad is not working	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MS Excel 2010 - How to fix the File Block issue	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MS Excel Share file with multiple clients & allow change	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MS Office 2010	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-225	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	MS Word - How to Link a notes database or document in Microsoft Word?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MTF - Issues with Automated Reports	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	MTF Capability - Access Levels	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	NDS - Application Support for Network Data Systems	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Netmeeting - HealthNet User Guide and Service Desk Guide	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	NetMeeting - Unable To Use In Citrix	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-226	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	NetMeeting - Troubleshooting Tips	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Network - How to install updates for the SCCM client?	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Network - How to Obtain an IP address from a Client	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Network - Leave of Absence Policy	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Network - Mapping a Network Drive	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Network - User reports a Virus	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-227	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Network Ports - Support of Network Ethernet Jacks	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	NOTES.INI file cannot be found	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	NYSNA - New York State Nurses Associates Support Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ODBC - error connection to kdb_readfailed	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	ODBC - Troubleshooting Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Oncall SDM schedule for 2013	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-228	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Opus - Application Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Opus Display user name *=wildcard -MHN	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Opus Searching for an User Name	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Oracle - DLGPRD Dialogue Oracle Data Base	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	OTRA - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - Alarm Point On Call Database	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-229	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	P1/P2 - Escalation Team Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - Explanation of P1/P2 Template	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - HealthNet Red Book On Call List	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - List of Business Critical Applications	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - Remedy Routing For High Priority Outage Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	P1/P2 - Service Desk Process For Priority 1 (P1) and Priority 2 (P2) Remedy Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-230	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	P1/P2 - SWAT Call Setups for High Priority Problem Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PageCenter - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Pagers - Updated Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PAOS - How to logoff an user	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Password Resets - Quick List	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PCM Web Research and PCM Reassignment Tool - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-231	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Pega Prime - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	People Soft - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PETRS - Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - Agents With PGBA Calling in Healthnet Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - How To Look Up a Client’s RACF PIN Number	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - Issues Resetting or Unlocking a RACF ID	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-232	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	PGBA - MYE-work.com	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - P1/P2 Ticket Procedure	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - Roaming Profile error for PGBA Applications	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA - Support Process for PGBA Application Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA Citrix - Disable/Enable Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA Citrix - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-233	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	PGBA Citrix - RACF ID Password Reset (2nd Screen)	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PGBA FHP3 - Locating a User’s RACF PIN Number	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PHI - General Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Phone - Call Center Re-Routing Calls	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PIM Password Governance - Application Instructions	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PlanView - Access issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-234	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	PlanView - Account Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PMAPS - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PQM (Tumbleweed) - Personal Quarantine Manager Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Prelude - Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Prelude Display User Name *=wildcard - MHN	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Prelude Display User Profile - MHN	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-235	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	PreludeRe-enabling an account	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printer - KODAK PRINTER Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printer - Recycling Toner Cartridges	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printer - Routing Xerox FAX/Printing Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printer - Supported Ikon models	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printer - Toner Ordering	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-236	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Printer Support Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printers - IBM InfoPrint	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printers - Installing a Local Printer	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printers - Installing Network Printers on TSC Machines	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printers - Network Printer Via Citrix Does Not Work	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Printers - Tektronix Phaser	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-237	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Prior Authorization and Referral Submission Tool - Accessing and Submitting Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Prior Authorization Determination Tool - How to Access the Application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Provider Calls - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PSA Archive - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PSA Archive - URL Links	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	PSAS - Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-238	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Qcare - Medi-Cal Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Qcare - Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Qcare - System Hours of Availability	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Qfiniti - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Quality Center - IE8 Compatibility issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Quality Center - Installation Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-239	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Quality Center - Overview	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Quality Center - Support & Password Resets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Quality Center - Upgrade FAQ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Quantum Choice (PC3) - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	QuotaMod Increase Home Drive Space Quota for Users	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	RacF - ECRS Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-240	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	RacF - HNP2 Password Reset	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	RacF - How to look up a user by last name in FHP1	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	RacF - IBM Change Password Tool	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	RacF - Resetting Application Passwords that use FHP1	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	RacF - Unlock user account in FHP1	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Reflections - How to access Integrity Host systems from Reflections.	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-241	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Re-image and Redeployment of System	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - “Authentication Failure error messages”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Adding or Removing individual name from Remedy Group	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Alva Web	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Application Support For Material Request	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-242	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Application Support For Membership Desktop	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Application Support for Problem Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Application Support on SPMS .	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Application Support PSA Archive application	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Attaching or Zinclnking Tickets to a Problem Ticket	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - BlackBerry Requests	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-243	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Change/Add Notification Method	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Changing a Flag For An External Government User	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Coding a Wrong Number Ticket	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Contact information for support teams during non-prime hours	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Creating a P1/P2 Ticket	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Creating an Outage Alert Board	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-244	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Creating And Submitting A Web Ticket	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Crystal Report Error	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - CSI (Customer Service Interface) Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Deskside Support Queue	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Distributed Operations and One View Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Ergonomic Keyboard installation	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-245	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Error “One (or more) servers were unavailable for login!”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Error “One (or more) servers were unavailable for login!”	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - FAQ	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Filling Out the Performance Tab	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - HealthNet Server and Application Maintenance Window	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Home Page not populating	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-246	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - How Log Into the Remedy QA/Test Environment	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - IBM Application Installation and Server Details for Remedy	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - IBM Resolver Group’s Contact Information	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Information Required in tickets sent to Printer Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Knowledge Base(KB) Application Support	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - License errors	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-247	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Licensing Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Logging into the Web interface	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Logon Issues	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Looking Up Personal Ticket History	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Lowering or Raising P1/P2 Problem Ticket Priority	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Manual Ticket Logging	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-248	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - MHNGS and HNFS should be handled separately	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Non Prime Escalation Procedures	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - On-Call SDM Escalation Process	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Performance vs. Functionality CTI When Coding A Ticket	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Printer Warranty	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

					
	IT - Access Admin	  	Remedy - Priority Levels for Problem and Incident Tickets	  		  	All	  	 Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access

Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-249	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Priority Setting For Development, Test and QA Related Tickets	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Priority Status for Training Groups and Training Rooms	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Problem Ticket Slow Response Procedure	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Quick Reference Guide	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Remedy Stagging or Remedy UAT	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Reopening a Priority Problem P1/P2 Ticket	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-250	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Resolver Group Information Related to all URLs that end with healthnet.Com	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Reviewing a User’s Ticket History	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Reviewing and Monitoring the Outage Alert Board	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Reviewing the IBM ZINCLNK Queue	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - RSA Tokens	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Service Desk Ticket Templates	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-251	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Service Desk Transferring of Incident Tickets	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - SLA Timeframes for Problem and Incident Tickets	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Symphony General Support	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Tacoma WA Ticket Assignments	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Telecom/Voice, Network Related issues	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Telephone Problems	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-252	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Ticket Assignment for MDM application	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Ticket Pending Codes	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - ticket to Operations Team	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Trusted User Procedure	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Unable to Submit a Web Remedy Ticket	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Unity Commercial Information needed for slowness or time out issues	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-253	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Unix Pass Phrase reset	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Updating the Client Impacted tab	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Updating the Performance Information tab	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - User and Group Access Requests	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Users Not Receiving Email Notifications	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Using the Job Failure CTI	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-254	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Remedy - Verifying a Client’s SSN	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - VIP Process	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Web Ticket Procedure	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy - Web Ticket Procedures	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remedy- Application Outage Procedure and Use of Paper Tickets	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Remote Control - Connecting To A Client’s Computer	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-255	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Review Manager - Ticket assignment	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Right Fax Error 1722 Health Net of Oregon	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Right Fax - Login Instructions	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Right Fax Web Application Error	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Right Fax Web Page Cannot be Displayed	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	RightFax - Application Support	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-256	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	RightFax - Setup Documentation	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	RightFax - Web Utility Logon	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Risk Navigator - Contact Information	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	RISKTRAQ - Contact information	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Rockwell - HD Announcements	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	RRS Retrospective Review System Application Support (TIBCO/Staffware)	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-257	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	RSA Token - Lost or Missing Token	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	RSI Guard - Information	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Salsa - Error message on startup	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Salsa - Password Requirements	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Salsa(Siebel) - Account Modifications	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Salsa(Siebel) - Creating a Account	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-258	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Salsa(Siebel) - Reactive/Restore Account	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Salsa(Siebel) - Unlocking an Account	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAP - BIP Password reset	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAP - Changing Default Printer	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAP - Password Reset	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAP - QAS Password Reset	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-259	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	SAP - RAZZA or HCS	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAP - Remedy Ticket Routing	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SAS - Information	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SCOUT IT OUT - Information	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Seamless Search Client Sign On for the OnDemand Internet Access Feature	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Seamless Search Password Reset	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-260	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	  	 Description
	  	Category (LOB)	  	 Filename/Location

	IT - Access Admin	  	Secure Messaging	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Servers - Quota Extensions For Folders Running Out of Space	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Desk - Access Admin Contact and ISR Escalation	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Desk - How and When to End Calls	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Desk - Opening and Closing Scripts	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Desk - Shift Start and End Times	  		  	All	  	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-261	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Service Desk - Windows 7 Migration	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service request - Cancel a service request	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Request Approval Reassignment	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Service Request Approvals	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Shadow (Neon) - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Showcase - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-262	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Showcase - Login for MHN Users	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Showcase - Reporting from Professional Relations	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Simple Selling - System Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SIR - MHN users	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SIR Support and Passwords	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SiteMinder - Tool for HNFS Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-263	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Smart View - System information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Software - Add/remove a software from Desktop/Laptop	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Software - Adding the Essbase Excel Addin and Toolbar for Office 2000	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Software - IBM Change Password Tool	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Software - Instructions for EP Admin backout	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Software - Reflections Application Not Working Or Missing From The Advertised Programs	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-264	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Software - Reflections v10 Scroll Lock Error	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Special Expense Procedure - CSC Domain Names	 		 	All	 	H:\IT Governance\Vendor Relations\Policy and Procedures
					
	IT - Access Admin	  	Spirit - Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Spirit - Re-enabling an account	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Spirit - User Lookup	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SPOC LIST - Single Points Of Contact	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Spool Explorer - Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-265	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	SRM - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Changing Approvers	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Client User Guide	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Creating a Remedy Ticket	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Hardware Removal and e-Waste at HealthNet	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Issues with Approval Status and Work Orders	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-266	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	SRM - Quick Start Guide	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Searching for a Work Order Number	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Submitting a Request	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SRM - Weblink to Service Request Manger for Support Teams	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	STARS - Printing	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	STARS VIPS - Government and Commercial	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-267	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Supplies - HNFS Users Ordering Office Supplies	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symantic - Virus Definition Files Not Up To Date	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - Confidential Account	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - Error: cannot signon to more than one device	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - HNFS Unlocks and Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - Macros	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-268	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Symphony - Password Requirements	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - Password Reset Instructions	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symphony - Printing in landscape in error	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Symposium - MHN Telecom Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Sysgem - DAccount Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Sysgem - Logon and functionality	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-269	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Sysgem - Password resets for DSS, PRD, DEV, ODS and UAT using Sysgem	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SysGem ABS User authorization Failure	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SysGem Account Search	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SysGem Agent Group Setup and Search Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	SysGem User Logon Process	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TAD4D Console Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-270	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	TAG - Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Taleo - Contact information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Taleo - Password Reset Contacts	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TAO1 Totally Automated Office for PGBA	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Targus - Security Cable Lock Combinations	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Telecom - E-Talk, EPAdmin, Seagate, eWorkForce Management	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-271	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Teleconference - WebEx Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Telephone - Telecom/Voice, Network Related Issues	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Termination - Urgent Termination of System Access	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Termination Procedure - IBM (HNC/FS) Master Document for Access Administration	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Termination Procedure - Salsa(Siebel)	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Termination Procedure - VMS (DSS, DEV, DEVi64, PRD, UAT)	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-272	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Terminations - Approved OE LIST	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Time Reporting - Application and Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Tivoli - Remote In Tool for IM Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Tivoli Identity Manager (ITIM) - How to Log into Tivoli	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TPaPS - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TPaPS - HNFS Account Management	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-273	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Tricare Prime Remote (TPR) - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Tricare.mil - Website Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Trizetto / IPI / JAdvantage - Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TSC - Procedure for IP port security	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Tumbleweed - Unable to receive external mails from outside HN network	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	TWS (OPC) - Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-274	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	UDMS - ABS Production Application	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	UMVS - UHC Users and Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unity - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unity - Application Support for MHN and Commercial	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unity - Finding The Unity Server Name	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unity - Power Account Password Reset	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-275	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Unity MARS Test - Account Setup	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unix - Checking the Error Logs	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unix - LDAP Change from novell to Active Directory	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unix - Login Server connection refused	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unix - Password Issues	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Unix - SSH Key Failure from login	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-276	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Updated OE List	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	UPS II - Password Reset	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Urgent Termination of System Access	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Valuetech - Hours of system availabiltiy	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Valutech - Application Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VDI - Confirming VMWare IP Address Is Active and Listening on the Port	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-277	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	VDI - Deploy Software	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VDI - Drive Space Issues on VDI Workstations	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VDI - HNFS User Outage Support	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VDI - Logging Into VDI On Windows XP For the First Time	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VDI - Troubleshooting Application Performance Issues	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Visual Info Client (VIC) - Password reset	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-278	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	VM Ware - CHCC VM Ware- Childrens Hospital of Central California	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VMS - Activating DAccounts	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VMS - ‘D’ Account Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VMS - ODW/ADW/BKB Test	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Voicemail - Password Reset	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VPN - Commercial Troubleshooting	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-279	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	VPN - Connection error	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VPN - HNFS Troubleshooting	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VPN - Map Network Drives	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	VPN - RSA Token First-Time Setup Directions for HNFS	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Webex (1-800-Conference) - Conference System Information	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	WebMD / Emdeon - Connectivity Issues with Real Time Eligibility Link	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-280	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Websites Blocked by Network Data Loss Prevention (NDLP)	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	What if Tool (WIT) - URL, Password and Support and Access	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	WIKI - Support Procedure	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Win XP/Notes toolbar didnt load via IE	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Windows - Error: The Trust Relationship Between This Workstation and the Primary Domain Failed.	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Windows - HealthNet Microsoft Patches and Installations	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-281	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Windows - Security log in this system is full	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Windows 7 - Cisco IP Phone Headset Issues	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Windows 7 - Quick user guide	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Windows/Citrix/VPN account getting Locked frequently	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Workstation - Add a new port	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	WPA - Web Power Agent Setup and Troubleshooting Tips	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-282	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	WPA ScreenPop Troubleshooting	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	XenApp - Exceed application	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	XenDesktop - How to Remote Desktop a XenDesktop user	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	XenDesktop - Logging into XenDesktop	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Active Thread Pop Up Box Appears	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Application Support and Troubleshooting	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-283	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Zavanta - Attempting to Install After Clicking on the Icon but Never Finishes	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Document Missing	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Error Messages	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Forgot User ID and/or Password	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - In a Document, Author Is Unable To Access the ‘ID Information’ Page	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Locked Sessions and Password Resets	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-284	  	Health Net / Cognizant Confidential

 Final 

									
	 Area
	  	 Policy Name
	 	 Description
	 	Category (LOB)	 	 Filename/Location

	IT - Access Admin	  	Zavanta - Miniature Image of Documents Print In Upper Corner of Document	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Overview	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - Trialware Appears when Logging Into Zavanta	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures
					
	IT - Access Admin	  	Zavanta - User Training and Education	 		 	All	 	Z:\DataCenter\Common03\ESCALATION MANAGEMENT\Access Administration\Procedures\IBM AA Procedures NEW\Solution Procedures

  

					
	Schedule P	  	P-285	  	Health Net / Cognizant Confidential

 Final 
  

	3.	HEALTH NET POLICIES LOADED INTO THE NATIONAL POLICY LIBRARY 

 Listed below are the Health
Net Policies loaded into Health Net’s national policy library, which the Parties acknowledge have been disclosed to Supplier by Health Net prior to the Effective Date. 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy

Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	iHealth Coding Edit Exceptions	 	Melina B Begi	 	KN621-10822	 		 	HNAZ, HNCA, HNOR	  	Account Management - Affiliate, Account Management - Commercial, Claims [more...]	 	1/29/2014	 	All
								
	Employer Group Termination Process	 	Dana X Manley	 	PD1220-9512	 		 	HNAZ	  	Account Management	 	10/3/2013	 	HMO, Commercial, POS, PPO, Indemnity
								
	Federal Parity: MHPA and MHPAEA	 	Alex M Black	 	BA227-144714	 		 	MHN	  	Actuarial, Business Solutions, MHN Configurations [more...]	 	4/25/2014	 	Commercial, MBHO - Managed Behavioral Health Organization
								
	Medicare Advantage (MA) and Medicare Advantage with Part D (MAPD) Bid Submission: CMS Benefit and Cost Sharing Review Process	 	Sherry E Brown	 	DB217-163930	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	  	Actuarial	 	1/27/2014	 	Medicare Advantage
								
	Year to Year Actuary Total & Volume Comparison by Contract_Policy & Procedures	 	Lakhwinder Kaur	 	KL79-85246	 	NE	 	HNAZ, HNCA, HNOR, HNPS	  	Actuarial	 	3/11/2014	 	Medicare Part D
								
	Access Administration Associate Transfer Policy	 	Mia S Terry- Samuels	 	DL1024-91618	 		 	All	  	All Departments	 	5/23/2014	 	N/A
								
	Access Administration Roles and Responsibilities	 	Mia S Terry- Samuels	 	DL925-81654	 		 	All	  	All Departments	 	5/29/2014	 	N/A
								
	Access Administration Termination Policy	 	Mia S Terry- Samuels	 	DL1024-85857	 		 	All	  	All Departments	 	5/27/2014	 	N/A
								
	Access to Associate Lotus Notes Mail Files	 	Harry A Belt	 	WN312-104053	 		 	HNI	  	All Departments	 	2/11/2014	 	N/A
								
	AHCCCS- Health Net Access Dental Services Program	 	Helen C Lansche	 	LH319-15447	 		 	Health Net Access	  	All Departments	 	5/28/2014	 	 AHCCCS (AZ
 Medicaid)

  

					
	Schedule P	  	P-286	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy
Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	AHCCCS- Health Net Access Dental Services Programâ€TMs Coordination of Care and Services	 	Helen C Lansche	 	LH528-103941	 		 	Health Net Access	  	All Departments	 	7/10/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Health Net Access QM Program Communication with Contracted Staff & Providers	 	Helen C Lansche	 	LH111-84818	 		 	Health Net Access	  	All Departments	 	3/4/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Health Net Access Quality Management Program	 	Helen C Lansche	 	LH1030-82649	 		 	Health Net Access	  	All Departments	 	3/4/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Immediate Jeopardy Response	 	Helen C Lansche	 	LH711-145511	 		 	Health Net Access	  	All Departments	 	9/2/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Marketing, Outreach and Retention	 	Filiberto L Gurrola	 	GF49-13126	 		 	Health Net Access	  	All Departments	 	4/9/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Provider Reporting Incidents of Abuse, Neglect or Exploitation	 	Helen C Lansche	 	LH85-132617	 		 	Health Net Access	  	All Departments	 	3/4/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS- Reporting Abuse, Neglect, Exploitation or Unexpected Death of Members	 	Helen C Lansche	 	LH224-144031	 		 	Health Net Access	  	All Departments	 	3/4/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS - Compliance Plan	 	Susan A Gilkey	 	GS73-161411	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS - Health Net Access Dental Services Programâ€TMs Dental Home Assignment	 	Helen C Lansche	 	LH528-105137	 		 	Health Net Access	  	All Departments	 	7/10/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Compliance Officer & Compliance Committee	 	Susan A Gilkey	 	GS712-14144	 		 	Health Net Access	  	All Departments	 	5/30/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Effective Lines of Communication	 	Susan A Gilkey	 	GS719-1456	 		 	Health Net Access	  	All Departments	 	5/30/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Enforcement of Standards	 	Susan A Gilkey	 	GS719-135725	 		 	Health Net Access	  	All Departments	 	5/30/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Escalation of Compliance Issues/Risks	 	Susan A Gilkey	 	GS73-161127	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Issue Notification / Prompt Responses to Detected Offenses	 	Susan A Gilkey	 	GS73-151258	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Monitoring and Auditing	 	Susan A Gilkey	 	GS73-153124	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Compliance: Training & Education	 	Susan A Gilkey	 	GS712-65833	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-287	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy
Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	AHCCCS Compliance: Written Policies and Procedures and Standards of Conduct	 	Susan A Gilkey	 	GS722-72549	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Member Rights and Responsibilities	 	Helen C Lansche	 	LH423-81751	 		 	Health Net Access	  	All Departments	 	4/25/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Policy & Procedure Development and Committee Approval Process	 	Susan A Gilkey	 	GS41-143849	 		 	Health Net Access	  	All Departments	 	5/15/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS â€“ Member Retention	 	Filiberto L Gurrola	 	GF811-133341	 		 	Health Net Access	  	All Departments	 	8/11/2014	 	AHCCCS (AZ Medicaid)
								
	Arizona Health Care Cost Containment System (AHCCCS) exclusion requirements monitoring	 	Afrodite P Smith	 	LJ711-155059	 		 	Health Net Access	  	All Departments	 	7/16/2014	 	AHCCCS (AZ Medicaid)
								
	Assessment of Bilingual Associates	 	Humaira S Theba	 	HM326- 201849	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	  	All Departments	 	7/17/2014	 	Commercial, Medicaid, Medicare, HMO, Medicare Advantage, Medicare Part D [more...]
								
	Associate Policy: Accounting and Recordkeeping	 	Sharon X Ogawa-Shono	 	MP912-9526	 		 	All	  	All Departments	 	11/21/2013	 	N/A
								
	Associate Policy: Administrative Pay Corrections	 	Sharon X Ogawa-Shono	 	LM810- 125721	 		 	All	  	All Departments	 	1/23/2014	 	N/A
								
	Associate Policy: Adoption Reimbursement Program	 	Sharon X Ogawa-Shono	 	FR45-16317	 		 	All	  	All Departments	 	1/23/2014	 	N/A
								
	Associate Policy: Alcohol and Drug Misuse	 	Remy M Franklin	 	MP21-1521	 		 	All	  	All Departments	 	7/2/2014	 	N/A
								
	Associate Policy: Associate Wellness Incentive Program	 	Sharon X Ogawa-Shono	 	MS520-10595	 		 	All	  	All Departments	 	7/8/2014	 	N/A
								
	Associate Policy: Attendance	 	Remy M Franklin	 	MP19-91816	 		 	All	  	All Departments	 	5/6/2014	 	N/A
								
	Associate Policy: Background Investigations	 	Sharon X Ogawa-Shono	 	MP215-9121	 		 	All	  	All Departments	 	10/21/2013	 	N/A
								
	Associate Policy: Benefits While on a Leave of Absence	 	Remy M Franklin	 	SS326-95934	 		 	All	  	All Departments	 	6/2/2014	 	N/A
								
	Associate Policy: Bereavement Pay	 	Sharon X Ogawa-Shono	 	MP123-102936	 		 	All	  	All Departments	 	1/27/2014	 	N/A

  

					
	Schedule P	  	P-288	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	Associate Policy: Board of Directors - Retainer Fees, Per Meeting Fees, Equity Awards and Reimbursements	 	Sharon X Ogawa-Shono	 	SS112-14531	 	NE	 	 HN Life, HNAZ, HNCA, HNCT, HNFS, HNI, HNINY, HNNE, HNOR, HNPS,

MHN [more...]
	  	All Departments	 	5/12/2014	 	All
								
	Associate Policy: Bridging of Service	 	Sharon X Ogawa-Shono	 	MP116-11821	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: California Family Military Leave of Absence	 	Remy M Franklin	 	MP1119- 102045	 		 	All	  	All Departments	 	8/5/2014	 	N/A
								
	Associate Policy: Cell Phone Use	 	Sharon X Ogawa-Shono	 	MP617-16226	 		 	All	  	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Confidentiality of Company Information	 	Sharon X Ogawa-Shono	 	MP912-111512	 		 	All	  	All Departments	 	11/18/2013	 	N/A
								
	Associate Policy: Conflicts of Interest	 	Sharon X Ogawa-Shono	 	MP912-145942	 		 	All	  	All Departments	 	4/23/2014	 	N/A
								
	Associate Policy: Continuing Education: CME Reimbursement Guidelines for Clinical Staff	 	Sharon X Ogawa-Shono	 	LM627-95443	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Continuing Education: CME Reimbursement Guidelines for Physician Staff	 	Sharon X Ogawa-Shono	 	LM627-94029	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Continuing Education: Professional Cost Reimbursement Guidelines: Sales, Account Management, and Other Licensed Positions	 	Sharon X Ogawa-Shono	 	LM627-10115	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Corporate Compliance Programs and Other Required Training	 	Sharon X Ogawa-Shono	 	MP910-9165	 		 	All	  	All Departments	 	12/4/2013	 	N/A
								
	Associate Policy: Corporate Opportunities	 	Sharon X Ogawa-Shono	 	MP913-95353	 		 	All	  	All Departments	 	11/18/2013	 	N/A
								
	Associate Policy: Dealing with the Government	 	Sharon X Ogawa-Shono	 	MP226-82258	 		 	All	  	All Departments	 	12/10/2013	 	N/A
								
	Associate Policy: Designation of Chief Compliance Officers and Obligation of Associates to Support the Compliance Mission	 	Sharon X Ogawa-Shono	 	MP927-9829	 		 	All	  	All Departments	 	11/18/2013	 	N/A

  

					
	Schedule P	  	P-289	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	Associate Policy: Director Stock Ownership Policy	 	Remy M Franklin	 	SS112-152651	 		 	All	  	All Departments	 	1/28/2014	 	All
								
	Associate Policy: Education Reimbursement	 	Sharon X Ogawa-Shono	 	LM627-93150	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Employee Assistance Program (EAP)	 	Sharon X Ogawa-Shono	 	LM625- 154915	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Employment at Will	 	Sharon X Ogawa-Shono	 	MP927-142114	 		 	All	  	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Employment of Foreign Nationals	 	Sharon X Ogawa-Shono	 	LM66-104712	 		 	All	  	All Departments	 	1/8/2014	 	N/A
								
	Associate Policy: Equal Employment and Affirmative Action	 	Remy M Franklin	 	MP21-151111	 		 	All	  	All Departments	 	5/19/2014	 	N/A
								
	Associate Policy: Ergonomic Support	 	Remy M Franklin	 	RA18-94924	 		 	All	  	All Departments	 	8/28/2014	 	N/A
								
	Associate Policy: Executive Officer Stock Ownership Policy	 	Remy M Franklin	 	SS112-143948	 		 	All	  	All Departments	 	1/28/2014	 	All
								
	Associate Policy: Fair Dealing	 	Sharon X Ogawa-Shono	 	MP913-101751	 		 	All	  	All Departments	 	11/18/2013	 	N/A
								
	Associate Policy: Fringe Benefits and Awards	 	Sharon X Ogawa-Shono	 	EL330-142935	 		 	All	  	All Departments	 	1/23/2014	 	N/A
								
	Associate Policy: Gifts and Entertainment	 	Sharon X Ogawa-Shono	 	MP914-143646	 		 	All	  	All Departments	 	6/9/2014	 	N/A
								
	Associate Policy: Health Net, Inc., Compensation Recovery Policy	 	Sharon X Ogawa-Shono	 	SS618-112715	 	NE	 	 HN Life, HNAZ, HNCA, HNCT, HNFS, HNI, HNINY, HNNE, HNOR, HNPS,

MHN [more...]
	  	All Departments	 	5/1/2014	 	All
								
	Associate Policy: Holiday Pay	 	Remy M Franklin	 	LM627- 155024	 		 	All	  	All Departments	 	3/3/2014	 	N/A
								
	Associate Policy: In Memoriam	 	Sharon X Ogawa-Shono	 	LM618-93945	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Inclement Weather / Hazardous Conditions	 	Sharon X Ogawa-Shono	 	LM812- 234049	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Independent Contractors	 	Sharon X Ogawa-Shono	 	MP1126-115257	 		 	All	  	All Departments	 	4/22/2014	 	N/A
								
	Associate Policy: Information Security	 	Sharon X Ogawa-Shono	 	MP226-83222	 		 	All	  	All Departments	 	1/8/2014	 	N/A

  

					
	Schedule P	  	P-290	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	  	 Department
	 	Effective	 	 Product

	Associate Policy: Internal Consideration and Job Posting	 	Sharon X Ogawa-Shono	 	MP215-83034	 		 	All	  	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Jury Duty and Voting	 	Sharon X Ogawa-Shono	 	LM627-162216	 		 	All	  	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Military/ Reserve Peace Officer/Emergency Duty Leave of Absence	 	Remy M Franklin	 	MP1125-125027	 		 	All	  	All Departments	 	11/15/2012	 	N/A
								
	Associate Policy: Mobile Device Policy for IT Testing Devices	 	Sharon X Ogawa-Shono	 	OS1029-11540	 		 	All	  	All Departments	 	7/28/2014	 	N/A
								
	Associate Policy: Mobile Device Usage	 	Sharon X Ogawa-Shono	 	OS1029-102336	 		 	All	  	All Departments	 	7/28/2014	 	N/A
								
	Associate Policy: Mobile Device	 	Sharon X Ogawa-Shono	 	OS1029-93252	 		 	All	  	All Departments	 	7/28/2014	 	N/A
								
	Associate Policy: No Gross-Up for Section 16b Officers	 	Sharon X Ogawa-Shono	 	SS615-142424	 		 	All	  	All Departments	 	7/7/2014	 	All
								
	Associate Policy: Open Door and Problem Resolution	 	Sharon X Ogawa-Shono	 	LM625-1466	 		 	All	  	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Paid Time Off (“PTO”)	 	Remy M Franklin	 	MS1125-134753	 		 	All	  	All Departments	 	8/12/2014	 	N/A
								
	Associate Policy: Performance Improvement	 	Remy M Franklin	 	MP829-74055	 		 	All	  	All Departments	 	3/18/2014	 	All
								
	Associate Policy: Performance Review Process	 	Sharon X Ogawa-Shono	 	MP829-7215	 		 	All	  	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Personal Leave of Absence	 	Remy M Franklin	 	MP125-141640	 		 	All	  	All Departments	 	8/5/2014	 	N/A
								
	Associate Policy: Personnel Records and Access to Records	 	Remy M Franklin	 	MP22-838	 		 	All	  	All Departments	 	12/11/2013	 	N/A
								
	Associate Policy: Photo Identification Badge and Access Code	 	Sharon X Ogawa-Shono	 	LM89-111821	 		 	All	  	All Departments	 	2/4/2014	 	N/A
								
	Associate Policy: Political Activities	 	Sharon X Ogawa-Shono	 	MP226-8137	 		 	All	  	All Departments	 	11/18/2013	 	N/A
								
	Associate Policy: Preventing and Detecting Fraud, Waste and Abuse of Government Programs	 	Remy M Franklin	 	MP27-72938	 		 	All	  	All Departments	 	2/19/2014	 	N/A
								
	Associate Policy: Privacy in the Workplace	 	Sharon X Ogawa-Shono	 	MP911-93517	 		 	All	  	All Departments	 	10/18/2013	 	N/A

  

					
	Schedule P	  	P-291	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Associate Policy: Professional Ethics	 	Sharon X Ogawa-Shono	 	MP913-103339	 		 	All	 	All Departments	 	8/27/2014	 	N/A
								
	Associate Policy: Prohibition Against Sexual Harassment and Other Workplace Harassment	 	Sharon X Ogawa-Shono	 	MP21-134918	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Proof of Right to Work in the United States	 	Sharon X Ogawa-Shono	 	MP614-85413	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: PTO Sharing	 	Remy M Franklin	 	LM813-161313	 		 	All	 	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Reasonable Accommodation Policy	 	Remy M Franklin	 	SS326-103344	 		 	All	 	All Departments	 	8/12/2014	 	N/A
								
	Associate Policy: Release of Information on Associates and Former Associates	 	Remy M Franklin	 	MP212-75649	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Reporting and Investigating Violations / Non-Retaliation	 	Remy M Franklin	 	MP86-145819	 		 	All	 	All Departments	 	6/10/2014	 	N/A
								
	Associate Policy: Requests for Information from Outside Parties	 	Remy M Franklin	 	LM810-114850	 		 	All	 	All Departments	 	1/27/2014	 	N/A
								
	Associate Policy: Rideshare Program	 	Remy M Franklin	 	LM627-15286	 		 	All	 	All Departments	 	9/3/2014	 	N/A
								
	Associate Policy: Safety Net Security Program	 	Sharon X Ogawa-Shono	 	MP87-91231	 		 	All	 	All Departments	 	12/18/2013	 	N/A
								
	Associate Policy: Salary Administration	 	Remy M Franklin	 	MP215-9221	 		 	All	 	All Departments	 	12/4/2013	 	N/A
								
	Associate Policy: Selection and Placement	 	Remy M Franklin	 	MP212-81652	 		 	All	 	All Departments	 	2/4/2014	 	N/A
								
	Associate Policy: Separation of Employment	 	Remy M Franklin	 	MP212-8757	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Severance Benefits	 	Remy M Franklin	 	MP712-114227	 		 	All	 	All Departments	 	5/6/2014	 	N/A
								
	Associate Policy: Smoking	 	Remy M Franklin	 	MP129-84441	 		 	All	 	All Departments	 	4/2/2014	 	N/A
								
	Associate Policy: Solicitation, Distribution and Posting	 	Remy M Franklin	 	MP226-81032	 		 	All	 	All Departments	 	10/18/2013	 	N/A

  

					
	Schedule P	  	P-292	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Associate Policy: Special Restrictions with Respect to Government Employees and Public Officials	 	Remy M Franklin	 	MP87-9462	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Specified Employees	 	Remy M Franklin	 	FR45-154540	 	N/A	 	All	 	All Departments	 	1/2/2014	 	N/A
								
	Associate Policy: SPOT Cash Awards	 	Remy M Franklin	 	FR119-73410	 		 	All	 	All Departments	 	4/23/2014	 	N/A
								
	Associate Policy: Standards of Conduct	 	Remy M Franklin	 	MP913-104021	 		 	All	 	All Departments	 	12/16/2013	 	N/A
								
	Associate Policy: Standards of Dress	 	Remy M Franklin	 	MP129-85243	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Statutory Medical and Family Care Leave of Absence	 	Remy M Franklin	 	SS310-14143	 		 	All	 	All Departments	 	11/15/2012	 	N/A
								
	Associate Policy: Subpoena Process and Request for Employment Records	 	Remy M Franklin	 	MP212-8256	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Telecommuting / Work at Home	 	Remy M Franklin	 	MP87-101558	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Temporary Assignments	 	Remy M Franklin	 	LM625-142136	 		 	All	 	All Departments	 	11/12/2013	 	N/A
								
	Associate Policy: Timekeeping	 	Remy M Franklin	 	LM813-143843	 		 	All	 	All Departments	 	1/24/2014	 	N/A
								
	Associate Policy: Use of Company Assets	 	Remy M Franklin	 	MP913-105141	 		 	All	 	All Departments	 	12/5/2013	 	N/A
								
	Associate Policy: Use of Company Owned Vehicles	 	Remy M Franklin	 	MP911-142838	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate Policy: Use of E-Mail and Other Electronic Messaging Functions	 	Remy M Franklin	 	MP622-105548	 		 	All	 	All Departments	 	8/15/2014	 	N/A
								
	Associate Policy: Victims of Violence or Crime Leave	 	Remy M Franklin	 	MP810-75615	 		 	All	 	All Departments	 	11/15/2012	 	N/A
								
	Associate Policy: Visitors in the Workplace	 	Sharon X Ogawa-Shono	 	MP129-135825	 		 	All	 	All Departments	 	10/29/2013	 	N/A
								
	Associate Policy: Workers’ Compensation	 	Remy M Franklin	 	LM88-184034	 		 	All	 	All Departments	 	8/12/2014	 	N/A
								
	Associate Policy: Working Hours and Pay Practices	 	Remy M Franklin	 	MP712-11205	 		 	All	 	All Departments	 	2/7/2014	 	N/A

  

					
	Schedule P	  	P-293	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Associate Policy: Workplace Violence Prevention	 	Remy M Franklin	 	MP19-81853	 		 	All	 	All Departments	 	10/18/2013	 	N/A
								
	Associate use of social media	 	Mike J Spasoff	 	SM810-142635	 		 	All	 	All Departments	 	11/12/2013	 	All
								
	Automated External Defibrillators AED)	 	Afsoun Rahimian	 	RA430-134721	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNI, HNINY, HNNE, HNOR, HNPS	 	All Departments	 	7/28/2014	 	N/A
								
	Board of Directors â€“ Perquisites, Special Payments, and Gifts and Entertainment	 	Lisa Eisen	 	MP45-145117	 		 	HNI	 	All Departments	 	2/12/2014	 	N/A
								
	BOM & Kit Template Management	 	Shelly L Ferrel	 	FS829-13311	 		 	All	 	All Departments	 	6/25/2014	 	All
								
	Broker of Record (BOR) Change - Member Initiated	 	Tammy M Brown	 	CT614-165512	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	3/10/2014	 	Medicare
								
	CDS Database Special Mailing Requests	 	Shelly L Ferrel	 	FS1120-133222	 		 	All	 	All Departments	 	10/2/2013	 	All
								
	Change Management Process	 	Mia S Terry-Samuels	 	TM225-174121	 		 	All	 	All Departments	 	4/4/2014	 	All
								
	Check Request Policy	 	Rene X Turk	 	TR108-9343	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN	 	All Departments	 	2/22/2014	 	N/A
								
	Clinical Criteria for Medical (Utilization) Management Decisions	 	Jean V Serratore	 	WJ68-104821	 		 	HNAZ, HNCA, HNI, HNNE, HNOR, MHN	 	All Departments	 	1/15/2014	 	Dual Eligible, All
								
	Clinical Practice Guideline Development	 	Jean V Serratore	 	WJ68-14530	 		 	HNI	 	All Departments	 	1/15/2014	 	All, Dual Eligible
								
	CM00_Change Process Overview_SOP	 	Mia S Terry-Samuels	 	TM226-194932	 		 	All	 	All Departments	 	4/4/2014	 	All
								
	CMS Data Use Attestation	 	Shelley X Axelson	 	MP94-75049	 	NE	 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN Govt. Srvs	 	All Departments	 	7/17/2013	 	Medicaid, Medicare, Medicare Advantage, Medicare Part D, Medi-Cal [more...]

  

					
	Schedule P	  	P-294	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Commercial Compliance - Compliance Plan	 	Pamela L Gregg	 	GS720-15256	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	3/25/2014	 	POS, Indemnity, EPO, Medicare Supplement, Commercial HMO, Commercial PPO
								
	Commercial Compliance - Managing Responses to Regulator Compliance Communications	 	Pamela L Gregg	 	GS628-144551	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	5/12/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Compliance - Monitoring and Oversight	 	Pamela L Gregg	 	GS628-151555	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/2/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Compliance â€“ Issue Notification / Prompt Responses to Detected Offenses	 	Pamela L Gregg	 	GS628-153149	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	5/27/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Compliance â€ “Regulator Audits & Regulator Corrective Action Plans	 	Pamela L Gregg	 	GS628-152435	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	5/27/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Compliance: Corrective Action Plans	 	Pamela L Gregg	 	GP59-1149	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	5/27/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Compliance: Escalation of Compliance Issues/Risks	 	Pamela L Gregg	 	GP56-15205	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	5/6/2014	 	Indemnity, Commercial, MBHO - Managed Behavioral Health Organization, EAP [more...]
								
	Commercial Customer Experience Reportable Issues Process	 	Natalie X Kaufmann	 	KN63-85824	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	8/21/2014	 	HMO, Commercial, POS, PPO, IFP, Commercial HMO, Commercial PPO [more...]

  

					
	Schedule P	  	P-295	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Consultations, Coding Variation	 	Melina B Begi	 	SK325-103048	 		 	HNCA, HNOR	 	All Departments	 	2/7/2014	 	Commercial
								
	Corporate Compliance Internal Corrective Action Plans	 	Afrodite P Smith	 	SA927-14269	 		 	All	 	All Departments	 	6/11/2014	 	N/A
								
	Coverage Gap Discount Program (CGDP) Payment Overview	 	Le C Nguyen	 	NL1211-135622	 		 	HN Life, HNAZ, HNCA, HNINY, HNOR	 	All Departments	 	12/20/2013	 	Medicare Part D
								
	Covering Physicians	 	Karen M Ellington	 	PA1221-131914	 	W	 	HNAZ	 	All Departments	 	12/16/2013	 	HMO, Commercial, Medicare Advantage, POS, PPO
								
	Creating Health Net Policies and Procedures	 	Afrodite P Smith	 	MP323-869	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	All Departments	 	1/17/2014	 	All
								
	Cultural Competency Training	 	Diana M Carr	 	WN111-152953	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, MHN	 	All Departments	 	8/4/2014	 	Commercial, Medicare, Medicare Advantage, POS, PPO, IFP, Medi-Cal [more...]
								
	Data Collection, Analysis and Reporting to Evaluate Special Needs Plan (SNP) Model of Care	 	Candace C Ryan	 	RC77-11317	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	2/4/2014	 	Medicare Advantage Special Needs Plan
								
	Developing Written and Web-Based Communication in Plain Language	 	April X Canetto	 	PV926-121241	 		 	HNAZ, HNCA, HNOR, MHN	 	All Departments	 	5/5/2014	 	Medi-Cal, Cal MediConnect, Medicare, Commercial (HMO/PPO/EPO/POS)
								
	Dual Eligible Demonstration Physical Accessibility Review Survey (PARS) for Provider Sites (Attachment C)	 	Kelly R Kono	 	KK23-12433	 		 	HNCA, HNCS	 	All Departments	 	2/7/2014	 	Dual Eligible
								
	Dual Enrollee Nondiscrimination Policy	 	Diane Sargent	 	SS44-14360	 		 	HNCA, HNCS, HNPS, MHN	 	All Departments	 	1/13/2014	 	Dual Eligible
								
	Enrollee Rights and Responsibilities	 	Diane Sargent	 	SS45-1299	 		 	HNCA	 	All Departments	 	1/13/2014	 	Dual Eligible
								
	Enterprise Process for SBC Fulfilment	 	Cecil J Woods	 	WC226-9591	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	1/28/2014	 	Commercial
								
	Evidence of Coverage (EOC) Fulfillment Process	 	Shelly L Ferrel	 	FS87-105957	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN Govt. Srvs	 	All Departments	 	8/19/2013	 	All

  

					
	Schedule P	  	P-296	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Facilities Standards and Policies	 	Afsoun Rahimian	 	RA49-135553	 		 	All	 	All Departments	 	8/18/2014	 	All
								
	FEHBP Provider Sanctions Implementation Policy	 	Cecilia X Arrieta	 	TS127-152422	 		 	HN Life, HNAZ, HNCA, HNPS, MHN	 	All Departments	 	3/3/2014	 	HMO
								
	First Aid Kit Inspection & Restocking	 	Shelly L Ferrel	 	FS1226-154829	 		 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR, HNPS	 	All Departments	 	11/11/2013	 	All
								
	Focused Records Review Program	 	Melina B Begi	 	SK325-105628	 		 	HNCA, HNOR, HNAZ	 	All Departments	 	1/14/2014	 	All
								
	Genetic Information Nondiscrimination	 	Afrodite P Smith	 	MS1120-94711	 		 	HN Life, HNAZ, HNCA, HNCT, HNI, HNINY, HNNE, HNOR, HNPS	 	All Departments	 	6/10/2014	 	HMO, Commercial, POS, PPO, IFP, EPO, AIM, Healthy Kids, Healthy Families [more...]
								
	Governance Operational Request	 	Melina B Begi	 	SK1011-12545	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	9/3/2014	 	All
								
	Governance Plan Change Control Process	 	Melina B Begi	 	SK1011-132323	 	NW	 	HNAZ, HNCA, HNOR	 	All Departments	 	9/3/2014	 	All
								
	Health Net Internal Audit Charter for Government Services Division	 	Geraldine T Gillen	 	GG129-101359	 		 	 HNFS, MHN
 Govt. Srvs
	 	All Departments	 	6/10/2013	 	All
								
	Health Net Language Line Oversight	 	Christine X Martignoni	 	BV813-132148	 		 	All	 	All Departments	 	11/4/2013	 	All
								
	Health Net Medicare Operations Language Line Requirements	 	Christine X Martignoni	 	BV423-12467	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	9/2/2014	 	Medicare
								
	Health Net Pharmaceutical Services - 2015 Medicare-Medicaid Long Term Care Pharmacy Transition Program	 	Donna M Lenhoff	 	LD527-141422	 		 	HNPS	 	All Departments	 	6/2/2014	 	Medicare-Medicaid
								
	Health Net Pharmaceutical Services - Medicare-Medicaid Retail Transition Program	 	Donna M Lenhoff	 	LD527-9430	 		 	HNPS	 	All Departments	 	5/27/2014	 	Medicare-Medicaid

  

					
	Schedule P	  	P-297	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services 2015 Medicare Part D Long Term Care Pharmacy Transition Program	 	Donna M Lenhoff	 	LD527-112734	 		 	HNPS	 	All Departments	 	6/2/2014	 	Medicare Part D
								
	Health Net Pharmaceutical Services Commercial On/Off Exchanges - Pharmacy Claims Processor Compliance	 	Katherine J Gumpert	 	GK94-10225	 		 	HNPS	 	All Departments	 	9/4/2013	 	Health Benefit Exchange, Commercial
								
	Health Net Pharmaceutical Services Medicare-Medicaid - Pharmacy Claims Processor Compliance	 	Donna M Lenhoff	 	LD411-81954	 		 	HNPS	 	All Departments	 	5/16/2014	 	Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare-Medicaid Long Term Care Pharmacy Transition Program	 	Donna M Lenhoff	 	LD527-125534	 		 	HNPS	 	All Departments	 	5/27/2014	 	Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D - Long Term Care Pharmacy Transition Program	 	Donna M Lenhoff	 	BB128-135810	 		 	HNPS	 	All Departments	 	5/27/2014	 	Medicare Part D
								
	Health Net Pharmaceutical Services Medicare Part D - Retail Transition Program	 	Donna M Lenhoff	 	BB117-155113	 		 	HNPS	 	All Departments	 	5/27/2014	 	Medicare Part D
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coverage Determination for Payment - Letter Review, Testing and QA Process	 	Donna M Lenhoff	 	LD119-145228	 		 	HNPS	 	All Departments	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Excluded Provider/Pharmacy Process	 	Donna M Lenhoff	 	BB123-989	 		 	HNPS	 	All Departments	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - First Tier Downstream and Related Entity Requirements	 	Donna M Lenhoff	 	LD52-151221	 		 	HNPS	 	All Departments	 	5/23/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid â€“ End Stage Renal Disease Drug Coverage and ESRD EligibilityMaintenance Process	 	Donna M Lenhoff	 	LD14-103912	 		 	HNPS	 	All Departments	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid â€“ Medicare Program Metrics Review	 	Donna M Lenhoff	 	LD53-101255	 		 	HNPS	 	All Departments	 	10/21/2013	 	Medicare Part D, Medicare-Medicaid

  

					
	Schedule P	  	P-298	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D â€“ Fraud, Waste and Abuse (FWA) Training	 	Donna M Lenhoff	 	LD426-92322	 		 	HNPS	 	All Departments	 	8/29/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Pharmacy Service Center Telephone Quality Assurance Process and Standards	 	Donna M Lenhoff	 	BB108-1438	 		 	HNPS	 	All Departments	 	6/12/2014	 	Medicaid, Medicare, Commercial, Medicare-Medicaid
								
	Health Net Pharmacy Network Access	 	Catherine E Cole	 	CC34-91824	 		 	HNPS	 	All Departments	 	6/9/2014	 	Medicare Part D, Dual Eligible
								
	HEALTH NET, INC. POLICY REGARDING COMMUNICATIONS WITH ANALYSTS, SECURITYHOLDERS AND OTHERS	 	Angelee F Bouchard	 	MP218-103951	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	6/3/2014	 	N/A
								
	HEALTH NET, INC. POLICY STATEMENT ON TRADING IN SECURITIES BY OFFICERS, DIRECTORS AND DESIGNATED ASSOCIATES AND RELATED COMPLIANCE MATTERS	 	Afrodite P Smith	 	MP218-113651	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN Govt. Srvs	 	All Departments	 	8/8/2013	 	N/A
								
	High Level Incident Management Work Flow	 	Shelly L Ferrel	 	FS125-133438	 		 	HN Life, HNAZ, HNCA, HNCS, HNCT, HNI, HNINY, HNNE, HNOR, HNPS, MHN [more...]	 	All Departments	 	12/17/2013	 	All
								
	High Level Mail Stop Code Change Work Flow	 	Shelly L Ferrel	 	FS1211-134912	 		 	All	 	All Departments	 	1/2/2014	 	All
								
	High Level Production Process Work Flow	 	Shelly L Ferrel	 	FS829-124936	 		 	All	 	All Departments	 	6/17/2014	 	All
								
	HIPAA Policies -1.1 through 5.3	 	Shelley X Axelson	 	MP628-152752	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN	 	All Departments	 	7/2/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	HNPS Network Pharmacy Communications Policy & Procedure	 	Rena M Vasile	 	BL125-132542	 		 	HNAZ, HNCA, HNI, HNOR, HNPS	 	All Departments	 	6/11/2014	 	ALL

  

					
	Schedule P	  	P-299	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Hospital-Acquired Conditions Policy	 	Louba X Aaronson	 	TS517-11441	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	12/9/2013	 	Commercial, HMO, Medicare, Medicare Advantage, POS, PPO, Indemnity, EPO [more...]
								
	iHealth (iHT) Reason Code and ABS Disallow Codes	 	Melina B Begi	 	KN523-121129	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	11/25/2013	 	All
								
	Independent Review Entity (IRE) Quality Review of Effectuation Policy and Procedure	 	Christine X Martignoni	 	BV52-132648	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	9/25/2013	 	Medicare
								
	Insider Trading and Disclosure of Material Inside Information	 	Sharon X Ogawa-Shono	 	LM88-19330	 		 	All	 	All Departments	 	1/14/2014	 	N/A
								
	Internal Audit Department Policy and Procedures (IAD Charter)	 	Geraldine T Gillen	 	MP38-75840	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	7/12/2013	 	N/A
								
	International Anti-Bribery Laws	 	Afrodite P Smith	 	MS210-165311	 		 	 Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNFS, HNI, HNNE, HNOR, HNPS

[more...]
	 	All Departments	 	2/11/2014	 	All
								
	Interpreter Services	 	Diana M Carr	 	FD529-85329	 		 	Health Net Access	 	All Departments	 	7/24/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Interpreter Services	 	Diana M Carr	 	HM326-193022	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR	 	All Departments	 	7/24/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]

  

					
	Schedule P	  	P-300	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	 Issue Identification, Tracking, Escalation
 &
Resolution â€“ First Tier, Down Stream and Related Entities
	 	Curt Nelson	 	MD45-124554	 	NE	 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	3/18/2014	 	Medicare Advantage and Medicare Part D
								
	 Issue Identification, Tracking, Escalation
 &
Resolution
	 	Curt Nelson	 	MD321-154443	 	NE	 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	3/18/2014	 	Medicare Advantage and Medicare Part D
								
	IT Admin Rights Annual Qualification Procedure	 	Christopher Stephens	 	SC529-9176	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Asset Management Exiting Associates Procedure	 	Christopher Stephens	 	SC529-93933	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Asset Management New Associates Procedure	 	Christopher Stephens	 	SC529-135933	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Asset Management Transferring Associates Procedure	 	Christopher Stephens	 	SC530-74434	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Collection and Storage of Physical Software Media Procedure	 	Christopher Stephens	 	SC529-92934	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Desktop License Transfer In Compliance With License Agreement Procedure	 	Christopher Stephens	 	SC529-93325	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT External Audit of Software Installation Procedure	 	Christopher Stephens	 	SC529-94513	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Service Level Metric Team Ad Hoc Report Request Procedure	 	Randy C Linden	 	WP618-102143	 		 	All	 	All Departments	 	7/7/2014	 	All
								
	IT Service Level Metric TeamCross Vendor (HN, CTS & IBM)Ticket Ownership Dispute Procedure	 	Randy C Linden	 	WP626-102859	 		 	All	 	All Departments	 	7/7/2014	 	All
								
	IT Service Request for Software Removal Procedure	 	Christopher Stephens	 	SC529-14358	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	IT Software Approval and Updating of eBuyer Catalog Procedure	 	Christopher Stephens	 	SC530-73151	 		 	All	 	All Departments	 	7/30/2014	 	Commercial
								
	IT Steady State Non Lease Equipment Procedure	 	Christopher Stephens	 	SC530-74119	 		 	All	 	All Departments	 	7/30/2014	 	Commercial
								
	ITAM Advertised Programs Package Request Procedure	 	Christopher Stephens	 	SC529-92545	 		 	All	 	All Departments	 	7/30/2014	 	All
								
	ITAM PIM - Health NetProcess Interface ManualAsset Management	 	Noah A Plaza	 	PN417-14226	 		 	All	 	All Departments	 	2/25/2014	 	N/A

  

					
	Schedule P	  	P-301	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	ITG Disaster Recovery Plan Testing Policy & Procedure	 	Mia S Terry- Samuels	 	TM123-165415	 		 	All	 	All Departments	 	1/7/2014	 	All
								
	Junk Fax Prevention	 	Shelley X Axelson	 	MP511-84739	 	NE	 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN	 	All Departments	 	7/2/2013	 	Commercial, HMO, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	KIM (Kit Information Management) BOM Error Correction	 	Shelly L Ferrel	 	FS1120-75820	 		 	All	 	All Departments	 	2/17/2014	 	All
								
	Language Assistance Program	 	Diana M Carr	 	OM617-134632	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	All Departments	 	7/24/2014	 	Commercial HMO, PPO, POS, Medicare Advantage, Medicare [more...]
								
	Links to Web-based applications	 	Mike J Spasoff	 	SM918-125037	 	N/A	 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	12/2/2013	 	N/A
								
	Marketing Guidelines for PHI Security	 	Thuy W Cardiel	 	CT113-10532	 	NW	 	HN Life, HNAZ, HNCA, HNCT, HNI, HNOR	 	All Departments	 	9/3/2013	 	All
								
	Medi-Cal PCP Facility Site & Medical Record Review Process	 	Kelly R Kono	 	KK118-141356	 		 	HNCA, HNCS	 	All Departments	 	4/3/2014	 	Medi-Cal, Dual Eligible
								
	Medi-Cal Physical Accessibility Review Survey for Provider Sites that Serve Seniors and Persons with Disabilities	 	Kelly R Kono	 	KK118-141633	 		 	HNCA, HNCS	 	All Departments	 	7/29/2014	 	Medi-Cal
								
	Medicaid Compliance-Managing Health Net Medicaid Programs Issue Write-ups	 	Komsan X Sem	 	SK329-11332	 		 	All	 	All Departments	 	5/15/2014	 	Medi-Cal
								
	Medicaid Compliance - Effective Lines of Communication	 	Alejandra Q Clyde	 	CA524-13470	 		 	HNCA, HNCS, HNI, HNPS	 	All Departments	 	7/16/2014	 	Medi-Cal
								
	Medicaid Compliance - Monitoring and Auditing	 	Daria V Baker	 	CA65-172513	 		 	HNCA, HNCS, HNI, HNPS	 	All Departments	 	7/16/2014	 	Medi-Cal
								
	Medicaid Compliance Department - External Audits by DHCS, DMHC, or Subcontractors	 	Daria V Baker	 	ED423-165349	 		 	HNCA, HNCS, HNPS	 	All Departments	 	6/23/2014	 	Medi-Cal

  

					
	Schedule P	  	P-302	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicaid Compliance Intranet Website Maintenance	 	Komsan X Sem	 	SK715-105335	 		 	HNCA	 	All Departments	 	6/16/2014	 	Medi-Cal
								
	Medicaid Compliance Oversight	 	Deanna L Eaves	 	ED423-163140	 		 	HNCA, HNCS, HNPS	 	All Departments	 	5/29/2014	 	Medi-Cal
								
	Medicaid Compliance â€“ Prompt Response to Detected Offenses	 	Deanna L Eaves	 	ED422-95546	 		 	HNCA, HNCS	 	All Departments	 	9/30/2013	 	Medicaid
								
	Medicaid Compliance: California Medi-Cal Compliance Plan	 	Alejandra Q Clyde	 	CA523-124316	 		 	HNCA, HNCS, HNPS	 	All Departments	 	6/27/2014	 	Medi-Cal
								
	Medicaid Compliance: Compliance Officer and California Medi-Cal Compliance Committee	 	Alejandra Q Clyde	 	CA523-165421	 		 	HNCA, HNCS, HNPS	 	All Departments	 	7/25/2014	 	Medi-Cal
								
	Medicaid Compliance: Enforcement of Standards	 	Alejandra Q Clyde	 	CA65-152517	 		 	HNCA, HNCS, HNI, HNPS	 	All Departments	 	7/25/2014	 	Medi-Cal
								
	Medicaid Compliance: Training and Education	 	Alejandra Q Clyde	 	CA65-1894	 		 	HNCA, HNCS, HNI, HNPS	 	All Departments	 	7/25/2014	 	Medi-Cal
								
	Medicaid Compliance: Written Policies and Procedures and Standards of Conduct	 	Alejandra Q Clyde	 	CA524-12335	 		 	HNCA, HNCS, HNPS	 	All Departments	 	6/27/2014	 	Medi-Cal
								
	Medicaid Third Party Liability (TPL) State Reporting Requirements	 	Perry D Beals	 	BP130-141359	 		 	HN Life, HNI, MHN	 	All Departments	 	5/15/2014	 	All
								
	Medical Record Confidentiality and Release of Information	 	Kelly R Kono	 	KK47-102834	 		 	HNCA	 	All Departments	 	6/25/2014	 	All
								
	Medical Records Documentation Standards	 	Kelly R Kono	 	KK47-121230	 		 	HNCA	 	All Departments	 	6/25/2014	 	HMO, Commercial, Medicare, Medicare Advantage, POS, PPO, EPO, AIM [more...]
								
	Medicare Advantage (MA) and Medicare Advantage with Prescription Drug (MAPD)	 	Celina X Hanna	 	SG1217-8381	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/9/2014	 	Medicare
								
	Medicare Advantage (MA) and Part D Marketing Material Obsolescence	 	Celina X Hanna	 	SG1217-161932	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/10/2014	 	Medicare
								
	Medicare Advantage (MA) and Part D Marketing Material Post Production Quality Maintenance	 	Celina X Hanna	 	SG1217-161420	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/10/2014	 	Medicare

  

					
	Schedule P	  	P-303	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Advantage (MA) Marketing Material Pre-Production Quality Review	 	Joel X Gomez	 	HD720-113333	 	NW	 	HNAZ, HNCA, HNOR, HNPS, MHN	 	All Departments	 	7/8/2014	 	Medicare
								
	Medicare Compliance - Auditing by CMS or its Designee	 	Sheryl D Pessah	 	HR328-152533	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	8/22/2014	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Compliance - Compliance Contact Responsibilities	 	Jennifer Evans	 	EJ510-95855	 		 	HN Life, HNAZ, HNCA, HNNE, HNOR, HNPS	 	All Departments	 	11/1/2013	 	Medicare Advantage, Medicare Part D
								
	Medicare Compliance - Effective Lines of Communication	 	Laetitia X Mayman	 	HR329-81145	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/4/2013	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Compliance - Managing Compliance Actions and CMS Enforcement Notices	 	Jennifer Evans	 	EJ56-75725	 		 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR, HNPS	 	All Departments	 	9/25/2013	 	Medicare Advantage, Medicare Part D
								
	Medicare Compliance â€“ Prompt Response to Detected Offenses	 	Laetitia X Mayman	 	EJ44-83932	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/11/2013	 	Dual Eligible, Medicare Advantage and Medicare Part D
								
	Medicare Compliance: Enforcement of Standards	 	Laetitia X Mayman	 	HR329-83126	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/4/2013	 	Dual Eligible, Medicare Advantage and Medicare Part D
								
	Medicare Compliance: Escalation of Compliance Issues	 	Sheryl D Pessah	 	SN37-112439	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	4/3/2014	 	Medicare Advantage, Medicare Part D, Dual Eligible
								
	Medicare Compliance: First Tier, Downstream & Related Entity (FDR) Oversight	 	Jennifer MacLean	 	PS525-121843	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	4/14/2014	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Compliance: Monitoring and Auditing	 	Laetitia X Mayman	 	HR810-84520	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/4/2013	 	Medicare Advantage and Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-304	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Compliance: Monitoring Medicare Part D Program Administration	 	Jessica A Warshaw	 	CA913-142334	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	2/4/2014	 	Medicare Part D, Medicare Advantage, Dual Eligible
								
	Medicare Compliance: Part C and D Data Reporting Outlier Notices	 	Heather M Milam	 	PS325-152057	 		 	HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	7/17/2013	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Compliance: Part C and D Data Reporting Submission	 	Heather M Milam	 	PS325-15215	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	7/1/2013	 	Dual Eligible, Medicare Advantage and Medicare Part D
								
	Medicare Compliance: Training and Education	 	Laetitia X Mayman	 	HR329-83615	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	All Departments	 	9/4/2013	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Part C Appeals Data Reporting	 	Daniel G Middaugh	 	SD731-101415	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/21/2014	 	Medicare Advantage, Medicare, Medicare Advantage PPO [more...]
								
	Medicare Part C Grievances Data Reporting	 	Daniel G Middaugh	 	SD731-95222	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/21/2014	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Part D Appeals Data Reporting	 	Daniel G Middaugh	 	SD314-122744	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/21/2014	 	Medicare, Medicare Advantage, Medicare Part D, Medicare Advantage PPO [more...]
								
	Medicare Part D Grievances Data Reporting	 	Daniel G Middaugh	 	SD314-122741	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	7/22/2014	 	Medicare Advantage, Medicare Part D, Medicare, Medicare Advantage HMO [more...]

  

					
	Schedule P	  	P-305	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Programs: Compliance Element I Written Policies and Procedures and Standards of Conduct	 	Laetitia X Mayman	 	PS729-65015	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	8/26/2014	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Programs: Compliance Element II Compliance Officer and Compliance Committee	 	Laetitia X Mayman	 	HR328-133757	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	8/26/2014	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Medicare Programs: Medicare Compliance Plan	 	Laetitia X Mayman	 	HR328-1543	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	All Departments	 	7/7/2014	 	Medicare Advantage and Medicare Part D
								
	Medication Error Reporting and Tracking	 	Kathleen Day	 	DK127-12150	 		 	HN Life, HNAZ, HNCA, HNCT, HNI, HNINY, HNNE, HNOR, HNPS, MHN	 	All Departments	 	6/4/2014	 	All
								
	Meetings and Events Expenditures/Taxation (Associate and Broker Related Expenses)	 	Lisa Eisen	 	MP715-14557	 	NE	 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	11/1/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	Member Notification - Unqualified Brokers	 	Yolanda M Marino	 	CT610-15723	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	11/4/2013	 	Medicare
								
	Member Rights and Responsibilities Statements	 	Blanca X Becerra	 	BB86-9306	 		 	HNAZ, HNCA	 	All Departments	 	7/11/2014	 	 CA Commercial HMO, POS, PPO, IFP, EPO,
 Exchange
HMO, Exchange PPO [more...]

								
	Missed Appointments (No-shows)	 	Karen M Ellington	 	PA1221-121523	 	W	 	HNAZ	 	All Departments	 	11/19/2013	 	HMO, Commercial, Medicare Advantage, POS, PPO
								
	Mobile Device Request Process	 	Mia S Terry-Samuels	 	TM1120-183018	 		 	All	 	All Departments	 	7/18/2014	 	All
								
	Monitoring of Individuals and Entities Sanctioned or Excluded from Participation by the Government	 	Afrodite P Smith	 	MP95-65755	 		 	All	 	All Departments	 	12/13/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]

  

					
	Schedule P	  	P-306	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Monthly Website Review and Attestation	 	Timothy X Iannetta	 	IT1025-112332	 		 	HNAZ, HNCA, HNOR, HNPS	 	All Departments	 	1/15/2014	 	Medicare Advantage, Medicare, Medicare Part D
								
	Multi-Function Device (MFD) Enhanced Lock Print (ELP)	 	Afsoun Rahimian	 	RA49-15412	 		 	All	 	All Departments	 	4/7/2014	 	N/A
								
	National Pharmacy and Therapeutics Committee 2014	 	Cathrine V Misquitta	 	MC613-10318	 		 	HNPS	 	All Departments	 	6/4/2014	 	All
								
	New Year Go Live Medicare Issue Escalation Process	 	Christine X Martignoni	 	WE27-11323	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	2/18/2014	 	All
								
	Non-Member Removal Requests from Marketing Promotions	 	Florence X Wong	 	MA428-102043	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	1/21/2014	 	Medicare Advantage and Medicare Part D
								
	Non-Production Systems Data Recovery for Electronic Media	 	Mia S Terry-Samuels	 	TM85-10324	 		 	HNI	 	All Departments	 	8/5/2014	 	N/A
								
	Notification to Members When Pharmacy Removed From Network	 	Catherine E Cole	 	CC324-115612	 		 	HNPS	 	All Departments	 	7/2/2014	 	Medicare Part D, Dual Eligible
								
	Obsolescence Processing Work Flow	 	Shelly L Ferrel	 	FS829-13951	 		 	All	 	All Departments	 	9/9/2013	 	All
								
	Offshore Subcontracting Attestation Review and Submission via HPMS	 	Jennifer MacLean	 	BW15-151210	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS	 	All Departments	 	3/13/2014	 	Medicare Advantage and Medicare Part D, Dual Eligible
								
	Part D Prescription Drug Event (PDE) P2P Reconciliation	 	Le C Nguyen	 	NL117-14846	 	NE	 	HN Life, HNAZ, HNCA, HNINY, HNOR	 	All Departments	 	7/15/2014	 	Medicare Part D
								
	Pharmacy Claims Processor Oversight	 	Virginia E White	 	WV27-17252	 		 	HNPS	 	All Departments	 	8/2/2013	 	All
								
	Pharmacy Minimum Standards Language	 	Catherine E Cole	 	CC521-12023	 		 	HNPS	 	All Departments	 	7/2/2014	 	Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	PHI/PII Prohibited in Remedy Tickets	 	Bonnie W Lam	 	WN31-135635	 	N/A	 	HN Life, HNAZ, HNCA, HNCT, HNFS, HNI, HNINY, HNNE, HNOR, HNPS, MHN [more...]	 	All Departments	 	8/25/2014	 	N/A

  

					
	Schedule P	  	P-307	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Prohibition of Storing Protected Health Information (PHI) on the CorpShare Drive	 	Shelley X Axelson	 	MP109-1137	 	NE	 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	7/2/2013	 	N/A
								
	Provider Compliance with Patient Self Determination Act	 	Kelly R Kono	 	KK47-14207	 		 	HNCA	 	All Departments	 	6/25/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	Provider Fraud, Waste and Abuse Training	 	Catherine E Cole	 	CC1210-93348	 		 	HNPS	 	All Departments	 	12/11/2013	 	Medicare Part D, Dual Eligible
								
	Purchasing Policy	 	Rene X Turk	 	TR829-14017	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	3/12/2014	 	N/A
								
	Quality Improvement Program Provider Participation and Update Process	 	Kelly R Kono	 	KK726-123246	 		 	HNCA	 	All Departments	 	9/3/2013	 	Medi-Cal
								
	Quality Improvement/Corrective Action Development Policy	 	Angela N Kuba	 	BV221-135638	 		 	All	 	All Departments	 	6/2/2014	 	All
								
	Records and Information Management (RIM) Policy (BUSINESS CONFIDENTIAL â€“ FOR INTERNAL USE ONLY)	 	Pamela S Willis	 	WP816-122946	 		 	 Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNCT, HNI, HNINY,

HNNE [more...]
	 	All Departments	 	6/2/2014	 	All
								
	Regulatory Requests Policy and Procedure	 	Christine X Martignoni	 	BV418-154858	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	2/11/2014	 	All
								
	Related Party Transactions	 	Afrodite P Smith	 	MP710-131617	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN Govt. Srvs	 	All Departments	 	8/8/2013	 	N/A

  

					
	Schedule P	  	P-308	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Report Request Process	 	Christine X Martignoni	 	MC78-10719	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	10/2/2013	 	All
								
	Reportable Issues Process	 	Christine X Martignoni	 	WE27-142847	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	7/11/2014	 	Medicare, Medicaid
								
	Reporting of Payments to Labor Organization Officers and Employees	 	Irene X Sandoval	 	MP723-955	 	NE	 	HNI	 	All Departments	 	11/6/2013	 	N/A
								
	Required Training for Special Needs Plan (SNP) Model of Care	 	Candace C Ryan	 	RC77-91119	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	7/17/2014	 	Medicare Advantage Special Needs Plans
								
	Satellite Telephones	 	Marianne Acosta	 	MS128-114610	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	8/5/2014	 	All
								
	SBC Tracking and Reporting	 	Cecil J Woods	 	WC311-102327	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	1/28/2014	 	Commercial
								
	Selection, Design, and Implementation of Quality Improvement Projects	 	Kelly R Kono	 	KK726-101544	 		 	HNCA	 	All Departments	 	8/27/2014	 	Medi-Cal
								
	Signature Authority Policy	 	Rene X Turk	 	MP1022-131643	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	7/24/2014	 	N/A
								
	Site Point of Contact (SPOC) Process	 	Connie E Shaffer	 	SC510-104352	 		 	All	 	All Departments	 	11/21/2013	 	All
								
	Special Professional Associate Policy: Accounting and Recordkeeping	 	Sharon X Ogawa-Shono	 	OS1116-84621	 		 	MHN Govt. Srvs	 	All Departments	 	11/21/2013	 	N/A
								
	Special Professional Associate Policy: Administrative Pay Corrections	 	Sharon X Ogawa-Shono	 	SS1112-95553	 		 	MHN Govt. Srvs	 	All Departments	 	1/23/2014	 	N/A

  

					
	Schedule P	  	P-309	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Special Professional Associate Policy: Alcohol and Drug Misuse	 	Remy M Franklin	 	SS1112-95619	 		 	MHN Govt. Srvs	 	All Departments	 	7/2/2014	 	N/A
								
	Special Professional Associate Policy: Bridging of Service	 	Sharon X Ogawa-Shono	 	OS1114-144915	 		 	All	 	All Departments	 	1/27/2014	 	N/A
								
	Special Professional Associate Policy: California Family Military Leave of Absence	 	Sharon X Ogawa-Shono	 	SS1112-95346	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Cell Phone Use	 	Sharon X Ogawa-Shono	 	SS1112-95652	 		 	MHN Govt. Srvs	 	All Departments	 	11/20/2013	 	N/A
								
	Special Professional Associate Policy: Confidentiality of Company Information	 	Sharon X Ogawa-Shono	 	SS1112-9577	 		 	MHN Govt. Srvs	 	All Departments	 	11/18/2013	 	N/A
								
	Special Professional Associate Policy: Conflicts of Interest	 	Sharon X Ogawa-Shono	 	SS1112-95721	 		 	MHN Govt. Srvs	 	All Departments	 	4/23/2014	 	N/A
								
	Special Professional Associate Policy: Corporate Compliance Programs and Other Required Training	 	Sharon X Ogawa-Shono	 	SS1112-94318	 		 	MHN Govt. Srvs	 	All Departments	 	12/4/2013	 	N/A
								
	Special Professional Associate Policy: Corporate Opportunities	 	Sharon X Ogawa-Shono	 	SS1112-94447	 		 	MHN Govt. Srvs	 	All Departments	 	11/18/2013	 	N/A
								
	Special Professional Associate Policy: Dealing with the Government	 	Sharon X Ogawa-Shono	 	HL1112-124849	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	N/A
								
	Special Professional Associate Policy: Designation of Chief Compliance Officers and Obligation of Associates to Support the Compliance Mission	 	Sharon X Ogawa-Shono	 	SS1112-94822	 		 	MHN Govt. Srvs	 	All Departments	 	11/18/2013	 	N/A
								
	Special Professional Associate Policy: Employment at Will	 	Sharon X Ogawa-Shono	 	SS1112-94845	 		 	MHN Govt. Srvs	 	All Departments	 	12/12/2013	 	N/A
								
	Special Professional Associate Policy: Employment of Foreign Nationals	 	Sharon X Ogawa-Shono	 	SS1112-9496	 		 	MHN Govt. Srvs	 	All Departments	 	1/8/2014	 	N/A
								
	Special Professional Associate Policy: Equal Employment and Affirmative Action	 	Remy M Franklin	 	NK1112-94328	 		 	MHN Govt. Srvs	 	All Departments	 	5/19/2014	 	N/A
								
	Special Professional Associate Policy: Fair Dealing	 	Sharon X Ogawa-Shono	 	NK1112-94410	 		 	MHN Govt. Srvs	 	All Departments	 	11/21/2013	 	N/A
								
	Special Professional Associate Policy: Holiday Pay	 	Remy M Franklin	 	NK1112-94513	 		 	MHN Govt. Srvs	 	All Departments	 	3/3/2014	 	N/A

  

					
	Schedule P	  	P-310	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Special Professional Associate Policy: In Memoriam	 	Sharon X Ogawa-Shono	 	NK1112-94811	 		 	MHN Govt. Srvs	 	All Departments	 	1/27/2014	 	N/A
								
	Special Professional Associate Policy: Inclement Weather / Hazardous Conditions	 	Remy M Franklin	 	NK1112-94437	 		 	MHN Govt. Srvs	 	All Departments	 	4/2/2014	 	N/A
								
	Special Professional Associate Policy: Information Security	 	Sharon X Ogawa-Shono	 	NK1112-94528	 		 	MHN Govt. Srvs	 	All Departments	 	1/8/2014	 	N/A
								
	Special Professional Associate Policy: Insider Trading & Disclosure of Material Inside Information	 	Sharon X Ogawa-Shono	 	OS93-112455	 		 	All	 	All Departments	 	1/14/2014	 	N/A
								
	Special Professional Associate Policy: Internal Consideration and Job Posting	 	Sharon X Ogawa-Shono	 	NK1112-94754	 		 	MHN Govt. Srvs	 	All Departments	 	11/20/2013	 	N/A
								
	Special Professional Associate Policy: Jury Duty and Voting	 	Sharon X Ogawa-Shono	 	OS1113-113737	 		 	MHN Govt. Srvs	 	All Departments	 	1/27/2014	 	N/A
								
	Special Professional Associate Policy: Military/ Reserve Peace Officer/Emergency Duty Leave of Absence	 	Sharon X Ogawa-Shono	 	SS1112-95323	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Open Door and Problem Resolution	 	Sharon X Ogawa-Shono	 	NK1112-94828	 		 	MHN Govt. Srvs	 	All Departments	 	11/20/2013	 	N/A
								
	Special Professional Associate Policy: Performance Improvement	 	Sharon X Ogawa-Shono	 	NK1112-94845	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	All
								
	Special Professional Associate Policy: Personnel Records and Access to Records	 	Remy M Franklin	 	NK1112-9460	 		 	MHN Govt. Srvs	 	All Departments	 	12/11/2013	 	N/A
								
	Special Professional Associate Policy: PHI/PII Prohibited in Remedy Tickets	 	Bonnie W Lam	 	NK1112-94625	 		 	MHN Govt. Srvs	 	All Departments	 	8/25/2014	 	N/A
								
	Special Professional Associate Policy: Political Activities	 	Remy M Franklin	 	NK1112-94642	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Preventing and Detecting Fraud, Waste and Abuse of Government Programs	 	Remy M Franklin	 	NK1112-94658	 		 	MHN Govt. Srvs	 	All Departments	 	2/19/2014	 	N/A

  

					
	Schedule P	  	P-311	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Special Professional Associate Policy: Privacy in the Workplace	 	Remy M Franklin	 	NK1112-94710	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Prohibition Against Sexual Harassment and Other Workplace Harassment	 	Sharon X Ogawa-Shono	 	NK1112-94724	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	N/A
								
	Special Professional Associate Policy: Proof of Right to Work in the United States	 	Remy M Franklin	 	SS1112-94958	 		 	MHN Govt. Srvs	 	All Departments	 	5/9/2014	 	N/A
								
	Special Professional Associate Policy: Reasonable Accommodation Policy	 	Sharon X Ogawa-Shono	 	SS1112-9542	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Release of Information on Associates and Former Associates	 	Remy M Franklin	 	SS1112-95142	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Reporting and Investigating Violations / Non-Retaliation	 	Remy M Franklin	 	SS1112-9523	 		 	MHN Govt. Srvs	 	All Departments	 	6/10/2014	 	N/A
								
	Special Professional Associate Policy: Requests for Information from Outside Parties	 	Sharon X Ogawa-Shono	 	OS1113-104819	 		 	MHN Govt. Srvs	 	All Departments	 	1/27/2014	 	N/A
								
	Special Professional Associate Policy: Selection and Placement	 	Remy M Franklin	 	SS1112-95014	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	N/A
								
	Special Professional Associate Policy: Separation of Employment	 	Remy M Franklin	 	SS1112-95245	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Sick Leave	 	Remy M Franklin	 	SS1112-95032	 		 	MHN Govt. Srvs	 	All Departments	 	8/5/2014	 	N/A
								
	Special Professional Associate Policy: Smoking	 	Remy M Franklin	 	DY1112-111737	 		 	MHN Govt. Srvs	 	All Departments	 	4/2/2014	 	N/A
								
	Special Professional Associate Policy: Solicitation, Distribution and Posting	 	Remy M Franklin	 	DY1113-84230	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Special Restrictions with Respect to Government Employees and Public Officials	 	Remy M Franklin	 	DY1113-94547	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Standards of Conduct	 	Remy M Franklin	 	DY1112-131333	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A

  

					
	Schedule P	  	P-312	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Special Professional Associate Policy: Standards of Dress	 	Remy M Franklin	 	DY1112-151042	 		 	MHN Govt. Srvs	 	All Departments	 	5/9/2014	 	N/A
								
	Special Professional Associate Policy: Statutory Medical and Family Care Leave of Absence	 	Sharon X Ogawa-Shono	 	SS1112-9534	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Subpoena Process and Request for Employment Records	 	Sharon X Ogawa-Shono	 	OS1112-15953	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	N/A
								
	Special Professional Associate Policy: Timekeeping	 	Remy M Franklin	 	DY1112-134737	 		 	MHN Govt. Srvs	 	All Departments	 	2/4/2014	 	N/A
								
	Special Professional Associate Policy: Use of Company Assets	 	Remy M Franklin	 	FR1112-13642	 		 	MHN Govt. Srvs	 	All Departments	 	12/5/2013	 	
								
	Special Professional Associate Policy: Use of Company Owned Vehicles	 	Remy M Franklin	 	FR1112-131513	 		 	MHN Govt. Srvs	 	All Departments	 	12/16/2013	 	N/A
								
	Special Professional Associate Policy: Use of E-mail and Other Electronic Messaging Functions	 	Remy M Franklin	 	FR1112-131925	 		 	MHN Govt. Srvs	 	All Departments	 	8/15/2014	 	N/A
								
	Special Professional Associate Policy: Victims of Violence or Crime Leave	 	Sharon X Ogawa-Shono	 	OS1211-104748	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Visitors in the Workplace	 	Sharon X Ogawa-Shono	 	FR1114-91443	 		 	MHN Govt. Srvs	 	All Departments	 	10/29/2013	 	N/A
								
	Special Professional Associate Policy: Workers’ Compensation	 	Sharon X Ogawa-Shono	 	OS1119-105241	 		 	MHN Govt. Srvs	 	All Departments	 	11/15/2012	 	N/A
								
	Special Professional Associate Policy: Working Hours and Pay Practices	 	Sharon X Ogawa-Shono	 	OS1113-102210	 		 	MHN Govt. Srvs	 	All Departments	 	11/20/2013	 	N/A
								
	Special Professional Associate Policy: Workplace Violence Prevention	 	Sharon X Ogawa-Shono	 	OS1113-103124	 		 	MHN Govt. Srvs	 	All Departments	 	12/10/2013	 	N/A
								
	Specialty Pharmacy Advisory Committee (SPAC) Roles and Responsibilities	 	Donna M Lenhoff	 	BB331-104727	 		 	HNPS	 	All Departments	 	2/12/2014	 	All

  

					
	Schedule P	  	P-313	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Standards for Medical Records Documentation	 	Kelly R Kono	 	KK78-15747	 		 	HN Life, HNAZ, HNCA, HNOR	 	All Departments	 	2/14/2014	 	HMO, Commercial, Medicare, Medicare Advantage, POS, PPO, EPO, AIM [more...]
								
	Statutory Reporting Unit Policies and Procedures	 	Cynthia Pera	 	PC65-9122	 		 	All	 	All Departments	 	2/3/2014	 	See attached
								
	Summary of Benefits and Coverage Creation Process	 	Jesse X Foster	 	WC226-93242	 		 	HNAZ, HNCA, HNOR	 	All Departments	 	11/1/2013	 	Commercial
								
	Technology Assessment Policy	 	Jean V Serratore	 	WJ68-14859	 		 	HNI	 	All Departments	 	1/15/2014	 	Dual Eligible, All
								
	Third Party Information Security and Privacy Assessment and Oversight	 	Shelley X Axelson	 	KL819-125014	 	NE	 	 HN Life, HNAZ, HNCA, HNCT, HNFS, HNI, HNINY, HNNE, HNOR, HNPS,

MHN [more...]
	 	All Departments	 	10/1/2013	 	All
								
	Tiered Vendor Governance Framework	 	Jamie X Babby	 	BJ1112-10417	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	11/14/2013	 	N/A
								
	Tracking Medicare Sales Allegations	 	Curt Nelson	 	TR56-134432	 		 	HNAZ, HNCA, HNI, HNOR, HNPS	 	All Departments	 	6/11/2014	 	Medicare, Medicare Advantage, Medicare Part D
								
	Translation of Medicare Sales and Member Materials	 	Timothy X Iannetta	 	SG1217-162356	 		 	HN Life, HNAZ, HNCA, HNCT, HNI, HNOR	 	All Departments	 	10/18/2012	 	Medicare
								
	Translation of Written Member Informing Materials	 	April X Canetto	 	LW723-124352	 		 	Health Net Access	 	All Departments	 	11/8/2013	 	Access
								
	Translation of Written Member Informing Materials	 	Diana M Carr	 	HM326-20831	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR	 	All Departments	 	8/4/2014	 	 HMO, PPO, POS,
 Medi-Cal, Medicare Advantage,
Medicare Part D, Medi-Cal [more...]

								
	Translation Services- Alternate Formats	 	Diana M Carr	 	WN111-144835	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR	 	All Departments	 	7/24/2014	 	Medicare, Medi-Cal, PPO, HMO, HNAZ, HNOR, HNWA
								
	Translation Services-Alternate Formats	 	Diana M Carr	 	FD1011-91657	 		 	Health Net Access	 	All Departments	 	12/9/2013	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-314	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Travel and Business Expense Policy	 	Deelayna L Manski	 	MP1211-122858	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	6/2/2014	 	N/A
								
	Updating the Health Net Contact List and Organization Data in HPMS	 	Eva Y Lo	 	LE42-105048	 		 	HNI	 	All Departments	 	4/15/2014	 	Medicare, Medicare Advantage, Medicare Part D, Dual Eligible
								
	Vendor Escalation Policy - Governance Based	 	Sudesh X Sharma	 	SS1217-82733	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	12/17/2013	 	N/A
								
	Vendor Escalation Policy - Issue Based	 	Sudesh X Sharma	 	SS1122-134346	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	All Departments	 	12/17/2013	 	N/A
								
	Vendor Press Releases	 	Lori A Hillman	 	HL713-142014	 		 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN	 	All Departments	 	8/20/2013	 	Commercial, Medicaid, Medicare, Medicare Advantage, Outlook [more...]
								
	Workstation Placement Guidelines	 	Mia S Terry-Samuels	 	DR116-92155	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN, MHN

Govt. Srvs
	 	All Departments	 	5/29/2014	 	N/A
								
	Appeals and Grievances (A&G) Evaluation Procedure Final Letter Review	 	Elena L Wisner	 	LV810-155712	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Appeals and Grievances (Member) [more...]	 	9/25/2013	 	Medicare

  

					
	Schedule P	  	P-315	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Policies & Procedures: P&P Creation & Maintenance	 	Elena L Wisner	 	LV89-153012	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Appeals and Grievances (Member) [more...]	 	6/3/2014	 	Commercial, Medicaid, Medicare Advantage, Medicare Part D [more...]
								
	SHP Reporting Guidelines	 	Daniel G Middaugh	 	SD523-12586	 		 	HNAZ, HNCA	 	Appeals and Grievances (Member), Appeals and Grievances (Member)	 	10/25/2013	 	Medicaid
								
	CTS BPO - Invoicing Process Policy & Procedure	 	Renne A Ochoa	 	OR823-9287	 		 	HN Life, HNAZ, HNCA, HNNE, HNOR, MHN	 	Appeals and Grievances (Member), Claims, Member Services, Membership [more...]	 	7/2/2013	 	Commercial, Medicare, SHP, Medi-Cal
								
	AHCCCS - Managing the Loss of a Key Provider/Material Network Change	 	Karen M Ellington	 	PA419-52214	 		 	Health Net Access	 	Appeals and Grievances (Member), Compliance, Credentialing [more...]	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS - Provider Performance Issues and Non-Compliance	 	Karen M Ellington	 	PA421-142644	 		 	Health Net Access	 	Appeals and Grievances (Member), Compliance, Credentialing [more...]	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Follow-up on Quality of Care Concerns	 	Sue L Fischer	 	FB222-13540	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Credentialing, Medical Management	 	11/18/2013	 	Commercial, Medicare Advantage, Indemnity, IFP, EPO, Medi-Cal [more...]

  

					
	Schedule P	  	P-316	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Peer Review Committee	 	Elizabeth E Rivas	 	FS312-9658	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Credentialing, Medical Management	 	12/30/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	NCQA File Review Policy and Procedure	 	Vandana X Massey	 	WA107-143132	 		 	HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	Appeals and Grievances (Member), Credentialing, Program Accreditation [more...]	 	7/28/2014	 	Medi-Cal(Health Net Community Solutions), Commercial HMO/POS [more...]
								
	MHN P&P - Exempt Grievance	 	Viola Lo	 	CS724-93418	 		 	MHN	 	Appeals and Grievances (Member), Customer Service	 	6/17/2014	 	Commercial PPO, Commercial HMO, Healthy Kids, AIM, Healthy Families, IFP [more...]
								
	AHCCCS Follow up Quality of Care Concerns	 	Sue L Fischer	 	FS79-73046	 		 	Health Net Access	 	Appeals and Grievances (Member), Medical Management, Quality Management	 	8/14/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Referrals for Potential Quality of Care	 	Sue L Fischer	 	FS621-102517	 		 	Health Net Access	 	Appeals and Grievances (Member), Medical Management	 	8/14/2014	 	AHCCCS (AZ Medicaid)
								
	Experimental/Investigational Review for Terminally Ill	 	Sue L Fischer	 	FS727-195925	 		 	HN Life, HNCA	 	Appeals and Grievances (Member), Medical Management	 	3/25/2014	 	Commercial

  

					
	Schedule P	  	P-317	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Hospital Inpatient Discharge and Immediate Review Process	 	Sue L Fischer	 	FS429-132912	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Medical Management	 	10/28/2013	 	Medicare Advantage, Dual Eligible
								
	Referrals of Potential Quality Issues	 	Sue L Fischer	 	FS224-122130	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Medical Management	 	2/21/2014	 	Commercial, Medicare Advantage, Indemnity, IFP, EPO, Medi-Cal [more...]
								
	Auditing and Assessing Training Program Effectiveness, Improvement and Compliance P&P (CCC & A&G)	 	Viola Lo	 	ZT520-82216	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Member Services	 	1/11/2014	 	Commercial, Medicaid, Medicare Advantage
								
	Policies & Procedures: Processing Suggestions	 	Daniel G Middaugh	 	LV222-142129	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member), Member Services	 	11/19/2013	 	Commercial, Medicare Advantage, Medicare Part D, Medi-Cal [more...]
								
	CTS BPO Vendor Oversight/Monitoring	 	Renne A Ochoa	 	OR822-10362	 		 	HN Life, HNAZ, HNCA, HNNE, HNOR, MHN	 	Appeals and Grievances (Member), Membership [more...]	 	12/20/2013	 	Commercial, Medicare, Medi-Cal, SHP
								
	A&G (Grievances and CTMs) - Escalation and Root Cause Process	 	Elena L Wisner	 	WE624-85738	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/24/2013	 	Medicare, SPD
								
	A&G Case Monitoring â€“ Process for Monitoring Appeals and Grievances Case Inventory	 	Elena L Wisner	 	WE61-15535	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/14/2014	 	Commercial, HMO, PPO/POS
								
	ADOI Complaints (Member Specific)	 	Elena L Wisner	 	FS1110-15105	 		 	HNAZ	 	Appeals and Grievances (Member)	 	9/2/2014	 	HMO, Commercial, POS, PPO, Indemnity, IFP, HSA
								
	AHCCCS Member Appeals - AZ	 	Elena L Wisner	 	WE515-155922	 		 	Health Net Access	 	Appeals and Grievances (Member)	 	1/2/2014	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-318	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AHCCCS Member Grievances - AZ	 	Elena L Wisner	 	WE515-161026	 		 	Health Net Access	 	Appeals and Grievances (Member)	 	6/17/2014	 	 AHCCCS (AZ
 Medicaid)

								
	ALJ (Administrative Law Judge) Hearings Preparation Process	 	Elena L Wisner	 	WE131-122936	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	12/26/2013	 	 HMO, PPO, POS,
 Medicare

								
	Annnual EOC Updates for A&G	 	Elena L Wisner	 	WE522-153254	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/9/2014	 	Dual Eligible
								
	Annual EOC Updates for A&G	 	Elena L Wisner	 	WE710-9269	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	4/10/2014	 	Medicare, commercial
								
	Appeals & Grievances - State Fair Hearing Process	 	Elena L Wisner	 	WE1120-135311	 		 	HNAZ	 	Appeals and Grievances (Member)	 	1/3/2014	 	State Health Programs (SHP), AHCCCS (AZ Medicaid)
								
	Appeals & Grievances (A&G) CTM, Marketing Misrepresentation and Formal Grievance Sales Allegation	 	Elena L Wisner	 	WE131-13337	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	5/2/2014	 	Medicare
								
	Appeals & Grievances Policy & Procedure: Appointment of Representative (AOR) / Power of Attorney (POA) â€“ Cal MediConnect	 	Elena L Wisner	 	WE522-155745	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/10/2014	 	Dual Eligible
								
	Appeals & Grievances: General Audit	 	Elena L Wisner	 	WE630-174838	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/5/2014	 	Medicare, Commercial, SHP
								
	Appeals and Grievances (A&G) Outbound Mail Tracking Process - Part C & Part D	 	Elena L Wisner	 	WE1122-105740	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/9/2014	 	Medicare
								
	Appeals and Grievances (A&G) Website Content Review and Maintenance - Cal MediConnect	 	Elena L Wisner	 	WE522-161121	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/9/2014	 	Dual Eligible
								
	Appeals and Grievances Daily CAPs For Daily Non-Compliant Cases	 	Elena L Wisner	 	WE1111-13129	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/6/2013	 	Medicare
								
	Appeals and Grievances New Hire Training Program	 	Elena L Wisner	 	WE95-145626	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/10/2014	 	Commercial, Medicare Advantage, Medicare Part D, Cal MediConnect

  

					
	Schedule P	  	P-319	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Appeals and Grievances Weekend and Overnight Support	 	Elena L Wisner	 	WE131-125633	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/5/2014	 	Medicare
								
	Appeals Case Leveling - Commercial	 	Elena L Wisner	 	WE1012-132333	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	4/22/2014	 	POS, PPO, HMO
								
	Appeals Quality Audit Process and CAP Requirements	 	Elena L Wisner	 	WE216-141319	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/11/2014	 	Commercial/SHP & Medicare
								
	Appointment of Representative (AOR) / Power of Attorney (POA) - Medicare Part C and Part D	 	Elena L Wisner	 	WE54-101941	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	1/11/2014	 	Medicare
								
	Case Classification - Medicare Advantage	 	Elena L Wisner	 	DR51-14455	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare Advantage
								
	Case Classification - Medicare Part D	 	Elena L Wisner	 	DR1022-185310	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare Part D
								
	Case Classification Cal MediConnect Part D	 	Elena L Wisner	 	WE73-102030	 		 	HNCA	 	Appeals and Grievances (Member)	 	8/5/2014	 	Dual Eligible - Cal MediConnect
								
	Commercial and SHP (State Health Programs) Daily CAPs for Daily Non- Compliant Cases	 	Elena L Wisner	 	WE1117-131840	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/6/2014	 	Commercial
								
	CTM - Medicare Advantage & Part D	 	Elena L Wisner	 	WE107-142911	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/8/2014	 	Medicare Advantage and Medicare Part D
								
	CTM Weekend and Overnight Support	 	Elena L Wisner	 	WE527-161941	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/10/2014	 	Medicare, Cal MediConnect
								
	Development & Approval of Appeals and Grievances (A&G) Letters - Medicare Advantage and Part D	 	Elena L Wisner	 	WE828-103643	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	3/25/2014	 	Medicare Advantage, Medicare Part D
								
	Expedited Appeals - Medicare Advantage	 	Elena L Wisner	 	DR51-1427	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	12/11/2013	 	Medicare Advantage

  

					
	Schedule P	  	P-320	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Expedited Appeals - Medicare Part D	 	Elena L Wisner	 	DR1022-184221	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	9/25/2013	 	Medicare Part D
								
	Expedited Appeals Part D - Cal MediConnect	 	Elena L Wisner	 	WE722-163013	 		 	HNCA	 	Appeals and Grievances (Member)	 	8/8/2014	 	Dual Eligible - Cal MediConnect
								
	Expedited Grievances - Medicare Advantage	 	Elena L Wisner	 	DR424-125956	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare Advantage
								
	 Expedited Grievances - Medicare
 Part D
	 	Elena L Wisner	 	DR1022-184832	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare Part D
								
	Expedited Grievances Cal MediConnect Part D	 	Elena L Wisner	 	WE78-122914	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/30/2014	 	Dual Eligible - Cal MediConnect
								
	Federal Employees Health Benefits Program (FEHBP) Debarred/Suspended Providers Appeals & Grievances Policy and Procedure	 	Elena L Wisner	 	BV531-13629	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/10/2014	 	HMO
								
	GA-101 Grievance and Appeal Process	 	Elena L Wisner	 	WE1129-11550	 		 	HNCA	 	Appeals and Grievances (Member)	 	9/25/2013	 	Commercial HMO, Commercial POS, Flex Fund
								
	GA-103: Binding Arbitration	 	Elena L Wisner	 	FB222-133817	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/14/2014	 	Commercial
								
	GA-108 Linguistic and Cultural Services	 	Elena L Wisner	 	FB222-135942	 		 	HNCA	 	Appeals and Grievances (Member)	 	2/19/2014	 	 HMO, POS, PPO,
 Healthy Families/Kids,
AIM

								
	GA-117 PPO Grievance and Appeal Process	 	Elena L Wisner	 	WE1022-10624	 		 	HNCA	 	Appeals and Grievances (Member)	 	8/30/2013	 	Commercial PPO, Commercial EPO, Flex-NET
								
	GA-201ML: Medi-Cal Member Grievance Process	 	Elena L Wisner	 	FB222-141813	 		 	HNCA	 	Appeals and Grievances (Member)	 	4/25/2014	 	Medi-Cal
								
	GA-202ML: Medi-Cal Member Appeal Process	 	Elena L Wisner	 	FB222-142129	 		 	HNCA	 	Appeals and Grievances (Member)	 	3/25/2014	 	AIM, Healthy Kids, Medi-Cal, Medi-Cal

  

					
	Schedule P	  	P-321	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	GA-503: Medicare Inquiry Correspondence Research - Medicare Advantage & Part D	 	Elena L Wisner	 	FB222-142751	 		 	HNCA, HNAZ, HNOR	 	Appeals and Grievances (Member)	 	9/25/2013	 	Medicare
								
	GA 101.1 CA Healthy Family, Healthy Kids, AIM	 	Elena L Wisner	 	WE43-11138	 		 	HNCA	 	Appeals and Grievances (Member)	 	12/2/2013	 	Healthy Families, Healthy Kids, AIM
								
	GA 303: Inquiry Research Correspondence Policy and Procedure	 	Elena L Wisner	 	FB222-142442	 		 	HNCA	 	Appeals and Grievances (Member)	 	6/3/2014	 	HMO, POS, PPO
								
	Good Cause - Medicare Advantage	 	Elena L Wisner	 	DR51-14324	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	12/26/2013	 	Medicare Advantage
								
	Good Cause - Medicare Part D	 	Elena L Wisner	 	DR1022-185046	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/9/2014	 	Medicare Part D
								
	Good Cause Cal MediConnect Part D	 	Elena L Wisner	 	WE73-92828	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/30/2014	 	Dual Eligible - Cal MediConnect
								
	Grievances - Cal MediConnect Part D	 	Elena L Wisner	 	WE73-10381	 		 	HNCA	 	Appeals and Grievances (Member)	 	7/29/2014	 	Dual Eligible - Cal MediConnect
								
	Grievances - Medicare Advantage	 	Elena L Wisner	 	DR423-165034	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	Appeals and Grievances (Member)	 	1/2/2014	 	Medicare Advantage
								
	Grievances - Medicare Part D	 	Elena L Wisner	 	DR1022-184518	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare Part D
								
	Health Net Medicare Part D Misrouted Late Enrollment Penalty Reconsideration Requests Procedure	 	Elena L Wisner	 	WE125-154120	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	5/2/2014	 	Medicare Part D
								
	Independent Medical Review (IMR)	 	Sue L Fischer	 	FB222-14350	 		 	HNCA	 	Appeals and Grievances (Member)	 	12/19/2013	 	Commercial, Indemnity, IFP, Healthy Kids, Medi-Cal, Healthy Families [more...]
								
	Medicare A&G Final Letters Reconciliation Process	 	Elena L Wisner	 	WE831-10842	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/8/2014	 	Medicare Advantage, Medicare Part D

  

					
	Schedule P	  	P-322	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Advantage Organization Determination	 	Christine X Martignoni	 	WE55-103356	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	3/3/2014	 	Medicare
								
	Member Appeals and Grievance Procedure - Washington	 	Elena L Wisner	 	WE331-13473	 		 	HN Life, HNOR	 	Appeals and Grievances (Member)	 	9/25/2013	 	PPO, POS
								
	 Member Grievance and Appeal Procedure
 -
OR
	 	Elena L Wisner	 	WE330-95449	 		 	HNOR	 	Appeals and Grievances (Member)	 	5/2/2014	 	EPO, PPO, POS
								
	Oversight of Sox Controls 3866 (Reconciliation of Member A&G Received vs. Processed) and 3868 (Authorized Levels of Admin Pay Sign Off)	 	Elena L Wisner	 	WE211-13856	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/5/2014	 	HMO, Medicare, PPO, POS
								
	Peer Review Protected Activities	 	Sue L Fischer	 	FB222-134610	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/11/2014	 	Commercial, Medicare Advantage, IFP, Indemnity, EPO, Medi-Cal [more...]
								
	PIR (Provider Information Request) Escalation Process - Part D	 	Elena L Wisner	 	WE921-101224	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	9/25/2013	 	Medicare
								
	PIR (Provider Information Request) Escalation Process â€” Part C	 	Elena L Wisner	 	WE109-171116	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	9/25/2013	 	Medicare Advantage
								
	Records Retention	 	Elena L Wisner	 	WE521-144729	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/21/2014	 	Medicare Advantage
								
	REOPENING AND REVISING DETERMINATIONS AND DECISIONS PART C	 	Elena L Wisner	 	BV54-122921	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	2/6/2014	 	Medicare Advantage
								
	REOPENING AND REVISING DETERMINATIONS AND DECISIONS PART D	 	Elena L Wisner	 	BV54-123635	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	7/10/2014	 	Medicare Part D
								
	Same/Similar Specialist Review - Clinical Member Appeals	 	Sue L Fischer	 	FB222-141027	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	8/5/2014	 	Commercial, Medicare Advantage, Indemnity, EPO, Medi-Cal, Dual Eligible

  

					
	Schedule P	  	P-323	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	SNP (Special Needs Program) Appeals Process - Medicare Part C	 	Elena L Wisner	 	WE29-164324	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	6/3/2014	 	Medicare
								
	Standard & Expedited Grievances and Pre-Service & Post-Service Appeals (Commercial Membership) - AZ	 	Elena L Wisner	 	FS1120-114950	 		 	HNAZ	 	Appeals and Grievances (Member)	 	2/10/2014	 	Commercial, HMO, POS, PPO, Indemnity, IFP
								
	Standard Appeals - Medicare Advantage	 	Elena L Wisner	 	DR51-135816	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	12/26/2013	 	Medicare Advantage
								
	Standard Appeals - Medicare Part D	 	Elena L Wisner	 	DR1022-183510	 		 	HN Life, HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	1/3/2014	 	Medicare Part D
								
	Triage Process â€“ Appeals & Grievances (A&G) Medicare Part C	 	Elena L Wisner	 	WE627-131237	 		 	HNCA, HNOR	 	Appeals and Grievances (Member)	 	5/13/2014	 	Medicare
								
	Triage Process â€“ Appeals & Grievances (A&G) Medicare Part D	 	Elena L Wisner	 	WE627-134743	 		 	HNAZ, HNCA, HNOR	 	Appeals and Grievances (Member)	 	5/13/2014	 	Medicare
								
	Connecticut Department of Insurance Complaint Process	 	Arlana Flores	 	CV515-113847	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	Connecticut DOI: Justified & Questionable Report	 	Arlana Flores	 	CV1227-102717	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	N/A
								
	CT Member Medical Necessity Appeals	 	Arlana Flores	 	CG125-131133	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	Executive Response Unit Complaint Process	 	Arlana Flores	 	CV719-16927	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	POS, Outlook, PPO, HMO, Commercial
								
	New Jersey Regulatory Complaint Process	 	Arlana Flores	 	CV712-151129	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	New York Department of Health Complaint Process	 	Arlana Flores	 	CV515-163333	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	New York Department of Insurance Complaint Process	 	Arlana Flores	 	CV515-121813	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	New York DOI Prompt Pay Report	 	Arlana Flores	 	CV126-13532	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	New York Commercial

  

					
	Schedule P	  	P-324	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	NJ FamilyCare/New Jersey Medicaid Member Medical Necessity Appeals Review	 	Arlana Flores	 	GG617-105822	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Medicaid
								
	NJ Member Medical Necessity Appeals	 	Arlana Flores	 	CG126-142550	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	HMO, POS, PPO
								
	Processing Vendor-Related Regulatory Complaints	 	Arlana Flores	 	CV1217-155727	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	HMO, Commercial, Outlook, POS, PPO, EPO
								
	State of New York Office of the Attorney General Complaint Process	 	Arlana Flores	 	CV517-103119	 	NE	 	HNNE	 	Appeals and Grievances	 	2/10/2014	 	Commercial
								
	Annual IPA (BHA and CHIPA) Oversight Audits	 	Alex M Black	 	BA1211-13209	 		 	MHN	 	Business Solutions	 	11/14/2013	 	Commercial
								
	Medicare: Internal Audits of Claims	 	Alex M Black	 	SL428-18322	 		 	MHN	 	Business Solutions	 	1/10/2014	 	Medicare Advantage
								
	High Level Check Stock Handling and Processing	 	Shelly L Ferrel	 	FS1211-13847	 		 	HNAZ, HNCA, HNCS, HNCT, HNNE, HNOR, MHN	 	Capitation, Claims, CDS - Customer Distribution Services, ITG [more...]	 	10/23/2013	 	All
								
	Capitation Process	 	Cecil J Woods	 	WC1024-84232	 		 	HN Life, HNAZ, HNCA, HNOR, MHN	 	Capitation	 	8/20/2014	 	All
								
	ANOC Mailing	 	Shelly L Ferrel	 	MP124-154414	 		 	 HN Life, HNAZ, HNCA, HNFS, HNI, HNOR, HNPS, MHN,

MHN Govt. Srvs
	 	CDS - Customer Distribution Services, Marketing, Membership	 	4/21/2014	 	Medicare
								
	“Notice of Denial of Payment” for Medicare Advantage Claims	 	Nan Broaddus	 	BN810-134745	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/24/2014	 	Medicare Advantage
								
	PROVIDER TAX ID NUMBER AND TITLING VERIFCATIONCONTRACTED AND NON-CONTRACTED PROVIDERS	 	Adela Velazquez	 	MJ714-212258	 	W	 	HNCA	 	Claims, Credentialing, Provider Data Management [more...]	 	1/15/2014	 	HMO, POS, Healthy Families, PPO, AIM, Medi-Cal

  

					
	Schedule P	  	P-325	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Oversight of Claims Processing â€“ Medicare Advantage	 	Rita M Lonzo	 	LR412-84258	 		 	HNAZ, HNCA, HNOR	 	Claims, Delegation Oversight, Medicare Compliance, Compliance	 	6/27/2014	 	Medicare Advantage, Medicare Advantage HMO
								
	Oversight of Claims Processing: Commercial HMO	 	Rita M Lonzo	 	LR412-10445	 		 	HNCA	 	Claims, Delegation Oversight, Provider Network Management	 	7/25/2014	 	HMO
								
	Provider Preventable Condition Program - Medi-Cal and Cal Medi-Connect	 	Sue L Fischer	 	FS1112-171856	 		 	HNCA	 	Claims, Medical Management	 	4/9/2014	 	Medi-Cal, Dual Eligible
								
	Medicare Secondary Payor Overview	 	Jeremy W Berquist	 	PM227-15611	 		 	HNAZ, HNCA, HNOR	 	Claims, Membership, Sales Operations	 	3/3/2014	 	Commercial HMO, Commercial PPO
								
	California Emergency Physicians PPG Balance Pay Claims	 	Blythe X Johnson	 	AJ226-135721	 		 	HNCA, HNCS	 	Claims, Provider Network Management	 	8/11/2014	 	 HMO, POS, PPO,
 Medicare, EPO, Dual
Eligibles

								
	ACA Exchange Reporting - Transparency in coverage	 	Jeremy L Inman	 	IJ820-16101	 		 	All	 	Claims	 	8/27/2014	 	Health Benefit Exchange
								
	AHCCCS - Claims Processing	 	Menita X Avila	 	AM426-101556	 		 	Health Net Access	 	Claims	 	8/14/2014	 	HMO
								
	AHCCCS - Coordination of Benefits	 	Menita X Avila	 	AM626-95257	 		 	Health Net Access	 	Claims	 	11/6/2013	 	AHCCCS (AZ Medicaid)
								
	AHCCCS -Remittance Advice for Claims Payments/Denials	 	Menita X Avila	 	AM829-95114	 		 	Health Net Access	 	Claims	 	11/6/2013	 	AHCCCS (AZ Medicaid)
								
	Developing Medicare Advantage Claims for Additional Information	 	Nan Broaddus	 	BN810-101220	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/24/2014	 	Medicare Advantage
								
	Division of Financial Responsibility(DOFR) - Medicare Advantage	 	Nan Broaddus	 	BN810-93531	 		 	HNCA	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Excluding Services Furnished Under a Private Contract	 	Nan Broaddus	 	BN420-16539	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage

  

					
	Schedule P	  	P-326	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Interest Requirements for Medicare Advantage Claims	 	Nan Broaddus	 	BN810-125723	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Medicare Secondary Payer	 	Nan Broaddus	 	BN210-91045	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Payment Rules for Certain Non- Contracted Providers	 	Nan Broaddus	 	BN103-10640	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Reasonable Reimbursement for Covered Services	 	Nan Broaddus	 	BN210-9337	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Special Rules for Coverage That Begins or Ends During an Inpatient Hospital Stay	 	Nan Broaddus	 	BN420-14467	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	Timely Adjudication of Medicare Advantage Claims	 	Nan Broaddus	 	BN810-112433	 		 	HN Life, HNAZ, HNCA, HNOR	 	Claims	 	2/6/2014	 	Medicare Advantage
								
	CPAC Drug Therapeutic Use Position Papers and Clinical Pearls	 	Debra R Weltz	 	WD73-103936	 		 	HNPS	 	Clinical Operations	 	9/3/2014	 	All
								
	OHS Standarized Staffing Metrics 19-03	 	Leslie X Coleman	 	CL731-161637	 		 	MHN Govt. Srvs	 	Clinical Operations	 	12/11/2013	 	N/A
								
	Incentives for Nondiscriminatory Wellness Programs in Group Health Plans.	 	Janet D Johnson- Yosgott	 	RM42-10311	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Commercial Sales, Compliance, Medical Management, Marketing, Sales	 	7/23/2014	 	HMO, Commercial, POS, PPO, Indemnity, EPO, Affiliate, Community Care [more...]
								
	CA, AZ and OR IFP Sales Off Exchange Annual Open Enrollment Periods & Special Enrollment Policy and Procedure	 	Francine J Klein	 	KF1022-9233	 		 	HN Life, HNAZ, HNCA, HNOR	 	Commercial Sales	 	8/28/2014	 	HMO
								
	Health Net Sales and Marketing - Demand Generation Non-Discrimination	 	Francine J Klein	 	KF717-101045	 		 	HN Life, HNAZ, HNCA, HNOR	 	Commercial Sales	 	6/19/2014	 	Commercial
								
	Policy and Procedure for CA Member Plan Based Enrollers for Prospective Member Exchange calls	 	Francine J Klein	 	KF102-92711	 		 	HN Life, HNCA	 	Commercial Sales	 	10/30/2013	 	Commercial

  

					
	Schedule P	  	P-327	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Policy and Procedure for PBE Phone Number Implementation and Verification	 	Francine J Klein	 	KF1016-123930	 		 	HN Life, HNCA	 	Commercial Sales	 	11/4/2013	 	Commercial
								
	Sales Grandfathered Group Plans Policy and Procedure	 	Francine J Klein	 	KF417-10430	 		 	HNAZ, HNCA, HNOR	 	Commercial Sales	 	12/17/2013	 	Commercial
								
	AHCCCS-Transportation Services for Members	 	Karen M Ellington	 	PA419-4367	 		 	Health Net Access	 	Compliance, Appeals and Grievances (Member), Medical Management [more...]	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Arizona Department of Insurance Form & Advertisement Filing	 	Steven M Ruby	 	GS18-132819	 	W	 	HNAZ	 	Compliance	 	4/8/2013	 	 HMO, POS, PPO,
 Indemnity, IFP

								
	Maintaining Advertising/Marketing Files per Insurance Division Requirements	 	Christy K Bosse	 	HM67-10250	 		 	HN Life, HNOR	 	Compliance	 	2/10/2014	 	Commercial
								
	Burgess Access Policy and Procedure	 	Jimmy Ly	 	LJ731-1026	 		 	All	 	Configuration	 	8/4/2014	 	n/a
								
	Caremark HSA/Medicare Accumulator File Exchange Oversight Process	 	Karen A Caswell	 	MR114-154654	 	NE	 	HNNE	 	Configuration	 	7/16/2014	 	Commercial
								
	Configuration Policy on Turn Around Times	 	Laurie X Amantia	 	PM113-152533	 		 	HNCA, HNOR	 	Configuration	 	5/8/2014	 	all
								
	Fee Schedule and Claim Code and Pricer Updates	 	Laurie X Amantia	 	PM725-95820	 		 	HNCA, HNOR	 	Configuration	 	2/18/2014	 	all
								
	NE and AZ High Dollar Edit Table	 	Linda R Rios	 	CS226-141225	 	NE	 	HNAZ, HNNE	 	Configuration	 	12/2/2013	 	All
								
	Reciprocity Contract Configuration	 	Laurie X Amantia	 	PM113-102359	 		 	HNCA, HNOR	 	Configuration	 	4/1/2014	 	All
								
	Tables Maintained by Configuration Fee Sched Team	 	Laurie X Amantia	 	PM1121-125256	 		 	HNAZ, HNCA, HNOR	 	Configuration	 	1/24/2014	 	All
								
	Vendor Accumulator Oversight Process	 	Debbie D Tierney	 	DM63-142047	 	NE	 	HNNE	 	Configuration	 	7/31/2013	 	 Commercial, HMO, Medicare, Medicare Part D, POS, PPO,

Medicaid [more...]

								
	External Media Access and Use	 	Sherry E Brown	 	BS1116-125050	 		 	HNI	 	Corporate Actuarial	 	9/18/2013	 	All
								
	Medicare Advantage (MA) Part D Monthly Accrual Process	 	Sherry E Brown	 	BS310-13146	 		 	HN Life, HNAZ, HNCA, HNOR, HNPS	 	Corporate Actuarial	 	8/29/2013	 	Medicare Part D

  

					
	Schedule P	  	P-328	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Premium Deficiency Reserves (PDR)	 	Sherry E Brown	 	BS21-143131	 		 	HN Life, HNAZ, HNCA, HNOR, MHN	 	Corporate Actuarial	 	8/29/2013	 	All
								
	Corporate Compliance Program Training for Contractors	 	Afrodite P Smith	 	NK717-162544	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Corporate Compliance Department, Organization Effectiveness [more...]	 	5/8/2014	 	N/A
								
	Code of Business Conduct and Ethics	 	Afrodite P Smith	 	MP1024-81730	 		 	HNI	 	Corporate Compliance Department	 	4/29/2014	 	All
								
	Corporate Compliance Program Self- Monitoring Review	 	Afrodite P Smith	 	SN79-154138	 		 	HNI	 	Corporate Compliance Department	 	6/11/2014	 	N/A
								
	Handling Complaints Made or Issues Raised to Health Net’s Corporate Ethics Office or the Health Net Integrity Line	 	Afrodite P Smith	 	MP510-152830	 		 	 HN Life, HNAZ, HNCA, HNCT, HNFS, HNI, HNINY, HNOR, HNPS, MHN

[more...]
	 	Corporate Compliance Department	 	8/19/2014	 	All
								
	Medicaid Compliance â€“ Escalation of Compliance Issues/Risks	 	Deanna L Eaves	 	ED44-165321	 		 	HNCA, HNCS, HNPS	 	Corporate Compliance Department	 	6/20/2014	 	Medi-Cal
								
	Medicare Compliance Medicare Advantage (MA) and Part D Marketing Material Review and CMS Submission Process	 	Glenn A Hertel	 	NK517-113124	 		 	HNI	 	Corporate Compliance Department	 	8/23/2013	 	Medicare
								
	Delegation Revocation Process	 	Rita M Lonzo	 	WB217-111929	 		 	HNAZ, HNCA, HNOR	 	Credentialing, Delegation Oversight, Medical Management [more...]	 	7/25/2014	 	 AHCCCS (AZ
 Medicaid), Community Care, Dual
Eligible, Commercial PPO [more...]

  

					
	Schedule P	  	P-329	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Peer Review Protected Information Sharing	 	Sue L Fischer	 	FS45-133753	 		 	HN Life, HNCA	 	Credentialing, Legal	 	5/5/2014	 	Commercial, Medicare Advantage, EPO, Dual Eligible, Medi-Cal, Indemnity [more...]
								
	Interdepartmental Procedure 01- HNCA Credentialing Directives and Data Changes to PDM and PNM	 	Michael J Catello	 	MJ210-131816	 		 	HNCA	 	Credentialing, Provider Data Management, Provider Network Management	 	3/10/2014	 	 HMO, POS, PPO, EPO, AIM, IFP, Medi-
 Cal,
CalMediConnect, Medicare [more...]

								
	Delegated Entity Evaluation and Delegation Determination - Credentialing	 	Rita M Lonzo	 	WB106-125123	 		 	HNAZ, HNCA, HNOR	 	Credentialing, Provider Network Management, Delegation Oversight [more...]	 	9/23/2013	 	 AHCCCS (AZ
 Medicaid), Community Care, Dual
Eligible, Medi-Cal [more...]

								
	Interdepartmental Procedure 03 - Loading new or making changes to Network	 	Michael J Catello	 	MJ916-14615	 		 	HNCA	 	Credentialing, Provider Network Management, Provider Data Management	 	3/10/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	Interdepartmental Western Region Policy 05 - Recredentialing and Lost Delegation Mailing and Outreach Process - CRED, PNM, PDM	 	Michael J Catello	 	MJ19-122558	 		 	HNAZ, HNCA, HNOR	 	Credentialing, Provider Network Management, Provider Data Management	 	3/13/2014	 	Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO, AIM [more...]
								
	Interdepartmental Western Region Policy 06 - Initial Credentialing Outreach Process - CRED, PNM, PDM	 	Michael J Catello	 	MJ110-93337	 		 	HNAZ, HNCA, HNOR	 	Credentialing, Provider Network Management, Provider Data Management	 	3/19/2014	 	Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO, EPO, AIM [more...]
								
	Interdepartmental Western Region Policy 04 - Credentialing Volume and Service	 	Michael J Catello	 	MJ19-102159	 		 	HNAZ, HNCA, HNOR	 	Credentialing, Provider	 	3/19/2014	 	Commercial, Medicaid, Medicare, Medicare

  

					
	Schedule P	  	P-330	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Assessment for Practitioners	 		 		 		 		 	Network Management	 		 	Advantage, PPO, POS, EPO, AIM [more...]
								
	Adverse Action	 	Elizabeth E Rivas	 	RE429-15914	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	12/30/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, PPO, Medi-Cal [more...]
								
	Certification/Recertification of Organizational Providers	 	Elizabeth E Rivas	 	RE429-143331	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	3/25/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	Credentialing Appeals Process	 	Elizabeth E Rivas	 	RE430-124241	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	12/30/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	Credentialing Committee Charter	 	Elizabeth E Rivas	 	RE429-133123	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	12/30/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	Credentialing/Recredentialing	 	Elizabeth E Rivas	 	RE429-14334	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	12/30/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Outlook, POS [more...]
								
	Health Net AHCCCS Certification/Recertification of Organizational Providers	 	Elizabeth E Rivas	 	RE513-10751	 		 	Health Net Access, HNAZ	 	Credentialing	 	8/5/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net AHCCCS Credentialing Committee Charter	 	Elizabeth E Rivas	 	RE513-9231	 		 	Health Net Access, HNAZ	 	Credentialing	 	8/5/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net AHCCCS Practitioner Credentialing/Recredentialing	 	Elizabeth E Rivas	 	RE513-9444	 		 	Health Net Access, HNAZ	 	Credentialing	 	8/5/2014	 	AHCCCS (AZ Medicaid)
								
	Peer Review Committee Charter	 	Elizabeth E Rivas	 	RE513-123427	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	1/7/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]

  

					
	Schedule P	  	P-331	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Practitioner Office Site Quality	 	Elizabeth E Rivas	 	RE430-1331	 		 	HNAZ, HNCA, HNOR	 	Credentialing	 	3/7/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, POS, PPO [more...]
								
	MHN QI P&P: Member Complaints	 	Viola Lo	 	LV59-103332	 		 	MHN	 	Customer Service, EAP	 	4/4/2014	 	Commercial, EAP
								
	Health Net Medicare AZ/CA/OR/PDP/WA Language Line Policy and Procedure	 	Edwin X Ram	 	RE829-154625	 		 	HNAZ, HNCA, HNOR	 	Customer Service	 	10/11/2013	 	Medicare
								
	Health Net Medicare CSR ID Policy	 	Christine X Martignoni	 	BV121-10828	 		 	HNAZ, HNCA, HNOR	 	Customer Service	 	11/12/2013	 	Medicare
								
	HN Medicare - Contact Center Call Driver and Major Member Impacting Escalation Process	 	Christine X Martignoni	 	WE27-151535	 		 	HNAZ, HNCA, HNOR	 	Customer Service	 	8/30/2013	 	Medicare Advantage
								
	Requisition Approval Process	 	Edwin X Ram	 	RE89-103232	 		 	HNAZ, HNCA, HNOR	 	Customer Service	 	8/7/2013	 	All
								
	State Health Insurance Plan (SHIP) Support Policy & Procedure	 	Christine X Martignoni	 	BV121-94924	 		 	HNAZ, HNCA, HNOR	 	Customer Service	 	12/2/2013	 	Medicare
								
	Deficit Reduction Act Reporting	 	Alex M Black	 	BA1218-16105	 		 	MHN	 	 Data Analysis, MHN
 Configurations
	 	11/25/2013	 	MBHO - Managed Behavioral Health Organization
								
	Delegated Provider Financial Solvency Reporting Process	 	Kristina M Rodriguez	 	RK98-82517	 		 	HNAZ, HNCA, HNCS	 	Delegation Oversight, Corporate Compliance Department, Finance [more...]	 	5/22/2014	 	Commercial HMO, Medicare Advantage HMO, Dual Eligible, Medi-Cal
								
	Delegated Provider Financial Solvency Oversight Process	 	Kristina M Rodriguez	 	RK96-141922	 		 	HNAZ, HNCA, HNCS	 	Delegation Oversight, Finance, Corporate Compliance Department [more...]	 	5/22/2014	 	Dual Eligible, Commercial HMO, Medicare Advantage HMO, Medi-Cal

  

					
	Schedule P	  	P-332	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Delegation Oversight - Corrective Action Plan	 	Rita M Lonzo	 	GS318-114855	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNNE, HNOR	 	Delegation Oversight, Provider Network Management	 	7/25/2014	 	 Health Benefit Exchange, Community Care, AHCCCS (AZ

Medicaid) [more...]

								
	Delegation Oversight - Delegated Partners Reporting	 	Rita M Lonzo	 	WA916-14642	 		 	HNAZ, HNCA, HNOR	 	Delegation Oversight, Provider Network Management	 	3/3/2014	 	POS, Community Care, Health Benefit Exchange, AHCCCS (AZ Medicaid) [more...]
								
	Delegated Entity Evaluation and Delegation Determination	 	Rita M Lonzo	 	WB106-104247	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNOR	 	Delegation Oversight	 	7/25/2014	 	 Health Benefit Exchange, CalViva, Community Care, AHCCCS (AZ

Medicaid) [more...]

								
	Delegation Oversight - Delegation Program Description Approval Process	 	Rita M Lonzo	 	WA722-85410	 		 	HNAZ, HNCA, HNOR	 	Delegation Oversight	 	1/16/2014	 	 Health Benefit Exchange, Community Care, AHCCCS (AZ

Medicaid) [more...]

								
	Medicare Advantage Part C Clinical and Non Clinical Decision Reporting for First Tier and Downstream Contracted Entities	 	Rita M Lonzo	 	LR322-143713	 		 	HNAZ, HNCA, HNOR, MHN	 	Delegation Oversight	 	8/18/2014	 	Cal MediConnect, Medicare Advantage HMO, Medicare Advantage PPO
								
	Oversight of Claims Processing - Medicaid	 	Rita M Lonzo	 	LR16-152440	 		 	Health Net Access, HNCA	 	Delegation Oversight	 	3/3/2014	 	 AHCCCS (AZ
 Medicaid), Medi-Cal

								
	Provider Dispute Resolution: Commercial, Medi-Cal and Medicare Advantage	 	Rita M Lonzo	 	WB218-12555	 		 	HNAZ, HNCA, HNOR	 	Delegation Oversight	 	7/28/2014	 	 POS, PPO,
 Commercial HMO, Medi-Cal, and Medicare Advantage HMO

								
	Separation of Medical Decisions and Financial Concerns	 	Rita M Lonzo	 	WB218-114445	 		 	Health Net Access, HNAZ, HNCA, HNOR	 	Delegation Oversight	 	2/21/2014	 	 AHCCCS (AZ
 Medicaid), Dual Eligible, Medicare
Advantage HMO [more...]

								
	OHS- Administrative File Flow Process 50-07	 	Leslie X Coleman	 	CL326-112736	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	1/8/2014	 	N/A

  

					
	Schedule P	  	P-333	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	OHS- Dismissal of Program Participants for Subsequent DUI Conviction 56-08	 	Leslie X Coleman	 	CL59-142737	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/29/2014	 	N/A
								
	OHS- Orientation Video and Overheads 60-08	 	Leslie X Coleman	 	CL1112-135812	 	SW	 	 HNFS, MHN
 Govt. Srvs
	 	Direct Clinical Services - OHS	 	3/3/2014	 	Commercial
								
	OHS- Reportable Incidents and Confidentiality 03-01	 	Leslie X Coleman	 	CL101-17249	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	1/2/2014	 	N/A
								
	OHS- The Habits of Highly Effective Managers Policy 52-07	 	Leslie X Coleman	 	CL35-9574	 		 	MHN	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS- Transporting of Confidential Participant Files and Information Between OHS Sites 36-05	 	Leslie X Coleman	 	CL928-114039	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	8/18/2014	 	N/A
								
	OHS- Use of Program Status Letters 54- 08	 	Leslie X Coleman	 	CL326-113650	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/29/2014	 	N/A
								
	OHS-Time Reporting:Scheduled and Unscheduled PTO and Schedule Changes 42-06	 	Leslie X Coleman	 	CL831-112839	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS - DUI Program Census Validation Procedures 33-05	 	Leslie X Coleman	 	CL717-1095	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	12/16/2013	 	N/A
								
	OHS - DUI Program Filing System Procedures 31-05	 	Leslie X Coleman	 	CL717-95823	 		 	MHN	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Activity Sign-in Rosters 09-02	 	Leslie X Coleman	 	CL1019-112712	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	12/16/2013	 	N/A
								
	OHS Administrative Absences & Charging Appropriate Ancillary Fees 40- 06	 	Leslie X Coleman	 	CL35-16156	 		 	HNFS	 	Direct Clinical Services - OHS	 	6/3/2014	 	N/A
								
	OHS Administrative Referral Out (ARO) 22-03	 	Leslie X Coleman	 	CL1017-164353	 		 	HNFS	 	Direct Clinical Services - OHS	 	5/30/2014	 	N/A
								
	OHS Breathalyzer Procedures 14-02	 	Leslie X Coleman	 	CL1015-122625	 	SW	 	 HNFS, MHN
 Govt. Srvs
	 	Direct Clinical Services - OHS	 	3/3/2014	 	Commercial
								
	OHS Children in The Workplace 37-05	 	Leslie X Coleman	 	CL723-101240	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Computer Communication Tips and Usage 46-07	 	Leslie X Coleman	 	CL730-111611	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Confidentiality, Legal Issues and Receipt of Subpoenas 06-01	 	Leslie X Coleman	 	CL215-112237	 		 	MHN	 	Direct Clinical Services - OHS	 	1/16/2014	 	N/A

  

					
	Schedule P	  	P-334	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	OHS Counselor Certification Tracking 43-06	 	Leslie X Coleman	 	CL723-102810	 		 	HNFS	 	Direct Clinical Services - OHS	 	5/2/2014	 	N/A
								
	OHS Court Referrals/Dockets Processing Procedures 07-01	 	Leslie X Coleman	 	CL1120-11388	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Culture of Quality - 45-06	 	Leslie X Coleman	 	KT418-161524	 		 	MHN	 	Direct Clinical Services - OHS	 	8/20/2013	 	OHS Driving Under the Influence Programs
								
	OHS DMV Reporting â€“DL107, DL101a, DL101 - 17-02	 	Leslie X Coleman	 	CL614-162115	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/2/2014	 	N/A
								
	OHS DUI Participant Dismissal Policy 35-05	 	Leslie X Coleman	 	CL1016-154552	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	2/4/2014	 	N/A
								
	OHS DUI Participant Surveys & OHS Comment Cards 34-05	 	Leslie X Coleman	 	CL723-10723	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS DUIP Professional Guidelines 18-03	 	Leslie X Coleman	 	CL731-161357	 		 	HNFS	 	Direct Clinical Services - OHS	 	4/15/2014	 	N/A
								
	OHS Evacuation Procedures 20-03	 	Leslie X Coleman	 	CL716-153827	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Face-to-Face Services - Policy 45- 06B	 	Leslie X Coleman	 	KT418-163045	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	6/25/2014	 	N/A
								
	OHS Forms 49-07	 	Leslie X Coleman	 	CL614-163656	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/21/2014	 	N/A
								
	OHS Group Board Procedures 25-03 (Assigning and Managing Client Activity Lists in Civerex )	 	Leslie X Coleman	 	CL716-1710	 		 	HNFS	 	Direct Clinical Services - OHS	 	3/28/2014	 	N/A
								
	OHS Guidelines for facilitating Tele- Groups and Tele-Meetings 47-07	 	Leslie X Coleman	 	CL730-11202	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Handling Legal Requests 39-06	 	Leslie X Coleman	 	CL723-101540	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	1/2/2014	 	N/A
								
	OHS Holiday Coverage 38-05	 	Leslie X Coleman	 	CL814-155617	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Incident Reports 41-06	 	Leslie X Coleman	 	CL723-102344	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Key and Building Access Policy 51-07	 	Leslie X Coleman	 	CL1128-153452	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Leave of Absence (LOA) Procedures 10-02	 	Leslie X Coleman	 	CL928-112120	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	4/15/2014	 	N/A
								
	OHS Make-up Group Procedures 24-03	 	Leslie X Coleman	 	CL1015-9512	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/10/2014	 	N/A

  

					
	Schedule P	  	P-335	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	OHS MOP Transitioning Procedure (San Marcos Only) 58-08	 	Leslie X Coleman	 	CL812-1193	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/30/2014	 	N/A
								
	OHS Non-Enrolled (Dismissed) Participants â€“ Release of Credits 23-03	 	Leslie X Coleman	 	CL928-114539	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/10/2014	 	N/A
								
	OHS OHS Group Progress Notes (Counseling and Documentation) 15-03	 	Leslie X Coleman	 	CL731-16825	 		 	HNFS	 	Direct Clinical Services - OHS	 	3/28/2014	 	N/A
								
	OHS OHS Internal Quality Assurance Procedures Including Associate Acknowledgement of OHS Operations Manual and Policies access 48-07	 	Leslie X Coleman	 	CL723-103158	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	OHS Peer Auditing Policy and Procedures 21-03	 	Leslie X Coleman	 	CL731-161947	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	1/2/2014	 	N/A
								
	OHS Performance Reviews 11-02	 	Leslie X Coleman	 	CL35-143950	 		 	HNFS	 	Direct Clinical Services - OHS	 	2/5/2014	 	N/A
								
	OHS Quality Management Notification Procedures 05-01	 	Leslie X Coleman	 	CL82-103817	 	SW	 	MHN	 	Direct Clinical Services - OHS	 	12/16/2013	 	N/A
								
	OHS Standards for Females in DUIP Counseling Groups 29-04	 	Leslie X Coleman	 	CL717-94622	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/10/2014	 	N/A
								
	OHS Telephone Etiquette 30-05	 	Leslie X Coleman	 	CL717-95152	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	6/20/2014	 	N/A
								
	OHS Threats of Violence 32-05 (Revised 2009)	 	Leslie X Coleman	 	CL717-10512	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	5/30/2014	 	N/A
								
	OHS Title Nine (9) Case Management 53-08	 	Leslie X Coleman	 	CL326-113432	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	10/22/2013	 	N/A
								
	OHS Tracking Sheet Procedures 26-03	 	Leslie X Coleman	 	CL716-17419	 		 	HNFS	 	Direct Clinical Services - OHS	 	3/28/2014	 	N/A
								
	OHS Transfers of Enrolled DUIP Participants 13-02	 	Leslie X Coleman	 	CL115-142213	 		 	MHN	 	Direct Clinical Services - OHS	 	3/10/2014	 	N/A
								
	OHS Under the Influence of Drugs other than Alcohol 27-04	 	Leslie X Coleman	 	CL101-165423	 		 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	2/4/2014	 	N/A
								
	OHS Untoward Events and Documentation 02-00	 	Leslie X Coleman	 	CL928-113047	 	SW	 	MHN Govt. Srvs	 	Direct Clinical Services - OHS	 	3/3/2014	 	N/A
								
	Customized Training Request	 	Linda K Peery	 	HM1112-152212	 	NE	 	MHN	 	EAP, Account Management - Commercial, Account Services	 	2/24/2014	 	Commercial

  

					
	Schedule P	  	P-336	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Request for Training Webinar	 	Linda K Peery	 	HM1113-114014	 		 	MHN	 	EAP, Account Management - Commercial, Account Services	 	5/6/2014	 	Commercial
								
	Scheduling EAP Orientations And EAP Training For Supervisors	 	Christeen X Richardson	 	HM88-112321	 	NE	 	MHN	 	EAP, Account Management - Commercial, Account Services	 	7/7/2014	 	Commercial
								
	Requesting Other Materials From the Training Department	 	Linda K Peery	 	HM88-84745	 	NE	 	MHN	 	EAP, Account Services, Account Management	 	5/21/2014	 	Commercial
								
	ANOC/EOC Tracking Log â€“ CDS Reporting	 	Shelly L Ferrel	 	FS52-124727	 		 	HNAZ, HNCA, HNOR	 	Employer Contracts, CDS - Customer Distribution Services, Marketing	 	4/1/2014	 	Medicare
								
	Health Net Access Medicaid Member Handbook Development	 	Miriam A Macias	 	MM1118-101214	 		 	HNAZ	 	Employer Contracts	 	1/2/2014	 	Medicaid
								
	Delegated Provider Financial Solvency CAP Process	 	Kristina M Rodriguez	 	RK97-65518	 		 	HNAZ, HNCA, HNCS	 	Finance, Corporate Compliance Department, Provider Network Management [more...]	 	5/22/2014	 	Commercial HMO, Medicare Advantage HMO, Dual Eligible, Medi-Cal
								
	Medicare Secondary Payer Part C Accrual Process	 	Lisa L Karustis	 	KL89-112728	 		 	HN Life, HNAZ, HNCA, HNOR	 	Finance, Medicare Compliance, Actuarial	 	5/1/2014	 	Medicare Advantage Part C

  

					
	Schedule P	  	P-337	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Part D Coordination of Benefits (COB) - Weekly Review of Members who should be set up as MSP of A, B, G and Review of ECRS Submissions for MSP	 	Richard E Pyaro	 	KD84-95713	 		 	HNAZ, HNCA, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	1/29/2014	 	Medicare Part D, Dual Eligible
								
	Part D Coordination of Benefits (COB) Data File Processing Policy	 	Richard E Pyaro	 	KD101-104637	 		 	HNAZ, HNCA, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	1/29/2014	 	Medicare Part D, Dual Eligible
								
	Part D Coordination of Benefits (COB) Error File Processing Policy	 	Richard E Pyaro	 	KD330-165620	 		 	HNAZ, HNCA, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	1/29/2014	 	Medicare Part D, Dual Eligible
								
	Part D Prescription Drug Event (PDE) Acumen Analysis PDE Error Policy & Procedure	 	Melissa A Renfro	 	KD924-10639	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	11/14/2013	 	Medicare Part D, Dual Eligible
								
	Part D Prescription Drug Event (PDE) Conversion of Events In Error (EIE) Report from SAS	 	Lakhwinder Kaur	 	KD924-164351	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	1/6/2014	 	Medicare Part D
								
	Part D Prescription Drug Event (PDE) No Further Action Required (NFAR)-Policy & Procedure	 	Lakhwinder Kaur	 	KD1015-10159	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, Membership, National Medicare Compliance, HNPS	 	4/22/2014	 	Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-338	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	R&R Reconciliation & Analysis	 	Lakhwinder Kaur	 	KD1015-93330	 		 	HN Life, HNAZ, HNCA, HNOR, HNPS	 	Finance, Membership, National Medicare Compliance, HNPS	 	4/21/2014	 	Medicare Part D, Dual Eligible
								
	Medicare Secondary Payer Load and Update Policy - for NPL KL1122-1541	 	Lisa L Karustis	 	KD1221-93541	 		 	HN Life, HNAZ, HNCA, HNOR	 	Finance, Membership, National Medicare Compliance	 	3/7/2014	 	Medicare Advantage Part C
								
	Part D â€“ Coordination of Benefits, Medicare Secondary Payer Subrogation Vendor Recovery	 	Melissa A Renfro	 	KD816-163442	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, Membership, National Medicare Compliance	 	1/30/2014	 	Medicare Part D, Dual Eligible
								
	Medical Loss Ratio (MLR) Four Part Test Reporting	 	Kristina M Rodriguez	 	RK611-12515	 		 	HNAZ, HNCA, HNOR	 	Finance, Membership, Provider Network Management	 	8/29/2014	 	Commercial HMO
								
	Part D â€“ Prescription Drug Event (PDE) â€” Part D Exclusion Warning Report	 	Lakhwinder Kaur	 	KL410-134436	 		 	HN Life, HNAZ, HNOR, HNPS	 	 Finance, National Medicare Compliance, HNPS,

Membership
	 	4/22/2014	 	Medicare Part D, Dual Eligible
								
	Part D - Prescription Drug Event (PDE) Potential Duplicate	 	Lakhwinder Kaur	 	KD1019- 103033	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNNE, HNOR, HNPS	 	Finance, National Medicare Compliance, HNPS	 	11/4/2013	 	Medicare Part D
								
	Part D Prescription Drug Event (PDE) Performance Guarantees with Vendor: Vendor Error Tracking of Events In Error (EIE), Vendor PDE Submission/Return Files and Financial Reports Policy & Procedure	 	Lakhwinder Kaur	 	KD101-95710	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, National Medicare Compliance, HNPS	 	2/18/2014	 	Medicare Part D

  

					
	Schedule P	  	P-339	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Prescription Drug Event (PDE) - CMS Report 1 - 4 - 40 Reconciliation	 	Mary H Engquist	 	KD1021-162150	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	Finance, National Medicare Compliance, Membership, HNPS	 	1/3/2014	 	Medicare Part D
								
	Part D Prescription Drug Event (PDE)- Acumen Eligibility Reports	 	Lakhwinder Kaur	 	KL1216-154731	 		 	HNAZ, HNCA, HNCT, HNNE, HNOR	 	Finance, National Medicare Compliance, Membership	 	6/2/2014	 	Medicare, Dual Eligible
								
	#Part D â€“ Coordination of Benefits, Patient Assistance Program Process & Procedure	 	Melissa A Renfro	 	KD329-104723	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, National Medicare Compliance, Pharmacy, Membership	 	11/25/2013	 	Medicare Part D
								
	Part D Prescription Drug Event (PDE) Conversion of CMS PDE Report # 01 from SAS	 	Lakhwinder Kaur	 	KD930-163223	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance, National Medicare Compliance	 	11/4/2013	 	Medicare Part D
								
	AHCCCS Financial Reporting Requirements	 	Trista A Loops	 	LT71-135124	 		 	Health Net Access	 	Finance	 	6/2/2014	 	Medicaid
								
	AHCCCS Internal Viability Monitoring Requirements	 	Trista A Loops	 	LT71-154526	 		 	Health Net Access	 	Finance	 	6/2/2014	 	Medicaid
								
	Business Case Tool (BCT)	 	Leticia T Velasquez	 	MS519-144810	 		 	HN Life, HNAZ, HNCA, HNCT, HNI, HNINY, HNNE, HNOR, HNPS	 	Finance	 	9/12/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	Financial Viability Monitoring â€“ Delegated Entities	 	Trista A Loops	 	PE1130-13754	 		 	HNAZ	 	Finance	 	6/2/2014	 	Medicare Advantage, HMO

  

					
	Schedule P	  	P-340	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	High Level PDE Error Process	 	Lakhwinder Kaur	 	KD1016-115341	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	Finance	 	2/18/2014	 	Medicare Part D
								
	P2P Reconciliation & Analysis	 	Lakhwinder Kaur	 	KL1014-95624	 		 	HN Life, HNAZ, HNCA, HNOR	 	Finance	 	11/5/2013	 	Medicare Part D, Dual Eligible
								
	Provider Payment Advances	 	Trista A Loops	 	HT1214-142819	 		 	HNAZ	 	Finance	 	6/2/2014	 	HMO, Commercial, Medicare, Medicare Advantage, POS, PPO, Medicare Part D [more...]
								
	EDR_Metric Dashboard (Dundas) Access	 	James X Lee	 	CD419-14535	 		 	HNFS	 	Government Services Analytical Services	 	7/31/2014	 	Government Services Analytical Services
								
	PMR Support Team Change Process Management	 	James X Lee	 	CD417-92912	 		 	HNFS	 	Government Services Analytical Services	 	7/31/2014	 	Government Services Analytical Services
								
	PMR Support Team Commercial PMR Administration and Facilitation	 	James X Lee	 	CD419-14304	 		 	HNFS	 	Government Services Analytical Services	 	7/31/2014	 	Government Services Analytical Services
								
	PMR Support Team Data Collection and Reporting	 	James X Lee	 	CD419-151747	 		 	HNFS	 	Government Services Analytical Services	 	8/12/2014	 	Government Services Analytical Services
								
	Health Education Oversight and Monitoring	 	Hoa C Su	 	SH34-113425	 		 	HNCA, HNCS	 	Health Education	 	2/12/2014	 	Medi-Cal, Health Net Dental, Health Net Access, Cal MediConnect [more...]
								
	Health Education Programs, Services and Resources	 	Hoa C Su	 	SH34-105942	 		 	HNCA	 	Health Education	 	3/19/2014	 	Medi-Cal, Medi-Cal Seniors and Persons with Disabilities [more...]
								
	Individual Health Education Behavioral Assessment	 	Hoa C Su	 	SH34-115026	 		 	HNCA	 	Health Education	 	2/12/2014	 	Medi-Cal

  

					
	Schedule P	  	P-341	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Implementation of New Legislation	 	Afrodite P Smith	 	NK1215-16221	 		 	HNI	 	Health Services, HN Life, Medical Management [more...]	 	1/22/2014	 	 HMO, POS, PPO,
 Indemnity, IFP, EPO, AIM, Healthy
Kids, Medi-Cal [more...]

								
	Transition from Legislation Implementation to Compliance Monitoring	 	Sina R Franques	 	NK1215-163847	 	SW	 	All	 	Health Services, HN Life, Medical Management [more...]	 	12/6/2013	 	 HMO, POS, PPO,
 Indemnity, IFP, EPO, AIM, Healthy
Kids, Medi-Cal [more...]

								
	SPD- Staff Focused Sensitivity Training	 	Rogelio Lopez	 	LR315-14728	 	W	 	HNCA	 	Health Services	 	12/11/2013	 	Medi-Cal
								
	EPCO Change Implementation Policy and Procedure	 	Dannette K Berch	 	AJ1111-133827	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, MHN	 	HN Life, Appeals and Grievances (Member), Commercial Sales, Compliance [more...]	 	12/12/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	CA, AZ, OR & WA Commercial Product Development ABS Naming Convention - 2014	 	Heidianne K Caine	 	FA831-124651	 		 	HNAZ, HNCA, HNOR	 	 HN Life, HNAZ, HNCA
 Other, HNOR
	 	1/3/2014	 	HMO, Commercial, POS, PPO, Indemnity, IFP, EPO, Commercial HMO [more...]
								
	EPCO - Change Notice Intake Policy & Procedure	 	Dannette K Berch	 	HW110-173750	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS, MHN	 	HN Life, Medical Management, Appeals and Grievances (Member) [more...]	 	12/12/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	QI Western Region Medicare Provider Availability Monitoring	 	Jenny P Anderson	 	AJ920-11495	 		 	HN Life, HNAZ, HNCA, HNOR	 	HN Life, Provider Network Management, Quality Assurance	 	1/17/2014	 	Medicare Advantage HMO, Medicare Advantage PPO, Medicare Advantage SNP
								
	Claims 1, Life Claim Analysis	 	Menita X Avila	 	AC96-17230	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life

  

					
	Schedule P	  	P-342	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Claims 2, Claims Denial	 	Menita X Avila	 	AC1019-164124	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 3, Life Claims - Pend	 	Menita X Avila	 	AC1019-165958	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 4, Life Claims Payment	 	Menita X Avila	 	AC1022-132418	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 5, Life Claim Appeal	 	Menita X Avila	 	AC1024-154953	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 6, Life Claims Fraud	 	Menita X Avila	 	AC1029-154641	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 7, Waiver of Premium	 	Menita X Avila	 	AC123-162257	 		 	HN Life	 	HN Life	 	7/16/2014	 	Basic Life
								
	Claims 8, Long Term Disability	 	Menita X Avila	 	AC1219-152628	 		 	HN Life	 	HN Life	 	7/16/2014	 	Long Term Disability
								
	Call Routing Modification Policy and Procedure	 	Daniel G Middaugh	 	SD64-15549	 		 	All	 	 HNAZ,
 Member Services, HNOR,

Customer Service
	 	6/17/2014	 	All
								
	System Outage Communication and Escalation Process	 	Daniel G Middaugh	 	SD64-15553	 		 	All	 	 HNAZ,
 Member Services, HNOR,

Customer Service
	 	7/7/2014	 	All
								
	Federal Employees Benefit (FEHB) Program Rating and Audit Support	 	Sherry E Brown	 	BS116-143041	 		 	HNAZ, HNCA, HNI	 	 HNAZ,
 Underwriting - Group, Commercial Sales,
Actuarial [more...]
	 	7/10/2014	 	Commercial HMO
								
	AHCCCS Problem Management Policy/Procedure	 	John R Dancoisne	 	DJ712-14433	 		 	HNAZ	 	HNAZ	 	5/22/2014	 	AHCCCS (AZ Medicaid)
								
	AHCCCS Security Assessment Policy/Procedure	 	John R Dancoisne	 	WN624-151938	 		 	HNAZ	 	HNAZ	 	5/27/2014	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-343	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Chief Executive Officer - Plan of Authority	 	Pamela L Gregg	 	GS417-11166	 		 	HNAZ	 	HNAZ	 	1/28/2014	 	HMO, Commercial, Medicare Advantage, POS, PPO, IFP
								
	Blue and Gold HMO Non-Contracted Sutter Hospitals Post Stabilization and Transfer Authorization Requests	 	Viola Lo	 	ZT426-12015	 	W	 	HNCA	 	HNCA Other, Member Services, Provider Services	 	4/1/2014	 	Commercial
								
	Cal Optima Outbound 837 Procedures	 	Marisela D Buehrle	 	BM101-125055	 		 	HNCA	 	HNCA Other	 	10/11/2013	 	California Medicaid of California (Medi-Cal) [more...]
								
	CalViva Family HealthCare Encounter volume submission & rejection reports.	 	Marisela D Buehrle	 	BM108-9314	 		 	HNCA	 	HNCA Other	 	1/2/2014	 	Cal Viva
								
	CHP Outbound File Procedures	 	Marisela D Buehrle	 	BM827-143219	 		 	HNCA	 	HNCA Other	 	1/2/2014	 	PPO, Comm, Healthy Kids
								
	Community Advisory Committee	 	April X Canetto	 	WN111-145741	 		 	HNCA	 	HNCA Other	 	6/30/2014	 	Medi-Cal, Dual Eligible
								
	Compliance Monitoring for Specialty Plans and Ancillary Vendors	 	Humaira S Theba	 	OM101-162834	 		 	HN Life, HNCA, HNI	 	HNCA Other	 	5/5/2014	 	HMO, POS, PPO, EPO
								
	Culturally and Linguistically Appropriate Community Resources and Referrals	 	April X Canetto	 	WN111-153430	 		 	HNCA	 	HNCA Other	 	5/5/2014	 	Medi-Cal, Dual Eligible
								
	Health Education and Cultural and Linguistic Services Group Needs Assessment	 	Lali E Witrago	 	WN111-152526	 		 	HNCA	 	HNCA Other	 	6/26/2014	 	Medi-Cal
								
	Language Assessment for SHP Bilingual Representatives	 	Edwin X Ram	 	ED119-13490	 	W	 	HNCA	 	HNCA Other	 	3/31/2014	 	Medicaid
								
	Medi-Cal C&L Program Description	 	Diana M Carr	 	TH1018-95146	 		 	HNCS	 	HNCA Other	 	7/18/2014	 	Medicaid
								
	SHP Medi-Cal Event MOU (Memo of Understanding) Process	 	Diane X Baxter	 	BD120-213155	 		 	HNCA	 	HNCA Other	 	1/28/2014	 	Medicaid
								
	Signature Authority Policy - Capitation Checks	 	Cecil J Woods	 	WC713-163020	 	NW	 	HNCA	 	HNCA Other	 	5/27/2014	 	HMO
								
	Personal Fundraising Guidelines for HN Officers and HN Inc. Directors	 	Afrodite P Smith	 	AB76-85622	 		 	All	 	HNI, Legal, Finance, Corporate Compliance Department	 	12/6/2013	 	N/A

  

					
	Schedule P	  	P-344	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Board of Directors - Majority Voting	 	Remy M Franklin	 	SS428-113534	 		 	All	 	HNI	 	1/28/2014	 	All
								
	Telemarketing Do Not Call Master Policy - 1/20/05	 	Shelley X Axelson	 	MP628-153118	 	NE	 	HN Life, HNAZ, HNCA, HNFS, HNI, HNNE, HNOR, HNPS, MHN	 	HNI	 	7/2/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	State of Connecticut Office of the Attorney General Complaint Process	 	Arlana Flores	 	CV515-112251	 	NE	 	HNNE	 	HNNE	 	2/10/2014	 	Commercial
								
	HN Medicare (all regions) Request to Reinstate Coverage Policy & Procedure	 	Christine X Martignoni	 	LV118-15017	 		 	HNAZ, HNCA, HNOR	 	 HNOR, HNCA
 Other, HNAZ
	 	8/15/2014	 	Medicare Advantage
								
	CCC P&P - HNOR/HNWA Members requesting assistance filing a written Appeal, Grievance or Complaint	 	Viola Lo	 	ZT525-10126	 		 	HNOR	 	HNOR	 	7/30/2013	 	Commercial, HMO, POS, PPO
								
	Medicare Advantage (MA) and Part D Website Marketing Content	 	Celina X Hanna	 	SG56-82154	 		 	HN Life, HNAZ, HNCA, HNOR, HNPS	 	HNPS, Chief Technology Office (CTO), Marketing	 	7/10/2014	 	Medicare Advantage, Medicare Part D
								
	Medicare Part D Claims Reconciliation to PDE	 	Eric X Juline	 	KD18-101029	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	HNPS, Finance, Membership, National Medicare Compliance	 	4/2/2014	 	Medicare Part D, Dual Eligible
								
	PDE Error Correction And Tracking	 	Lakhwinder Kaur	 	KL105-113249	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	HNPS, Finance, Membership, National Medicare Compliance	 	4/21/2014	 	Medicare Part D, Dual Eligible
								
	Medicare Part D PDE Aging Report	 	Eric X Juline	 	KL1122-144119	 		 	HNAZ, HNCA, HNOR, HNPS	 	HNPS, Finance, Membership	 	4/2/2014	 	Medicare Part D, Dual Eligible
								
	Part D Prescription Drug Event (PDE) Immediately Actionable PDE Errors	 	Lakhwinder Kaur	 	KD924-83525	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR	 	 HNPS,
 Membership, Finance, National Medicare
Compliance
	 	3/3/2014	 	Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-345	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	ACA Exchange Reporting - Prescription Drug Distribution and Cost Reporting	 	Scott M Wert	 	WS423-9583	 		 	HNPS	 	HNPS	 	5/5/2014	 	Health Benefit Exchange
								
	Advanced Payment of the Premium Tax Credit (APTC)	 	Lorraine L Dennis	 	DL123-1406	 		 	HNPS	 	HNPS	 	1/27/2014	 	Health Benefit Exchange
								
	Distribution of the â€œMedicare Prescription Drug Coverage and Your Rightsâ€ Standardized Pharmacy Notice	 	Catherine E Cole	 	CC227-14920	 		 	HNPS	 	HNPS	 	8/18/2014	 	Dual Eligible, Medicare Part D
								
	Drug Recall, Market Withdrawal or Drug Shortage	 	Rena M Vasile	 	VR624-154421	 		 	HNPS	 	HNPS	 	8/28/2014	 	All
								
	Formulary & Benefit Management Supervisor Change Request (CR) Quality Assurance Review	 	Crystal X Alford	 	MC1216-133535	 		 	HNPS	 	HNPS	 	12/11/2013	 	Medicaid, Medicare, Commercial, Medicare Part D, Healthy Kids, Medi-Cal [more...]
								
	Formulary Management Overall Policy	 	Crystal X Alford	 	PC1213-8539	 		 	HNPS	 	HNPS	 	9/25/2013	 	Commercial, Medicaid, Medicare Part D, Healthy Kids, Medi-Cal [more...]
								
	Formulary/Drug List - Development, Updates and Posting	 	Phyllis Y Noble	 	NP118-85524	 		 	HNOR	 	HNPS	 	5/12/2014	 	 POS, PPO, EPO,
 Community Care

								
	Generic Substitution	 	Phyllis Y Noble	 	VC1219-115559	 		 	HNOR	 	HNPS	 	4/4/2014	 	 Commercial, POS, PPO, EPO,
 Community
Care

								
	 Health Net electronic prescribing
 (e- prescribing
or e-Rx) Policy
	 	Crystal X Alford	 	PC36-5593	 		 	HNPS	 	HNPS	 	11/8/2013	 	Medicaid, Commercial, Medicare Part D, Healthy Kids, Medi-Cal [more...]
								
	Health Net Pharmaceutical Services - Pharmacy Audit and Recovery Department Overview	 	Donna M Lenhoff	 	BB83-113453	 		 	HNPS	 	HNPS	 	5/19/2014	 	All
								
	Health Net Pharmaceutical Services Centralization Process for Appeals and Grievances Medicare Part D Responses	 	Donna M Lenhoff	 	UC615-7138	 		 	HNPS	 	HNPS	 	8/13/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Contract Team	 	Katherine J Gumpert	 	GK627-124821	 	N/A	 	HNPS	 	HNPS	 	2/4/2014	 	All

  

					
	Schedule P	  	P-346	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Establish and Implement the Rebate Administration - Annual Notice	 	Katherine J Gumpert	 	GK624-131148	 	N/A	 	HNPS	 	HNPS	 	4/7/2014	 	All
								
	Health Net Pharmaceutical Services Medi-Cal - After-Hours Emergency Overrides	 	Donna M Lenhoff	 	LD731-154837	 		 	HNPS	 	HNPS	 	8/3/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - California Children Services (CCS) Program	 	Donna M Lenhoff	 	LD81-16542	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Carve-Out Medications	 	Donna M Lenhoff	 	LD731-123949	 		 	HNPS	 	HNPS	 	8/3/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Compound Medications	 	Donna M Lenhoff	 	LD81-124531	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Drug Utilization Review (DUR)	 	Donna M Lenhoff	 	LD84-102312	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Emergency Medication Provisions	 	Donna M Lenhoff	 	LD84-94223	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - HNMC Reimbursement Appeals	 	Donna M Lenhoff	 	LD81-121929	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Injectable Medications	 	Donna M Lenhoff	 	LD84-105734	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Medication Denial of Coverage	 	Donna M Lenhoff	 	LD81-141552	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Medication Prior Authorizations, Pre-Service Decisions, and Exceptions	 	Donna M Lenhoff	 	LD731-145221	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Nutritional Supplements	 	Donna M Lenhoff	 	LD84-162239	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medi-Cal - Pharmacy Prior Authorization (PA) Staff Training Process	 	Donna M Lenhoff	 	LD85-123522	 		 	HNPS	 	HNPS	 	8/5/2014	 	Medi-Cal

  

					
	Schedule P	  	P-347	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medi-Cal - Recommended Drug List (RDL) Development and Application	 	Donna M Lenhoff	 	LD85-15236	 		 	HNPS	 	HNPS	 	8/8/2014	 	Medi-Cal
								
	Health Net Pharmaceutical Services Medicare-Medicaid â€“ Non Part D Drug Formulary Maintenance Processes	 	Donna M Lenhoff	 	LD327-162636	 		 	HNPS	 	HNPS	 	3/31/2014	 	Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D - Annual Pharmacy Directory Development and Review Process	 	Donna M Lenhoff	 	BB917-163715	 		 	HNPS	 	HNPS	 	8/7/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D - Monthly Medicare Part D and Medicare-Medicaid Plan Formulary Compare Process	 	Donna M Lenhoff	 	BB131-144712	 		 	HNPS	 	HNPS	 	11/12/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Appointment of Representative Process for Coverage Determinations for Benefits	 	Donna M Lenhoff	 	BB319-14132	 		 	HNPS	 	HNPS	 	3/5/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - B vs. D Rejected Pharmacy Claim Review	 	Donna M Lenhoff	 	BB621-105332	 		 	HNPS	 	HNPS	 	10/31/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Best Available Evidence Process	 	Donna M Lenhoff	 	BB109-155935	 		 	HNPS	 	HNPS	 	6/13/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Bundling of Medicare Part D Home Infusion Drugs Under a Medicare Part C Supplemental Benefit	 	Donna M Lenhoff	 	BB123-133754	 		 	HNPS	 	HNPS	 	11/7/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Centers for Medicare and Medicaid Services Required Reporting	 	Donna M Lenhoff	 	BB228-161426	 		 	HNPS	 	HNPS	 	5/16/2014	 	Medicare Part D and Medicare-Medicaid

  

					
	Schedule P	  	P-348	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Claims Processing Error Resolution Process	 	Donna M Lenhoff	 	BB729-155428	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - CMS Approved Formularies - Provision of Adequate Formularies	 	Donna M Lenhoff	 	BB34-95514	 		 	HNPS	 	HNPS	 	11/7/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coordination of Benefits Pharmacy Service Center Support	 	Donna M Lenhoff	 	BB123-104815	 		 	HNPS	 	HNPS	 	6/10/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coordination of Benefits: Patient Assistance Program	 	Donna M Lenhoff	 	BB325-151017	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Cost Sharing Guidelines for Low-Income Individuals	 	Donna M Lenhoff	 	BB123-1115	 		 	HNPS	 	HNPS	 	8/29/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coverage Determination for Payment Process	 	Donna M Lenhoff	 	BB411-104014	 		 	HNPS	 	HNPS	 	3/31/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coverage Determination Internal Monitoring Program	 	Donna M Lenhoff	 	BB78-145521	 		 	HNPS	 	HNPS	 	10/28/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Coverage of Replacement Medications	 	Donna M Lenhoff	 	BB102-9050	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - CVS Caremark Medicare Part D and Medicare-Medicaid Plan Administration Issues Reporting	 	Donna M Lenhoff	 	BB614-165134	 		 	HNPS	 	HNPS	 	5/23/2014	 	Medicare Part D and Medicare-Medicaid

  

					
	Schedule P	  	P-349	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - DESI Drug Maintenance Process	 	Donna M Lenhoff	 	LD210-16330	 		 	HNPS	 	HNPS	 	10/28/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Drug Coverage Under Medicare Part D	 	Donna M Lenhoff	 	BB1123-141418	 		 	HNPS	 	HNPS	 	8/25/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Early Refill Process	 	Donna M Lenhoff	 	BB316-91759	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Formulary Change and Notification Process	 	Donna M Lenhoff	 	BB914-105830	 		 	HNPS	 	HNPS	 	1/15/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Formulary Development, Submission and Posting Processes	 	Donna M Lenhoff	 	BB910-155847	 		 	HNPS	 	HNPS	 	8/26/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Formulary Education	 	Donna M Lenhoff	 	BB35-155719	 		 	HNPS	 	HNPS	 	11/5/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Formulary Maintenance Processes	 	Donna M Lenhoff	 	BB34-101626	 		 	HNPS	 	HNPS	 	11/7/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - HNPS and Medical Claims Department Interfaces	 	Donna M Lenhoff	 	BB513-154043	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Interface Between Membership Repository Database and Pharmacy Claims Processor	 	Donna M Lenhoff	 	BB717-111032	 		 	HNPS	 	HNPS	 	7/11/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Issues Reporting and Tracking	 	Donna M Lenhoff	 	BB614-154020	 		 	HNPS	 	HNPS	 	5/23/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - MAM Process	 	Donna M Lenhoff	 	LD37-151343	 		 	HNPS	 	HNPS	 	7/11/2014	 	Medicare Part D, Medicare-Medicaid

  

					
	Schedule P	  	P-350	  	Health Net / Cognizant Confidential

 Final 

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Medicare Drug Integrity Contractor Requests	 	Donna M Lenhoff	 	BB226-95334	 		 	HNPS	 	HNPS	 	5/16/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Member Explanation of Benefits Process	 	Donna M Lenhoff	 	BB521-9226	 		 	HNPS	 	HNPS	 	7/9/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Member Initiated Coverage Determination for Benefits Request Processing	 	Donna M Lenhoff	 	BB730-153826	 		 	HNPS	 	HNPS	 	9/20/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Member TrOOP and Gross Drug Spend Reporting Upon Disenrollment	 	Donna M Lenhoff	 	BB521-85533	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Non-Matched NDC Maintenance and Communication Process	 	Donna M Lenhoff	 	BB14-15913	 		 	HNPS	 	HNPS	 	11/5/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - NSDE and No NDA/ANDA or BLA Maintenance Process	 	Donna M Lenhoff	 	BB89-152542	 		 	HNPS	 	HNPS	 	10/25/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Pharmacy Access During a Federal Disaster or Other Public Health Emergency Declaration	 	Donna M Lenhoff	 	BB625-105454	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Pharmacy Service Center Complaint Tracking Module Process	 	Donna M Lenhoff	 	BB925-144023	 		 	HNPS	 	HNPS	 	6/10/2014	 	Medicare Part D, Medicare-Medicaid

  

					
	Schedule P	  	P-351	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Pharmacy Services Center (PSC) Member Correspondence Processing	 	Donna M Lenhoff	 	BB411-1634	 		 	HNPS	 	HNPS	 	8/13/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Pharmacy Technical Support	 	Donna M Lenhoff	 	BB515-113132	 		 	HNPS	 	HNPS	 	9/26/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Policies and Procedures Management	 	Donna M Lenhoff	 	BB516-1300	 		 	HNPS	 	HNPS	 	5/16/2014	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Prescription Claim Timely Filing Limitations	 	Donna M Lenhoff	 	BB1211-95750	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Preventing Part D Payment for Drugs Included in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS)	 	Donna M Lenhoff	 	BB516-164139	 		 	HNPS	 	HNPS	 	11/21/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Preventing Part D Payment for Hospice Drugs	 	Donna M Lenhoff	 	BB518-115947	 		 	HNPS	 	HNPS	 	12/19/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Prior Authorization Criteria Documentation Development, Submission and Website Posting Processes	 	Donna M Lenhoff	 	BB727-82435	 		 	HNPS	 	HNPS	 	6/25/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Provider Submitted Non-Electronic Claim Processing	 	Donna M Lenhoff	 	BB319-122128	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Provider Toll-Free Formulary Exceptions and Prior Authorization Support	 	Donna M Lenhoff	 	BB521-93936	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid

  

					
	Schedule P	  	P-352	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Rejected and Paid Pharmacy Claim Review Process	 	Donna M Lenhoff	 	BB331-15457	 		 	HNPS	 	HNPS	 	8/13/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Retroactive Low Income Cost-Sharing Level Claims Reprocessing Monitoring	 	Donna M Lenhoff	 	BB1117-132536	 		 	HNPS	 	HNPS	 	8/30/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Transition Fill Program Grandfather Drug List	 	Donna M Lenhoff	 	BB85-154356	 		 	HNPS	 	HNPS	 	11/8/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Transition Program Member Notification Process and Oversight	 	Donna M Lenhoff	 	BB714-16384	 		 	HNPS	 	HNPS	 	8/15/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Transition Program Prescriber Notification Process and Oversight	 	Donna M Lenhoff	 	BB330-114936	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Vaccine and Vaccine Administration Claim Submission Verification Process	 	Donna M Lenhoff	 	BB59-161458	 		 	HNPS	 	HNPS	 	3/18/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Vaccine Access	 	Donna M Lenhoff	 	BB229-132316	 		 	HNPS	 	HNPS	 	9/24/2013	 	Medicare Part D and Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Vaccine Administration	 	Donna M Lenhoff	 	BB123-165242	 		 	HNPS	 	HNPS	 	11/7/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid - Website Content	 	Donna M Lenhoff	 	BB31-95335	 		 	HNPS	 	HNPS	 	11/7/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid Expedited Coverage Determination for Benefits	 	Sarka Parod	 	PS29-114549	 		 	HNPS	 	HNPS	 	3/24/2014	 	Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-353	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid Standard Coverage Determination for Benefits	 	Sarka Parod	 	PS29-92854	 		 	HNPS	 	HNPS	 	3/24/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid â€“ B versus D Rejected Pharmacy Claim Review	 	Donna M Lenhoff	 	LD328-93549	 		 	HNPS	 	HNPS	 	8/13/2014	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid â€“ Member Notification of Part D Coverage and Applicable Discount When CMS Specifies a Retroactive Effective Date for a Labeler Code	 	Donna M Lenhoff	 	LD57-16494	 		 	HNPS	 	HNPS	 	10/28/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D and Medicare-Medicaid â€“ PDE Error 867 Monitoring Process	 	Donna M Lenhoff	 	LD72-91330	 		 	HNPS	 	HNPS	 	8/30/2013	 	Medicare Part D, Medicare-Medicaid
								
	Health Net Pharmaceutical Services Medicare Part D Process for Administrative Law Judge Hearings	 	Sarka Parod	 	PS629-145549	 		 	HNPS	 	HNPS	 	6/9/2014	 	Medicare Part D
								
	Health Net Pharmaceutical Services Trade Relations Manufacturer Rebate Agreement Compliance Reviews	 	Katherine J Gumpert	 	GK624-133258	 	N/A	 	HNPS	 	HNPS	 	2/4/2014	 	All
								
	Health Net Pharmacy Network - Dual Eligible Program Support	 	Donna M Lenhoff	 	LD42-151538	 		 	HNPS	 	HNPS	 	3/25/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Pharmacy Network Louisiana Quarterly Claim Review	 	Catherine E Cole	 	CC85-14166	 		 	HNPS	 	HNPS	 	7/2/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Pharmacy Network Validation of Medicare Part D Reporting	 	Catherine E Cole	 	CC311-145844	 		 	HNPS	 	HNPS	 	3/26/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Pharmacy Network â€“ Pharmacy Access â€“ Review Claims that Rejected for being â€œOut of Networkâ€ ̈; Solicit
Pharmacies	 	Catherine E Cole	 	CC418-10418	 		 	HNPS	 	HNPS	 	8/14/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Pharmacy Networks - Competitive Price Reviews	 	Catherine E Cole	 	CC814-10141	 		 	HNPS	 	HNPS	 	8/23/2013	 	Commercial, State, Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-354	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmacy Networks - Prompt Payment by Part D Sponsors	 	Catherine E Cole	 	CC126-121239	 		 	HNPS	 	HNPS	 	7/2/2014	 	Medicare Part D, Dual Eligible
								
	Health Net Veterans Affairs - Community Based Outpatient Clinic - Retail Pharmacy Contracting	 	Donna M Lenhoff	 	BB53-161159	 		 	HNPS	 	HNPS	 	5/5/2014	 	Health Net Veteran’s Affairs
								
	Health Net Veterans Affairs - Formulary Maintenance	 	Donna M Lenhoff	 	BB427-105210	 		 	HNPS	 	HNPS	 	6/2/2014	 	Health Net Veterans Affairs
								
	Health Net Veterans Affairs - Pharmacy Benefit Setup and Maintenance	 	Donna M Lenhoff	 	BB427-83742	 		 	HNPS	 	HNPS	 	6/2/2014	 	Health Net Veterans Affairs
								
	HNPS (Rancho Cordova Location) Health Care Professionals Licensure Requirement.	 	Sarka Parod	 	CC128-134351	 		 	HNPS	 	HNPS	 	6/20/2014	 	N/A
								
	HNPS Associate of the Month Program Policy & Procedure	 	Stephen J Callagy	 	BL125-133212	 	NW	 	HNPS	 	HNPS	 	1/6/2014	 	N/A
								
	HNPS Communication Origination P&P	 	Rena M Vasile	 	VR21-111338	 		 	HNPS	 	HNPS	 	5/14/2014	 	All
								
	HNPS Communications Annual P&P Reviews	 	Rena M Vasile	 	VR1027-85846	 		 	HNPS	 	HNPS	 	4/23/2014	 	All
								
	HNPS Drug Utilization Review (DUR)	 	Michael J McClusky	 	MM1023-92649	 		 	HNPS	 	HNPS	 	7/11/2014	 	 HMO, Commercial, Medicare, Medicare Advantage, Medicare Part D, POS, PPO

[more...]

								
	HNPS Intranet Policy & Procedure	 	Stephen J Callagy	 	CS123-142117	 		 	HNPS	 	HNPS	 	8/14/2013	 	N/A
								
	HNPS Medicare & Commercial Benefit Request Policy	 	Crystal X Alford	 	PC312-7461	 		 	HNAZ, HNCA, HNNE, HNOR, HNPS	 	HNPS	 	9/13/2013	 	Medicare Part D, Commercial, Dual Eligible
								
	HNPS Medicare Part D: Drug Utilization Management and Quality Assurance and Retrospective Drug Utilization Review	 	Linda L Reynolds	 	RS45-133638	 		 	HNPS	 	HNPS	 	7/24/2014	 	Medicare Part D, Dual Eligible
								
	HNPS Member Communications Policy & Procedure	 	Rena M Vasile	 	VR103-131931	 		 	HNPS	 	HNPS	 	11/8/2013	 	All

  

					
	Schedule P	  	P-355	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	HNPS Quality Improvement Organization Collaboration	 	Michael J McClusky	 	MM330- 112157	 		 	HNAZ, HNCA, HNOR, HNPS	 	HNPS	 	1/21/2014	 	Medicare Part D, Dual Eligible
								
	HNPS Resident Interview and Ranking Process	 	Cathrine V Misquitta	 	MC1017- 102913	 		 	HNPS	 	HNPS	 	11/22/2013	 	N/A
								
	MAC â€“ Coordination of Updating MAC Lists with Caremark	 	Catherine E Cole	 	CC63-10146	 		 	HNPS	 	HNPS	 	8/27/2014	 	N/A
								
	Medicare Changes â€“ Benefit Administration Request Testing Review	 	Crystal X Alford	 	BC322-10855	 		 	HNPS	 	HNPS	 	2/20/2014	 	Medicare, Dual Eligible
								
	Medicare DIR Reporting Processes	 	Kathleen D Overbey	 	OK113-153031	 		 	HNPS	 	HNPS	 	8/12/2014	 	Medicare
								
	Medication Therapy Management	 	Carrie N Holden	 	HC37-83341	 		 	HNPS	 	HNPS	 	6/19/2014	 	Medicare Part D, Dual Eligible
								
	Opioid Overutilization Management	 	Cathrine V Misquitta	 	MC1115-8299	 		 	HNAZ, HNCA, HNOR, HNPS	 	HNPS	 	11/22/2013	 	Medicare Part D, Dual Eligible
								
	Pharmacy Claims Processing	 	Kathleen D Overbey	 	OK1223- 113858	 		 	HNPS	 	HNPS	 	11/12/2013	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	Pharmacy Claims Processor User ID Access Control	 	Virginia E White	 	WV129-13320	 		 	HNPS	 	HNPS	 	1/6/2014	 	All
								
	Pharmacy Department Claims Processing	 	Phyllis Y Noble	 	VC1210- 102846	 		 	HNOR	 	HNPS	 	4/4/2014	 	 Commercial, POS, PPO, EPO,
 Community
Care

								
	Pharmacy Policies Procedures Overview	 	Phyllis Y Noble	 	NP527-14834	 		 	HNOR	 	HNPS	 	6/9/2014	 	 Commercial, POS, PPO, EPO,
 Community
Care

								
	Prescription Drug Samples - HNPS	 	Cathrine V Misquitta	 	MC12-85954	 		 	HNAZ, HNCA, HNNE, HNOR, HNPS	 	HNPS	 	6/4/2014	 	HMO
								
	Prescription Synchronization	 	Kelsey M Wallace	 	WK57-1435	 		 	HNOR	 	HNPS	 	5/8/2014	 	 Commercial, PPO, EPO, POS,
 Community
Care

								
	Prior Authorization/Formulary Exceptions	 	Phyllis Y Noble	 	PL521-115955	 		 	HN Life, HNOR, HNPS	 	HNPS	 	3/14/2014	 	Commercial, EPO, POS, PPO, Indemnity, Community Care

  

					
	Schedule P	  	P-356	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Rebate G/L Accounting Control Processes and Procedures	 	Kathleen D Overbey	 	OK811-13330	 		 	HNPS	 	HNPS	 	6/2/2014	 	ALL
								
	Rebate Invoicing	 	Kathleen D Overbey	 	OK811-14220	 		 	HNPS	 	HNPS	 	7/21/2014	 	HMO, Commercial, Medicaid, Medicare Advantage, Medicare Part D, PPO [more...]
								
	Rebate Payment Receipt and Allocation	 	Kathleen D Overbey	 	OK218-112240	 		 	HNPS	 	HNPS	 	7/21/2014	 	HMO, Commercial, Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	Rebate Reconciliation - Rebate True up - Rebate Reserves Processes and Procedures	 	Kathleen D Overbey	 	OK811-12536	 		 	HNPS	 	HNPS	 	6/2/2014	 	ALL
								
	Residency Standards and Expectations	 	Cathrine V Misquitta	 	MC626- 134633	 		 	HNPS	 	HNPS	 	6/4/2014	 	N/A
								
	Third Party Clinical Reviews	 	Lynn Pettitt	 	PL722-16025	 		 	HNOR	 	HNPS	 	6/24/2014	 	Commercial
								
	Vacation Supply Overrides	 	Phyllis Y Noble	 	VC1219-12016	 		 	HNOR	 	HNPS	 	1/22/2014	 	Commercial, EPO, POS, PPO, Indemnity, Community Care
								
	Internal Audit Department Policy and Procedures on Annual Letter of Assurance for Internal Management Control Review Reporting (Report No. H004)	 	Mayra J Villalta	 	VM27-103735	 		 	HNFS	 	Internal Audit Department	 	5/7/2014	 	HNFS/TRICARE
								
	Internal Audit Department Policy and Procedures on Internal Control Reviews (Report No. H015)	 	Mayra J Villalta	 	VM27-114551	 		 	HNFS	 	Internal Audit Department	 	5/7/2014	 	HNFS/TRICARE
								
	Internal Audit Department Policy and Procedures on Statement on Standards for Attestation Engagements no. 16 (SSAE 16) (Report No. C020)	 	Mayra J Villalta	 	VM27-12224	 		 	HNFS	 	Internal Audit Department	 	5/7/2014	 	HNFS/TRICARE
								
	Internal Audit Department Policy and Procedures on Vulnerability Assessments (Report No. H014)	 	Mayra J Villalta	 	VM27-121325	 		 	HNFS	 	Internal Audit Department	 	5/7/2014	 	HNFS/TRICARE
								
	Internal Audit Department Work Instructions on Audit Processes and Documentation	 	Mayra J Villalta	 	VM111- 114236	 		 	 HNFS, MHN
 Govt. Srvs
	 	Internal Audit Department	 	6/6/2014	 	N/A

  

					
	Schedule P	  	P-357	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Internal Audit Department Work Instructions on Organizational Status and Administration	 	Mayra J Villalta	 	VM111-94455	 		 	 HNFS, MHN
 Govt. Srvs
	 	Internal Audit Department	 	8/5/2014	 	N/A
								
	Medicare Fee Schedule Validation	 	Alex M Black	 	SL429-16347	 		 	MHN	 	 ITG, MHN
 Claims, MHN Configurations
	 	7/11/2014	 	Medicare Advantage
								
	ECP - Project Brief Creation	 	Mia S Terry- Samuels	 	TM325- 163957	 		 	HNI	 	ITG	 	6/3/2014	 	All
								
	ECP Wintel Storage Management Process	 	Mia S Terry- Samuels	 	TM220-1713	 		 	All	 	ITG	 	6/3/2014	 	All
								
	EPSS ID_003 Sponsoring Projects	 	Mia S Terry- Samuels	 	TM72-104617	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_013 Special Projects	 	Mia S Terry- Samuels	 	TM78-161823	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_017 Report Status	 	Mia S Terry- Samuels	 	TM710- 154923	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_020 Daily Operations Review Meeting	 	Mia S Terry- Samuels	 	TM73-113043	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_023 Initiate SWAT Bridges for Severe Outages	 	Mia S Terry- Samuels	 	TM410- 123949	 		 	All	 	ITG	 	6/4/2014	 	N/A
								
	EPSS ID_024 Contact Service Delivery Manager	 	Mia S Terry- Samuels	 	TM73-111438	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_025 Service Delivery Manager Engagement	 	Mia S Terry- Samuels	 	TM710- 153630	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_029 Formal Communication of Outages	 	Mia S Terry- Samuels	 	TM528- 165830	 		 	All	 	ITG	 	6/4/2014	 	N/A
								
	EPSS ID_030 Attend SWAT Calls	 	Mia S Terry- Samuels	 	TM63-165333	 		 	All	 	ITG	 	6/4/2014	 	N/A
								
	EPSS ID_031 Formal Resolution of Production System Availability & Response Issues	 	Mia S Terry- Samuels	 	TM626- 132646	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_032 Sending G2 Notifications	 	Mia S Terry- Samuels	 	TM624- 161738	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_040 Turnover Transition to On Call SDM	 	Mia S Terry- Samuels	 	TM625-1529	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_044 Weekend On Call Duties	 	Mia S Terry- Samuels	 	TM625- 153926	 		 	All	 	ITG	 	8/13/2014	 	N/A

  

					
	Schedule P	  	P-358	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	EPSS ID_095 Telephone Tree	 	Mia S Terry- Samuels	 	TM628-14252	 		 	All	 	ITG	 	8/13/2014	 	N/A
								
	EPSS ID_096 Use of Pending in Remedy Tickets	 	Mia S Terry- Samuels	 	TM73-14025	 		 	All	 	ITG	 	8/14/2014	 	N/A
								
	EPSS Weekly Report Card Procedure	 	Mia S Terry- Samuels	 	TM728- 203032	 		 	All	 	ITG	 	7/29/2014	 	N/A
								
	EPSS Weekly Ticket Stats Procedure	 	Mia S Terry- Samuels	 	TM728- 211724	 		 	All	 	ITG	 	7/29/2014	 	N/A
								
	Health Net Desktop Lifecycle Workflow Methodology	 	Christopher Stephens	 	SC531-7455	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	Health Net Process Interface Manual Asset Management	 	Christopher Stephens	 	SC530-103542	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	Health Net Security Assessment Policy/Procedure	 	John R Dancoisne	 	WN624- 153828	 		 	HNI	 	ITG	 	8/14/2014	 	All
								
	HealthNet ITG Testing Policy	 	Dave A Eggers	 	RW328-10738	 		 	HNI	 	ITG	 	1/8/2014	 	N/A
								
	Information Technology Service Level Process Manual	 	Connie E Shaffer	 	SC823-114822	 		 	All	 	ITG	 	3/5/2014	 	All
								
	Inventory Tool Update and Reporting Procedure	 	Christopher Stephens	 	SC529-133835	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	IT Asset Management Group Mailbox Procedure	 	Christopher Stephens	 	SC529-123726	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	IT Internal Software Audit Procedure	 	Christopher Stephens	 	SC529-12435	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	ITAM Software Naming Standard Procedure	 	Christopher Stephens	 	SC530-73740	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	ITG Asset Management Delivery Confirmation Document Policy & Procedure	 	Mia S Terry- Samuels	 	TM1211- 131047	 		 	HNI	 	ITG	 	6/2/2014	 	All
								
	ITG Asset Management Policy & Procedure	 	Mia S Terry- Samuels	 	TM211- 112852	 		 	All	 	ITG	 	6/2/2014	 	N/A
								
	ITG Disaster Recovery Program	 	Mia S Terry- Samuels	 	TM115- 115532	 		 	All	 	ITG	 	1/7/2014	 	All
								
	ITG Disaster Recovery Standards	 	Mia S Terry- Samuels	 	TM129- 152924	 		 	All	 	ITG	 	1/7/2014	 	All
								
	ITG Production Services Change Management Policy	 	Mia S Terry- Samuels	 	TM515- 162438	 		 	All	 	ITG	 	5/29/2014	 	N/A

  

					
	Schedule P	  	P-359	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	ITG Release Management Business Communication Plan Procedure	 	Mia S Terry- Samuels	 	TM515-13913	 		 	All	 	ITG	 	5/27/2014	 	N/A
								
	ITG Release Management DB Refresh Procedure	 	Mia S Terry- Samuels	 	TM314- 101524	 		 	HNI	 	ITG	 	6/2/2014	 	N/A
								
	ITG Release Management Project Information Collection	 	Mia S Terry- Samuels	 	TM59-142158	 		 	HNI	 	ITG	 	5/27/2014	 	N/A
								
	ITG Release Management SIT & UAT At Risk Report	 	Mia S Terry- Samuels	 	TM510-9314	 		 	HNI	 	ITG	 	5/27/2014	 	N/A
								
	ITG Release Scheduling Policy & Guidelines	 	Mia S Terry- Samuels	 	TM31-143347	 		 	All	 	ITG	 	5/27/2014	 	All
								
	Manual Deprovisioning	 	Mia S Terry- Samuels	 	TM43-143732	 		 	All	 	ITG	 	6/3/2014	 	N/A
								
	Server Software Inventory Tool Update and Reporting Procedure	 	Christopher Stephens	 	SC529-141132	 		 	HNI	 	ITG	 	7/30/2014	 	Commercial
								
	Provider Network Management - Contracted Provider Non-Claim Provider Dispute Process	 	Anna M Young	 	YA1014- 151458	 		 	HNCA, HNCS	 	Legislation Implementation, Provider Network Management, Provider Services	 	4/24/2014	 	HMO, Commercial, Medicare Advantage, POS, PPO, Healthy Families [more...]
								
	Collateral: Creation, Updates and Access	 	Radhika X Mathur	 	MR410- 164421	 		 	MHN	 	Marketing and Communication	 	8/1/2014	 	N/A
								
	Marketing and Communications Material List Maintenance	 	Wendy M Welsh	 	WW818- 113324	 		 	MHN	 	Marketing and Communication	 	12/2/2013	 	Commercial
								
	MHN Quarterly Statistics Update	 	Wendy M Welsh	 	MR610-16350	 		 	MHN	 	Marketing and Communication	 	11/6/2013	 	MBHO - Managed Behavioral Health Organization
								
	Website Content: Creation and Updates	 	Radhika X Mathur	 	MR410- 165133	 		 	MHN	 	Marketing and Communication	 	8/1/2014	 	N/A
								
	BOM Management Medicare Post- Enrollment Kit Season Set-Up	 	Shelly L Ferrel	 	FS116-141642	 		 	HNI	 	 Marketing, CDS
 - Customer Distribution Services,
Employer Contracts
	 	1/2/2014	 	Medicare

  

					
	Schedule P	  	P-360	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medi-Cal Member Handbook Development	 	Miriam A Macias	 	VE1030- 104835	 		 	HNCA	 	Marketing, Employer Contracts	 	1/2/2014	 	Medi-Cal
								
	Escalation Process - ANOC/EOC Development for AEP	 	Teresa Rodriguez	 	DB45-14436	 	W	 	HN Life, HNAZ, HNCA, HNOR	 	Marketing, Medicare Marketing Review Team, Medicare Product Development [more...]	 	2/24/2014	 	Medicare Advantage and Medicare Part D
								
	Medicaid Compliance - Implementation and Communication of Regulatory and Contractual Changes	 	Sally C Chow	 	CS37-13252	 		 	HNCA	 	Medicaid Compliance	 	5/5/2014	 	Medicaid
								
	Medicaid Compliance â€“ Regulatory Communication Distribution Process	 	Deanna L Eaves	 	TS118-144851	 		 	HNCS	 	Medicaid Compliance	 	11/20/2013	 	Medicaid
								
	Pre-Service Organization Determinations- Medicare Advantage	 	Sue L Fischer	 	FS310-164038	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management, Appeals and Grievances (Member)	 	5/1/2014	 	Medicare Advantage
								
	Termination of Provider Services: Notice of Medicare Non-Coverage of Skilled Nursing Facility, Home Health Agency or Comprehensive Outpatient Rehabilitation Facility	 	Sue L Fischer	 	FS52-191550	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management, Appeals and Grievances (Member)	 	10/28/2013	 	Medicare Advantage, Dual Eligible
								
	One Sheet Enrollment Form Kits	 	Shelly L Ferrel	 	FS108-1762	 		 	HNAZ, HNCA, HNOR	 	 Medical Management, CDS -
 Customer Distribution
Services
	 	6/25/2014	 	Medicare
								
	AHCCCS Reinsurance	 	Trista A Loops	 	LT81-132927	 		 	Health Net Access	 	Medical Management, Finance, Claims	 	5/22/2014	 	 AHCCCS (AZ

Medicaid)

  

					
	Schedule P	  	P-361	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AHCCCS-Missed Appointments/No Show	 	Karen M Ellington	 	PA66-104653	 		 	Health Net Access	 	Medical Management, Provider Network Management, Member Services	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Accessibility of Services	 	Arlana Flores	 	CS715-1590	 	NE	 	HNNE	 	Medical Management	 	2/10/2014	 	All
								
	Advance Directives - Dual Eligible	 	Sue L Fischer	 	FS1127-85615	 		 	HNCA	 	Medical Management	 	11/18/2013	 	Dual Eligible
								
	Advance Directives -Medicare Advantage	 	Sue L Fischer	 	BG1127-13635	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	7/7/2014	 	Medicare Advantage
								
	AHCCCS Advance Directives	 	Sue L Fischer	 	FS610-19455	 		 	Health Net Access	 	Medical Management	 	5/14/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Appropriate Professionals	 	Sue L Fischer	 	EA428-6299	 		 	Health Net Access	 	Medical Management	 	9/17/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Care Coordination	 	Sue L Fischer	 	FS610-132514	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Case Management Identification of Members with Serious/Complex Conditions	 	Sue L Fischer	 	FS66-13168	 		 	Health Net Access	 	Medical Management	 	10/1/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Clinical Criteria & Practice Guidelines for Utilization Care Management	 	Jean V Serratore	 	EA426-16518	 		 	Health Net Access	 	Medical Management	 	8/21/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Community Resources	 	Sue L Fischer	 	FS85-152656	 		 	Health Net Access	 	Medical Management	 	8/14/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Consistent Application of Utilization Management Criteria by Health Net Medical Directors/Inter Rater Reliability	 	Sue L Fischer	 	EA422-153448	 		 	Health Net Access	 	Medical Management	 	8/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Denial, Modification or Deferral of Services for Lack of Medical Necessity	 	Sue L Fischer	 	EA426-182016	 		 	Health Net Access	 	Medical Management	 	9/24/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Discharge Planning	 	Sue L Fischer	 	EA515-15535	 		 	Health Net Access	 	Medical Management	 	8/12/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Disease Management	 	Sue L Fischer	 	EA428-64543	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-362	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AHCCCS Emergent Care and Post- Stabilization Coverage	 	Sue L Fischer	 	EA430-113712	 		 	Health Net Access	 	Medical Management	 	8/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Hierarchy of Medical Resources	 	Jean V Serratore	 	FS610-12737	 		 	Health Net Access	 	Medical Management	 	9/25/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Inpatient Concurrent Review	 	Sue L Fischer	 	EA418-21139	 		 	Health Net Access	 	Medical Management	 	8/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Inpatient Hospital Limits for Adults	 	Sue L Fischer	 	EA419-104110	 		 	Health Net Access	 	Medical Management	 	9/17/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Inter-Rater Reliability Non Physicians	 	Sue L Fischer	 	EA422-193927	 		 	Health Net Access	 	Medical Management	 	9/17/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Medical Home	 	Sue L Fischer	 	FS814-12106	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Medical Management Maternity Care Services	 	Sue L Fischer	 	FS613-21725	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Medical Management Training and Education	 	Sue L Fischer	 	FS79-72933	 		 	Health Net Access	 	Medical Management	 	8/14/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Members with Catastrophic Illnesses	 	Sue L Fischer	 	EA417-16448	 		 	Health Net Access	 	Medical Management	 	8/14/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Notice of Action for Service Determinations	 	Sue L Fischer	 	EA418-213945	 		 	Health Net Access	 	Medical Management	 	8/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Nutritional Supplements	 	Sue L Fischer	 	FS85-14527	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Obstetrical Admission and Delivery	 	Sue L Fischer	 	FS812-94052	 		 	Health Net Access	 	Medical Management	 	10/2/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Peer Review Committe Charter	 	Elizabeth E Rivas	 	RE79-124550	 		 	Health Net Access	 	Medical Management	 	8/5/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Peer Review Committee	 	Elizabeth E Rivas	 	RE79-122450	 		 	Health Net Access	 	Medical Management	 	8/5/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Potential Over and Under- Utilization Member and Provider Profiling	 	Sue L Fischer	 	EA418-181022	 		 	Health Net Access	 	Medical Management	 	5/22/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Pregnancy Terminations	 	Sue L Fischer	 	FS613-22297	 		 	Health Net Access	 	Medical Management	 	9/24/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Prior Authorization and Referral Process	 	Sue L Fischer	 	EA418-19932	 		 	Health Net Access	 	Medical Management	 	9/19/2013	 	 AHCCCS (AZ

Medicaid)

  

					
	Schedule P	  	P-363	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AHCCCS Prior Authroization List Maintenance and Annual Review	 	Sue L Fischer	 	FS66-145052	 		 	Health Net Access	 	Medical Management	 	9/19/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Reinsurance	 	Sue L Fischer	 	FS610-105141	 		 	Health Net Access	 	Medical Management	 	8/18/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Retrospective Review	 	Sue L Fischer	 	EA428-55327	 		 	Health Net Access	 	Medical Management	 	10/21/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Separation of Medical Decisions and Financial Concerns	 	Sue L Fischer	 	FS63-152556	 		 	Health Net Access	 	Medical Management	 	10/1/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Technology Assessment Policy	 	Jean V Serratore	 	EA422-213931	 		 	Health Net Access	 	Medical Management	 	9/24/2013	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Timeliness of Decision Making	 	Sue L Fischer	 	EA425-123630	 		 	Health Net Access	 	Medical Management	 	8/5/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Transplants	 	Sue L Fischer	 	EA418-11222	 		 	Health Net Access	 	Medical Management	 	10/2/2013	 	 AHCCCS (AZ
 Medicaid)

								
	Ambulance, Emergency and Urgently Needed and Post Stabilization Care Services - Medicare Advantage-Cal Medi- Connect	 	Sue L Fischer	 	FS415-135959	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	3/21/2014	 	Medicare Advantage, Dual Eligible
								
	Annual Consumer Assessment of Health Care Providers and Systems (CAHPS) Reporting	 	Leah N Smith	 	SL712-161030	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	4/11/2014	 	Commercial, Medicare, Medi-Cal, Dual Eligible, Health Benefit Exchange
								
	Annual HEDIS Reporting	 	Leah N Smith	 	SL712-153536	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	4/11/2014	 	Health Benefit Exchange
								
	Annual Medicare Health of Seniors (HOS) Reporting	 	Leah N Smith	 	SL712-153759	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	4/14/2014	 	Medicare
								
	Application of the Member Evaluation Tool (MET) for Seniors and Personâ€TMs with Disabilities (SPDs) UMCM-243 ML	 	Sue L Fischer	 	MS718-145045	 		 	HNCA	 	Medical Management	 	4/9/2014	 	Medi-Cal
								
	Appropriate Professionals	 	Sue L Fischer	 	BG121-135911	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	9/2/2014	 	Commercial, Medicare Advantage, Medi-Cal, Dual Eligible
								
	Approval and Distribution of Health Education Materials for Members in Case Management	 	Sue L Fischer	 	BG1127- 123525	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/19/2013	 	Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual Eligible

  

					
	Schedule P	  	P-364	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Assessment for Case Management -Cal Medi-Connect	 	Sue L Fischer	 	FS1127-85845	 		 	HNCA	 	Medical Management	 	4/1/2014	 	Dual Eligible
								
	Assessment for Case Management	 	Sue L Fischer	 	BG1127- 131519	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/27/2014	 	Commercial, Medicare Advantage, IFP, Indemnity
								
	Assessment for Complex Case Management and/or Care Coordination for SPD -#UMCM-236ML	 	Sue L Fischer	 	MS1229- 133131	 		 	HNCA	 	Medical Management	 	8/26/2014	 	Medi-Cal
								
	Assisting Enrollee with HRA Completion â€“Cal Medi-Connect	 	Sue L Fischer	 	FS1014- 164216	 		 	HNCA	 	Medical Management	 	3/18/2014	 	Dual Eligible
								
	Behavioral Health Referral	 	Aderonke X Komolafe	 	KA527-185339	 		 	Health Net Access	 	Medical Management	 	5/28/2014	 	Medicaid
								
	Care Settings Transition-Medicare Advantage Special Needs	 	Sue L Fischer	 	FS827-145949	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	10/30/2013	 	Medicare Advantage Special Needs Plan
								
	Care Settings Transition - Cal Medi- Connect	 	Sue L Fischer	 	FS1127-91858	 		 	HNCA	 	Medical Management	 	3/22/2014	 	Dual Eligible
								
	Case Management Identification of Members with Serious/Complex Condition #UMCM-230ML	 	Sue L Fischer	 	MS1229- 122714	 		 	HNCA	 	Medical Management	 	6/11/2014	 	Medi-Cal
								
	Case Management Identification of Members with Serious/Complex Conditions	 	Sue L Fischer	 	BG1127-1430	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/26/2014	 	Commercial, Medicare, Medicare Advantage, Indemnity, IFP
								
	Case Management Program Effectiveness	 	Sue L Fischer	 	BG1127- 134223	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	12/12/2013	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	Case/Care Management - # UMCM- 215ML	 	Sue L Fischer	 	MS1228- 145813	 		 	HNCA	 	Medical Management	 	6/27/2014	 	Medi-Cal
								
	CCC Transfer Process to Resolution Team for Explanation of Benefit (EOB) Reconciliation	 	Daniel G Middaugh	 	MD55-92150	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	5/29/2014	 	Medicare Advantage, Medicare Advantage HMO, Medicare Advantage PPO [more...]

  

					
	Schedule P	  	P-365	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Clinical Criteria for Utilization/Care Management Decisions - Medi-Cal UMCM 227	 	Sue L Fischer	 	MS1229- 121048	 		 	HNCA	 	Medical Management	 	12/16/2013	 	Medi-Cal
								
	Clinical Information for Utilization Management	 	Sue L Fischer	 	BG1127-11184	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/2/2013	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	Clinical Information Required for Review Determination -Medi-Cal #UMCM- 211ML:	 	Sue L Fischer	 	MS1228-14129	 		 	HNCA	 	Medical Management	 	12/6/2013	 	Medi-Cal
								
	CMS Universe Development and Oversight Process	 	Sue L Fischer	 	FS39-163850	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/1/2013	 	Medicare Advantage, Dual Eligible
								
	Communication and Accessibility to UM Associates	 	Sue L Fischer	 	BG1127- 114332	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	5/29/2014	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	Communication and UM Accessibility # UMCM-228 Medi-Cal	 	Sue L Fischer	 	MS1229- 121631	 		 	HNCA	 	Medical Management	 	5/27/2014	 	Medi-Cal
								
	Communication with Disenrolled- Terminated Enrollees- Medicare Advantage- Dual Eligible	 	Sue L Fischer	 	FS113-155250	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/2/2013	 	Medicare Advantage, Dual Eligible
								
	Community Based Adult Services (CBAS) Authorization Process - Medi-Cal	 	Sue L Fischer	 	MS53-111446	 		 	HNCA	 	Medical Management	 	5/7/2014	 	Medi-Cal
								
	Community Resources - Cal Medi- Connect	 	Sue L Fischer	 	FS1127-91226	 		 	HNCA	 	Medical Management	 	3/22/2014	 	Dual Eligible
								
	Community Resources - Medicare Advantage	 	Sue L Fischer	 	FS46-173429	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/26/2014	 	Medicare Advantage
								
	Complaints from Members Regarding Breach of Privacy/Confidentiality	 	Arlana Flores	 	CS716-93015	 	NE	 	HNNE	 	Medical Management	 	2/10/2014	 	All
								
	Complex Case Closure Criteria and Process - Medi-Cal #UMCM-229ML	 	Sue L Fischer	 	MS1229- 122324	 		 	HNCA	 	Medical Management	 	6/27/2014	 	Medi-Cal
								
	Complex Case Management including Coordination of Care for Seniors and Persons with Disabilities -#UMCM- 242ML:	 	Sue L Fischer	 	MS326-14731	 		 	HNCA	 	Medical Management	 	8/27/2014	 	Medi-Cal

  

					
	Schedule P	  	P-366	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Complex Case Management Program Effectiveness - # UMCM-231 ML	 	Sue L Fischer	 	MS1229-12365	 		 	HNCA	 	Medical Management	 	6/27/2014	 	Medi-Cal
								
	Complex Case Management Review Monitoring -Medi-Cal #UMCM-232ML	 	Sue L Fischer	 	MS1229- 124224	 		 	HNCA	 	Medical Management	 	6/27/2014	 	Medi-Cal
								
	Consent for Case Management -Cal Medi- Connect	 	Sue L Fischer	 	FS1127-9525	 		 	HNCA	 	Medical Management	 	3/28/2014	 	Dual Eligible
								
	Consent for Case Management	 	Sue L Fischer	 	BG1127- 144210	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	1/31/2014	 	Commercial, Medicare Advantage, Indemnity, IFP, EPO
								
	Consent for Complex Case Management Medi-Cal #UMCM-233ML	 	Sue L Fischer	 	MS1229- 124611	 		 	HNCA	 	Medical Management	 	6/27/2014	 	Medi-Cal
								
	Consistent Application of Utilization Management Criteria by Health Net Medical Directors/Inter Rater Reliability	 	Sue L Fischer	 	FS69-8153	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/11/2013	 	Commercial, Medicare, Indemnity, IFP, Medi- Cal, Dual Eligible
								
	Continuity and Coordination of Care for Existing Members	 	Sue L Fischer	 	BG96-101017	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/27/2014	 	Commercial, Medicare Advantage
								
	Continuity and Coordination of Care Related to Benefit Exhaustion for Existing Members- Dual Eligible	 	Sue L Fischer	 	FS1127-9841	 		 	HNCA	 	Medical Management	 	11/18/2013	 	Dual Eligible
								
	Continuity of Care - Medi-Cal #UMCM- 216ML	 	Sue L Fischer	 	MS1228-15444	 		 	HNCA	 	Medical Management	 	3/26/2014	 	Medi-Cal
								
	Continuity of Care Assistance- CA HMO	 	Sue L Fischer	 	FS818-141122	 		 	HNCA	 	Medical Management	 	4/2/2014	 	Commercial
								
	Continuity of Care Assistance - CA PPO	 	Sue L Fischer	 	FS23-113158	 		 	HN Life, HNCA	 	Medical Management	 	4/2/2014	 	PPO
								
	Continuity of Care Assistance - Medicare Advantage	 	Sue L Fischer	 	FS46-173538	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/2/2013	 	Medicare Advantage, Dual Eligible
								
	Continuity of Care Assistance - Oregon	 	Sue L Fischer	 	AM518- 144953	 		 	HNOR	 	Medical Management	 	11/12/2013	 	EPO, POS, PPO
								
	Continuity of Care Assistance - Washington	 	Sue L Fischer	 	FS212-11148	 		 	HNOR	 	Medical Management	 	3/5/2014	 	Commercial
								
	Continuity of Care Assistance -Arizona	 	Sue L Fischer	 	BK113-12243	 		 	HNAZ	 	Medical Management	 	3/5/2014	 	Commercial
								
	Continuity of Care Assistance EPO - California	 	Sue L Fischer	 	FS1119-1199	 		 	HN Life	 	Medical Management	 	2/24/2014	 	EPO - California

  

					
	Schedule P	  	P-367	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Continuity of Care for Existing Members - Cal Medi-Connect	 	Sue L Fischer	 	FS1210- 134237	 		 	HNCA	 	Medical Management	 	5/1/2014	 	Dual Eligible
								
	Denial of Services for Lack of Medical Necessity	 	Sue L Fischer	 	BG1130- 142935	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	4/2/2014	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	Denial, Modification or Deferral of Services for Lack of Medical Necessity - Medi-Cal #UMCM-207	 	Sue L Fischer	 	MS1228- 132856	 		 	HNCA	 	Medical Management	 	12/19/2013	 	Medi-Cal
								
	Development, Implementation and Monitoring of the Case Management Plan of Care- Commercial	 	Sue L Fischer	 	FS913-75148	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	1/31/2014	 	Commercial, Indemnity, IFP, EPO
								
	Development, Implementation and Monitoring of the Case Management Plan of Care- Medicare Advantage	 	Sue L Fischer	 	BG1127- 144857	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/26/2014	 	Medicare Advantage< Medicare Advantage Special Needs Population
								
	Development, Implementation and Monitoring of the Case Management Plan of Care - Cal Medi-Connect	 	Sue L Fischer	 	FS1127-91438	 		 	HNCA	 	Medical Management	 	3/18/2014	 	Dual Eligible
								
	Development, Implementation and Monitoring of the Complex Case Management Plan of Care -#UMCM- 237ML	 	Sue L Fischer	 	MS1229- 133924	 		 	HNCA	 	Medical Management	 	8/27/2014	 	Medi-Cal
								
	Discharge Planning - Medi-Cal #UMCM- 208ML:	 	Sue L Fischer	 	EA418-184237	 		 	HNCA	 	Medical Management	 	5/1/2014	 	Medi-Cal
								
	Emergency Care Services - # UMCM- 212ML	 	Sue L Fischer	 	MS1228- 143839	 		 	HNCA	 	Medical Management	 	5/30/2014	 	Medi-Cal
								
	Emergency Room Utilization and Hospital Admission and Readmission Rates -Cal Medi-Connect	 	Sue L Fischer	 	FS1217- 121651	 		 	HNCA	 	Medical Management	 	3/28/2014	 	Dual Eligible
								
	Emergency Services	 	Sue L Fischer	 	BG1130- 151121	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	2/20/2014	 	Commercial, Indemnity, IFP, EPO, Healthy Kids, Healthy Families
								
	Enhanced Case Management for Non- CBAS eligible members - #UMCM- 248ML	 	Sue L Fischer	 	MS53-114114	 		 	HNCA	 	Medical Management	 	8/28/2014	 	Medi-Cal

  

					
	Schedule P	  	P-368	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Extended Care (SNF) Services - Medicare Advantage and Dual Eligible	 	Sue L Fischer	 	BG121-133325	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/6/2013	 	Medicare Advantage, Dual Eligible
								
	Facilitating Membersâ€TM Adherence to Prescribed Treatments	 	Sue L Fischer	 	BG1128- 142441	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/2/2013	 	Medicare Advantage, Dual Eligible
								
	Federal Disaster or Public Health Emergency -Medicare Advantage	 	Sue L Fischer	 	FS617-213557	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/21/2013	 	Medicare Advantage
								
	Health Risk Assessment - Medicare Advantage	 	Sue L Fischer	 	FS914-9190	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/27/2014	 	Medicare Advantage
								
	Health Risk Assessment -Cal Medi- Connect	 	Sue L Fischer	 	FS1127-91651	 		 	HNCA	 	Medical Management	 	4/1/2014	 	Dual Eligible
								
	HEDIS Unit Part C Reporting Process - PF	 	Matthew J Roseberry	 	SL314-132013	 		 	HN Life, HNAZ, HNCA, HNCT, HNOR	 	Medical Management	 	8/18/2014	 	Medicare Advantage
								
	HEDIS Unit Part C Reporting Process Reporting SRAE	 	Matthew J Roseberry	 	SL314-135724	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	2/21/2014	 	Medicare Advantage
								
	Hierarchy of Medical Resources	 	Jean V Serratore	 	SJ85-164029	 		 	HNI	 	Medical Management	 	4/22/2014	 	All, Dual Eligible
								
	Hospice Care Services - Medi-Cal	 	Sue L Fischer	 	FS66-113641	 		 	HNCA	 	Medical Management	 	5/9/2014	 	Medi-Cal
								
	Identification and Referral of CCS members Medi-Cal #UMCM-217ML:	 	Sue L Fischer	 	MS1228-15165	 		 	HNCA	 	Medical Management	 	12/19/2013	 	Medi-Cal
								
	Identification of Members for Disease Management Program Referral	 	Sue L Fischer	 	BG1128- 143939	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	5/27/2014	 	Commercial, Medicare Advantage, Indemnity, IFP, EPO
								
	Identification of Members for Disease Management Program Referrals -Cal Medi-Connect	 	Sue L Fischer	 	FS1214-8442	 		 	HNCA	 	Medical Management	 	3/28/2014	 	Dual Eligible
								
	Inpatient Concurrent Utilization Review - Medi-Cal (#UMCM-213ML)	 	Sue L Fischer	 	MS1228- 145145	 		 	HNCA	 	Medical Management	 	7/23/2014	 	Medi-Cal
								
	Inpatient Management	 	Sue L Fischer	 	BG1128-14582	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/19/2013	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

  

					
	Schedule P	  	P-369	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Inter-Rater Reliability Non Physicians	 	Sue L Fischer	 	BG1128- 151328	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	10/30/2013	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible [more...]

								
	Interdisciplinary Care Team Coordination of Care - Cal Medi-Connect	 	Sue L Fischer	 	FS1127-92015	 		 	HNCA	 	Medical Management	 	3/18/2014	 	Dual Eligible
								
	Management of Enrollees in Subacute Long Term Care â€“ Cal MediConnect & Medi-Cal	 	Sue L Fischer	 	FS620-114348	 		 	HNCA	 	Medical Management	 	7/2/2014	 	Medi-Cal, Dual Eligible
								
	Management of Long Term Care Members- Medi-Cal (CCI Counties)	 	Sue L Fischer	 	FS610-132152	 		 	HNCA	 	Medical Management	 	7/2/2014	 	Medi-Cal, Full Duals, Partials
								
	Management of Members in Long Term Care- Cal Medi-Connect	 	Sue L Fischer	 	FS1218- 144320	 		 	HNCA	 	Medical Management	 	7/25/2014	 	Dual Eligible
								
	 Medi-Cal Disease Management Programs

-#UMCM-223ML
	 	Sue L Fischer	 	MS1228- 153814	 		 	HNCA	 	Medical Management	 	8/28/2014	 	Medi-Cal
								
	Medical Management Compliance Training and Education	 	Sue L Fischer	 	FS119-111519	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/6/2013	 	Commercial, Medicare Advantage, Indemnity, Medi-Cal, Dual Eligible
								
	Medical Management Pre-Service Reopening Decisions - Medicare Advantage	 	Sue L Fischer	 	FS39-17621	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/6/2013	 	Medicare Advantage, Dual Eligible
								
	Medicare Quality Improvement Program	 	Candace C Ryan	 	LG720-92434	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	6/6/2014	 	Medicare
								
	Medicare SNF Admission/Readmission and Levels of Care	 	Sue L Fischer	 	FS713-72932	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	3/28/2014	 	Medicare Advantage
								
	Medicare SNP Emergency Room Utilization and Hospital Admission/Readmission Rates	 	Sue L Fischer	 	FS620-142545	 		 	HNAZ, HNCA	 	Medical Management	 	2/20/2014	 	Medicare Advantage Special Needs Plan
								
	Medicare Special Needs Plan Member Stratification	 	Charlene M Khanlian	 	KC623-11460	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	4/8/2014	 	Medicare
								
	Member and Provider Annual Assessment Interface - Medicare Advantage	 	Sue L Fischer	 	FS1025- 173143	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	2/25/2014	 	Medicare Advantage
								
	Member Complaints about Quality of Care Service	 	Arlana Flores	 	CS715-154718	 	NE	 	HNNE	 	Medical Management	 	2/10/2014	 	All

  

					
	Schedule P	  	P-370	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Obstetrical Admission and Delivery	 	Sue L Fischer	 	BG1128- 154930	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/6/2013	 	Commercial, Medicare Advantage, Indemnity, IFP, Dual Eligible, EPO
								
	Part C Medicare Reporting - Medical Management	 	Sue L Fischer	 	HP45-82517	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	5/22/2014	 	Medicare Advantage, Dual Eligible
								
	Post-Stabilization, In-Patient Care Requested by Non-Contracted Hospitals	 	Sue L Fischer	 	TS316-15559	 		 	HNCA	 	Medical Management	 	3/25/2014	 	Commercial
								
	Post Stabilization Inpatient Care Requested by Non-Contracting Hospitals - Medi-Cal	 	Sue L Fischer	 	MS53-113244	 		 	HNCA	 	Medical Management	 	5/2/2014	 	Medi-Cal
								
	Potential Over- and Under-Utilization - Medicare Advantage-Cal Medi-Connect	 	Sue L Fischer	 	BG1128- 161532	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	4/1/2014	 	Medicare Advantage, Dual Eligible
								
	Potential Over- and Under-Utilization- Medi-Cal #UMCM-221ML	 	Sue L Fischer	 	MS1228-15349	 		 	HNCA	 	Medical Management	 	3/25/2014	 	Medi-Cal
								
	Potential Over and Under Utilization- Commercial	 	Sue L Fischer	 	FS16-12725	 		 	HN Life, HNAZ, HNCA	 	Medical Management	 	3/25/2014	 	Commercial
								
	Precertification and Prior Authorization Request Procedure -Medi-Cal # UMCM - 209ML	 	Sue L Fischer	 	MS1228- 134735	 		 	HNCA	 	Medical Management	 	12/19/2013	 	Medi-Cal
								
	Prior Authorization List Maintenance and Annual Review	 	Sue L Fischer	 	BG1128- 163053	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	3/5/2014	 	Commercial, Medicare Advantage, Medi-Cal, Dual Eligible
								
	Provision of Nutritional Supplements/ Replacements -Medi-Cal	 	Sue L Fischer	 	MS21-9823	 		 	HNCA	 	Medical Management	 	5/1/2014	 	Medi-Cal
								
	Quality Review and Evaluation of Cal MediConnect (the Dual Demonstration)	 	Shekinah A Wright	 	WS226-15829	 		 	HNCS	 	Medical Management	 	5/30/2014	 	Dual Eligible
								
	 Referral to Case Management - Medi-Cal

#UMCM-235ML:
	 	Sue L Fischer	 	MS1229- 132328	 		 	HNCA	 	Medical Management	 	12/6/2013	 	Medi-Cal
								
	Referral to Case Management	 	Sue L Fischer	 	FS58-161316	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/27/2014	 	Commercial, Medicare Advantage, Indemnity, IFP

  

					
	Schedule P	  	P-371	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	 Referrals to Non-participating Practitioners/Providers -Medi-cal

#UMCM-210ML:
	 	Sue L Fischer	 	MS1228-13548	 		 	HNCA	 	Medical Management	 	12/6/2013	 	Medi-Cal
								
	Regulatory Compliance Monitoring - Medicare Advantage and Dual Eligible	 	Sue L Fischer	 	FS52-175031	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	12/2/2013	 	Medicare Advantage, Dual Eligible
								
	Screening Criteria for Ambulatory Case Management - # UMCM-234ML	 	Sue L Fischer	 	MS1229- 125142	 		 	HNCA	 	Medical Management	 	8/27/2014	 	Medi-Cal
								
	Screening Criteria for Case Management	 	Sue L Fischer	 	BG121-141652	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	3/26/2014	 	Commercial, Medicare Advantage, Indemnity, IFP
								
	Second Opinion -#UMCM-240ML	 	Sue L Fischer	 	MS326-1408	 		 	HNCA	 	Medical Management	 	8/27/2014	 	Medi-Cal
								
	Separation of Medical Decisions and Financial Concerns	 	Sue L Fischer	 	BG121-135030	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/11/2013	 	Commercial, Medicare Advantage, Indemnity, IFP, Dual Eligible, Medi-Cal [more...]
								
	Skilled Nursing Facility Admission/Readmission, CBAS Utilization, Long Term Care and Levels of Care - Cal Medi-Connect	 	Sue L Fischer	 	FS1217-84836	 		 	HNCA	 	Medical Management	 	3/28/2014	 	Dual Eligible
								
	Special Needs Program Interdisciplinary Care Team Coordination of Care	 	Sue L Fischer	 	FS102-13245	 		 	HNAZ, HNCA, HNOR	 	Medical Management	 	8/4/2014	 	Medicare Advantage Special Needs Program
								
	Specialty Referral System - Medi-Cal	 	Sue L Fischer	 	FS226-144855	 		 	HNCA	 	Medical Management	 	8/14/2014	 	Medi-Cal
								
	Standing Referral to Specialty Care - Medi-cal #UMCM-224ML:	 	Sue L Fischer	 	MS1229- 115057	 		 	HNCA	 	Medical Management	 	7/8/2014	 	Medi-Cal
								
	Standing Referral to Specialty Care	 	Sue L Fischer	 	BG1130- 144440	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	11/6/2013	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	State Health Program (SHP) Perinatal Case Management Program #UM/CM- 219ML:	 	Sue L Fischer	 	MS1213-15164	 		 	HNCA	 	Medical Management	 	2/24/2014	 	Medi-Cal
								
	Stratification Methodology - Cal Medi- Connect	 	Sue L Fischer	 	FS1210- 133948	 		 	HNCA	 	Medical Management	 	3/18/2014	 	Dual Eligible

  

					
	Schedule P	  	P-372	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Transgender Services	 	Sue L Fischer	 	FS37-155146	 		 	HNCA	 	Medical Management	 	3/24/2014	 	HMO, POS
								
	Use of Board-Certified Physician Consultants in Utilization Management Decision-Making -#UMCM- 239ML:	 	Sue L Fischer	 	MS326-135213	 		 	HNCA	 	Medical Management	 	8/12/2014	 	Medi-Cal
								
	Use of Board-Certified Physician Consultants in Utilization Management Decision-Making	 	Sue L Fischer	 	BG1130-14178	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medical Management	 	8/25/2014	 	 Commercial, Medicare Advantage, Indemnity, IFP, EPO, Dual

Eligible

								
	Utilization Management Decions Timelines - Medi-Cal -#UMCM-225ML:	 	Sue L Fischer	 	MS1229- 115751	 		 	HNCA	 	Medical Management	 	8/7/2014	 	Medi-Cal
								
	Utilization Management Decision Timelines - Commercial - Arizona	 	Sue L Fischer	 	BJ518-125433	 		 	HN Life, HNAZ	 	Medical Management	 	2/21/2014	 	Commercial
								
	Utilization Management Decision Timelines - Commercial - Washington	 	Sue L Fischer	 	FS127-112859	 		 	HN Life, HNOR	 	Medical Management	 	2/24/2014	 	PPO, EPO
								
	Utilization Management Decision Timelines - Commercial - Oregon	 	Sue L Fischer	 	AM925- 121910	 		 	HN Life, HNOR	 	Medical Management	 	2/20/2014	 	 EPO, PPO,
 Commercial

								
	Utilization Management Decision Timelines - Commercial - California	 	Sue L Fischer	 	FS1110-83739	 		 	HN Life, HNCA	 	Medical Management	 	2/20/2014	 	Commercial, Indemnity, IFP
								
	Utilization Management Decisions Timelines - Cal MediConnect	 	Sue L Fischer	 	FS212-104025	 		 	HNCA	 	Medical Management	 	8/27/2014	 	Cal MediConnect
								
	Utilization Management Timely Access to Health Care Services	 	Sue L Fischer	 	FS114-92524	 		 	HNCA	 	Medical Management	 	8/25/2014	 	Commercial, Medi-Cal
								
	Scope of Appointment (SOA) Documentation Audit Process â€“ Producer Oversight	 	Curt Nelson	 	TR225-85324	 		 	HNAZ, HNCA, HNOR	 	Medicare Compliance, Medicare Sales, Sales Operations, Medicare Programs	 	4/30/2014	 	Medicare Advantage
								
	Medicare Compliance Intranet Website Maintenance	 	Eva Y Lo	 	LE42-11413	 		 	HNI	 	Medicare Compliance	 	4/4/2014	 	Medicare, Medicare Advantage, Medicare Part D, Dual Eligible

  

					
	Schedule P	  	P-373	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Compliance Obsolescence of Medicare Advantage (MA), Medicare- Medicaid Plan (MMP) and Part D Marketing Materials	 	Laura X Allen	 	LE45-11550	 		 	HNI	 	Medicare Compliance	 	2/19/2014	 	Medicare, Medicare Advantage, Medicare Part D, Dual Eligible
								
	Medicare Compliance â€“ Managing Health Net Medicare Programs Issue Write Ups	 	Roseanne X Cruz	 	CA56-131542	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR	 	Medicare Compliance	 	7/23/2013	 	Medicare Advantage, Medicare Part D, Dual Eligible
								
	Editing Procedure - County by County Grids	 	Daniel M Pasternak	 	PD920-14055	 		 	HNI	 	Medicare Product Development, Actuarial	 	10/17/2013	 	Medicare Advantage
								
	Medicare Advantage (MA) and Medicare Advantage with Part D (MAPD) Bid Submission: Rebate Reallocation Process	 	Sherry E Brown	 	DB217-165151	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Product Development, Corporate Actuarial	 	2/13/2014	 	Medicare Advantage
								
	Benefit Configuration Grid â€“ Creation and Quality Check Policy and Procedure	 	Kim M Nguyen	 	DB514-141728	 		 	HNAZ, HNCA, HNOR	 	Medicare Product Development	 	8/19/2013	 	Medicare
								
	Medicare Product Development Review Process for ANOCs and EOCs	 	Teresa Rodriguez	 	BJ19-92051	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Product Development	 	4/1/2014	 	Medicare, Medicare Advantage
								
	Medicare Advantage (MA) and Medicare Advantage with Part D (MAPD) Bid Submission: MA and MAPD Bid Development and Guiding Process	 	Sherry E Brown	 	DB217-153113	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Product Management and Corporate Actuarial	 	1/27/2014	 	Medicare Advantage
								
	Medicare Advantage (MA) and Medicare Advantage with Part D (MAPD) Bid Submission: Product View and ABC Report Process	 	Sherry E Brown	 	BS225-95215	 		 	HNAZ, HNCA, HNI, HNOR	 	Medicare Product Management and Corporate Actuarial	 	1/27/2014	 	Medicare Advantage
								
	Medicare Advantage (MA) and Medicare Advantage with Part D (MAPD) Submission: BPT Actuarial Peer Review Process	 	Sherry E Brown	 	BS928-142840	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Product Management and Corporate Actuarial	 	1/8/2014	 	Medicare Advantage

  

					
	Schedule P	  	P-374	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Advantage (MA) and Part D Bid Submission: PBP Desk Review Process	 	Sherry E Brown	 	DB217-161649	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Product Management and Corporate Actuarial	 	1/27/2014	 	Medicare Advantage
								
	Part D Creditability Testing	 	Sherry E Brown	 	BS429-10541	 		 	HNI	 	Medicare Product Management and Corporate Actuarial	 	8/29/2013	 	Medicare Part D
								
	Support for Claims Reserve Process	 	Sherry E Brown	 	BS1019-162048	 		 	HN Life, HNAZ, HNCA, HNOR, MHN	 	Medicare Product Management and Corporate Actuarial	 	1/24/2014	 	All
								
	Health Net Medicare Programs Customer Care TTY / TDD Policy and Procedure	 	Christine X Martignoni	 	BV1012-13741	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs, Customer Service	 	1/24/2014	 	Medicare
								
	Health Net Medicare Voicemail Procedure	 	Christine X Martignoni	 	BV1220-132657	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs, Member Services	 	6/16/2014	 	Medicare Advantage, Medicare
								
	Internet Response Team Quality Assurance Compliance	 	Viola Lo	 	MS1017-1175	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs, Member Services	 	3/26/2013	 	Commercial, Medicare, Medicare Advantage, Medicare Part D, POS, PPO, IFP
								
	Outbound Enrollment & Verification Process (OEV)	 	Vanessa x Boorman	 	DY426-14433	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs, Membership, Member Services	 	8/30/2013	 	Medicare, Medicare Advantage, Medicare Part D, Medicare Advantage PPO [more...]
								
	502 Error Threshold Reporting Process for CMS	 	Patrick Kurlej	 	DY427-22491	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	6/15/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Agent/Broker Certification & Contracting	 	Michael C Lehron	 	NC23-14548	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	2/27/2014	 	Medicare Advantage

  

					
	Schedule P	  	P-375	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Alternative Submission Method (ASM) File Format Processing	 	Patrick Kurlej	 	DY427-11499	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	6/16/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Annual Medicare First Tier, Downstream, Related Entity (FDR) Risk Assessment Process	 	Jamie X Babby	 	BJ717-85640	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Programs	 	7/23/2014	 	Medicare Advantage and Medicare Part D
								
	Auto Troop and Drug Spend Adjustment Validation Audit	 	Paula M Allen	 	AP1220-14558	 	NW	 	HNAZ, HNCA, HNNE, HNOR, HNPS	 	Medicare Programs	 	4/1/2014	 	Medicare
								
	CMS Part C & D User Calls Concurrent Process - Customer Contact Center and Appeals and Grievances	 	Angela N Kuba	 	BV1128-111656	 		 	All	 	Medicare Programs	 	12/19/2013	 	Medicare
								
	Contact Center Correspondence & Document Management	 	Edwin X Ram	 	RE619-115053	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	7/5/2013	 	Medicare, Medicare Advantage PPO, Medicare Advantage HMO
								
	Health Net Medicare Programs P&P: Mailing Notification Policy	 	Viola Lo	 	LV1215-101242	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	6/6/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Programs P&P: Power Of Attorney (POA) & Authorization Of Representation (AOR)	 	Viola Lo	 	LV110-84511	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	2/20/2014	 	Medicare Advantage
								
	HN CCC Medicare TTY Testing Policy	 	Vanessa x Boorman	 	BV110-103338	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	3/20/2014	 	Medicare
								
	iRADS Error Processing - Claims	 	Patrick Kurlej	 	DY427-125542	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare, Medicare Advantage, Medicare Advantage and Medicare Part D [more...]
								
	Medicare Advantage (MA) and Part D bid Submission: PBP Peer Review Process	 	Sherry E Brown	 	DB217-155516	 		 	HN Life, HNAZ, HNCA, HNI, HNOR, HNPS	 	Medicare Programs	 	2/13/2014	 	Medicare Advantage
								
	Medicare Call Center Process for A&G	 	Christine X Martignoni	 	BV131-1286	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	7/11/2014	 	Medicare

  

					
	Schedule P	  	P-376	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Risk Adjustment Data Validation Process	 	Fia R Roberts	 	DY427-13352	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	5/16/2012	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Risk Adjustment Optum Oversight	 	Fia R Roberts	 	DY427-125154	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	5/16/2012	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Risk Adjustment Vendor Security Oversight	 	Fia R Roberts	 	DY427-132720	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	4/10/2012	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Monthly Audit File Processing	 	Patrick Kurlej	 	DY427-115833	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	4/19/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Monthly Medicare Risk Adjustment Accrual Process	 	Janet L Fina	 	DY427-125934	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	10/15/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	National Broker HUB Application Processing	 	Yolanda M Marino	 	MY317-101553	 		 	HNAZ, HNCA, HNOR	 	Medicare Programs	 	11/4/2013	 	Medicare Advantage
								
	National Medicare Broker Contracting Policies and Procedures	 	Michael C Lehron	 	PD314-14358	 		 	HN Life, HNAZ, HNCA, HNNE, HNOR, HNPS	 	Medicare Programs	 	4/30/2014	 	Medicare
								
	National Medicare Broker Services - HIPAA Compliance	 	Tammy M Brown	 	BT414-81444	 		 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR	 	Medicare Programs	 	4/21/2014	 	Medicare
								
	National Medicare Broker Services - Part D Rx Claims Routing via Macess	 	Tammy M Brown	 	BT1229-121740	 	NE	 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR	 	Medicare Programs	 	12/3/2012	 	Medicare
								
	National Medicare Broker Services - Sales Event Submission	 	Tammy M Brown	 	BT215-124424	 	NE	 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR	 	Medicare Programs	 	2/3/2014	 	Medicare
								
	RADC Error Processing - Claims	 	Patrick Kurlej	 	DY427-134237	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]

  

					
	Schedule P	  	P-377	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	RADC File Parser	 	Patrick Kurlej	 	DY427-13316	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	RAPS Return Files	 	Patrick Kurlej	 	DY427-113619	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Retiree Drug Subsidy	 	Donna C Mendizabal	 	MD76-113312	 		 	HNCA	 	Medicare Programs	 	6/2/2014	 	Medicare, Commercial, Medicare Advantage and Medicare Part D
								
	Risk Adjustment Data Reconciliation Process - iRADs	 	Patrick Kurlej	 	DY427-121029	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Risk Adjustment Data Reconciliation Process	 	Patrick Kurlej	 	DY427-121740	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	6/16/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Risk Adjustment Final Payment Calculation	 	Patrick Kurlej	 	DY427-13641	 		 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	8/1/2013	 	Medicare Advantage, Medicare, Medicare Advantage PPO [more...]
								
	Risk Adjustment Mid-Year Payment Calculation	 	Patrick Kurlej	 	DY427-132041	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	6/16/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Submission of Risk Adjustment Data	 	Patrick Kurlej	 	DY412-132625	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Medicare Programs	 	4/19/2013	 	Medicare, Medicare Advantage, Medicare Part D
								
	Transfer of Files to Ingenix	 	Patrick Kurlej	 	DY427-123655	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Medicare Programs	 	9/3/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]

  

					
	Schedule P	  	P-378	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Late Application Policy and Procedure - Producer	 	Yvonne M Douglas	 	DY1221-10406	 		 	HNAZ, HNCA, HNOR	 	Medicare Sales, Medicare Programs, Membership, National Medicare Compliance	 	9/3/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Late Application Policy and Procedure â€“ Sales Associates	 	Yvonne M Douglas	 	DY61-113620	 		 	HNAZ, HNCA, HNOR	 	Medicare Sales, Medicare Programs, Membership, National Medicare Compliance	 	9/22/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Late Application CAP for Producers and Sales Associates	 	Yvonne M Douglas	 	DY314-154436	 	NW	 	HNAZ, HNCA, HNI, HNOR	 	Medicare Sales, National Medicare Compliance, Medicare Programs	 	9/30/2013	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Medicare Sales Agent Activities and Oversight	 	Curt Nelson	 	NC102-145815	 		 	HNAZ, HNCA, HNOR	 	Medicare Sales, Sales Operations, Member Services, Sales Operations	 	9/2/2014	 	Medicare, Medicare Advantage, Medicare Advantage PPO [more...]
								
	Broker Referral Program	 	Curt Nelson	 	JS110-133332	 	W	 	HNAZ	 	Medicare Sales	 	7/16/2014	 	Medicare Advantage
								
	Internal CMS In Home Scope of Appointment Audit	 	John M Obrenovich	 	OJ511-11844	 	W	 	HNAZ, HNCA, HNOR	 	Medicare Sales	 	2/7/2014	 	Medicaid, Medicare, Medicare Advantage, Medicare Part D [more...]
								
	Part D Creditability Status EG Communication	 	Curt Nelson	 	GK328-112524	 	NE	 	HN Life, HNAZ, HNCA, HNI, HNNE, HNOR, HNPS	 	Medicare Sales	 	3/18/2014	 	Medicare Advantage and Medicare Part D

  

					
	Schedule P	  	P-379	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Producer and Agent Sales Commission Compensation â€“ Medicare Products	 	Curt Nelson	 	TR310-94856	 		 	HNAZ, HNCA, HNOR	 	Medicare Sales	 	9/30/2013	 	Medicare Advantage, Medicare Part D
								
	Meetings and Events Program	 	Remy M Franklin	 	MP228-8128	 		 	All	 		 	5/19/2014	 	N/A
								
	CCC P&P: Commercial Provider Transitions	 	Viola Lo	 	MS1210-91636	 		 	HNCA	 	Member Services, Provider Network Management	 	4/16/2014	 	HMO, POS, PPO
								
	Language Increases Policy and Procedure	 	Edwin X Ram	 	RE213-14333	 		 	HNAZ, HNCA, HNOR, MHN	 	Member Services, Provider Services, Customer Service	 	2/18/2014	 	HMO, Commercial, Medicare, Medicaid, Medicare Advantage, POS, PPO [more...]
								
	Cal MediConnect CSR Role P&P	 	Edwin X Ram	 	RE523-145942	 		 	HNCA	 	Member Services, Provider Services	 	6/2/2014	 	Medicaid, Medicare, Dual Eligible
								
	Cal MediConnect: Optum Face to Face Interpreter Requests	 	Edwin X Ram	 	RE523-15819	 		 	HNCA	 	Member Services, Provider Services	 	6/2/2014	 	Medicaid, Medicare, Dual Eligible
								
	CCC P&P - Updating Out-of-Pocket Maximum	 	Viola Lo	 	ZT428-104054	 		 	HNCA	 	Member Services, Provider Services	 	4/16/2014	 	Commercial
								
	CCC Policy & Procedure: Internet Response Team â€“ Provider Services	 	Viola Lo	 	LV411-114125	 	SW	 	HNAZ, HNCA	 	Member Services, Provider Services	 	4/3/2014	 	HMO, POS, PPO
								
	Commercial/SHP Exempt Grievances Policy and Procedure	 	Edwin X Ram	 	RE327-13527	 		 	HNAZ, HNCA, HNOR	 	Member Services, Provider Services	 	4/25/2014	 	Commercial, Healthy Kids, Medi-Cal, Healthy Families

  

					
	Schedule P	  	P-380	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Inclement Weather Policy and Procedure	 	Edwin X Ram	 	RE326-1077	 		 	HNAZ, HNCA, HNOR	 	Member Services, Provider Services	 	2/24/2014	 	Commercial, Medicare, Healthy Kids, Medi- Cal, Healthy Families
								
	Cal MediConnect Assignment Protocol	 	Daniel G Middaugh	 	MD522-105645	 		 	HNCA	 	Member Services	 	5/29/2014	 	Dual Eligible
								
	CalViva Health Policy & Procedure: Case Management Referral	 	Viola Lo	 	LV1211-131353	 		 	HNCA	 	Member Services	 	1/16/2014	 	Medicaid, CalViva Health
								
	CCC Bilingual Hiring Policy	 	Viola Lo	 	CS823-111659	 		 	HNCA	 	Member Services	 	8/21/2014	 	Commercial, Medi-Cal
								
	CCC Disclosure Procedure for Medicare Beneficiaries	 	Christine X Martignoni	 	BV112-14237	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	6/17/2014	 	Medicare
								
	CCC Escalation to Resolution Unit Policy	 	Vanessa x Boorman	 	BV110-10467	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/30/2014	 	Medicare
								
	CCC P&P - A&G Associate Expectations for Processing Federally-facilitated Marketplace Complaints	 	Viola Lo	 	LV127-95750	 		 	HNAZ	 	Member Services	 	4/1/2014	 	HMO, POS, PPO
								
	CCC P&P - Callers who Receive another Memberâ€TMs Materials in Error	 	Viola Lo	 	ZT22-153144	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/1/2014	 	Medicaid, Medicare Advantage, HMO, POS, PPO
								
	CCC P&P - Ethnicity and Diversity- Updating CSI and ABS	 	Viola Lo	 	LV67-132540	 		 	HNCA	 	Member Services	 	8/24/2013	 	Commercial, Medicaid
								
	CCC P&P - Managing Service Forms/Work List Tab	 	Viola Lo	 	LV613-15820	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	5/12/2014	 	Commercial, Medicaid, Medicare Advantage
								
	CCC P&P - Outbound Calls	 	Viola Lo	 	ZT34-95321	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	2/26/2014	 	All
								
	CCC P&P - Transferring SHP Calls to the McKesson Nurse Advice Line	 	Viola Lo	 	LV425-151657	 		 	HNCA	 	Member Services	 	4/28/2014	 	Medi-Cal
								
	CCC P&P - WEB/IVR Issues/Suggestions/Remedy Ticket Request Routing	 	Viola Lo	 	LV827-105621	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	9/25/2013	 	Commercial, Medicare Advantage, Medicaid
								
	CCC P&P â€“ Call Driver Policy	 	Viola Lo	 	LV109-95051	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/16/2014	 	Commercial
								
	CCC P&P â€“ Telephone Requests for Heath Care Service Authorizations	 	Viola Lo	 	LV126-11232	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	2/25/2014	 	HMO, POS, PPO

  

					
	Schedule P	  	P-381	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	CCC P&P: #MS-101ML - PCP/PPG Change Policy	 	Viola Lo	 	LV13-162725	 		 	HNCA	 	Member Services	 	6/2/2014	 	Medi-Cal
								
	CCC P&P: Assessment of New Member Understanding	 	Viola Lo	 	LV77-134820	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	6/2/2014	 	 HMO, POS, PPO,
 Medicare Advantage

								
	CCC P&P: California Department of Insurance Resolution Acknowledgement Letter	 	Viola Lo	 	LV1219-9247	 		 	HNCA	 	Member Services	 	10/23/2013	 	POS, PPO
								
	CCC P&P: Call Abandonment and Wait Time Standards	 	Viola Lo	 	LV321-132720	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/16/2014	 	 HMO, POS, PPO, AHCCCS (AZ
 Medicaid), Medi-Cal,
EPO

								
	CCC P&P: CCC Accessibility of Providers	 	Viola Lo	 	LV15-15154	 		 	HNCA	 	Member Services	 	9/25/2013	 	Commercial, Medi-Cal
								
	CCC P&P: Handling DMHC Calls Regarding Urgent Grievances	 	Viola Lo	 	LV322-8152	 		 	HNCA	 	Member Services	 	2/24/2014	 	Commercial, Medicaid
								
	CCC P&P: Health Net Access Telephone Standards and Reporting	 	Viola Lo	 	LV314-145655	 		 	Health Net Access	 	Member Services	 	4/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	CCC P&P: HN Access New Hire Training Program	 	Viola Lo	 	LV96-1537	 		 	Health Net Access	 	Member Services	 	12/26/2013	 	 AHCCCS (AZ
 Medicaid)

								
	CCC P&P: HNOR Medicare Provider Transitions	 	Viola Lo	 	LV612-92026	 		 	HNOR	 	Member Services	 	7/29/2013	 	Medicare Advantage
								
	CCC P&P: HNOR/WA Ethnicity and Diversity	 	Viola Lo	 	LV1220-10733	 		 	HNOR	 	Member Services	 	4/16/2014	 	HMO, POS, PPO
								
	CCC P&P: Incoming Telephone Calls for Utilization Management	 	Viola Lo	 	LV1027-8561	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/4/2014	 	Commercial, Medicaid, Medicare Advantage
								
	CCC P&P: Internet Usage	 	Viola Lo	 	LV1124-104120	 		 	HNAZ, HNCA, HNOR, MHN	 	Member Services	 	4/1/2014	 	Commercial, Medicaid, Medicare Advantage
								
	CCC P&P: Medi-Cal Disenrollments	 	Viola Lo	 	LV119-104314	 		 	HNCA	 	Member Services	 	8/11/2014	 	Medi-Cal
								
	CCC P&P: Medi-Cal Provider Transitions	 	Viola Lo	 	MS218-134013	 		 	HNCA	 	Member Services	 	4/4/2014	 	Medi-Cal, CalOptima Medi-Cal (Orange County), CalViva Health
								
	CCC P&P: Medicare Provider Transitions	 	Viola Lo	 	MS1211-142423	 		 	HNCA	 	Member Services	 	4/16/2014	 	Medicare Advantage HMO, Dual Eligible

  

					
	Schedule P	  	P-382	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	CCC P&P: Member Complaints (HNCA)	 	Viola Lo	 	LV49-103810	 		 	HNCA	 	Member Services	 	6/20/2014	 	 HMO, POS, PPO,
 AIM, Healthy Kids, Medi-Cal,
Healthy Families

								
	CCC P&P: Non-Contracted Hospital Post Stabilization Authorization Requests	 	Viola Lo	 	LV43-10943	 		 	HNCA	 	Member Services	 	8/11/2014	 	Commercial, Medi-Cal
								
	CCC P&P: SB853 & Health Care Reform Translation Request for the Customer Contact Center and Centralized Unit Processes	 	Viola Lo	 	LV119-105442	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/1/2013	 	Commercial, Medicaid, Medicare Advantage
								
	CCC P&P: Seniors and Persons With Disabilities (SPD) and Non-SPD Membersâ€TM Protected Health Information (PHI)	 	Viola Lo	 	LV220-125916	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Appeals & Grievances Member Support on Clinical Referrals	 	Viola Lo	 	LV220-152338	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Claim Recovery	 	Viola Lo	 	LV221-10494	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Communication Call	 	Viola Lo	 	LV220-15379	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Communications Log Documentation	 	Viola Lo	 	LV322-131758	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal
								
	CCC P&P: SHP Eligibility Verification and Coordination Of Care	 	Viola Lo	 	LV220-142844	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Internet Network and Telephone Access	 	Viola Lo	 	LV221-101530	 		 	HNCA	 	Member Services	 	8/11/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Member Handbook	 	Viola Lo	 	LV222-133830	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Member Non-Compliance and Disenrollment	 	Viola Lo	 	LV222-102745	 		 	HNCA	 	Member Services	 	6/2/2014	 	Medi-Cal, CalViva Health, CalOptima
								
	CCC P&P: SHP Provider Dispute Resolution	 	Viola Lo	 	LV222-9312	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health
								
	CCC P&P: SHP Referral and Coordination	 	Viola Lo	 	LV221-114640	 		 	HNCA	 	Member Services	 	5/22/2014	 	Medi-Cal, CalViva Health

  

					
	Schedule P	  	P-383	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	CCC P&P: SHP Telecommunications Device For The Hearing And Speech Impaired (TDD/TTY)	 	Viola Lo	 	LV613-11352	 		 	HNCA	 	Member Services	 	4/16/2013	 	AIM, Healthy Kids, Medi-Cal, Healthy Families
								
	CCC P&P: State Health Programs New Hire Training Program	 	Viola Lo	 	LV24-10512	 		 	HNCA	 	Member Services	 	4/16/2014	 	Medi-Cal
								
	CCC P&P: The Affordable Care Act: Medical Loss Ratio	 	Viola Lo	 	LV610-112030	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/16/2014	 	 HMO, POS, PPO,
 Medicare Advantage

								
	CCC P&P: Transferring Calls to the Nurse Advice Line & Decision Power	 	Viola Lo	 	MS42-11136	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	6/14/2013	 	HMO, Medicare Advantage, POS, PPO, AIM, Healthy Kids, Medi-Cal [more...]
								
	CCC P&P: Transition of Care/Continuation of Care for Healthy Families Program members transitioning to Medi-Cal	 	Viola Lo	 	LV220-82024	 		 	HNCA	 	Member Services	 	5/6/2014	 	Medicaid, CalViva Health
								
	CCC Policy & Procedure: Crisis Call Guidelines & Procedure	 	Viola Lo	 	LV1116-132928	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	3/6/2014	 	Commercial, Medicare Advantage, Medicare Part D, Medicaid
								
	CCC Policy & Procedure: Procedure for Handling Department of Health Care Services Potential Member Calls	 	Viola Lo	 	LV1021-145950	 	SW	 	HNCA	 	Member Services	 	8/20/2013	 	Medicaid
								
	CCC Provider Complaints	 	Daniel G Middaugh	 	MD522-10565	 		 	HNCA	 	Member Services	 	5/29/2014	 	Dual Eligible
								
	CCC QA P&P - Partnership for Customer Service Excellence (PCSE) - Evaluation Procedures	 	Viola Lo	 	LV412-101733	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	5/6/2014	 	Commercial, Medicare Advantage, Medi-Cal
								
	CMC CCC PCP/PPG Change	 	Christine X Martignoni	 	MC523-132534	 		 	HNCA	 	Member Services	 	7/10/2014	 	Dual Eligible
								
	CMC CCC Power Of Attorney (POA) & Authorization of Representation (AOR)	 	Christine X Martignoni	 	MC523-133144	 		 	HNCA	 	Member Services	 	6/17/2014	 	Dual Eligible
								
	CMC CCC Telephone Requests for Health Care Service Authorizations	 	Christine X Martignoni	 	MC523-13356	 		 	HNCA	 	Member Services	 	7/10/2014	 	Dual Eligible
								
	CMC P&P: Oral Grievance	 	Viola Lo	 	LV710-111423	 		 	HNCA	 	Member Services	 	8/14/2014	 	Dual Eligible

  

					
	Schedule P	  	P-384	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Customer Contact Center (CCC) Website Content Review and Maintenance	 	Edwin X Ram	 	RE312-135818	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	7/12/2013	 	Commercial, Medicare, Healthy Families
								
	Customer Contact Center P&P: SHP Medi-Cal Provider Grievances	 	Viola Lo	 	LV1221-112441	 	SW	 	HNCA	 	Member Services	 	9/3/2014	 	Medicaid
								
	Customer Contact Center Policy & Procedure: Medicare Programs Best Available Evidence (BAE)	 	Viola Lo	 	LV824-9121	 	NW	 	HNAZ, HNCA, HNOR	 	Member Services	 	3/27/2013	 	Medicare Advantage, Medicare Part D
								
	Customer Contact Center Policy & Procedure: State Health Programs Advance Directives	 	Viola Lo	 	LV129-14481	 	SW	 	HNCA	 	Member Services	 	1/6/2014	 	Medi-Cal
								
	Customer Contact Center Policy/Procedure: Medicare and Cal MediConnect Provider Transitions	 	Daniel G Middaugh	 	MD522-105648	 		 	HNCA	 	Member Services	 	5/29/2014	 	Dual Eligible
								
	Customer Contact Center Policy/Procedure: Member Relations	 	Viola Lo	 	SS127-134136	 	SW	 	HNCA	 	Member Services	 	11/11/2013	 	Medi-Cal
								
	Health Net Access P&P - Case Management Referral and Coordination	 	Viola Lo	 	LV712-91241	 		 	HNAZ	 	Member Services	 	9/3/2014	 	Medicaid
								
	Health Net Access P&P - Health Plan Change Request	 	Viola Lo	 	LV611-105327	 		 	Health Net Access	 	Member Services	 	9/3/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net Access P&P - In Person, Telephone and Internet Network Accessibility	 	Viola Lo	 	LV610-163055	 		 	HNAZ	 	Member Services	 	4/16/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net Access P&P - Member Handbook Request Procedure	 	Viola Lo	 	LV625-133044	 		 	HNAZ	 	Member Services	 	5/5/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net Access P&P - PCP Assignment and Change Protocol	 	Viola Lo	 	LV519-10438	 		 	HNAZ	 	Member Services	 	5/19/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net Access P&P - Provider Dispute & Provider State Fair Hearing	 	Viola Lo	 	LV514-9737	 		 	HNAZ	 	Member Services	 	8/5/2014	 	AHCCCS (AZ Medicaid)
								
	Health Net Access P&P - Provider Transitions	 	Viola Lo	 	LV610-16442	 		 	HNAZ	 	Member Services	 	4/28/2014	 	Medicaid
								
	Health Net Access P&P - TDD/TTY (AZ SHP)	 	Viola Lo	 	LV610-161052	 		 	Health Net Access	 	Member Services	 	4/28/2014	 	AHCCCS (AZ Medicaid)

  

					
	Schedule P	  	P-385	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Medicare Oral Complaint Policy & Procedure	 	Edwin X Ram	 	LV214-154412	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	2/11/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Part D Transition Supply Program Policy	 	Christine X Martignoni	 	LV214-145053	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	3/3/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Programs P&P - Voluntary Disenrollment	 	Viola Lo	 	LV215-95141	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/15/2014	 	Medicare Advantage
								
	Health Net Medicare Programs P&P: Plan Material Request	 	Viola Lo	 	LV214-152039	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/15/2014	 	Medicare Advantage
								
	Health Net Medicare Programs P&P: Transferring/Referring to Medicare or Social Security Administration	 	Viola Lo	 	LV214-1614	 		 	HNAZ, HNCA, HNNE	 	Member Services	 	8/15/2014	 	Medicare Advantage
								
	Health Net Medicare Programs P&P:Re-enrollment Policy	 	Viola Lo	 	LV214-15323	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/30/2013	 	Medicare Advantage
								
	Health Net/MHN CCC P&P: Dress Code	 	Viola Lo	 	LV1028-142118	 		 	HNAZ, HNCA, HNOR, MHN	 	Member Services	 	4/16/2014	 	 HMO, POS, PPO,
 Medicare Advantage,
Medicaid

								
	Health Net/MHN Customer Contact Center Policy & Procedure: Performance Standards for Classroom Training Period	 	Viola Lo	 	SS612-11193	 		 	HNAZ, HNCA, HNOR, MHN	 	Member Services	 	10/22/2013	 	 Commercial, Medicare Advantage, Medicare Part D, IFP, AIM,

Healthy Kids [more...]

								
	HIPAA Compliance Policy and Procedures	 	Viola Lo	 	LV89-85947	 	SW	 	HNAZ, HNCA, HNOR	 	Member Services	 	6/30/2014	 	Commercial, Medicare Advantage, Medicare Part D, Medi-Cal
								
	HIPAA Privacy: Customer Contact Center Policies and Procedures	 	Edwin X Ram	 	RE1127-10364	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/25/2014	 	Commercial
								
	HN Medicare - Coordination of Benefits Survey Policy & Procedure	 	Christine X Martignoni	 	LV214-113252	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	10/1/2013	 	Medicare Advantage, Medicare
								
	HN Medicare - Verbal PlanCancellation Requests Policy	 	Christine X Martignoni	 	LV215-9201	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/20/2014	 	Medicare Advantage
								
	HN Medicare Creditable Coverage Attestations Policy & Procedure	 	Christine X Martignoni	 	LV214-112459	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/30/2013	 	Medicare Advantage
								
	HN Medicare Programs - Coordination of Benefits Verbal Update Policy	 	Christine X Martignoni	 	LV214-111121	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	9/5/2013	 	Medicare, Medicare Advantage

  

					
	Schedule P	  	P-386	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	HN Medicare Programs - Delinquency/Failure to Pay PremiumPolicy	 	Christine X Martignoni	 	LV215-92529	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	10/7/2013	 	Medicare Advantage
								
	HN Medicare Programs P&P - Sales Allegations	 	Viola Lo	 	LV215-9441	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/25/2014	 	Medicare Advantage, Medicare Part D
								
	HN Medicare Programs P&P - State Pharmacy Assistance Programs (SPAP)	 	Viola Lo	 	MP521-9721	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	3/3/2014	 	Medicare Advantage, Medicare Part D
								
	HN Medicare Programs P&P - Tracking, Reporting and Resolving CSR Performance Issues	 	Viola Lo	 	ZT61-11280	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/15/2014	 	Medicare Advantage
								
	HN Medicare Programs P&P: Maximum Out-of Pocket Procedure	 	Viola Lo	 	LV215-94450	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/25/2014	 	Medicare Advantage
								
	HN MHN CCC Performance Standards for Classroom POST Training Period	 	Viola Lo	 	SS95-123542	 		 	HNAZ, HNCA, HNOR, MHN	 	Member Services	 	7/18/2014	 	 Commercial, Medicare Advantage, Medicare Part D, IFP, AIM,

Healthy Kids [more...]

								
	Medi-Cal/Cal Viva CBAS CCC Procedure	 	Daniel G Middaugh	 	SD127-115233	 		 	HNCA	 	Member Services	 	9/25/2013	 	Medi-Cal
								
	Medicare Programs Involuntary Disenrollment Policy & Procedure	 	Christine X Martignoni	 	LV214-142745	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	8/12/2014	 	Medicare Advantage
								
	Medicare Programs Out-of-Area Address Policy	 	Christine X Martignoni	 	KB726-155116	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	10/2/2013	 	Medicare, Medicare Advantage, Medicare Part D
								
	Member Request for Information Policy for Medicare	 	Christine X Martignoni	 	BV54-115219	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	7/14/2014	 	Medicare
								
	Provider Letter Obsolescence	 	Kristina M Rodriguez	 	RK217-95424	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Member Services	 	2/17/2014	 	Dual Eligible, Medicare Advantage HMO, Medicare Advantage PPO
								
	Provider Transition Unit P&P: Notifying the Member of the Status of a Requested Provider Transfer	 	Viola Lo	 	LV1121-82736	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	4/16/2014	 	 HMO, POS, PPO,
 Medicare Advantage,
Medi-Cal

								
	Sales Assistance Line	 	Vanessa x Boorman	 	BV23-112418	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	2/5/2014	 	Medicare

  

					
	Schedule P	  	P-387	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	SHP P&P: PCP Assignmnet Protocol for SPD and Non-SPD Medi-Cal Members	 	Viola Lo	 	LV725-135135	 		 	HNCA	 	Member Services	 	8/11/2014	 	Medi-Cal, CalViva Health
								
	Supervisor or Lead Weekend Status Reporting	 	Vanessa x Boorman	 	BV115-121913	 		 	HNAZ, HNCA, HNOR	 	Member Services	 	1/16/2014	 	Medicare
								
	PDE Timely Submission Verification	 	Eric X Juline	 	KL721-16235	 		 	HNAZ, HNCA, HNNE, HNOR, HNPS	 	Membership, Finance, National Medicare Compliance, HNPS	 	5/29/2014	 	Medicare Part D, Dual Eligible
								
	Part D - COB â€“ Applying Medicare set-aside (WCMSA) and Third Party Liability Process and Procedures - Section 50.13	 	Melissa A Renfro	 	KD1019-101917	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	 Membership, HNPS,
 Compliance
	 	1/30/2014	 	Medicare Part D
								
	Prescription Drug Event (PDE) - Annual Reconciliation of PDEs to PRS	 	Mary H Engquist	 	KD1021-161754	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNNE, HNOR, HNPS	 	Membership, National Medicare Compliance, Finance, HNPS	 	2/25/2014	 	Medicare Part D
								
	Auto TrOOP Balance Transfer Process	 	Paula M Allen	 	AP730-152528	 		 	HNAZ, HNCA, HNCT, HNI, HNINY, HNNE, HNOR, HNPS	 	Membership, National Medicare Compliance, Pharmacy, Medicare Programs	 	2/20/2014	 	Medicare, Dual Eligible
								
	Additional Enrollment Request Mechanisms for Employer/Union Sponsored Coverage	 	Brandi X Jackson	 	JB120-94715	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	1/30/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Additonal Eligibility Requirement SNP	 	Brandi X Jackson	 	JB119-131327	 		 	HNAZ, HNCA, HNOR	 	Membership	 	6/23/2014	 	Medicare Advantage and Medicare Part D
								
	Auto and Facilitated Enrollment	 	Brandi X Jackson	 	JB123-55525	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	1/30/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Best Available Evidence (BAE)	 	Brandi X Jackson	 	JB123-72112	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	4/10/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D

  

					
	Schedule P	  	P-388	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Broker Compensation	 	Brandi X Jackson	 	JB329-101727	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	8/1/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Disenrollment Procedures for Employer/Union Sponsored Plans	 	Brandi X Jackson	 	JB120-123548	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Disenrollment Procedures	 	Brandi X Jackson	 	JB119-113412	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Election Periods and Effective Dates	 	Brandi X Jackson	 	JB1215-94541	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	ESRD and Enrollment	 	Brandi X Jackson	 	JB123-64242	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Health Net Access Primary Care Provider (PCP) Auto Assignment Algorithm	 	Brandi X Jackson	 	JB66-13108	 		 	Health Net Access	 	Membership	 	10/24/2013	 	 AHCCCS (AZ
 Medicaid)

								
	Late Enrollment Penalty	 	Brandi X Jackson	 	JB123-61932	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Part D, Medicare Advantage
								
	LIS (Low Income Subsidy) Grace Period	 	Brandi X Jackson	 	JB118-13187	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Part D, Medicare Advantage
								
	Loss of Special Needs Status	 	Brandi X Jackson	 	JB119-82341	 		 	HNAZ, HNCA, HNOR	 	Membership	 	6/11/2014	 	Medicare Advantage and Medicare Part D
								
	Medicare Broker Inquiries	 	Brandi X Jackson	 	JB89-114754	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D
								
	Medicare Broker of Record Exceptions	 	Brandi X Jackson	 	JB114-135055	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Medicare COB Membership CPWProcessing	 	Brandi X Jackson	 	JB32-1140	 	NW	 	HNCA, HNI	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D
								
	Medicare Membership HNPS Part D Processing	 	Brandi X Jackson	 	JB123-71146	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/8/2014	 	Medicare Advantage and Medicare Part D
								
	Medicare Membership Policies and Procedures and Desktop Procedures Process	 	Brandi X Jackson	 	JB96-9264	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D, Medicare Advantage and Medicare Part D

  

					
	Schedule P	  	P-389	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare Part D - COB Notification Processing	 	Brandi X Jackson	 	JB124-81327	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/8/2014	 	Medicare Advantage and Medicare Part D
								
	Medicare Part D Reporting Requirements	 	Brandi X Jackson	 	JB126-55950	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/8/2014	 	Medicare Advantage, Medicare Part D
								
	Medicare Statement Preparation and Distribution Process	 	Brandi X Jackson	 	JB89-112023	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D
								
	Members Who Change Residence	 	Brandi X Jackson	 	JB119-152837	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Monthly Certification Enrollment and Payment Data	 	Brandi X Jackson	 	JB112-111711	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D, Medicare Advantage and Medicare Part D
								
	Monthly Reconciliation	 	Brandi X Jackson	 	JB112-9534	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D, Medicare Advantage and Medicare Part D
								
	OHI Data Validation on Application Process	 	Brandi X Jackson	 	JB123-716	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/8/2014	 	Medicare Part D, Medicare Advantage and Medicare Part D
								
	Ongoing Training, Monitoring and Development	 	Brandi X Jackson	 	JB331-121324	 		 	HNAZ, HNCA, HNOR	 	Membership	 	4/1/2014	 	Medicare Advantage and Medicare Part D
								
	Other Coverage Through an Employer/Union Group (TRC127)	 	Brandi X Jackson	 	JB118-155654	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Possible Out of Area Tracking	 	Brandi X Jackson	 	JB118-161052	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Post Enrollment Activities	 	Brandi X Jackson	 	JB120-1592	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Premium Billing for Individual Plans	 	Brandi X Jackson	 	JB123-84252	 		 	HNAZ, HNCA, HNOR	 	Membership	 	10/24/2013	 	Medicare Advantage, Medicare Part D, Medicare Advantage and Medicare Part D
								
	Prescription Drup Event (PDE)	 	Brandi X Jackson	 	JB118-153223	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	4/1/2014	 	Medicare Advantage, Medicare Part D

  

					
	Schedule P	  	P-390	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Processing and Reconciliation of AHCCCS 834 files	 	Brandi X Jackson	 	JB529-7478	 		 	Health Net Access	 	Membership	 	5/29/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Processing and Reconciliation of AHCCCS Pharmacy TPL Data	 	Brandi X Jackson	 	JB529-8149	 		 	Health Net Access	 	Membership	 	8/22/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Processing Acumen LIS Match Rate Report	 	Brandi X Jackson	 	JB118-145939	 		 	HNAZ, HNCA, HNOR	 	Membership	 	2/7/2014	 	Medicare Advantage, Medicare Part D
								
	Processing Prescription Drug Event (PDE) Error Report	 	Brandi X Jackson	 	JB119-134244	 	NW	 	HNAZ, HNCA, HNOR	 	Membership	 	5/1/2014	 	Medicare Advantage, Medicare Part D
								
	Processing the Enrollment Request	 	Brandi X Jackson	 	JB1116-91132	 		 	HN Life, HNAZ, HNCA, HNOR	 	Membership	 	2/3/2014	 	Medicare Advantage, Medicare Advantage and Medicare Part D
								
	Medicare: MHN Support of HN Appeals and Grievances	 	Alex M Black	 	BB331-103820	 	NE	 	MHN	 	MHN Appeals and Grievances	 	2/11/2014	 	Medicare Advantage
								
	Medicare Part C Reporting	 	Alex M Black	 	BB331-10139	 		 	MHN	 	MHN Claims, MHN Appeals and Grievances, Data Analysis	 	8/25/2014	 	Medicare Advantage
								
	Medicare and HN OR Commercial Exchange: Claims - Sanctioned Providers	 	Alex M Black	 	BA1117- 162426	 		 	MHN	 	MHN Claims, Provider Network Management	 	11/25/2013	 	Medicare Advantage, Health Benefit Exchange
								
	Acknowledgement of Claim Submissions	 	Alex M Black	 	BA718-18194	 		 	MHN	 	MHN Claims	 	11/13/2013	 	All
								
	Claims and Appeals Conflict of Interest	 	Alex M Black	 	BA718-173831	 		 	MHN	 	MHN Claims	 	5/5/2014	 	All
								
	Claims Receipt Date	 	Alex M Black	 	BA718-175557	 		 	MHN	 	MHN Claims	 	5/5/2014	 	All
								
	Claims Turnaround Time	 	Alex M Black	 	BA1221- 112949	 		 	MHN	 	MHN Claims	 	1/16/2014	 	CalViva, Commercial, Medi-Cal
								
	Clean and Other than Clean Claims	 	Alex M Black	 	BA718-184829	 		 	MHN	 	MHN Claims	 	8/4/2014	 	Commercial
								
	Internal Controls against Fraud in Claims Processing System	 	Alex M Black	 	BA718-183414	 		 	MHN	 	MHN Claims	 	3/27/2014	 	All
								
	Medicare Claims Reopening Decisions	 	Alex M Black	 	BA1220-18143	 		 	MHN	 	MHN Claims	 	1/15/2014	 	Medicare Advantage
								
	Medicare Secondary Payer	 	Alex M Black	 	BB216-93743	 		 	MHN	 	MHN Claims	 	1/7/2014	 	Medicare Advantage
								
	Medicare Timely Filing	 	Alex M Black	 	SL428-18156	 		 	MHN	 	MHN Claims	 	1/7/2014	 	Medicare Advantage
								
	Medicare: Authorization not Needed for PPO Payment	 	Alex M Black	 	SL67-142957	 		 	MHN	 	MHN Claims	 	8/25/2014	 	Medicare Advantage PPO

  

					
	Schedule P	  	P-391	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Medicare: Developing Claims for Additional Information	 	Alex M Black	 	BB214-144842	 		 	MHN	 	MHN Claims	 	1/27/2014	 	Medicare Advantage
								
	Medicare: Foreign Claims	 	Alex M Black	 	BA1220-183339	 		 	MHN	 	MHN Claims	 	1/14/2014	 	Medicare Advantage
								
	Medicare: Non-discrimination against Beneficiaries	 	Alex M Black	 	BA713-155454	 		 	MHN	 	MHN Claims	 	5/5/2014	 	Medicare Advantage
								
	Medicare: Prompt Payment of Claims	 	Alex M Black	 	BB215-14413	 		 	MHN	 	MHN Claims	 	1/10/2014	 	Medicare Advantage
								
	Medicare: SCA Claims	 	Alex M Black	 	BA713-17854	 		 	MHN	 	MHN Claims	 	11/13/2013	 	Medicare Advantage
								
	Medicare: Special Needs Plan Claims	 	Alex M Black	 	BB331-124742	 		 	MHN	 	MHN Claims	 	1/14/2014	 	Medicare Advantage
								
	PPACA Emergency Services Requirements	 	Alex M Black	 	BA84-115631	 		 	MHN	 	MHN Claims	 	1/30/2014	 	MBHO - Managed Behavioral Health Organization
								
	Retro Eligibility Claims Adjustments	 	Alex M Black	 	BA620-9656	 		 	MHN	 	MHN Claims	 	5/5/2014	 	All
								
	Timely Forwarding of Claims to HN	 	Alex M Black	 	BA713-81348	 		 	MHN	 	MHN Claims	 	5/5/2014	 	Affiliate
								
	Affiliate Cross Data Accumulator (CDA) File Oversight	 	Alex M Black	 	SE1212-72546	 		 	HNAZ, HNCA, HNCT, HNNE, HNOR, MHN	 	 MHN
 Configurations, MHN Claims, ITG
	 	1/27/2014	 	All
								
	CMS Ansi Reason and Remark Codes	 	Alex M Black	 	BA1027-91031	 		 	MHN	 	 MHN
 Configurations, MHN Claims
	 	4/10/2014	 	MBHO - Managed Behavioral Health Organization
								
	 FH MEDICAL BENCHMARKS Fee
 Schedules Update -
Month Year US PSR ASCII LF
	 	Alex M Black	 	SL429-162717	 		 	MHN	 	 MHN
 Configurations, MHN Claims
	 	7/11/2014	 	MBHO - Managed Behavioral Health Organization
								
	Medicare Interest Rate Updates	 	Alex M Black	 	BB330-6371	 		 	MHN	 	 MHN
 Configurations, MHN Claims
	 	1/14/2014	 	Medicare Advantage
								
	Interest Rate Updates (Non-Medicare)	 	Alex M Black	 	SL427-151115	 		 	MHN	 	 MHN
 Configurations
	 	2/18/2014	 	Commercial
								
	QA Turnaround Time	 	Alex M Black	 	BA122-112018	 		 	MHN	 	 MHN
 Configurations
	 	7/11/2014	 	MBHO - Managed Behavioral Health Organization
								
	SAP Billing Configuration	 	Alex M Black	 	CL1218-162326	 		 	MHN	 	 MHN
 Configurations
	 	7/8/2014	 	Commercial
								
	Claims Checks and Remittance Advices	 	Alex M Black	 	BA718-10738	 		 	MHN	 	MHN Finance	 	8/26/2014	 	All

  

					
	Schedule P	  	P-392	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Credit Card Process	 	Alex M Black	 	BA914-81910	 		 	MHN	 	MHN Finance	 	8/26/2014	 	Commercial
								
	Michigan Claims Surcharge	 	Alex M Black	 	BA1219-121720	 		 	MHN	 	MHN Finance	 	8/26/2014	 	MBHO - Managed Behavioral Health Organization
								
	MFLC SPA Travel and Expense Policy	 	Loretta X Bailey	 	CD63-103444	 		 	 HNFS, MHN
 Govt. Srvs
	 	 MHN GS -
 Field Ops - Full Time, MHN GS

- Field Ops - On Demand [more...]
	 	7/9/2014	 	MHN GS - MFLC
								
	Part D Prescription Drug Event (PDE) Excluded Providers	 	Lakhwinder Kaur	 	KD1019-101140	 	NE	 	HN Life, HNAZ, HNCA, HNCT, HNNE, HNOR, HNPS	 	National Medicare Compliance, Finance, HNPS	 	11/11/2013	 	Medicare Part D
								
	Part D Prescription Drug Event (PDE) No Further Action Required (NFAR) Recon-Policy & Procedure	 	Lakhwinder Kaur	 	KL312-124150	 	NW	 	HN Life, HNAZ, HNCA, HNCT, HNOR, HNPS	 	National Medicare Compliance, Finance, HNPS	 	6/10/2014	 	Medicare, Dual Eligible
								
	CMS/AHIP Memo Distribution Process	 	Jennifer Evans	 	LE56-91248	 		 	HNI	 	National Medicare Compliance	 	7/25/2014	 	Medicare, Medicare Advantage, Medicare Part D, Medicare-Medicaid Plan
								
	EPOC Approver â€“ Processing and Maintenance of Individuals Authorized Access to CMS Computer Services (IACS) Requests	 	Eva Y Lo	 	LE56-94754	 		 	HNI	 	National Medicare Compliance	 	6/6/2014	 	Medicare, Medicare Advantage, Medicare Part D, Dual Eligible
								
	Medicare Compliance Medicare Advantage (MA) and Part D Marketing Material Monitoring Review Process	 	Glenn A Hertel	 	EJ712-124810	 		 	HNI	 	National Medicare Compliance	 	7/7/2014	 	Medicare Advantage
								
	Medicare Compliance: Processing and Submitting Requests for HPMS Access to CMS	 	Eva Y Lo	 	LE428-102514	 		 	HNI	 	National Medicare Compliance	 	4/3/2014	 	Medicare Advantage, Medicare Part D, Medicare, Dual Eligible
								
	Monitoring of Medicare Advantage (MA) and Part D Requirements on www.healthnet.com	 	Sherri A Katz	 	HP224-103624	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	National Medicare Compliance	 	8/23/2013	 	Medicare Advantage, Medicare Part D
								
	Monthly Monitoring of Sales Events	 	Phuong L Dao	 	LE630-135755	 		 	HNI	 	National	 	3/4/2014	 	Medicare, Medicare

  

					
	Schedule P	  	P-393	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Reporting to CMS	 		 		 		 		 	Medicare Compliance	 		 	Advantage, Medicare Part D
								
	#RX- 133 Pharmacy Benefit Manager Monitoring and Oversight	 	Janet M Smith	 	SJ619-85152	 		 	HNPS	 	Pharmacy	 	6/24/2014	 	Medicare Advantage HMO
								
	Part D Coordination of Benefits (COB) Unmatched N1 Transaction Processing Policy	 	Richard E Pyaro	 	RM812-93657	 		 	HNAZ, HNCA, HNOR	 	Pharmacy, Finance, National Medicare Compliance, Membership	 	1/29/2014	 	Medicare Part D, Dual Eligible
								
	PDE Error Correction and Tracking - Restacker/RAS	 	Lakhwinder Kaur	 	KL1012-151233	 		 	HN Life, HNAZ, HNCA, HNCT, HNINY, HNOR, HNPS	 	Pharmacy, Finance	 	2/12/2014	 	Medicare Part D, Dual Eligible
								
	AHCCCS - Pharmacy Home Program	 	Pamela J White	 	WP131-111848	 		 	Health Net Access	 	Pharmacy	 	4/23/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Coordination of Benefits for Pharmacy Benefit (Prescription) Claims	 	Pamela J White	 	WP125-82916	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	 AHCCCS (AZ
 Medicaid), Commercial

								
	CPAC Quarterly Appeals Report	 	Sarka Parod	 	GA923-10024	 		 	HNPS	 	Pharmacy	 	1/23/2014	 	All
								
	Drug and Therapeutic Class Reviews and Preferred Drug List Maintenance	 	Pamela J White	 	WP124-123341	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	 AHCCCS (AZ
 Medicaid), Commercial

								
	Drug Prior Authorization Process / Physician-initiated Requests	 	Pamela J White	 	WP124-163114	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Grandfathering Coverage of Prescription Drugs (Continuation of Pre-Existing Prescription Drug Therapy and Transition of Care)	 	Pamela J White	 	WP127-14416	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Grandfathering Process	 	Phyllis Y Noble	 	NP1212-1585	 		 	HNOR	 	Pharmacy	 	2/4/2014	 	POS, PPO, Indemnity, EPO, Community Care
								
	Health Net Access (HNA) Pharmacy Notice of Action Process	 	Pamela J White	 	WP813-125750	 		 	HNAZ	 	Pharmacy	 	8/20/2014	 	 AHCCCS (AZ
 Medicaid)

  

					
	Schedule P	  	P-394	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Health Net Pharmaceutical Services Medicare - Coverage and Organization Determination Clinical Accuracy Monitoring Program	 	Sarka Parod	 	PS1018-15412	 		 	HNPS	 	Pharmacy	 	8/11/2014	 	Medicare Part D, Cal MediConnect
								
	Health Net Pharmaceutical Services Medicare Pharmacy Pre-Service Organization Determinations	 	Sarka Parod	 	PS73-132958	 		 	HNPS	 	Pharmacy	 	12/20/2013	 	Medicare Advantage, Medicaid, Medicare
								
	Health Net Pharmaceutical Services Prior Authorization Pharmacist Quality Assurance/Inter-Rater Reliability	 	Sarka Parod	 	PD29-121018	 		 	HNPS	 	Pharmacy	 	12/10/2013	 	All
								
	Health Net Pharmaceutical Services Quality Assurance Process & Standards for Prior Authorization - Technicians and Intake Coordinators	 	Sarka Parod	 	CJ16-114952	 		 	HNPS	 	Pharmacy	 	7/23/2014	 	All
								
	HNAZ Pharmacy and Therapeutics (P&T) Committee	 	Pamela J White	 	WP126-153337	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial, AHCCCS (AZ Medicaid)
								
	Injectable Drugs (in-office) & Growth Hormone (self-injected by patients)	 	Pamela J White	 	WP125-93925	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial, AHCCCS (AZ Medicaid)
								
	Medical Foods	 	Pamela J White	 	WP125-10014	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Member Submitted Prescription Claim Reimbursement and Manual Claim Adjustments	 	Pamela J White	 	WP125-11256	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Pharmaceutical Denial Notification Process	 	Pamela J White	 	WP126-105433	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Pharmaceutical Patient Safety	 	Phyllis Y Noble	 	NP118-12359	 		 	HNOR, HNPS	 	Pharmacy	 	3/24/2014	 	POS, PPO, EPO, Community Care
								
	Pharmacy Communication Services	 	Pamela J White	 	WP127-73546	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial, AHCCCS (AZ Medicaid)
								
	Policy/Procedure #RX-101:Recommended Drug List (RDL) Development and Application	 	Janet M Smith	 	SD828-82155	 		 	HNCA	 	Pharmacy	 	5/7/2014	 	HMO, POS, PPO, Medi-Cal
								
	Policy/Procedure #RX-102:Pharmacy Exceptions / Prior Authorization/Pre-Service Decisions of Drugs	 	Janet M Smith	 	SD828-82931	 		 	HNCA	 	Pharmacy	 	5/8/2014	 	HMO, POS, PPO, Medicare HMO, Medicare POS
								
	Policy/Procedure #RX-104:Generic Substitution	 	Janet M Smith	 	SD828-83911	 		 	HNCA	 	Pharmacy	 	5/8/2014	 	POS, PPO, Medicare HMO, Medicare, POS, Medicare PDP

  

					
	Schedule P	  	P-395	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Policy/Procedure #RX-105: Step-Therapy	 	Janet M Smith	 	UC53-10489	 		 	HNCA	 	Pharmacy	 	5/29/2014	 	HMO, Medicare Part D, POS, PPO, Medi-Cal
								
	Policy/Procedure #RX-106:Non-Preferred (or Non-Formulary) Drug Coverage Guidelines	 	Janet M Smith	 	SD828-91030	 		 	HNCA	 	Pharmacy	 	5/13/2014	 	HMO, POS, PPO, Medi-Cal
								
	Policy/Procedure #RX-108:Compounded Drug Coverage Policy	 	Janet M Smith	 	SD828-133820	 		 	HNCA	 	Pharmacy	 	5/19/2014	 	HMO, POS, PPO
								
	Policy/Procedure #RX-112:Early Refill Policy	 	Janet M Smith	 	SD828-134542	 		 	HNCA	 	Pharmacy	 	5/19/2014	 	HMO, POS, PPO, Medicare HMO, Medicare POS
								
	Policy/Procedure #RX-113:Vacation Override Prescription Policy	 	Janet M Smith	 	SD828-135511	 		 	HNCA	 	Pharmacy	 	5/21/2014	 	HMO, POS, PPO
								
	Policy/Procedure #RX-117Consistent Application of Pharmacy Criteria/Inter-rater Reliability Testing	 	Janet M Smith	 	SD1021-102518	 		 	HNCA	 	Pharmacy	 	5/21/2014	 	HMO, POS, PPO, Medicare HMO Medicare POS
								
	Policy/Procedure #RX-119:Third Party Clinical Reviews	 	Janet M Smith	 	SD1021-10558	 		 	HNCA	 	Pharmacy	 	5/27/2014	 	All
								
	Policy/Procedure #RX-120:Pharmacy Claims Reimbursement Policy	 	Janet M Smith	 	SD1021-11726	 		 	HNCA	 	Pharmacy	 	5/27/2014	 	All
								
	Policy/Procedure #RX-123:Pharmacy Prior Authorization/Pre-Service Decision Turn Around Time Standards/PAOS Queue Handling	 	Janet M Smith	 	SD1021-13053	 		 	HNCA	 	Pharmacy	 	5/27/2014	 	HMO, POS, PPO, Medicare HMO, Medicar POS
								
	Policy/Procedure #RX-124:Prior Authorization Guideline Development	 	Janet M Smith	 	SD1021-132559	 		 	HNCA	 	Pharmacy	 	5/19/2014	 	All
								
	Policy/Procedure #RX-125:Notification of Changes to the Recommended Drug List/Medicare Drug List Policy	 	Janet M Smith	 	SD111-121752	 		 	HNCA	 	Pharmacy	 	12/3/2013	 	HMO, POS, PPO, Medi-cal, Medicare HMO, Medicare POS
								
	Policy/Procedure #RX-126:Pharmacy Prior Authorization Staff Training Process	 	Janet M Smith	 	SD111-13225	 		 	HNCA	 	Pharmacy	 	5/27/2014	 	HMO, POS, PPO, Medicare HMO, Medicare POS

  

					
	Schedule P	  	P-396	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Policy/Procedure #RX- 127:Pharmaceutical Patient Safety	 	Janet M Smith	 	SD111-132318	 		 	HNCA	 	Pharmacy	 	5/28/2014	 	 HMO, POS, PPO,
 Medi-Cal, Medicare HMO, Medicare
POS

								
	Policy/Procedure #RX-130:Pharmacy Provider Dispute Resolution Process	 	Janet M Smith	 	SD1021- 151317	 		 	HNCA	 	Pharmacy	 	5/28/2014	 	HMO, POS, PPO
								
	Policy/Procedure #RX-131:â€œAfter- Hoursâ€ ̈ Prior Authorization Requests	 	Janet M Smith	 	SD117-82332	 		 	HNCA	 	Pharmacy	 	5/28/2014	 	 HMO, POS, PPO,
 Medicare HMO, Medicare
POS

								
	Policy/Procedure #RX-132Continuity of Care Policy	 	Janet M Smith	 	SD1021- 152242	 		 	HNCA	 	Pharmacy	 	5/28/2014	 	HMO, POS, PPO
								
	Policy/Procedure #RX-134: Mandatory Mail Order Pharmacy Benefits	 	Janet M Smith	 	SD1024-85450	 		 	HNCA	 	Pharmacy	 	6/16/2014	 	HMO, POS, PPO
								
	Policy/Procedure #RX-135:Fulfillment of Oral / Written Vital Documents Translation Services For Pharmacy Initiated Documents	 	Janet M Smith	 	SD1024-9626	 		 	HNCA	 	Pharmacy	 	6/16/2014	 	HMO, POS, PPO
								
	Policy/Procedure RX-100:Pharmacy Policies and Procedures	 	Janet M Smith	 	SD828-75945	 		 	HNCA	 	Pharmacy	 	5/7/2014	 	All
								
	Preferred Drug List Document Maintenance and Distribution	 	Pamela J White	 	WP127- 101650	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial, AHCCCS (AZ Medicaid)
								
	Preferred Drug List Revision Notification	 	Pamela J White	 	WP127-85158	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Prior Authorization Change Notification	 	Phyllis Y Noble	 	NP422-104418	 		 	HNOR	 	Pharmacy	 	4/4/2014	 	 Commercial, POS, PPO, EPO,
 Community
Care

								
	Smoking Cessation	 	Pamela J White	 	WP127-12837	 		 	HNAZ	 	Pharmacy	 	7/14/2014	 	Commercial
								
	Step-Therapy	 	Phyllis Y Noble	 	NP118-111054	 		 	HNOR	 	Pharmacy	 	3/13/2014	 	 POS, PPO, EPO,
 Indemnity, Community
Care

								
	Zip Code Crossover Notification	 	Daniel M Pasternak	 	TR427-162353	 	NW	 	HNAZ, HNCA, HNOR	 	Product Development and Management, Sales Operations, Medicare Sales [more...]	 	2/1/2014	 	Medicare, Medicare Advantage, Medicare Part D

  

					
	Schedule P	  	P-397	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Electronic Document Routing to Provider Data Management	 	Chris Wagner	 	WC45-135331	 		 	HNCA, HNCS	 	Provider Data Management, Provider Network Management	 	7/24/2014	 	All
								
	Provider Network Management - Provider Data Management Project Request Form	 	Anna M Young	 	YA823-12442	 		 	HNAZ, HNCA, HNOR	 	Provider Data Management, Provider Network Management	 	10/4/2013	 	 HMO, POS, PPO, IFP,
 EPO, Healthy Kids, Medi-Cal,
Healthy Families [more...]

								
	Provider Network Management Practitioner Add	 	Anna M Young	 	YA1116- 111955	 		 	HNCA, HNCS	 	Provider Data Management, Provider Network Management	 	6/16/2014	 	 HMO, POS, PPO, IFP,
 EPO, Medi-Cal, Medicare
Advantage PPO [more...]

								
	Auto-Suffixing Work Flow	 	Adela Velazquez	 	MJ627-17939	 		 	HNAZ, HNCA, HNOR	 	Provider Data Management	 	2/12/2014	 	N/A
								
	Provider Data Management PHI Policy	 	Adela Velazquez	 	MJ627-173449	 		 	HNAZ, HNCA, HNOR	 	Provider Data Management	 	1/15/2014	 	N/A
								
	Provider Data Management Turnaround Times â€“ Provider Adds/Updates	 	Adela Velazquez	 	MJ627-175118	 		 	HNCA, HNOR, HNAZ	 	Provider Data Management	 	4/8/2014	 	Commercial, Medicaid, Medicare
								
	Pre-Contractual Due Diligence	 	Rita M Lonzo	 	LR316-104056	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNOR	 	Provider Network Management, Delegation Oversight [more...]	 	8/6/2014	 	 Medicaid, Health Benefit Exchange, Community Care, AHCCCS (AZ

Medicaid) [more...]

								
	Provider Data Integrity	 	Kristina M Rodriguez	 	RK54-65626	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management, ITG	 	10/4/2013	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible
								
	Network Change Form	 	Anna M Young	 	GE123-115950	 		 	HNAZ, HNCA, HNOR	 	Provider Network Management, Member Services, HNCA Other	 	8/27/2014	 	 HMO, POS, PPO, IFP,
 EPO, Medi-Cal, Medicare
Advantage PPO [more...]

  

					
	Schedule P	  	P-398	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Add New Participating Physician Group (PPG) to Network	 	Anna M Young	 	GE111-10317	 		 	HNCA, HNCS	 	Provider Network Management	 	8/6/2014	 	 HMO, Medicare, POS, PPO, IFP, EPO, Medi-
 Cal,
Dual Eligible

								
	Agreements with Federally Qualified Health Centers	 	Kristina M Rodriguez	 	RK53-144518	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	3/27/2014	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible
								
	AHCCCS-Provider Education	 	Karen M Ellington	 	PA531-82741	 		 	Health Net Access	 	Provider Network Management	 	7/30/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS-Use and Duration of Non- Contracted Providers	 	Karen M Ellington	 	PA77-112721	 		 	Health Net Access	 	Provider Network Management	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS - Tracking Provider Inquiries and Complaints	 	Karen M Ellington	 	PA420-71848	 		 	Health Net Access	 	Provider Network Management	 	7/1/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Availability of Providers & Practitioners	 	Dan Owsley	 	CM816- 101539	 	NW	 	HN Life, HNOR	 	Provider Network Management	 	1/9/2014	 	Commercial PPO, Commercial HMO, Medicare Advantage HMO [more...]
								
	CBAS Contracting Process	 	Kristina M Rodriguez	 	RK41-6474	 		 	HNCA, HNCS	 	Provider Network Management	 	3/27/2014	 	Medi-Cal, Dual Eligible
								
	Contractor Oversight and Management	 	Steven X Mar	 	CM66-12233	 		 	HNOR	 	Provider Network Management	 	5/14/2014	 	All
								
	Coordination of PNM Processing of Practitioner Changes	 	Anna M Young	 	YA1116-12410	 		 	HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	5/5/2014	 	 HMO, Commercial, Medicare Advantage, POS, PPO, EPO,

Medi-Cal, Dual Eligible

								
	Establishing PCP Panels	 	Elizabeth Gallagher	 	GE78-12236	 		 	HNCA, HNCS	 	Provider Network Management	 	6/30/2014	 	Medi-Cal, Medicare Advantage HMO, Dual Eligible

  

					
	Schedule P	  	P-399	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Hospital Provider Termination	 	Anna M Young	 	YA911-9545	 		 	HNCA	 	Provider Network Management	 	12/5/2013	 	HMO, POS, PPO, IFP, EPO, Medi-Cal, Healthy Families [more...]
								
	Limitations on Provider Indemnification	 	Kristina M Rodriguez	 	RK429-19298	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	7/2/2014	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible
								
	Medicare Advantage and Dual-Eligible Demonstration Network Adequacy	 	Elizabeth Gallagher	 	GE1220-211747	 		 	HNCA, HNCS	 	Provider Network Management	 	8/29/2014	 	Medicare Advantage HMO, Medicare Advantage PPO, Dual Eligible
								
	Medicare Advantage First Tier and Downstream Contract Maintenance	 	Kristina M Rodriguez	 	SJ41-9614	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	3/27/2014	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible
								
	Medicare Part C Reporting - Provider Network Adequacy	 	Elizabeth Gallagher	 	GE22-132349	 		 	HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	8/29/2014	 	Medicare Advantage, Dual Eligible
								
	Medicare Secondary Payer (MSP) PNM role	 	David S Davidson	 	DD728-144652	 		 	HNCA	 	Provider Network Management	 	2/27/2014	 	Medicare Advantage, Medicare, Commercial
								
	Monitor PCP Panels	 	Elizabeth Gallagher	 	GE418-15723	 		 	HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	8/28/2014	 	HMO, POS, EPO, Medi-Cal, Medicare Advantage HMO, Community Care, CalViva [more...]
								
	New Provider Contracting	 	Kristina M Rodriguez	 	RK1028-101516	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	4/8/2014	 	Community Care, AHCCCS (AZ Medicaid), Dual Eligible, Commercial PPO [more...]
								
	Physician Incentive Plans	 	Kristina M Rodriguez	 	RK53-111252	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	7/2/2014	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible

  

					
	Schedule P	  	P-400	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	PPG Provider Termination	 	Anna M Young	 	YA79-14112	 		 	HNCA	 	Provider Network Management	 	12/17/2013	 	HMO, POS, PPO, Healthy Kids, Medi-Cal, Medicare Advantage PPO [more...]
								
	Practitioner/Provider Liability Insurance Limits Review	 	Kristina M Rodriguez	 	RK54-83154	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	7/2/2014	 	Commercial, Medicare Advantage, Dual Eligible
								
	Pricing Committee Updates	 	Juanita X Sanchez	 	SJ119-93936	 		 	HNAZ	 	Provider Network Management	 	3/14/2014	 	HMO, Medicare, Medicare Advantage, POS, PPO, Indemnity, IFP
								
	Prison Network Contract Administration Onsite Policy & Procedure	 	Gil X Astorga	 	AV65-124748	 		 	HNCA	 	Provider Network Management	 	7/23/2014	 	Prison Healthcare
								
	Prison Network Contract Administration P&P Appeal-Review and Response policy	 	Gil X Astorga	 	AV516-134619	 		 	HNCA	 	Provider Network Management	 	12/4/2013	 	Prison Healthcare
								
	Prison Network Contract Administration Policy and Procedures: Contract Adds- updates- terminations	 	Gil X Astorga	 	AV516-11553	 		 	HNCA	 	Provider Network Management	 	12/4/2013	 	Prison Healthcare
								
	Prison Network Contract Administration Policy and Procedures: Contract Processing	 	Gil X Astorga	 	AV516-15241	 		 	HNCA	 	Provider Network Management	 	7/23/2014	 	Prison Healthcare
								
	Prison Network Contract Administration Policy and Procedures: Definitions	 	Gil X Astorga	 	AV516-11195	 		 	HNCA	 	Provider Network Management	 	7/23/2014	 	Prison Healthcare
								
	Process Medi-Cal FSR Invalid Sites Pend Report	 	Elizabeth Gallagher	 	GE611-113842	 		 	HNCA, HNCS	 	Provider Network Management	 	6/30/2014	 	Medi-Cal, Dual Eligible
								
	Provider Directory Review	 	Elizabeth Gallagher	 	GE1211-175233	 		 	HNCA, HNCS	 	Provider Network Management	 	3/28/2014	 	EPO, Medi-Cal, Medicare Advantage PPO, Medicare Advantage HMO [more...]
								
	Provider Grievances (Appeals)Recording/Reporting Requirements	 	Jocelyn A Espinoza	 	VM1215-15138	 	NE	 	HNAZ	 	Provider Network Management	 	8/22/2014	 	HMO, Commercial, Medicare Advantage, POS, PPO, Indemnity, IFP

  

					
	Schedule P	  	P-401	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Provider HIPAA Policy	 	Kristina M Rodriguez	 	RK415-82636	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	3/28/2014	 	Dual Eligible, AHCCCS (AZ Medicaid), Community Care, Commercial PPO [more...]
								
	Provider Network Administrator Annual Provider Performance Survey	 	Anna M Young	 	YA126-91553	 		 	HNCA	 	Provider Network Management	 	10/24/2013	 	N/A
								
	Provider Network Management - Closed Panel Initiative	 	Anna M Young	 	GE415-11431	 		 	HNCA, HNCS	 	Provider Network Management	 	6/25/2014	 	HMO, POS, PPO, Medi-Cal, Medicare Advantage PPO, Medicare Advantage HMO [more...]
								
	Provider Network Management - Creating and Distributing Policy and Procedure Documents	 	Anna M Young	 	MD728-105037	 		 	HNAZ, HNCA, HNOR	 	Provider Network Management	 	2/11/2014	 	N/A
								
	Provider Network Management - New PPG Education and Orientation	 	Anna M Young	 	YA106-101712	 		 	HNCA, HNCS	 	Provider Network Management	 	6/27/2014	 	HMO, Medicare Advantage, POS, PPO, Medicare Advantage PPO, Medi-Cal, EPO [more...]
								
	Provider Network Management - POP Agreements	 	Richard Leedom	 	YA1213-114621	 		 	HNCA	 	Provider Network Management	 	5/5/2014	 	HMO, Commercial, Medicare Advantage, IFP, Medi-Cal, Community Care
								
	Provider Network Management - PPG Risk Changes	 	Anna M Young	 	YA112-9541	 		 	HNCA, HNCS	 	Provider Network Management	 	7/23/2014	 	HMO, POS, PPO, Medi-Cal, Commercial HMO, Commercial PPO, Commercial [more...]
								
	Provider Network Management - Provider Termination or Substantial Change - Medi-Cal	 	Anna M Young	 	YA53-103215	 		 	HNCA	 	Provider Network Management	 	8/27/2014	 	Medi-Cal

  

					
	Schedule P	  	P-402	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Provider Network Management - Roles and Responsibilities for Physician Demographic Information and Fee Schedule/CPT Code Inquiries via the Internet	 	Anna M Young	 	GE325-194456	 		 	HNCA	 	Provider Network Management	 	9/17/2013	 	All
								
	Provider Network Management - Roster Review	 	Elizabeth Gallagher	 	GE625-213044	 		 	HNCA, HNCS	 	Provider Network Management	 	5/5/2014	 	HMO, POS, PPO, EPO, Medi-Cal, Medicare Advantage PPO [more...]
								
	Provider Network Management Capitation Deductions	 	Amy J Christian	 	CA619-154532	 		 	HNCA, HNCS	 	Provider Network Management	 	5/16/2014	 	HMO, Commercial, Medicare, Medicare Advantage, POS, IFP [more...]
								
	Provider Offshore Subcontracting	 	Matthew T Dugan	 	RK53-94135	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	12/13/2013	 	Medicare Advantage PPO, Medicare Advantage HMO, Dual Eligible
								
	Provider Orientation Process	 	Kristina M Rodriguez	 	RK330-152340	 		 	HNCA, HNCS	 	Provider Network Management	 	4/9/2014	 	Dual Eligible
								
	Provider Requests for Contract Copies	 	Matthew T Dugan	 	JB1129-113215	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	10/2/2013	 	HMO, PPO, Medi-Cal, Healthy Families, Medicare Advantage PPO [more...]
								
	Provider Termination Alert (PTA) â€“ CMS Account Manager Notification	 	Jennifer MacLean	 	BW16-123237	 		 	HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Provider Network Management	 	3/13/2014	 	Medicare Advantage
								
	Provider Termination	 	Elizabeth Gallagher	 	GE54-185259	 		 	HNAZ, HNCA, HNOR	 	Provider Network Management	 	8/6/2014	 	Medicare, Dual Eligible
								
	Quality and Cost Data Methodology for HNCA Hospitals	 	Federico Del Rosario	 	RF930-131458	 	W	 	HNCA	 	Provider Network Management	 	8/6/2014	 	HMO, Commercial, POS, PPO, Indemnity, IFP, EPO, AIM, Healthy Kids [more...]
								
	Retroactive Provider Contract Tracking	 	David S Davidson	 	DD320-1191	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	5/23/2014	 	Commercial, Medicare Advantage, Medi-Cal, AHCCCS (AZ Medicaid) [more...]

  

					
	Schedule P	  	P-403	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Western Region PNM Associate of the Month (AOM) P.R.I.D.E. Award	 	Federico Del Rosario	 	RF82-8405	 	NW	 	HNAZ, HNCA, HNOR	 	Provider Network Management	 	5/12/2014	 	N/A
								
	WR PNM Provider Directory Self-Audit	 	David S Davidson	 	DD322-181951	 		 	HN Life, HNAZ, HNCA, HNCS, HNOR	 	Provider Network Management	 	1/21/2014	 	HMO, PPO, POS, Medicare Advantage, EPO, Medi-Cal, AHCCCS (AZ Medicaid) [more...]
								
	Assigning Specialties to Non-Par Providers	 	Adela Velazquez	 	KD1031-111729	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	10/14/2013	 	N/A
								
	Delegated/Non Delegated Provider Adds	 	Adela Velazquez	 	KD1117-15042	 		 	HNCA	 	Provider Services	 	2/10/2014	 	N/A
								
	Direct Network Supersede Policy and Procedure for PPO/EPO Lines of Business	 	Adela Velazquez	 	KD115-92815	 		 	HNCA	 	Provider Services	 	11/12/2013	 	N/A
								
	HNCA Credentialing Directives and Data Changes to PDM	 	Adela Velazquez	 	KD115-84749	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	11/12/2013	 	N/A
								
	Non Par FS Exceptions	 	Laurie X Amantia	 	KD1031-121143	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	12/3/2013	 	N/A
								
	PPG ROSTER REVIEW	 	Adela Velazquez	 	KD115-94915	 		 	HNCA	 	Provider Services	 	11/12/2013	 	N/A
								
	Provider Terminations	 	Adela Velazquez	 	KD115-103623	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	3/17/2014	 	n/a
								
	Provider Updates â€“ Call-In Log	 	Adela Velazquez	 	KD115-82551	 		 	HNCA, HNOR, HNAZ	 	Provider Services	 	2/10/2014	 	N/A
								
	PROVIDER TAX ID NUMBER, NAME AND ADDRESS UPDATES FOR CONTRACTED AND NON-CONTRACTED PROVIDERS	 	Adela Velazquez	 	KD115-83632	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	2/11/2014	 	N/A
								
	Timely Filing for Non-Contracted Providers	 	Adela Velazquez	 	CT1028-91412	 		 	HNAZ, HNCA, HNOR	 	Provider Services	 	11/12/2013	 	N/A
								
	Public Health Coordination	 	Vergia L Slade	 	SV121-124129	 	W	 	HNCA	 	Public Health Coordination	 	4/9/2013	 	Medi-Cal

  

					
	Schedule P	  	P-404	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Dual Eligibles LTSS Network Adequacy	 	Elizabeth Gallagher	 	GE78-212838	 		 	HNCS	 	Public Health Coordination, Provider Network Management	 	8/29/2014	 	Dual Eligible
								
	Access to Certified Nurse Midwife Services	 	Rogelio Lopez	 	LR1130-114046	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Access to Certified Nurse Practitioners	 	Vergia L Slade	 	SV122-112618	 	W	 	HNCA	 	Public Health Coordination	 	4/9/2013	 	Medi-Cal
								
	Adult Preventive Care Screens	 	Rogelio Lopez	 	LR1129-144527	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	AHCCCS EPSDT/AzEIP Coordination	 	Vergia L Slade	 	SV1023-145644	 		 	Health Net Access	 	Public Health Coordination	 	11/4/2013	 	AHCCCS (AZ Medicaid)
								
	AIDS Waiver Program Coordination of Care	 	Rogelio Lopez	 	LR1118-155459	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	BEHAVIORAL HEALTH; CAL MEDI-CONNECT COORDINATION OF CARE â€œNO WRONG DOORâ€ ̈ [LA COUNTY]	 	Carol X Hartoonians	 	LR710-122235	 		 	HNCA	 	Public Health Coordination	 	7/1/2014	 	Dual Eligible
								
	Breastfeeding Promotion	 	Rogelio Lopez	 	LR1130-12130	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	California Children Services	 	Rogelio Lopez	 	LR1118-161131	 	W	 	HNCA	 	Public Health Coordination	 	9/24/2013	 	Medi-Cal
								
	Childhood Blood Lead Screening	 	Rogelio Lopez	 	LR1129-16641	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Coordinating CHDP Services with School-Based Health Programs	 	Rogelio Lopez	 	LR1119-12505	 	W	 	HNCA	 	Public Health Coordination	 	12/11/2013	 	Medi-Cal
								
	Coordination of Care for Children in Foster Care and Adoption Assistance Program	 	Vergia L Slade	 	SV1130-11918	 	W	 	HNCA	 	Public Health Coordination	 	4/9/2013	 	Medi-Cal
								
	Coordination with Community-Based Adult Services (CBAS) Providers	 	Rogelio Lopez	 	LR48-15519	 		 	HNCA	 	Public Health Coordination	 	4/10/2013	 	Medi-Cal
								
	DDS-Administered Home and Community Based Waiver Program	 	Rogelio Lopez	 	LR1119-124324	 	W	 	HNCA	 	Public Health Coordination	 	12/11/2013	 	Medi-Cal
								
	Direct Observation Therapy for Tuberculosis	 	Rogelio Lopez	 	LR1119-121335	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal

  

					
	Schedule P	  	P-405	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Early Start Program	 	Rogelio Lopez	 	LR1119-144244	 	W	 	HNCA	 	Public Health Coordination	 	12/11/2013	 	Medi-Cal
								
	EPSDT Supplemental Services	 	Rogelio Lopez	 	LR1119-13138	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Family Planning Services	 	Rogelio Lopez	 	LR1119-14287	 	W	 	HNCA	 	Public Health Coordination	 	12/11/2013	 	Medi-Cal
								
	HIV Testing and Counseling	 	Rogelio Lopez	 	LR1119-152050	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Hospice Care Services	 	Rogelio Lopez	 	LR1129-161210	 		 	HNCA	 	Public Health Coordination	 	9/24/2013	 	Medi-Cal
								
	Immunization Program	 	Rogelio Lopez	 	LR1119-152649	 	W	 	HNCA	 	Public Health Coordination	 	1/21/2014	 	Medi-Cal
								
	In Home Operations (IHO) Home & Community-Based Services (HCBS) Waivers	 	Rogelio Lopez	 	LR1118-152444	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Initial Health Assessment	 	Rogelio Lopez	 	LR1129-14550	 		 	HNCA	 	Public Health Coordination	 	12/23/2013	 	Medi-Cal
								
	Long Term Care	 	Rogelio Lopez	 	LR1118-154747	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Major Organ Transplants	 	Rogelio Lopez	 	LR1118-151230	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Mental Health Services	 	Rogelio Lopez	 	LR1118-161950	 		 	HNCA	 	Public Health Coordination	 	1/23/2014	 	Medi-Cal
								
	Miscellaneous Carve Out Services	 	Rogelio Lopez	 	LR1119-122337	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Non-Emergency, Non-Medical Transportation Assistance and Coordination; Hardship and Special Circumstances	 	Vergia L Slade	 	SV122-12926	 	W	 	HNCA	 	Public Health Coordination	 	4/10/2013	 	Medi-Cal
								
	Participating Provider Sensitivity Training	 	Rogelio Lopez	 	LR314-164842	 	W	 	HNCA	 	Public Health Coordination	 	1/21/2014	 	Medi-Cal
								
	Pediatric Preventive Care Services	 	Rogelio Lopez	 	LR1129-143813	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Perinatal Care	 	Rogelio Lopez	 	LR1130-11487	 	W	 	HNCA	 	Public Health Coordination	 	4/7/2014	 	Medi-Cal

  

					
	Schedule P	  	P-406	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Pregnancy Termination	 	Rogelio Lopez	 	LR1119-125435	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Regional Centers Coordination	 	Rogelio Lopez	 	LR1119-151347	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Skilled Nursing Facility	 	Rogelio Lopez	 	LR1118-15277	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	SPD Member Process to Request a Specialist as a Primary Care Provider	 	Rogelio Lopez	 	LR314-162151	 	W	 	HNCA	 	Public Health Coordination	 	12/11/2013	 	Medi-Cal
								
	Targeted Case Management (TCM) Services	 	Rogelio Lopez	 	LR1119-122717	 	W	 	HNCA	 	Public Health Coordination	 	12/10/2013	 	Medi-Cal
								
	Transportation Assistance and Coordination for Seniors and Persons with Disabilities (SPDs)	 	Vergia L Slade	 	SV122-113856	 	W	 	HNCA	 	Public Health Coordination	 	4/10/2013	 	Medi-Cal
								
	Vision Care	 	Rogelio Lopez	 	LR1119-1285	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	WIC Coordination	 	Rogelio Lopez	 	LR1129-1606	 	W	 	HNCA	 	Public Health Coordination	 	9/19/2013	 	Medi-Cal
								
	Alcohol and Drug Treatment Services	 	Carol X Hartoonians	 	LR1118-162421	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal
								
	Communicable Diseases Reporting	 	Carol X Hartoonians	 	SV122-104630	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Continuity of Care for Cal MediConnect	 	Carol X Hartoonians	 	LR326-112737	 		 	HNCA	 	Public Programs	 	3/28/2014	 	Dual Eligible, Medi-Cal
								
	Coordinating Services with Local Educational Agency (LEA) Providers	 	Carol X Hartoonians	 	SV121-133957	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Coordination of Care with Childrenâ€TMs Emergency Shelter Care Center	 	Carol X Hartoonians	 	SV1130-115536	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Coordination of Care with Sacramento County CHDP Program Foster Child Services	 	Carol X Hartoonians	 	SV1129-141139	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Detection and Treatment of Hansenâ€TMs Disease	 	Carol X Hartoonians	 	SV1129-154434	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Detection and Treatment of Tuberculosis	 	Carol X Hartoonians	 	LR1129-1569	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal
								
	Ensuring Access to Sensitive Services	 	Carol X Hartoonians	 	SV1130-14751	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal

  

					
	Schedule P	  	P-407	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Minor Consent Services	 	Carol X Hartoonians	 	SV122-105549	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Multidisciplinary Senior Services Program Waiver	 	Carol X Hartoonians	 	LR1118-154052	 		 	HNCA	 	Public Programs	 	5/12/2014	 	Dual Eligible, Medi-Cal
								
	Oversight of Subcontractor Compliance with Public Health Program Requirements	 	Carol X Hartoonians	 	SV1130-13436	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Policy and Procedure Revisions	 	Carol X Hartoonians	 	SV121-122543	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Problem Resolution	 	Carol X Hartoonians	 	SV121-114910	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Public Health Coordination and Internal HIPAA Policies	 	Carol X Hartoonians	 	SV122-95431	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal
								
	Refugee Health	 	Carol X Hartoonians	 	LR1119-121936	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal
								
	Reimbursement for Non-Contracting Providers	 	Carol X Hartoonians	 	SV121-13658	 		 	HNCA	 	Public Programs	 	7/5/2014	 	Medi-Cal
								
	Sexually Transmitted Disease Services	 	Carol X Hartoonians	 	LR1119-143425	 		 	HNCA	 	Public Programs	 	8/1/2014	 	Medi-Cal
								
	100% Quality Review of New Commercial Accounts	 	Alex M Black	 	CL1019-81123	 		 	MHN	 	 Quality Assurance, MHN
 Configurations
	 	4/29/2014	 	Commercial
								
	Affiliate Random Plan Code Audits	 	Alex M Black	 	RL529-112717	 		 	MHN	 	 Quality Assurance, MHN
 Configurations
	 	4/29/2014	 	MBHO - Managed Behavioral Health Organization
								
	Medicare: Benefit Configuration and Monthly Audit	 	Alex M Black	 	BB331-794	 		 	MHN	 	 Quality Assurance, MHN
 Configurations
	 	4/29/2014	 	Medicare Advantage
								
	QI Medicare Accessibility of Providers and Practitioners	 	Jenny P Anderson	 	AJ920-114632	 		 	HN Life, HNAZ, HNCA, HNOR	 	Quality Assurance, Quality Management	 	3/17/2014	 	Medicare Advantage HMO, Medicare Advantage PPO, Medicare Advantage SNP

  

					
	Schedule P	  	P-408	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Accessibility of Providers & Practitioners	 	Jenny P Anderson	 	AJ107-131155	 		 	HN Life	 	Quality Assurance	 	5/20/2014	 	PPO, EPO, and Health Benefit Exchange - PPO
								
	Availability of Providers - Commercial_SHP	 	Jenny P Anderson	 	AJ107-112910	 		 	HNCA	 	Quality Assurance	 	1/9/2014	 	Commercial HMO, POS, Health Benefit Exchange, Medi-Cal
								
	Availability of Providers & Practitioners	 	Jenny P Anderson	 	AJ107-143827	 		 	HN Life	 	Quality Assurance	 	1/9/2014	 	PPO, Commercial PPO, Health Benefit Exchange
								
	Commercial & SHPs Appointment Accessibility	 	Amy M Wittig	 	AJ107-103034	 		 	HNCA	 	Quality Assurance	 	11/7/2013	 	Commercial HMO, POS, Medi-Cal (including SPDs), Healthy Families
								
	Quality Improvement Performance Indicator Report	 	Rachael A Febus	 	FR928-93644	 		 	HNAZ, HNCA, HNOR, MHN	 	Quality Improvement, Data Analysis, Clinical Operations, Credentialing [more...]	 	6/20/2014	 	HMO, Commercial, Medicare, MBHO - Managed Behavioral Health Organization [more...]
								
	Member Rights and Responsibilities Statement	 	Lynne M Mechelke	 	CA13-12954	 		 	MHN	 	Quality Improvement	 	6/23/2014	 	EAP, Commercial Managed Care, Cal MediConnect, Medicare, MBHO, Medi-Cal [more...]
								
	Monitoring Access to Care	 	Stephen M Gross	 	CA13-12141	 		 	MHN	 	Quality Improvement	 	7/25/2014	 	Commercial, MBHO - Managed Behavioral Health Organization, Affiliate [more...]
								
	Monitoring Coordination of Care	 	Rachael A Febus	 	FR924-122957	 		 	MHN	 	Quality Improvement	 	6/20/2014	 	Commercial, EAP, Medicare, Cal MediConnect [more...]
								
	Monitoring Member Satisfaction	 	Rachael A Febus	 	CA13-122357	 		 	MHN	 	Quality Improvement	 	6/20/2014	 	Commercial, EAP, Cal MediConnect, Affiliate, Medicare, CalViva, Medi-Cal

  

					
	Schedule P	  	P-409	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	Peer Reviewer and Committee Confidentiality/Conflict of Interest	 	Lynne M Mechelke	 	ML925-123441	 		 	MHN	 	Quality Improvement	 	6/23/2014	 	EAP, Commercial Managed Care, Cal MediConnect, Medicare, MBHO [more...]
								
	Practitioner Satisfaction Questionnaires	 	Rachael A Febus	 	CA13-131328	 		 	MHN	 	Quality Improvement	 	6/20/2014	 	HMO, Commercial, Medicare, MBHO - Managed Behavioral Health Organization [more...]
								
	Quality Improvement Annual Evaluation	 	Lynne M Mechelke	 	CA13-131936	 		 	MHN	 	Quality Improvement	 	6/13/2014	 	EAP, Commercial Managed Care, Cal MediConnect, Medicare [more...]
								
	AHCCCS Medical Record Documentation Monitoring	 	Helen C Lansche	 	LH423-91944	 		 	Health Net Access	 	Quality Management, Credentialing, Provider Network Management	 	5/2/2014	 	 AHCCCS (AZ
 Medicaid)

								
	HN AZ Region Commercial Provider Availability Monitoring	 	Jenny P Anderson	 	AJ1216-164139	 		 	HN Life, HNAZ	 	Quality Management, Provider Network Management	 	6/10/2014	 	Commercial HMO and Arizona Insurance Marketplace Exchange HMO & PPO
								
	HN AZ Region Commercial QI Monitoring Access to Care	 	Jenny P Anderson	 	AJ1216-164528	 		 	HN Life, HNAZ	 	Quality Management, Provider Network Management	 	6/10/2014	 	Commercial HMO and Arizona Insurance Marketplace Exchange HMO & PPO
								
	AHCCCS- Communication of Clinical Information	 	Helen C Lansche	 	LH58-104159	 		 	Health Net Access	 	Quality Management	 	4/25/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS- Monitoring of Behavioral Health Services provided by PCPs	 	Helen C Lansche	 	LH1122-11170	 		 	Health Net Access	 	Quality Management	 	3/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS- Performance Improvement Projects (PIP)	 	Helen C Lansche	 	LH58-7248	 		 	Health Net Access	 	Quality Management	 	4/25/2014	 	 AHCCCS (AZ
 Medicaid)

  

					
	Schedule P	  	P-410	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AHCCCS- Quality Management Data Management and Validation	 	Helen C Lansche	 	LH1031-133350	 		 	Health Net Access	 	Quality Management	 	3/4/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS- Review, Monitoring and Reporting of Performance	 	Helen C Lansche	 	LH56-11715	 		 	Health Net Access	 	Quality Management	 	4/25/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS- Use of Health Care Information System for Quality Performance Montioring	 	Helen C Lansche	 	LH426-9240	 		 	Health Net Access	 	Quality Management	 	5/2/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS - Appointment Availability Monitoring and Reporting	 	Karen M Ellington	 	PA420-124447	 		 	Health Net Access	 	Quality Management	 	7/29/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Medical Record Documentation Standards	 	Helen C Lansche	 	LH430-62733	 		 	Health Net Access	 	Quality Management	 	5/2/2014	 	 AHCCCS (AZ
 Medicaid)

								
	AHCCCS Performance Measure Monitoring	 	Helen C Lansche	 	LH423-10748	 		 	Health Net Access	 	Quality Management	 	4/25/2014	 	 AHCCCS (AZ
 Medicaid)

								
	Quarterly Monitoring for Health Plan Management System Access (HPMS) - Customer Contact Center and Appeals and Grievances	 	Christine X Martignoni	 	BV124-95125	 		 	HNAZ, HNCA, HNOR	 		 	12/19/2013	 	Medicare
								
	Internal Sales Personnel File Requirements	 	Curt Nelson	 	TR513-102112	 		 	HNAZ, HNCA, HNOR	 	Sales Operations	 	5/30/2014	 	Medicare, Medicare Advantage, Medicare Part D
								
	Medicare Sales Materials	 	Curt Nelson	 	TR920-122549	 		 	HNAZ, HNCA, HNOR	 	Sales Operations	 	4/21/2014	 	Medicare, Medicare Part D, Medicare Advantage
								
	MLR ERISA Group Validation/Written Assurance Process	 	Jill C Sax	 	SJ314-101654	 	NW	 	HN Life, HNAZ, HNCA, HNOR	 	Sales Operations	 	4/1/2014	 	Commercial
								
	Sales Administration â€“ Request for Quotes (New Business)	 	Francine J Klein	 	KD1214-93033	 		 	HNAZ	 	Sales Operations	 	7/28/2014	 	Commercial, POS, PPO, Indemnity
								
	Sales Administration â€“ Sold Cases (New Business)	 	Francine J Klein	 	KD1214-9548	 		 	HNAZ	 	Sales Operations	 	12/17/2013	 	Commercial, POS, PPO, Indemnity
								
	Schedule C Distribution for Producers, Agencies, General Agencies (GAs), Managing Agencies (MAGY) and Field Marketing Organizations (FMOs)	 	Yvonne M Douglas	 	TR69-155824	 		 	HNAZ, HNCA, HNOR	 	Sales Operations	 	8/26/2014	 	Medicare, Medicare Advantage

  

					
	Schedule P	  	P-411	  	Health Net / Cognizant Confidential

 Final 
  

															
	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	AZ, CA, WA, OR Sales and Sales Operations General Policy and Procedures for Summary of Benefits and Coverage (SBC) Distribution	 	Francine J Klein	 	KF910-15937	 		 	HNAZ, HNCA, HNOR	 	Sales	 	4/2/2014	 	Commercial, IFP, Commercial HMO, Commercial PPO, HMO, POS, PPO
								
	Health Net Medicare and Exchange Marketing Phone Number Implementation and Verification	 	Ernie N Bernal	 	HD99-13568	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/13/2014	 	Medicare Advantage HMO, Medicare Advantage PPO, Medicare Advantage [more...]
								
	Health Net Medicare Inside Sale - Outbound Telemarketing	 	Ernie N Bernal	 	HD215-102641	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/6/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Inside Sales - Job Aides	 	Ernie N Bernal	 	HD718-85558	 		 	HN Life, HNAZ, HNCA, HNOR	 	Sales	 	8/13/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Inside Sales - Script Creation and Approval	 	Ernie N Bernal	 	HD215-141636	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/13/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Inside Sales - Telephonic Enrollment	 	Ernie N Bernal	 	HD913-17234	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/6/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Inside Sales - Training	 	Ernie N Bernal	 	HD726-152143	 		 	HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/13/2014	 	Medicare Advantage, Medicare Part D
								
	Health Net Medicare Inside Sales â€“ Call Center Requirements	 	Ernie N Bernal	 	HD215-14118	 		 	HN Life, HNAZ, HNCA, HNI, HNOR	 	Sales	 	8/13/2014	 	Medicare Advantage, Medicare Part D
								
	Language Select Service Desktop Procedure	 	Ernie N Bernal	 	TD58-93615	 		 	HNCA	 	Sales	 	8/13/2014	 	MediCare & ACA
								
	SIU Admin Procedures	 	Matthew A Ciganek	 	CM1115- 15431	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	12/12/2013	 	 All, AHCCCS (AZ
 Medicaid), Dual
Eligible

								
	SIU Case Investigations and Recovery	 	Matthew A Ciganek	 	PW323-10375	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI,	 	Special Investigations Unit	 	1/3/2014	 	 All, AHCCCS (AZ
 Medicaid), Dual
Eligible

								
		 		 		 		 	HNOR, HNPS, MHN	 		 		 	

  

					
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	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	SIU Definitions	 	Matthew A Ciganek	 	CM1012-135824	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	1/6/2014	 	All, Dual Eligible, AHCCCS (AZ Medicaid)
								
	SIU Financial Reporting	 	Matthew A Ciganek	 	PW323-134448	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	1/6/2014	 	 All, AHCCCS (AZ
 Medicaid), Dual
Eligible

								
	SIU Governing Regulations and Laws	 	Matthew A Ciganek	 	PW323-93652	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	1/6/2014	 	 All, AHCCCS (AZ
 Medicaid), Dual
Eligible

								
	SIU Initial Intake and Assessment of Referrals	 	Matthew A Ciganek	 	PW323-10182	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	1/3/2014	 	 All, AHCCCS (AZ
 Medicaid), Dual
Eligible

								
	SIU Oversight and Monitoring	 	Matthew A Ciganek	 	PW323-123443	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	12/12/2013	 	 AHCCCS (AZ
 Medicaid), Dual Eligible,
All

								
	SIU Training	 	Matthew A Ciganek	 	PW323-95230	 		 	Health Net Access, HN Life, HNAZ, HNCA, HNCS, HNI, HNOR, HNPS, MHN	 	Special Investigations Unit	 	12/12/2013	 	All, Dual Eligible, AHCCCS (AZ Medicaid)

  

					
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	 Policy Name
	 	 Policy Author
	 	 Policy Number
	 	 Region
	 	 Business Unit
	 	 Department
	 	 Effective
	 	 Product

	BST - The Training Model	 	Vincent M Price	 	PV59-125020	 		 	HNI	 	Transaction Services QA&T	 	7/16/2014	 	All
								
	Medicare CMS Mock Universe Sampling	 	Darryl X Nixon	 	PV510-145555	 		 	HNAZ, HNCA, HNOR	 	Transaction Services QA&T	 	7/5/2013	 	Medicare
								
	Oregon Notice of Rescission	 	Mark D Ludwig	 	LM410- 104824	 		 	HNOR	 	Underwriting - IFP	 	4/24/2014	 	Commercial

  

					
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SCHEDULE Q 
 SECURITY
REQUIREMENTS 

  

					
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SCHEDULE Q 
 SECURITY
REQUIREMENTS 
  

	1.	INTRODUCTION 

 In accordance with Section 14.3 (Data Security) of the Terms and
Conditions, Supplier shall comply with Health Net’s security requirements set forth in the remainder of this Schedule Q (Security Requirements). Supplier shall also be responsible for implementing additional reasonable and appropriate
security measures as may be necessary to protect Health Net Data from any unauthorized access or use and prevent any Security Breach. 
  

	2.	BUSINESS CONTINUITY, ENTERPRISE RESILIENCE, AND DISASTER RECOVERY 

  

	2.1	Business Impact Analysis: 

  

	2.2	***Recovery Strategies 

  

	 	(a)	*** 

  

	2.3	Recovery Plans and Procedures, and Maintenance 

  

	2.4	***Testing and Exercising 

  

	2.5	***Escalation and Crisis Management 

  

	 	(a)	*** 

  

	3.	IT RISK AND COMPLIANCE MANAGEMENT 

  

	3.1	Regulatory and Standards Implementation 

  

	3.2	***Risk and Compliance Assessments 

  

	3.3	***Policies, Standards, and Procedure Management 

  

	 	(a)	*** 

  

	3.4	Issue and Corrective Action Management 

  

	 	(a)	*** 

  

	3.5	Exception Management 

  

	 	(a)	*** 

  

	4.	DATA PROTECTION 

  

	4.1	Data Classification & Inventory 

  

	 	(a)	*** 

  

					
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	4.2	Data Lifecycle Analysis 

  

	 	(a)	*** 

  

	4.3	Data Encryption & Obfuscation 

  

	 	(a)	*** 

  

	4.4	Data Loss Prevention 

  

	4.5	***Data Retention and Destruction 

  

	5.	***THIRD PARTY RISK MANAGEMENT 

  

	5.1	Evaluation & Selection 

  

	5.2	***Contract & Service Initiation 

  

	5.3	***Security & Compliance Review 

  

	5.4	***Third Party Monitoring 

  

	6.	***IDENTITY & ACCESS MANAGEMENT 

  

	6.1	User Account Management 

  

	6.2	***Access Management 

  

	 	(a)	*** 

  

	6.3	Privileged User Management 

  

	 	(a)	*** 

  

	6.4	Data Platform Integration 

  

	6.5	***Access Reporting and Audit 

  

	6.6	***Access Governance 

  

	 	(a)	*** 

  

	6.7	Federation 

  

	7.	***SECURE DEVELOPMENT LIFECYCLE 

  

	7.1	Security and Risk Requirements 

  

	 	(a)	*** 

  

					
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	7.2	Security Design & Architecture 

  

	 	(a)	*** 

  

	7.3	Application Role Design and Access Privileges 

  

	 	(a)	*** 

  

	7.4	Secure Coding Guidelines 

  

	 	(a)	*** 

  

	7.5	Secure Build 

  

	 	(a)	*** 

  

	7.6	Security Testing 

  

	7.7	***Release Management 

  

	7.8	***Application Security Administration 

  

	 	(a)	*** 

  

	7.9	Legacy Environments 

  

	8.	***INFRASTRUCTURE, OPERATIONS AND NETWORK SECURITY/CYBER THREAT AND VULNERABILITY MANAGEMENT 

  

	8.1	Antivirus (AV) & Malware protection 

  

	8.2	***Intrusion Detection and Prevention 

  

	8.3	***Network Access Controls 

  

	8.4	***Network and Application Firewalls 

  

	8.5	***Proxy/Content Filtering 

  

	8.6	***Remote Access Controls 

  

	8.7	***Security Monitoring 

  

	8.8	***Wireless Security Controls 

  

	8.9	***Database Security 

  

	8.10	***Network Device Security 

  

	 	(a)	*** 

  

					
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	8.11	Network Segmentation 

  

	 	(a)	*** 

  

	8.12	OS Hardening and Secure Configuration 

  

	 	(a)	*** 

  

	8.13	Migration and Network Transition 

  

	 	(a)	*** 

  

	8.14	Patch Management 

  

	8.15	***Vulnerability Management 

  

	8.16	***Recurring Vulnerability Assessments and Penetration Testing 

 *** 

 

	8.17	Incident and Problem Management 

  

	 	(a)	*** 

  

	8.18	Capacity Management 

  

	8.19	***Configuration and Change Management 

  

	8.20	***Release Management 

  

	 	(a)	*** 

  

	8.21	Asset and Configuration Management 

  

	 	(a)	*** 

  

	9.	PHYSICAL SECURITY 

  

	9.1	General 

  

	 	(i)	*** 

  

	9.2	Policies, Standards, and Procedure Management 

  

	9.3	***Facility Access Controls 

  

	 	(a)	*** 

  

	9.4	Issue and Corrective Action Management 

  

	 	(a)	*** 

  

					
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	10.	GENERAL SECURITY REQUIREMENTS 

  

	11.	***CHANGES 

 *** 

  

					
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SCHEDULE R 
 CRITICAL
DELIVERABLES 

  

					
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SCHEDULE R 
 CRITICAL
DELIVERABLES 
  

	1.	GENERAL 

  

	1.1	Critical Deliverables; Critical Deliverables Credits 

  

	 	(a)	As part of Supplier’s obligations under the Agreement, Supplier is required to create and deliver to Health Net certain important deliverables (“Critical Deliverables),” by certain dates
(“Deliverable Due Dates”). The Critical Deliverables and their applicable Deliverable Due Date are set forth below. 

  

	 	(b)	If Supplier fails to complete and deliver a Critical Deliverable by the applicable Deliverable Due Date set forth below, then unless the failure is excused pursuant to Section 1.2, Supplier will pay to Health Net a
credit (“Critical Deliverable Credit”) as specified below on Supplier’s next invoice provided to Health Net under this Agreement. 

  

	 	(c)	Health Net’s receipt of Critical Deliverable Credits will be without prejudice to any other rights and remedies available to Health Net under the Agreement, at law, or in equity with respect to any failure of
Supplier to complete the Critical Deliverables in a timely manner and otherwise in accordance with this Agreement. 

  

	1.2	Excuses for Failure to Complete and Deliver Critical Deliverables 

 Supplier’s
failure to complete and deliver a Critical Deliverable by the applicable Deliverable Due Date will be excused to the extent (but only to the extent) that (i) such failure is caused by an Excusable Performance Failure Event as defined in
Section 4.4 of Schedule B (Service Levels), (ii) Supplier would have completed and delivered such Critical Deliverable prior to the Deliverable Due Date but for such Excusable Performance Failure Event, and (iii) Supplier is
without fault in causing such Excusable Performance Failure Event. 
  

	2.	CRITICAL DELIVERABLE CREDITS 

 The table below identifies the Critical Deliverables, the
Deliverable Due Date for each such Critical Deliverable, and the Critical Deliverable Credit payable by Supplier to Health Net if Supplier fails to complete and deliver a Critical Deliverable on or before the applicable Deliverable Due Date. The
Critical Deliverable Credit will be paid in the first invoice month after the Deliverable Due Date for the Critical Deliverable for which Supplier failed to perform as provided herein. 

  

					
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	 No.
	  	 Contract Section

Where
 Deliverable

Described
	  	 Deliverable

Name
	  	 Critical Deliverable
	  	 Deliverable Due Date(s)
	  	 Critical

Deliverable Credit

	 1.
	  	MSA 11.5	  	True-up Plan	  	A plan describing Supplier’s approach to conducting and completing the true-up contemplated by Section 11.5 of the Terms and Conditions.	  	45 days after the Effective Date	  	***
						
	 2.
	  	MSA 11.5	  	True-up Results	  	The results of the true-up process as described in Section 11.5 of the Terms and Conditions.	  	45 days after BPaaS Services Commencement Date	  	***
						
	 3.
	  	Section 1 of Schedule Z (Transition) and MSA 13.2	  	Transition Documents	  	Actionable Transition Documents, including Transition Deliverables and Transition Milestones (including transition gates) and Acceptance Criteria for each, per Section 1 of Schedule Z (Transition) and Section 13.2 of Terms
and Conditions.	  	 Weekly update by the Friday of each week, until completion of Transition

 
 Initial Updated Transition Documents (“December Updated Transition Documents”)
– due December 12, 2014
  
 Updated Transition Documents addressing all Health Net
comments provided to that point, and in form and substance satisfactory to Health Net (“January Updated Transition Documents”) - due January 16, 2015
	  	 December Updated Transition Documents - ***
  

January Updated Transition Documents - ***
  

(No further items are subject to a credit here)

						
	 4.
	  	MSA 17.2	  	Procedures Manual	  	Draft of the Procedures Manual (which includes detailed outline of Procedures Manual during Phase 1 (part 4(a)) and draft of the Procedures Manual in Phase 2 (part 4(b)) as described in Section 17.2 of Terms and Conditions and
Schedule S (Procedures Manual).	  	 4(a) - A Detailed outline of Procedures Manual within 90 days after the Effective Date

 
 4(b) - A Draft of the Procedures Manual within 180 days after the BPaaS Services
Commencement Date
	  	 4(a) - ***
  

4(b) - ***

						
	 5.
	  	MSA 17.3	  	Technology Plan	  	Draft Technology Plan as described in Section 17.3 of the Terms and Conditions.	  	9 months after Effective Date	  	***

  

					
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	 No.
	  	
Contract Section
Where
Deliverable
Described
	  	 Deliverable
Name
	  	 Critical Deliverable
	  	 Deliverable Due Date(s)
	  	 Critical
Deliverable Credit

	 6.
	  	MSA 11.2(e)(vii)	  	Dates by which Supplier must provide Resource Extension Notice	  	List of dates by which Supplier must provide the Resource Extension Notice (relating to Supplier’s use of Health Net Provided Resources after Phase 2)	  	180 days after the BPaaS Services Commencement Date	  	***
						
	 7.
	  	Schedule A (Cross Functional Services)	  	Innovation Plan	  	Draft of Innovation Plan as set forth in Section 3.7(c) of Schedule A (Cross Functional Services).	  	90 days after the BPaaS Services Commencement Date	  	***
						
	 8.
	  	Schedule A (Cross Functional Services)	  	Dashboard	  	Delivery of operational reporting Dashboard as set forth in Section 3.10 of Schedule A (Cross Functional Services).	  	 8(a) – Deliver the dashboard that Health Net is using as of the Effective Date on the BPaaS Services Commencement Date

 
 8(b) – Work collaboratively with Health Net to develop requirements for improved
dashboard no later than is commercially reasonable
  
 8(c) - Deliver the improved
dashboard meeting the requirements from 8(b) no later than the date agreed by the Parties at the time the requirements are finalized, which shall not be later than is commercially reasonable
	  	 8(a) - ***
  

8(b) - ***
  

8(c) - ***

						
	 9.
	  	Schedule G (Governance) Section 2.1	  	Governance Plan	  	Establishment of the Governance Plan as described in Section 2.1 of Schedule G (Governance).	  	 9(a) - A detailed outline of the Governance Plan within 30 days after the Effective Date

 
 9(b) - A Draft of the Governance Plan within 45 days after the Effective Date
	  	 9(a) – ***
  

9(b) - ***

  

					
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	 No.
	  	
Contract Section
Where
Deliverable
Described
	  	 Deliverable
Name
	  	 Critical Deliverable
	  	 Deliverable Due Date(s)
	  	 Critical
Deliverable Credit

						
	 10.
	  	BPaaS Supplemental Terms –Section 3	  	Roadmap	  	Deliver the Roadmap described in Section 3 of the BPaaS Supplemental Terms	  	 10(a) – Deliver a draft Roadmap by March 1, 2015
  

10(b) Deliver an updated Roadmap 120 days after BPaaS Services Commencement Date
	  	 10(a) - ***
  

10(b) - ***

						
	 11.
	  	MSA Schedule A- 1 (Cross Functional Solution)	  	Compliance Plan	  	CTS to develop a comprehensive Compliance Plan describing the specific manner in which the Compliance Program elements will meet the standards for all LOBs	  	 11(a) - A draft Compliance Plan within 60 days after the Effective Date. This shall be done in collaboration with Health Net.

 
 11(b) - A Final Compliance Plan within 90 days after the Effective Date
	  	 ***
  

***

						
	 12.
	  	Schedule X
(In Flight and Accelerated Projects)	  	Accelerated Projects	  	Supplier shall complete the Accelerated Projects by the applicable dates set forth in the table below	  	See table of Accelerated Projects below	  	See table of Accelerated Projects below

  

					
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	 Accelerated Project
	  	Deliverable Due Date	  	 Critical Deliverable Credit

			
	 IO Sliver
	  	03/01/2016	  	***
			
	 Password Vault
	  	12/01/2015	  	***
			
	 MHN to ABS [Excludes MHN-Unity Migration]
	  	03/01/2016	  	***
			
	 VOIP
	  	07/01/2015	  	***
			
	 IST, FARE, GENELCO, ACRS AND ECRS Migration
	  	12/01/2015	  	***
			
	 Provider Directory
	  	03/01/2016	  	***
			
	 iSeries and zSeries Data Archival & Retrieval
	  	06/01/2015	  	***
			
	 RMC Tool Improvements
	  	09/01/2015	  	***
			
	 Imaging and Workflow Modernization
	  	01/01/2017	  	***

  

					
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SCHEDULE S 
 PROCEDURES
MANUAL TABLE OF CONTENTS 

  

					
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TABLE OF CONTENTS 
  

							
	 1.
		INTRODUCTION AND OVERVIEW		 	1	  
			
	 2.
		SERVICE PERFORMANCE MANAGEMENT		 	1	  
			
			 2.1    Service Level Management
		 	1	  
			
	 3.
		CHARGES 		 	1	  
			
	 4.
		KEY SUPPLIER PERSONNEL		 	1	  
			
	 5.
		GOVERNANCE		 	1	  
			
	 6.
		CONTRACT MANAGEMENT		 	2	  
			
	 7.
		REGULATORY COMPLIANCE		 	2	  
			
	 8.
		DISENGAGEMENT ASSISTANCE		 	2	  
			
	 9.
		CRITICAL DELIVERABLES		 	3	  
			
	 10.
		SUPPLIER OWNED AND THIRD PARTY SOFTWARE		 	3	  
			
	 11.
		OPERATIONAL OVERSIGHT		 	3	  
			
	 12.
		PROJECT MANAGEMENT		 	3	  
			
	 13.
		SERVICE DELIVERY MANAGEMENT (CROSS FUNCTIONAL)		 	3	  
			
	 14.
		SERVICE DELIVERY MANAGEMENT (CLAIMS – SOW 1)		 	4	  
			
	 15.
		SERVICE DELIVERY MANAGEMENT (MEMBERSHIP AND CONFIGURATION – SOW 2)		 	4	  
			
	 16.
		SERVICE DELIVERY MANAGEMENT (CONTACT CENTER – SOW 3)		 	4	  
			
	 17.
		SERVICE DELIVERY MANAGEMENT (AO AND IO SERVICES – SOW 4)		 	5	  
			
	 18.
		SERVICE DELIVERY MANAGEMENT (QUALITY ASSURANCE – SOW 5)		 	5	  
			
	 19.
		SERVICE DELIVERY MANAGEMENT (APPEALS AND GRIEVANCES – SOW 6)		 	5	  
			
	 20.
		SERVICE DELIVERY MANAGEMENT (MEDICAL MANAGEMENT – SOW 7)		 	6	  

  

					
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SCHEDULE S 
 PROCEDURES
MANUAL TABLE OF CONTENTS 
 With reference to Section 17.2 (Procedures Manual) of the Terms and Conditions, the Procedures Manual
table of contents is set forth below. 
  

	1.	INTRODUCTION AND OVERVIEW 

  

	 	(a)	Overview: A high-level description of the Procedures Manual and its contents 

  

	 	(b)	Objectives: The purpose of the Procedures Manual; the expected audience and benefits 

  

	 	(c)	Owner: The resources responsible for drafting and updating the Procedures Manual, and the approving authority 

  

	2.	SERVICE PERFORMANCE MANAGEMENT 

  

	2.1	Service Level Management 

  

	 	(a)	Baselining: Process for Baselining to set targets for Service Level metrics that have no historical performance data available, in accordance with the Baselining provisions set forth in Schedule B (Service
Levels) 

  

	 	(b)	Performance Management: Procedures to ensure Services will be performed as per Service Level agreement listed in Schedules B, B-1, B-2, B-2-1, B-2-2, and B-3, and corrective action procedures for any
Services not meeting the Service Levels 

  

	 	(c)	Performance Measurement & Reporting: Sample selection, measurement and reporting methodology and tools 

  

	 	(d)	Dispute Management: Process for addressing disputes connected to Service Level performance; roles and responsibilities; escalation matrix 

 

	3.	CHARGES 

  

	 	(a)	Invoicing and Billing: Format and process for raising invoices with due consideration to PMPM Charges, Fixed Fees, Service Level Credits, any other Charges or fees, dates due, etc. as listed in Schedule C
(Charges) 

  

	 	(b)	Dispute Management: Process for addressing disputes connected to billing; escalation matrix 

  

	4.	KEY SUPPLIER PERSONNEL 

  

	 	(a)	Resources: Procedure for selection, removal, replacement, and training of Supplier Personnel and Key Supplier Personnel 

  

	 	(b)	Retention: Procedures for reducing turnover rate 

  

	5.	GOVERNANCE 

  

					
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	 	(a)	Governance Management: Procedures for managing the governance related requirements in the Agreement, including those listed in Schedule G (Governance) and its sub-schedules including the methodology and
tools to receive, qualify, identify, manage, and track Deliverables to completion 

  

	 	(b)	Resources: Organization charts containing operational and contractual authority and authorization levels, contact lists for Health Net, Supplier and third-parties, and roles and responsibilities

  

	 	(c)	Communications Management: Procedures and protocol for formal communications between Health Net, Supplier and third parties, including for those related to the obligations in Schedules G-2 (Committee and
Meeting Framework) and G-3 (Management Reports) 

  

	 	(d)	Dispute Management: Process for addressing disputes between Health Net, Supplier and third parties; escalation matrix 

  

	6.	CONTRACT MANAGEMENT 

  

	 	(a)	Contract Administration: Processes to manage the Agreement when action, negotiation, monitoring, review or tracking, are required - including contract interpretation, review of proposed new Charges, management
related to approvals, authorizations, consents and notices, and management of correspondence 

  

	 	(b)	Contract Issue Management: Process for maintaining and tracking Agreement-related issues from initiation through resolution with proper documentation 

 

	 	(c)	Change Control Management: Procedures for managing the requirements listed in Schedule H (Change Control Process) 

  

	 	(d)	Dispute Management: Process for addressing disputes connected to Change 

  

	 	(e)	Supplier Audit: Process for initiating, managing, and summarizing Supplier audits 

  

	7.	REGULATORY COMPLIANCE 

  

	 	(a)	Regulatory Compliance Management: Procedures for managing the regulatory compliance related requirements, including those listed in Schedule A (Cross Functional Services) and Schedule K (Regulatory
Compliance Addendum) 

  

	 	(b)	Dispute Management: Process for addressing disputes connected to Regulatory Compliance; roles and responsibilities; escalation matrix 

 

	8.	DISENGAGEMENT ASSISTANCE 

  

	 	(a)	Disengagement Assistance Management: Procedures for managing the Disengagement related requirements, including those listed in Schedule L (Disengagement Assistance) including knowledge retention, transfer
of assets, licenses, etc. 

  

	 	(b)	Resources: Staffing, roles and responsibilities 

  

	 	(c)	Dispute Management: Process for addressing disputes connected to Disengagement Assistance; roles and responsibilities; escalation matrix 

  

					
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	9.	CRITICAL DELIVERABLES 

  

	 	(a)	Critical Deliverables Management: Procedures for managing the quality and timings of Critical Deliverables and other requirements listed in Schedule R (Critical Deliverables) 

 

	 	(b)	Entry and Exit: Procedures to create the entry and exit criteria, sign-off process, etc. 

  

	 	(c)	Resources: Staffing, roles and responsibilities 

  

	 	(d)	Dispute Management: Process for addressing disputes connect to Critical Deliverables; roles and responsibilities; escalation matrix 

 

	10.	SUPPLIER OWNED AND THIRD PARTY SOFTWARE 

  

	 	(a)	Software Management: Procedures for managing the duties and obligations related to Supplier owned and Third Party software 

  

	 	(b)	Costs: Procedures to manage any costs including those incurred by Health Net under any of the third party Software licenses during the Term, Disengagement Assistance or prior to Phase 3 

 

	 	(c)	Dispute Management: Process for addressing disputes connect to Supplier Owned and Third Party Software; roles and responsibilities; escalation matrix 

 

	11.	OPERATIONAL OVERSIGHT 

  

	 	(a)	Activities: Procedures describing the high level activities that Supplier proposes to undertake in order to provide the Services, including direction, supervision, monitoring, staffing, reporting, planning, and
oversight activities; such processes may include: 

  

	 	(i)	Process Management 

  

	 	(ii)	Project Management 

  

	 	(iii)	Quality Management 

  

	 	(iv)	Service Continuity 

  

	 	(v)	Measurements and Reporting 

  

	12.	PROJECT MANAGEMENT 

  

	 	(a)	Project Management: Procedures for managing the requirements and project lifecycle, including as related to the framework detailed in Schedule J (Project Framework) 

 

	 	(b)	Resources: Staffing, roles and responsibilities 

  

	13.	SERVICE DELIVERY MANAGEMENT (CROSS FUNCTIONAL) 

  

	 	(a)	Service Delivery Management: Procedures for managing the obligations and responsibilities listed in Schedule A (Services) 

  

					
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	 	(b)	Documentation Management: Procedures for creation of Standard Operating Manuals and Desktop Procedures, refresh of manuals, training and refreshers, assessments, etc. 

 

	 	(c)	Change Management: Process for initiating changes to Supplier responsibilities under the Statements of Work, recording and socializing the changes, etc. 

 

	14.	SERVICE DELIVERY MANAGEMENT (CLAIMS – SOW 1) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services Outlined in the Statement of Work combined with
corresponding Service Levels 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

 

	15.	SERVICE DELIVERY MANAGEMENT (MEMBERSHIP AND CONFIGURATION – SOW 2) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services outlined in the Statement of Work combined with
corresponding Service Levels 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

 

	16.	SERVICE DELIVERY MANAGEMENT (CONTACT CENTER – SOW 3) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the Demand and Forecast volume necessary to delivery on the Services Outlined in the Statement of Work combined with
corresponding Service Levels 

  

					
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	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

 

	17.	SERVICE DELIVERY MANAGEMENT (AO AND IO SERVICES – SOW 4) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services outlined in the Statement of Work combined with
corresponding Service Levels 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

 

	18.	SERVICE DELIVERY MANAGEMENT (QUALITY ASSURANCE – SOW 5) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services outlined in the Statement of Work combined with
corresponding Service Levels 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

 

	19.	SERVICE DELIVERY MANAGEMENT (APPEALS AND GRIEVANCES – SOW 6) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services outlined in the Statement of Work combined with
corresponding Service Levels. 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

  

					
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	20.	SERVICE DELIVERY MANAGEMENT (MEDICAL MANAGEMENT – SOW 7) 

  

	 	(a)	Demand and Forecast Management: Process for estimating demand and creating a corresponding forecast of FTE’s using Membership volume adjusted for seasonality under the Statements of Work 

 

	 	(b)	Resource Planning and Scheduling: Process for planning resources and scheduling them to meet the demand and forecast volume necessary to delivery on the Services Outlined in the Statement of Work combined with
corresponding Service Levels 

  

	 	(c)	Service Delivery Management: Procedures for delivering the Services outlined in the Statement of Work 

  

	 	(d)	SLA Management: Management and supervisory processes as well as corrective actions necessary to comply with the corresponding Service Levels for this Statement of Work 

  

					
	Schedule S		S-6		Health Net / Cognizant Confidential

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SCHEDULE T 
 JOINDER
AGREEMENT 

  

					
	Schedule T		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE T 
 JOINDER
AGREEMENT 
 THIS JOINDER AGREEMENT is made on this [TBD] day of [DATE] (the “Joinder Agreement”), by and
between: 
 [Fill in name of Health Net related entity], a company incorporated in [Delaware] with its principle place of
business located at [TBD] (“Customer”); and 
 Cognizant Healthcare Services, LLC, a Delaware limited
liability company with its principle place of business located at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (“Supplier”); Customer and Supplier being referred to individually as a “Joinder
Party” and collectively as the “Joinder Parties”. 
 BACKGROUND: 

 

	(A)	Health Net, Inc. (“HNI”) and Supplier are parties to that certain Master Services Agreement dated November 2, 2014 (the “Agreement”), pursuant to which HNI will
procure, and Supplier will deliver, certain Services. 

  

	(B)	Customer is an HNI-related entity that requires certain of the Services from Supplier. As concerns any such HNI-related entity that requires Services from Supplier, HNI and Supplier have entered into the Agreement with
the understanding and intention that each such HNI-related entity may enter into a separate Joinder Agreement directly with Supplier should it desire to obtain services from Supplier. 

 

	(C)	In that regard, Section 3.9 of the Agreement’s Terms and Conditions provides that each such HNI-related entity may enter into a joinder agreement directly with Supplier, enabling such entity to procure
Services directly from Supplier, provided that such entity is financially responsible only for the charges associated with such Services provided by Supplier to such entity and not for any amounts due Supplier by HNI or any of HNI’s other
affiliates or any HNI-related entities. 

  

	(D)	Accordingly, Customer and Supplier wish to enter into this Joinder Agreement for the provision of Services by Supplier to Customer, which shall be deemed a separate agreement as between Customer and Supplier and shall
not be or form the basis for an agreement, directly or indirectly, between HNI and Customer. 

 NOW IT IS HEREBY AGREED AS FOLLOWS:

  

	1.	DEFINITIONS AND INTERPRETATION 

  

	1.1	Defined Terms 

 All capitalized terms used in this Joinder Agreement and not otherwise
defined herein shall have the meanings ascribed to them in Section 2.1 of the Agreement’s Terms and Conditions or, if applicable, elsewhere in the Agreement. 

  

					
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	1.2	Conflicts 

 This Joinder Agreement and the Agreement shall be construed wherever possible
to avoid conflict. In the event that a conflict cannot be avoided, the terms of the Agreement shall prevail, unless and to the extent that (i) this Joinder Agreement expressly identifies the provision(s) the Parties intend to override, and
(ii) such change applies solely to this Joinder Agreement. 
  

	2.	TERM AND TERMINATION 

  

	2.1	Commencement 

 This Joinder Agreement shall come into effect on the date that Customer
and Supplier sign this Joinder Agreement. 
  

	2.2	Term 

 This Joinder Agreement shall remain in effect until the earlier of (a) the
expiration or termination of the Agreement in its entirety, or (b) the termination of this Joinder Agreement pursuant to Section 2.3. 
  

	2.3	Termination 

  

	 	(a)	Customer may terminate this Joinder Agreement, in whole or in part, upon written notice to Supplier to the limited extent that the Services to be provided under this Joinder Agreement expire, cease or are otherwise
terminated, each pursuant to the Agreement. 

  

	 	(b)	Supplier may terminate this Joinder Agreement upon written notice to Customer only to the extent that Supplier terminates the Agreement in accordance with Section 16.3 of the Agreement’s Terms and Conditions.

  

	 	(c)	For avoidance of doubt, the termination of this Joinder Agreement shall apply solely to this Joinder Agreement and shall not result in a termination of any other Joinder Agreement or the Agreement. 

 

	3.	SUPPLIER AND CUSTOMER OBLIGATIONS 

  

	3.1	Services 

 Supplier shall provide the Services to Customer in accordance with the terms
of this Joinder Agreement and the Agreement. 
  

	3.2	Charges 

 Customer shall pay Supplier the Charges for such Services provided to Customer
under this Joinder Agreement, in accordance with the Agreement’s Terms and Conditions. 
  

	3.3	General 

  

	 	(a)	Customer and Supplier each hereby agree to comply with all applicable provisions of the Agreement with respect to the Services provided hereunder. For purposes of this clause, references in the Agreement to “Health
Net” shall mean Customer. 

  

					
	Schedule T		T-2		Health Net / Cognizant Confidential

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	 	(b)	Customer shall have the right to enforce the rights granted to HNI under the Agreement as they relate to Services provided to Customer under this Joinder Agreement. 

 

	 	(c)	Supplier shall have the right to enforce the rights granted to Supplier under the Agreement as they relate to Services provided to Customer under this Joinder Agreement. 

 

	 	(d)	Nothing set forth herein shall be interpreted to make Customer liable (i) under any other Joinder Agreement, or (ii) under the Agreement except as it relates solely to Services provided to Customer under this
Joinder Agreement. 

  

	 	(e)	Customer and Supplier agree and acknowledge that this Joinder Agreement is entered into for the provision of Services by Supplier to Customer, shall be deemed to be a separate agreement as between Customer and Supplier
and shall not be or form the basis for an agreement, directly or indirectly, between HNI and Customer. 

  

	4.	DISPUTE RESOLUTION 

  

	4.1	Resolution of Claims and Disputes 

 All disputes, claims, actions and proceedings arising
out of or related to this Joinder Agreement shall be resolved in accordance with Article 26 of the Agreement’s Terms and Conditions. 
  

	5.	RELATIONSHIP OF JOINDER AGREEMENT TO AGREEMENT; AMENDMENTS 

  

	5.1	General 

 This Joinder Agreement, and each Joinder Party’s obligations hereunder,
shall be governed by and subject to the Agreement, as such Agreement may be amended from time to time in accordance with Section 25.3 of the Agreement’s Terms and Conditions. 

 

	5.2	Amendments to the Agreement 

 Any amendment to or modification of the Agreement shall be
binding on the Joinder Parties under this Agreement, as applicable, without the necessity of further action by either Joinder Party. 
  

	5.3	Effect of this Joinder Agreement on Agreement 

 Except as may be expressly set forth
herein as a term that the Parties intend modifies the Agreement, this Joinder Agreement shall not be construed or interpreted to amend or modify the Agreement. Without limiting the generality of the foregoing, this Joinder Agreement shall not be
construed to (a) alter the Charges for the Services set forth in the Agreement, (b) create a separate or prorated obligation with regard to the Minimum Revenue Commitment, or (c) create a separate or prorated amount at risk with
respect to Service Level Credits. 
  

	6.	ADDITIONAL TERMS 

  

	6.1	Governing Law 

 This Joinder Agreement and performance under it shall be governed by and
construed in accordance with the laws of the State of California without regard to its choice of law principles. 

  

					
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	6.2	Amendments 

 No change, waiver, or discharge of the terms of this Joinder Agreement shall
be valid unless in writing and signed by an authorized representative of each Joinder Party. 
  

	6.3	Further Assurances 

 Customer and Supplier hereby agree that, in connection with and
subsequent to the execution and delivery of this Joinder Agreement and without any additional consideration, each of Customer and Supplier will execute and deliver any further legal instruments and perform any acts which are or may become reasonably
necessary to effectuate this Joinder Agreement, including in connection with obtaining any consents, approvals or other actions required for the implementation of the rights and obligations under this Joinder Agreement. 

 

	6.4	Counterparts 

 This Joinder Agreement may be executed in several counterparts, all of
which taken together constitute a single agreement between the Joinder Parties. Each signed counterpart, including a signed counterpart reproduced by facsimile or other reliable means, will be considered an original. 

 

	6.5	Notices 

 A notice under or in connection with this Joinder Agreement shall be made in
accordance with Section 27.5 of the Agreement’s Terms and Conditions and delivered as follows: 
 If to Customer: 

[Fill in name of Health Net related entity and notice address] 

______________________ 

______________________ 
 with a
copy to Health Net in accordance with Section 27.5 of the Agreement’s Terms and Conditions, and 
 If to Supplier: 

Cognizant Healthcare Services, LLC 

500 Frank W. Burr Blvd. 
 Teaneck,
New Jersey 07666 
 Attn: General Counsel 

  

					
	Schedule T		T-4		Health Net / Cognizant Confidential

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Intending to be legally bound, each of Customer and Supplier has caused its duly authorized representative to execute this Joinder Agreement on the date
indicated below: 
 Signed by 
 for and on behalf of 

Customer: 

									
					
	Signature	 	 	 		 	Date	 	 
					
	Name	 	 	 		 		 	
					
	Title	 	 	 		 		 	

 Signed by 
 for and on behalf of

 Supplier 

									
					
	Signature	 	 	 		 	Date	 	 
					
	Name	 	 	 		 		 	
					
	Title	 	 	 		 		 	

  

  

					
	Schedule T	  	T-5	  	Health Net / Cognizant Confidential

 Final 

SCHEDULE U 
 ASPECT
ASSIGNMENT AND ASSUMPTION AGREEMENT 
 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 

  

					
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SCHEDULE V 
 GUARANTY

  

					
	Schedule V		 		Health Net / Cognizant Confidential

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PARENT GUARANTY 
 This Parent Guaranty
(this “Guaranty”), dated November 2, 2014, is issued by Cognizant Technology Solutions Corporation, a Delaware corporation (“Cognizant”) and Cognizant Technology Solutions U.S. Corporation, a
Delaware corporation (“CTS US” and collectively with Cognizant, “Guarantors”), in favor of Health Net, Inc., a Delaware corporation (including its successors and permitted assigns under each of the
Agreements, “Client”). 
 Client and CTS US are parties to that certain Master Services Agreement dated September 28, 2008 (the
“AO Agreement”). On or about the date hereof, Client and Cognizant Healthcare Services, LLC, a Delaware limited liability company (“CHS” and collectively with CTS US,
“Obligors”), entered into the following agreements: (i) a Master Services Agreement (“MSA”), and (ii) an Asset Purchase Agreement (“APA”), and (iii) Client and
Obligors entered into a Business Associate Agreement (“BAA”) (such MSA, APA, BAA and AO Agreement, each as amended from time to time in accordance with its terms, are referred to herein as the
“Agreements”, and individually as an “Agreement”). CHS is a wholly owned subsidiary of CTS US, and CTS US is a wholly owned subsidiary of Cognizant and the Agreements form the legal framework for
Client’s procurement of services from Obligors. 
 In consideration of Client entering into the Agreements with Obligors, Guarantors hereby provide
Client with this Guaranty. 
 Guarantors and Client agree as follows: 
  

	1.	Subject to the terms of this Guaranty, (a) Cognizant hereby guarantees the payment of all sums payable by Obligors to Client under the Agreements as and when the same fall due (the “Secured
Obligations”), and CTS US hereby guarantees the payment of CHS’s Secured Obligations; and (b) Cognizant shall cause the due and punctual performance and observance by Obligors of all acts and obligations to be
performed or observed by Obligors under the Agreements (the “Obligor Performance Obligations”), and CTS US shall cause the due and punctual performance and observance by CHS of CHS’s Obligor
Performance Obligations. All obligations under this Guaranty that are obligations of both Cognizant and CTS US are joint and several. 

  

	2.	Except to the extent that Client is prohibited from giving notice as the result of a stay in bankruptcy or as a result of other applicable law, Client (including its successors and assigns) may not claim any amounts
pursuant to or under this Guaranty in respect of any Agreement unless Client (including its successors and assigns) gives all notices of breach to the applicable Obligor(s) required pursuant to such Agreement and the applicable period(s) (if any)
for Obligors to remedy such breaches(s) have expired. Provided that Client has given any notice required by this Section 2 and applicable time periods have expired, it shall not be necessary or required that Client file suit or proceed to
obtain or assert a claim for a judgment directly against Obligors or any other person or entity or make any other effort to require Obligors or any other person or entity to pay or perform as a condition of Guarantors fulfilling their obligations
under this Guaranty. Subject to the requirements of the first sentence of this Section 2, this is a Guaranty of payment and performance and not a Guaranty of collection. 

 

	3.	Client may not recover any loss or expense under this Guaranty which it would not have been able to recover from one of the Obligors under the Agreements except to the extent that Client’s inability to
recover is the result of (i) the failure of any of the Agreements to be duly authorized, executed or delivered by Obligors or (ii) the reduction or discharge of any obligations of either of the Obligors in a bankruptcy or other insolvency
proceeding. Client is subject to the same burden of proof in an action related to this Guaranty as it would have been subject to in an action under the Agreements. 

  

					
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	4.	Client may request payment of the Secured Obligations under this Guaranty in one or several times, provided that (i) the aggregate amount payable by Guarantors under this Guaranty in respect of any Agreement shall
not exceed the value of the sums required to be paid by Obligors under such Agreement, and (ii) there shall be no duplication of sums paid by Obligors under the Agreements and sums paid by Guarantors under this Guaranty. Guarantors’
liability under this Guaranty in respect of any Agreement will not exceed Obligors'’ liability or obligations under such Agreement, and Guarantors are entitled to claim all of the rights, limitations (including the limitation of
liability), benefits and defenses of Obligors under the Agreements, which are incorporated herein by this reference, except that Guarantors’ liability under this Guaranty may exceed Obligors’ liability or obligations under an
Agreement, and Guarantors shall not be entitled to claim any of the rights, limitations, benefits and defenses of Obligors, to the extent that Obligors’ liability or obligations are reduced or Obligors have any rights, limitations,
benefits or defenses resulting from or arising out of (i) the failure of any of the Agreements to be duly authorized, executed or delivered by Obligors or (ii) the reduction or discharge of any obligations of either of the Obligors in a
bankruptcy or other insolvency proceeding. The liability of Guarantors under this Guaranty shall be reinstated and revived and the rights of Client shall continue if and to the extent that for any reason any payment by or on behalf of a Guarantor or
an Obligor in respect of any obligations is rescinded or must be otherwise restored by Client, whether as a result of any proceedings in bankruptcy or reorganization or otherwise. Guarantors’ obligations under the preceding sentence of
this Section 4 shall survive termination of this Guaranty. 

  

	5.	Client may request Guarantors to cause performance of the Obligor Performance Obligations under this Guaranty at any time and from time to time, and Guarantors are entitled to claim all of the rights, limitations
(including the limitation of liability), benefits and defenses of Obligors under the Agreements, which are incorporated herein by this reference, except that Guarantors’ liability under this Guaranty may exceed Obligors’
liability or obligations under an Agreement, and Guarantors shall not be entitled to claim any of the rights, limitations, benefits and defenses of Obligors to the extent that Obligors’ liability or obligations are reduced or Obligors
have any rights, limitations, benefits or defenses resulting from or arising out of (i) the failure of any of the Agreements to be duly authorized, executed or delivered or (ii) the reduction or discharge of any obligations of an Obligor
in a bankruptcy or other insolvency proceeding. 

  

	6.	Except as provided in this Guaranty, this Guaranty is irrevocable, unconditional and absolute. To the extent Guarantors pay a Secured Obligation pursuant to this Guaranty, such payment shall be in satisfaction of
Obligors’ obligations under the Agreement that gave rise to the Secured Obligation and Guarantors’ obligations under this Guaranty with respect to that Secured Obligation. 

 

	7.	The obligations, covenants, agreements and duties of Guarantors under this Guaranty shall in no way be affected or impaired by reason of the happening from time to time of any of the following: (i) any permitted
assignment or subcontracting of any interests under the Agreements; (ii) to the extent permitted by applicable law, the voluntary or involuntary liquidation, dissolution, insolvency, or bankruptcy affecting a Guarantor or an Obligor or any of their
respective assets; or (iii) any merger, acquisition or corporate reorganization involving Guarantors or Obligors. This Guaranty will remain in full force and effect as to any renewal, modification or extension of each of the Agreements consistent
with its terms. 

  

					
	Schedule V		V-2		Health Net / Cognizant Confidential

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	8.	Guarantors waive (i) any right of subrogation, reimbursement, indemnification, contribution, substitution or any similar right it has against the Obligors (collectively, “Reimbursement
Rights”) until all Secured Obligations and Obligor Performance Obligations are paid and performed in full; (ii) any rights or defenses resulting from any loss, suspension or impairment of any Reimbursement Right;
(iii) any rights or defenses against Client resulting from release or waiver of Client’s rights against either of the Guarantors or any other guarantor; and (iv) any duty on the part of Client to disclose to Guarantors any
facts Client may now or hereafter know about Obligors, regardless of whether Client has reason to believe that any such facts materially increase the risk beyond that which Guarantors intends to assume or has reason to believe that such facts are
unknown to Guarantors. 

  

	9.	Guarantors’ liability under this Guaranty will not be discharged automatically or otherwise by any amendment, addendum or variation to an Agreement that is executed in accordance with the terms of such
Agreement. 

  

	10.	Sections 24.3 (Force Majeure), 25.12 (Severability), 26.1 (Informal Dispute Resolution), 27.8 (Covenant of Good Faith), and 27.12 (Mutually Negotiated) of the MSA shall be incorporated herein by reference and apply to
this Guaranty. 

  

	11.	This Guaranty shall remain in force from the date hereof until Obligors’ obligations under the Agreements are satisfied or otherwise completely terminated; provided, however, that this Guaranty shall remain
in force until Obligors’ obligations under the Agreements are satisfied if Obligors’ obligations are terminated as a result of rejection, discharge or other termination or reduction in a bankruptcy or other insolvency
proceeding. 

  

	12.	This Guaranty may be modified only by a written amendment executed by duly authorized officers or representatives of each of Guarantors and Client. Neither Guarantors nor Client may assign or otherwise transfer any of
its rights, duties or obligations under this Guaranty without the prior written consent of the other parties except that Client may assign its rights under this Guaranty in respect of an Agreement without the consent of Guarantors to the same extent
it assigns its rights under such Agreement in accordance with the terms of such Agreement. If any provision of this Guaranty is invalid, illegal or unenforceable in any jurisdiction, the validity, legality and enforceability of the remaining
provisions will not in any way be affected or impaired thereby. 

  

	13.	Except for claims made under this Guaranty against the Guarantors as legal entities, no claim may be made or recourse shall be had under this Guaranty against any direct or indirect, past, present or future, partners,
members, shareholders or other direct or indirect holders of ownership interests in Guarantors, whether by virtue of any statute or rule of law, or by assessment or penalty or otherwise. Client expressly and irrevocably waives, by virtue of its
acceptance of or reliance upon this Guaranty or its benefits, any such claim or recourse, and any liability otherwise arising therefrom. Nothing in this Section 13 is intended to release either Guarantor from any obligation under this Guaranty
because CTS US is a subsidiary of Cognizant. 

  

	14.	This Guaranty will be governed by and construed in accordance with the laws of the State of New York, without giving effect to the principles thereof relating to the conflicts of laws. The parties hereby irrevocably and
unconditionally consent to submit to the exclusive jurisdiction of the courts in the State of New York within the County of New York and of the United States of America located in the Southern District of New York for any actions, suits or
proceedings arising out of or relating to this Guaranty and the transactions contemplated hereby. 

  

					
	Schedule V		V-3		Health Net / Cognizant Confidential

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	15.	All notices under this Guaranty will be in writing and will be deemed to have been duly given if delivered personally or by commercial overnight delivery, or mailed by registered or certified mail, return receipt
requested, postage prepaid, to the parties at the addresses set forth below: 

  

	 	(a)	If to Guarantors or either Guarantor: 

 Attention: General Counsel 

Cognizant Technology Solutions Corporation 

500 Frank W. Burr Boulevard 

Teaneck, New Jersey 07666 
  

	 	(b)	If to Client: 

 Attention: General Counsel 

Health Net, Inc. 

21650 Oxnard Street 

Woodland Hills, CA 91367 
 All
notices under this Guaranty that are addressed as provided in this Section, (i) if delivered personally or by commercial overnight delivery, will be deemed given upon delivery, or (ii) if delivered by mail, will be deemed given on the
fifth (5th) business day after the day it is deposited in a regular depository of the United States mail. Either Guarantors or Client from time to time may change its address or designee for notification purposes by giving the other parties
notice of the new address or designee and the date upon which such change will become effective. 

  

					
	Schedule V		V-4		Health Net / Cognizant Confidential

 Final 

Guarantors and Client are signing this Guaranty on the date stated in the introductory clause. 

 

									
	HEALTH NET, INC.	 		 	COGNIZANT TECHNOLOGY SOLUTIONS CORPORATION
					
	By:	 	 	 		 	By:	 	 
					
	Name:	 	 	 		 	Name:	 	 
					
	Title:	 	 	 		 	Title:	 	 
			
		 		 	 COGNIZANT TECHNOLOGY SOLUTIONS

U.S. CORPORATION

					
		 		 		 	By:	 	 
					
		 		 		 	Name:	 	 
					
		 		 		 	Title:	 	 

  

					
	Schedule V	  	 	  	Health Net / Cognizant Confidential

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SCHEDULE W 
 GLOSSARY

 [TO BE DEVELOPED AFTER THE EFFECTIVE DATE IN ACCORDANCE WITH THE 

GENERAL TERMS AND CONDITIONS] 

  

					
	Schedule W		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE X 
 IN-FLIGHT AND
ACCELERATED PROJECTS 

  

					
	Schedule X		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE X 
 IN-FLIGHT AND
ACCELERATED PROJECTS 
  

	1.	IN-FLIGHT AND ACCELERATED PROJECTS 

  

	 	(a)	“In-Flight Project” means a project listed in Schedule X-1 (In-Flight Project List). 

 

	 	(b)	“Accelerated Project” means a project listed in Schedule X-2 (Accelerated Project List). 

 

	2.	PERFORMANCE AND COMPLETION OF IN-FLIGHT PROJECTS 

 If Supplier is at fault for failing to
complete an In-Flight Project by the applicable implementation date identified in Schedule X-1 (In- Flight Project List), the provisions of Section 13.7 (Completion of Transition Projects) of the Terms and Conditions will apply.
The following conditions will apply to In-Flight Projects 
  

	 	•	 	In-Flight Projects contain identification of BPaaS and Non-BPaaS IT Projects. 

  

	 	•	 	All resources assigned to In-Flight Projects will continue through implementation of the currently defined scope. 

  

	 	•	 	For projects which involve IBM oversight, only the PM/Oversight work is part of in-flight scope. All IBM work will be paid based on current terms. 

 

	 	•	 	For any changes to the in-flight project due to a Health Net requested schedule/ scope change on the agreed X-1, will be handled as AO until the BPaaS commencement date and transitions to the Phase-2 pool allocation
after the BPaaS commencement date. 

  

	 	•	 	For any new projects which are not included on the list, will be paid out of AO before the BPaaS commencement date and will transition to the Phase-2 Project governance model. 

  

					
	Schedule X		X-1		Health Net / Cognizant Confidential

 Final 

SCHEDULE X-1 
 IN-FLIGHT
PROJECT LIST 

  

					
	Schedule X-1		X-1-1		Health Net / Cognizant Confidential

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	 Count of BID PID
	  	 	Column Labels	  	  				  				  				  				  			
	 Row Labels
	  	BPaaS	 	  	BPaaS :
Business Only	 	  	IBM	 	  	Non-BPaaS	 	  	Non-BPaaS :
Business Only	 	  	Grand Total	 
	 In-Flight - No WO
	  	 	32	  	  	 	5	  	  	 	65	  	  	 	4	  	  	 	2	  	  	 	108	  
	 Inflight - WO exists
	  	 	121	  	  				  				  	 	9	  	  				  	 	130	  
	 Grand Total
	  	 	153	  	  	 	5	  	  	 	65	  	  	 	13	  	  	 	2	  	  	 	238	  

  

					
	Schedule X-1	  	X-1-2	  	Health Net / Cognizant Confidential

	
	

  

 Final 
Schedule X-1 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
1 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
10805 
17343 
10805 17343 
BPaaS 
Inflight—W O exists 
10805- 
13008_COG 
_W O_Ver 1.4 
10805 17343—MPTN 837I/P 5010 File Conversion 
This Project is part of the 51-100 Program. 
· The new Child PID will be used to manage
an additional track of the 5010 Program based on newly identified scope for the project. 
· The Child PID is needed based on a different schedule and
implementation dates for this new track. 
Confirmed Compliance 
Unassigned

11/17/2014 
14R4 
2 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
10805 
13008 
10805 13008 
BPaaS 
Inflight—W O exists 
10805- 
13008_COG 
_W O_Ver 1.4,10805- 
13008_COG 
_CR8_v1.1,1 0805- 
13008_COG 
_CR7_v1.2,1 0805- 
13008_COG 
_CR6_v1.0_1 1072013,108 
05- 
13008_COG 
_CR5_v1.0_0 6192013,108 
05- 
13008_COG 
_CR4_v1.0_0 4182013,108 
05- 
13008_COG 
_CR3_v1.1_0 3292013,108 
05- 
13008_COG 
_CR2_v1.1_0 3112013,108 
05- 
13008_COG 
_CR1_v1.0 
10805 13008—5010 EDI Translator Decomm Track 1 
CMS has issued new HIPAA regulations which require us to convert our EDI HIPAA compliant transactions to X12 version 5010 by January 1, 2011 for all regulated transactions so that
Health Net can perform the full mandated year of testing with trading partners. Full compliance date of January 1, 2012. 
The transactions impacted by the ruling
are 837 Professional and 837 Institutional Claims, 835 Electronic Remittance Advice, 820 Premium Payment, 834 benefit enrollment, 270/271 Eligibility, 278 authorizations, 276/277/277U, 999 Claims Status 
/Acknowledgement. 
Confirmed Compliance 
Compliance—HIPAA: 5010 
Joel Seguin 
9/22/2014 
14R3 
3 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
10805 
17143 
10805 17143 
BPaaS 
Inflight—W O exists 
10805- 
13008_COG 
_CR6_v1.0_1 1072013 
10805 17143—5010 EDI Translator Decomm Track 5 
CMS has proposed new HIPAA regulations
which require us to convert our EDI HIPAA compliant transactions to X12 version 5010 by April 1, 2010 for all regulated transactions. The transactions impacted by the ruling are 837 
Confirmed Compliance 
Compliance—HIPAA: 5010 
Joel Seguin 
9/22/2014 
14R3 
4

Infrastructure 
Not available 
Active 
Approved 
Child 
10805 
11820 
10805 11820 
BPaaS 
Inflight—W O exists 
10805- 
11820_COG 
_W O_Ver 1.4.doc,1080 
5- 
11820_COG 
_CR9_Ver1.0 
,10805- 11820_COG 
_CR8_Ver1.2 
,10805- 11820_COG 
_CR7_Ver1.0 
,10805- 11820_COG 
_CR6_Ver 1.0,10805- 
11820_COG 
_CR5_Ver 1.0.doc,1080 
5- 
11820_COG 
_CR4_Ver1.3 
,10805- 11820_COG 
_CR3_Ver1.0 
.doc 
10805 11820—Informatica Power Ctr Migrate Users 
This project will fully migrate the
Informatica System to a new Linux platform. Goal is to deliver an improved architecture to provide stability. 
Lights On 
Unassigned 
6/6/2014 
14R2 
5

Service Delivery 
David Kosterman 
Active 
Approved 
Parent 
10805 
10805 
10805 10805 
BPaaS 
Inflight—W O exists 
10805- 
13013_COG 
_CR1_Ver 1.1.doc,1080 
5_COG_W O 
_Ver 1.5.doc 
10805 10805—5010 Program 
CMS has proposed new HIPAA regulations which require us to convert our EDI HIPAA compliant transactions to X12 version 5010 by April 1, 2010 for all regulated transactions. The
transactions impacted by the ruling are 837 Professional and 837 Institutional Claims, 835 Electronic Remittance Advice, 820 Premium Payment, 834 benefit enrollment, 270/371 Eligibility, 278 authorizations, 276/277/277U claims Status/Acknowledgement

Confirmed Compliance 
Compliance—HIPAA: 5010 
Joel Seguin 
9/22/2014 
14R3 
X-1-3

Health Net / Cognizant Confidential 

	
	

  

 Final 
Schedule X-1 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
6 
Service Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
11544 
17303 
11544 17303 
BPaaS 
Inflight—W O exists 
In draft mode 
- XXXXX- XXXXX_CCC M_PRIME_1 5R2_APR_v1 
.0 
11544 17303—Prime Improvements for Magic Retirem 
Currently the State Health Programs Appeals and Grievances process is a manual one and the Appeals and Grievances standard documention, tracking, storage, auditing and reporting
processes are handled in the Macess EXP and MAGIC application environments. This project is to facilitate the adding of the State Health Programs (i.e. Medi-cal, Healthy Families and AIM) process to the Maecess EXP and MAGIC enviornments. In
addition to reduce risk of losing/misplacing paper files that are exchanged between the Corrodinator, Clinical Specialist, Manamgement and back to coordinator.

Healthy Family and AIM are currently located in the Macess EXP enviornment, however they are not utilizing all the capabilities of the Macess EXP enviornment due
to the manual process in A&G for State Health Programs. 
Performance Improvements 
Unassigned 
5/18/2015 
15R2 
7

Service Delivery 
Robert E Oetken Jr 
Active 
Approved 
Parent 
11544 
11544 
11544 11544 
BPaaS 
Inflight—W O exists 
SOW# 561—   
CCCM A&G—Implementati on; CR1-HN A&G;
CR2—   
HN A&G; CR3-HN A&G; CR4—   
HN
A&G; CR5-HN A&G; CR6—   
HN A&G; 
CR7-HN 
A&G 
11544 11544—State Health Prog Electronic Process 
Currently the State Health Programs Appeals and Grievances process is a manual one and the Appeals and Grievances standard documention, tracking, storage, auditing and reporting
processes are handled in the Macess EXP and MAGIC application environments. This project is to facilitate the adding of the State Health Programs (i.e. Medi-cal, Healthy Families and AIM) process to the Maecess EXP and MAGIC enviornments. In
addition to reduce risk of losing/misplacing paper files that are exchanged between the Corrodinator, Clinical Specialist, Manamgement and back to coordinator.

Healthy Family and AIM are currently located in the Macess EXP enviornment, however they are not utilizing all the capabilities of the Macess EXP enviornment due
to the manual process in A&G for State Health Programs. 
Performance Improvements 
Unassigned 
5/18/2015 
15R2 
8

Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
11916 
11916 
11916 11916 
BPaaS 
Inflight—W O exists 
11916- 
11916_COG 
_CR2_Ver_2. 1,11916- 
11916_COG 
_CR1_Ver 2.1,11916_C 
OG_W O_Ver 7.0.doc,1191 
6_11916_CO 
G_CR5_Ver 1.1,11916_11 
916_COG_C 
R4_Ver 1.0,11916_11 
916_COG_C 
R3_Ver 1.0 
WO# 1062—   
Weblogic & ESB Updates (Pega) 
BTI W O 09- 190 W LS 
and ESB Updates PID 11916 12-20- 
2013 
PCR01 09- 190 W LS 
and ESB Updates PID 11916 07-10- 
2014 
11916 11916—W LS & ESB Updates 
This enhancement request involves changing all user
names / passwords of W ebLogic Server (W LS) and Enterprise Service Bus (ESB) servers to “InfoSec” compliant user names and passwords. 
This project also
covers applying the necessary patches to the required WebLogic Servers to address the vulnerabilities identified in the currently deployed versions of this product; these issues are detailed in the next section below. 
Lights On 
Unassigned 
10/31/2014 
14R4 
9 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Parent 
12245 
12245 
12245 12245 
BPaaS : No Work 
In-Flight—No WO 
No Work : Parent PID—will be closed once children are done

12245 12245—ICD-10 PROGRAM 
Enable Health Net to conduct business with
its providers, members, vendors, and government agencies using ICD-10 codes for diagnostics and procedures, by October 1, 2013. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R4 
10 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
15006 
12245 15006 
BPaaS 
In-Flight—No WO 
12245 15006—ICD-10 Trading Partners 
This project is to identify, document, coordinate, and track Health Net’s trading partner’s roadmap and ICD-10 readiness. The project will determine trading partner’
readiness, establish trading partners’ specific strategies, identify partners for testing, coordinate testing efforts, and track the progress of each trading partner to ensure compliance and avoid business transition breakdown. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R3 
X-1-4

Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
11 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
14765 
12245 14765 
BPaaS 
Inflight—W O exists 
12245- 
14765_ICD1 
0_MHN_CR1 
_ V1.2_201308 16 ,12245- 
14765_ICD1 
0_HP_Patch 
_CR3_V1.0,1 2245- 
14765_ICD1 
0_278N_CR2 
_ V1.0_201310 17,12245- 
14765_COG 
_W O_Ver_1. 1_06142013, 
12245- 
14765_COG 
_CR9_Ver_1 
_0,12245- 14765_COG 
_CR8_Ver_1 
_0,12245- 14765_COG 
_CR7_Ver_1. 1,12245- 
14765_COG 
_CR6_Ver_1. 0,12245- 
14765_COG 
_CR5_Ver_1. 0,12245- 
14765_COG 
_CR10_Ver_ 1.2,12245 
14765_ICD1 
0_CR4_V1.0. 
doc 
WO# 1098- HN ICD-10 IT 
Implementati on; CR1-HN ICD-10 IT 
Implementati on; CR2-HN ICD-10 IT 
Implementati on 
12245 14765—ICD-10 ITG 
Implementation 
This project is to modify all Systems supporting Commercial, State Health
Plans, and MHN line of business that will be impacted as providers send claims and authorizations with ICD-10 codes for dates of service on or after 10/01/2013. These systems must support dual usage based on the dates of service: ICD9 for claims
with dates of service prior to 10/01/2013, and ICD-10 for dates of service on or after 10/01/2013. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R3 
12 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
14646 
12245 14646 
BPaaS 
In-Flight—No WO 
12245 14646—DOFR Configuration 
The intent of this project is to convert ICD-9 based components of the DOFR (Division of Financial Responsibility) tool to ICD-10. The conversion to ICD-10 should be seamless, and
the ICD-10 based version should be comprehensive, valid, and appropriate from a clinical and financial standpoint. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/31/2014 
14R3 
13 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
14647 
12245 14647 
BPaaS 
In-Flight—No WO 
12245 14647—ICD-10 Provider Contracts / Pricing 
To develop a W estern Region Provider Network Management (PNM) and Pricing Configuration implementation strategy to achieve compliance with the Health Insurance Portability and
Accountability Act of 1996 (HIPAA) ICD-10 final rule effective October 1, 2013. The ICD-10 final rule mandates the use of the ICD-10-CM code set for diagnosis coding and the ICD-10-PCS code set for inpatient hospital procedure coding for claims
received for encounters and discharges occurring on or after October 1, 2013. For services occurring prior to October 1, 2013, providers will continue to use the existing ICD-9 code sets 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R3 
14

Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
15081 
12245 15081 
BPaaS : No Work 
In-Flight—No WO 
No Work : Parent PID—will be closed once children are done 
12245 15081—ABS Claims
Policies & Procedures 
The intent of this project is to analyze the existing ABS Claims policies in Health Net and identify the ones that use ICD-9 codes. Those
policies that contain specific ICD-9 Diagnosis and/or Procedure Codes would be remediated to include the appropriate ICD- 10 Diagnosis and/or Procedure Codes.

Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R3 
15

Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
15213 
12245 15213 
BPaaS 
In-Flight—No WO 
12245 15213—ABS Benefit Configuration 
BUSINESS OBJECTIVE 
Ensure that benefits associated with Claims can be determined using the ICD-10 codification systems 
SCOPE 
Determine the relevant ICD-10 codes to be added to the Grouping Details within the
Service Categories 
Load the ICD-10 codes into SCATS 
Test that the ICD-10
codes are associated to the proper Service Categories 
Confirmed Compliance

Compliance—HIPAA: ICD10 
Joel Seguin 
8/18/2014 
14R3 
16 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
15214 
12245 15214 
BPaaS 
In-Flight—No WO 
12245 15214—Reporting and Analytics 
The purpose of this project is to remediate the business generated reports affected by ICD-10.

The Business users will need to finalize the reports that are required to be generated across the compliance date of 10/1/2013. Towards that the business users
will need to check if any of those required reports are currently being generated from the existing data stores or systems. If they are currently being generated then business users will need to analyze and define the changes that will be required
to make them ICD-10 compliant. If they are new reports then the business users will need to define requirements for those reports. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
7/31/2014 
14R3 
17 
Infrastructure 
Bart Keaney 
Active 
Approved 
Parent 
12295 
12295 
12295 12295 
IBM 
In-Flight—No WO 
See Child PID 
12295 12295—Data Security Program 
Lights On 
Unassigned 
9/30/2014 
14R3 
9/30/2014 
Schedule X-1 
X-1-5 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
18 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12295 
13438 
12295 13438 
IBM 
In-Flight—No WO 
BTI WO 10- 
306 Network IPS NAC PCR02 10- 306 IPS NAC 
Project 6-5- 11 
PCR03 10- 
306 Network IPS-NAC PID 12295 08-15- 
11 
PCR04 10- 306 RFS IPS 
NAC Project PID 12295- 13438 10-13- 
2011 
PCR05 10- 306 IPS NAC 
Project v2 PID 12295- 13438 12-01- 
2011 
PCR06 10- 306 IPS NAC 
Project PID12295- 13438 01-06- 
2012 
PCR07 10- 306 IPS NAC 
Project v2 PID12295- 13438 02-28- 
2012 
PCR08 10- 
306 Network IPS NAC v2 
12295 13438—Network IPS / NAC 
This is a part of the security foundation efforts, and is a sub project of 12295. This project is intended to implement a network intrusion prevention solution to protect the
Health Net corporate and federal services components. This is a DIACAP requirement for 2011. 
Lights On 
Unassigned 
11/1/2014 
14R4 
11/1/2014 
19 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12295 
13439 
12295 13439 
IBM 
In-Flight—No WO 
EXECUTED 
BTI WO 10- 
230 McAfee Hardware Expansion BARR WO 
10-031 Data Loss Prevention 
_PID 12295_ 10-8-10 
BTI WO10- 031 BTI 
McAfee Network DLP PCR01 10- 
031 McAfee NDLP v2 PID12295 11- 01-2011 PCR02 10- 
031 McAfee NDLP PID 12295 06-28- 
2012 
PCR03 10- 
031 Data Loss Prevention Evaluation v3 PID 12295 11-14-2012 PCR04 10- 
031 Data Loss Prevention
Evaluation 
PID 12295 10 
12295 13439—Data Loss Prevention 
Health Net Corporate recently underwent a Data Protection Audit via Internal Audit. It was found during this audit that Health Net does not monitor the flow of information outside
its network. There is no Data Leakage monitoring (or Data Loss Prevention) tool in place to monitor data movement. Without a Data Leakage monitoring solution, Health Net incurs the risk of having no visibility of sensitive data movement in to and
out of the enterprise. As a result, Health Net cannot quantify the level of business risk we are accepting with respect to the handling and security of sensitive data. This project is to put into place the technical controls required to remediate
this finding. 
Lights On 
Unassigned 
6/30/2014 
14R2 
6/10/2014 
Schedule X-1 
X-1-6 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
20 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12295 
13371 
12295 13371 
BPaaS 
Inflight—W O exists 
12295- 
13371_COG 
_W O_Ver2.2 
BTI WO 10- 
286 McAfee TPE PID 13371 2-22- 
11 
PCR01 10- 
286 McAfee TPE 
Implementat ion PID 13371 08-30- 
2011 
PCR02 10- 
286 McAfee TPE 
Implementat ion PID 13371 12-06- 
2011 
12295 13371—McAfee TPE Implementation 
Part of the security foundation efforts. This project is intended to prepare the environment and deploy McAfee Total Protection for Endpoint (TPE) to all Health Net desktops.
McAfee TPE will replace Symantec SEP and provide additional features. 
Lights On

Unassigned 
9/30/2014 
14R3 
9/30/2014 
21 
Finance/Corpor ate 
Cynthia T Nguyen 
Active 
Approved 
Single 
12352 
12352 
12352 12352 
BPaaS 
Inflight—W O exists 
12352- 
12352_COG 
_W O_ Ver 4.0 
12352 12352—Consolidations—Financial Trans 
The current HFM application is not
aligned with Health Net’s business and reporting requirements. As the Finance Transformation moves forward, HFM must be configured to align with the future state finance organization and be capable of supporting business and reporting
requirements. Objectives of this project include; alignment of actual and budget data for consolidation / reporting and streamlining the reporting process.

Performance Improvements 
Unassigned 
9/22/2014 
14R3 
22 
Service Delivery 
David Kosterman 
Active 
Approved 
Parent 
12365 
12365 
12365 12365 
BPaaS 
Inflight—W O exists 
WO# 1063- OMNI 
Release 1 ME support; CR1-OMNI 
Release 1 ME support; CR2-Pega Production Support – OMNI

Release 1 ME Support 
12365 12365—Contact Center Modernization

The intent of this project is to modernize our contact center systems to reduce cost and improve the customer experience. Our current systems and channels lack
integration and functionality resulting in long training lead times, high defect rates and AHT and the inability to provide consistent responses. Our CA Commercial agents current rely on over 40 applications and points of knowledge to assist
customers making it difficult to gain further operational efficiencies without impacting the customer experience. The proposed solution will build knowledge into all aspects of our systems to reduce training time, AHT and lead the agent through a
rules based approach to deliver the right answer consistently. It will also integrate our customer touch points such that they are integrated and treat the customer interaction as a single thread regardless of where the interaction starts.

Performance Improvements 
Unassigned 
13R2 
23

12434 
12434 
12434 12434 
BPaaS 
Inflight—W O exists 
12434- 
12434_COG 
_CR5_Ver 1.1,12434- 
12434_COG 
_CR4_Ver 1.0,12434_C 
OG_W O_Ver 1.1,12434_C 
OG_CR3_Ve r 1.0,12434_C 
OG_CR2_Ve r 1.0,12434_C 
OG_CR1_Ve r 1.1 
12434 12434—ODW PRD DB Move Project 
Infra 
Unassigned 
24 
Business Development 
David Kosterman 
Active 
Approved 
Parent 
12803 
12803 
12803 12803 
BPaaS 
Inflight—W O exists 
12803- 
12803_COG 
_W O_Ver 1.2,12803- 
12803_COG 
_CR2_Ver 1.1,12803- 
12803_COG 
_CR1_Ver 1.4 
12803 12803—ABS Modern Phase I RMC Streamline 
Currently the RMC, the main component and driver of a new product, is hard-coded in approximately 451 programs thoughout the core ABS and surround systems. 
Whenever Health Net launches a new product, the new RMC code must be added to each of the core systems¿ programs. 
Because of the large number of programs to change, the amount of time it takes to implement a new product (RMC) jeopardizes Health Net¿s ability to remain competitive in the
Health Care industry by: 
1) Posing a limitation on the number of ¿New Products¿ HN can implement each year. 
2) Posing a risk to the allocation of funds and 
3) Because of the aggressiveness of
¿New Products¿ projects, forces HN to reduce the life cycle of a project, thereby, risking the success of all projects within a scheduled release.

For Health Net to remain competitive with continued growth in today¿s market, it is essential to come up with a more efficient and cost effective solution
to implementing new products (RMCs). 
Performance Improvements 
Unassigned

2/23/2015 
15R1 
Schedule X-1 
X-1-7 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
25 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
12873 
12873 
12873 12873 
IBM 
In-Flight—No WO 
BARR WO 
10-168 
Corporate SQL Cluster Upgrade PID 12873 08-20- 
2012 
PCR01 BARR W O 10-168 
Corporate SQL Cluster Upgrade PID 12873 01-14- 
2013 
PCR02 BARR W O 10-168 
Corporate SQL Cluster Upgrade PID 12873 07-22- 
2013 
PCR02 BARR W O 10-168 
Corporate SQL Cluster Upgrade PID 12873 12-18- 
2012 
EXECUTED PCR01 10- 168 
Corporate SQL Cluster Upgrade Project (PID 12873) 
02072013 
12873 12873—Corporate SQL Cluster Upgrade 
In order to keep our SQL Servers current and up to date, all SQL Server 2000 Instances below will be upgraded/converted to SQL Server 2008 R2. This is very essential for HealthNet,
as it keeps the cost of carrying older versions of databases down. Upgrading will also keep our databases more secure, scaleable, and will allow the use of new features that improve performance and administration. 
Extended support for SQL Server 2000 will end in April 2013. This version upgrade will conform to the Health Nets Best Practices/IT Roadmap, Strategy and End State Model keeping
all DBMS software at vendor supported levels. 
Lights On 
Unassigned

11/15/2014 
14R4 
9/30/2014 
26 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12883 
17213 
12883 17213 
IBM 
In-Flight—No WO 
12883 17213—Alfresco Pilot for Membership Corro 
The current system architecture and
hardware for the MediCal FileNet system is nearing maximum capacity for the number of claims that can be scanned and processed in ‘normal’ processing windows. Even with the recent 
Lights On 
Unassigned 
11/17/2014 
14R4 
27 
Infrastructure 
Bart Keaney 
Active 
Approved 
Parent 
12883 
12883 
12883 12883 
BPaaS 
Inflight—W O exists 
12883- 
12883_COG 
_W O_Ver 2.0,12883- 
12883_COG 
_CR2_Ver 1.1,12883- 
12883_COG 
_CR1_Ver 1.1 
SOW# 440—   
Medi-Cal FileNet Modernizatio n;CR1-Medi- Cal FileNet Modernizatio
n; CR2-Medi- Cal FileNet Modernizatio n; CR3-Medi- Cal FileNet Modernizatio n; CR4-Medi- Cal FileNet Modernizatio n; CR5-HN MediCal Filenet Migration; CR6-HN

MediCal Filenet Migration; CR7-HN 
Filenet Alfresco Analysis; CR8-HN

Filenet Alfresco Analysis 
12883 12883—MediCal Application Link to PEGA

The current system architecture and hardware for the MediCal FileNet system is nearing maximum capacity for the number of claims that can be scanned and processed
in ‘normal’ processing windows. Even with the recent migration to Boulder CO as part of the Data Center Relocation effort, there are still significant exposures to the reliability and functionality of the FileNet Imaging system, most
notably that the existing FileNet software runs on a W indows 2000 operating system platform which will no longer be supported as of summer 2010. 
The current
system architecture and software for the MediCal FileNet system is aged, faces performance maximization for it’s processing ability for nightly processing, and runs components on a W indows 2000 platform that will no longer be support by
Microsoft as of July 2010. This puts the MediCal business as significant risk and the addition of additional lives due to the Tri-County RHA/LI implementation incereaases the business risk. 
Lights On 
Unassigned 
8/18/2014 
14R3 
28 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
12939 
12939 
12939 12939 
IBM 
In-Flight—No WO 
n/A—no W O as of yet 
12939 12939—PROJ Voice Server refresh Consolida 
Health Net¿s Cisco Call Manager
and Unity voice mail hardware is nearing EOL and the associated software is EOS. The current software versions do not support geographic redundancy, virtualization, SIP services, and other desired features. These systems require a hardware and
software refresh, consolidation, virtualization, and relocation to the Boulder data center. 
Lights On 
Unassigned 
11/17/2014 
15R2 
6/10/2015 
Schedule X-1 
X-1-8 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
29 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
12940 
12940 
12940 12940 
IBM 
In-Flight—No WO 
BARR WO 
10-193 
Archiving 
W indows File- Print Servers.pdf PCR01 BARR 10- 
193 Archiving W indows File and Print Servers
_PID 12940_ 05- 
31-2011.pdf BSD TSD WO 10-193 
Archiving Windows FilePrint

Servers PID 12940 12-06- 
2011.pdf 041212 Matt Coates_HNI_ McAfee 2.xls PCR01
10- 
193 Archiving W indows File Print Servers Project v5 PID 12940 08 27-2012.pdf PCR02 10- 
193 Archiving W indows File and Print Servers PID 12940 06-24- 
2013.pdf 
PCR03 10- 
12940 12940—Impl Archiving Solution for W in File 
Health Net is strengthening its data security controls on all company computers. Among the additional steps includes installing new control software to prevent reading, saving or
transferring any data to and from portable/removable storage devices, including DVDs, CDs and USB drives. 
Due to the limited amount of storage available on many of
our file servers, many associates have been archiving data to external devices. And in conjunction with the implementation of the device control software, associates will no longer have access to create new CDs and read existing CDs. The purpose of
this project is to provide the capability to archive data on the file servers thus providing the storage management needed to allow uploading of data from the existing inventory of external media. This project will also reduce future costs of
procuring storage to support growth. More importantly, this project will help eliminate the need for associates to use removable media 
Lights On 
Unassigned 
8/29/2014 
14R3 
8/29/2014 
30 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12972 
17315 
12972 17315 
IBM 
In-Flight—No WO 
N/A—no W O as of yet 
12972 17315—Decommission Verity & Sun One 
This project brief is to purchase and
implement IBM Tivoli Identitiy and Access Mamager \ Tivoli Identity and Access Assurance in to the Health Net Enterprise. This implementation will reduce access administration costs and improve the efficiency and security of access provisioning by
providing for automated approval, provisioning and revoking of access for pre-defined roles. 
Select and implement an Identity and Access Management (IAM or IDAM)
systems 
Lights On 
Unassigned 
2/23/2015 
15R1 
31 
Infrastructure 
Bart Keaney 
Active 
Approved 
Parent 
12972 
12972 
12972 12972 
Non-BPaaS 
Inflight—W O exists 
12972- 
SOW#562—   
12972 12972 
WO, BTI and PCR’s 
BARR W O 10-198 
Identity 
12972 12972—Identity Management System 
This project brief is to purchase and implement IBM Tivoli Identitiy and Access Mamager \ Tivoli Identity and Access Assurance in to the Health Net Enterprise. This implementation
will reduce access administration costs and improve the efficiency and security of access provisioning by providing for automated approval, provisioning and revoking of access for pre-defined roles. 
Lights On 
Unassigned 
2/23/2015 
15R1 
12972_COG _W O_ Ver 1.1 
HN IMS - Design Phase 
Management System PID 12972 12-20- 2011 PCR01 BARR W O 10-198 Identity Management System v2 PID 12972 06 26-2012 PCR02 BARR 10- 198 Identity Management System v3 PID 12972 08
10-2012 BTI W O 10- 198 Identity Management System Project PID 12972 10-15- 2012 PCR01 10- 198 Identity Management System v2 PID 12972 11 16-2012 PCR02 10 198 Identity 
Select and implement an Identity and Access Management (IAM or IDAM) systems 
Schedule X-1

X-1-9 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
32 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12972 
17313 
12972 17313 
IBM 
In-Flight—No WO 
WO_1178_I 
MS_Assess ment_V1.3 
12972 17313—Transition IMS into SSO 
This project brief is to purchase and implement IBM Tivoli Identitiy and Access Mamager \ Tivoli Identity and Access Assurance in to the Health Net Enterprise. This implementation
will reduce access administration costs and improve the efficiency and security of access provisioning by providing for automated approval, provisioning and revoking of access for pre-defined roles. 
Select and implement an Identity and Access Management (IAM or IDAM) systems 
Lights On

Unassigned 
8/18/2014 
14R3 
33

Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
12972 
17314 
12972 17314 
IBM 
In-Flight—No WO 
WO_1178_I 
MS_Assess ment_V1.3 
12972 17314—Complete IMS scope 
This project brief is to purchase and implement IBM Tivoli
Identitiy and Access Mamager \ Tivoli Identity and Access Assurance in to the Health Net Enterprise. This implementation will reduce access administration costs and improve the efficiency and security of access provisioning by providing for
automated approval, provisioning and revoking of access for pre-defined roles. 
Select and implement an Identity and Access Management (IAM or IDAM) systems

Lights On 
Unassigned 
11/17/2014 
14R4 
34 
13348

13348 
13348 13348 
IBM 
In-Flight—No WO 
13348 13348—Network IPS NAC 
Infra 
35 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
13778 
13778 
13778 13778 
BPaaS 
Inflight—W O exists 
13778- 
13778_COG 
_W O_Ver1.1 
BTI W O 11- 
056 Oracle V7.2.4 RDB 
Upgrade Project PID 13778 03-08- 
2013 
PCR01 11- 
056 Oracle v7.2.4 RDB 
Upgrade Project (PID 13778) 
13778 13778—Oracle Rdb Upgrade 
The driving initiative for this Project is the remain true to HealthNet’s overall ITG Tech Plan in keeping all database vendor software as current and up to date as possible.
It is absolutely imperative that this project get processed successfully as we must remain “on-track” against that Tech Plan direction. 
Lights On

Unassigned 
9/30/2014 
14R3 
36

Infrastructure 
Bart Keaney 
Active 
Approved 
Parent 
14001 
14001 
14001 14001 
BPaaS 
Inflight—W O exists 
14001- 
14001_COG 
_W O_Ver_1. 1_07182013 
WO# 1029—   
Windows 7 Enterprise 
BTI W O 11- 091 W indows 7 Enterprise PID 14001 10 07-2013 PCR01 11- 091
W indows 7 Enterprise PID 14001 01 13-2014 PCR02 11- 091 W indows 7 Enterprise PID 14001 03 07-2014 PCR03 11- 091 W indows 7 Enterprise (PID 14001) 05-2-2014 PCR04 11- 091 W indows 7 Enterprise PID 14001 06 17-2014 
14001 14001—W indows 7 Enterprise 
Windows 7 is the logical successor for XP. Industry
experts suggest that organizations should plan to complete migrations by early 2012. This project is intended to prepare the environment and deploy W in 7. 
Lights
On 
Unassigned 
9/12/2014 
14R3 
4/7/2014 
Schedule X-1 
X-1-10 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
37 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
14001 
16540 
14001 16540 
BPaaS 
Inflight—W O exists 
14001- 
16540_COG 
_W O_Ver1.4 
,14001- 16540_COG 
_CR3_Ver1.0 
,14001- 16540_COG 
_CR2_Ver2.0 
,14001- 16540_COG 
_CR5_Ver 1.4,14001- 
16540_COG 
_CR4_Ver 1.0,14001- 
16540_COG 
_CR1_Ver 1.0 
BTI W O 13- 079 
Entrendex to FormWork PID 16540 12 04-2013 PCR01 13- 079 
Entrendex to FormWork PID 16540 03 06-2014 PCR02 13- 079 
Entrendex to FormWork PID 16540 05
15-2014 
14001 16540—W R Entrendex to FormW orks 5.0 Migrat 
This project
is to migrate the WR Entrendex 7.01 application to FormWorks 5.0. Both of these applications are Sungard (Macess) applications. The Entrendex application that is currently being used supports front-end scanning, data entry and the importing of
documents into the Macess EXP application. The version of Entrendex that we are currently using is already sunset and therefore we only receive minimal support from the vendor, which will be completely eliminated at the end of 2013. 
Lights On 
Unassigned 
8/18/2014 
14R3 
8/18/2014 
38 
Infrastructure 
David Kosterman 
Active 
Approved 
Child 
14001 
16749 
14001 16749 
BPaaS 
Inflight—W O exists 
14001- 
16749_COG 
_W O_Ver1.1 
BTI WO is delayed until 09/16 due to some trouble the IBM team ran into with
quotes expiring. 
14001 16749—MACESS.EXP Version Upgrade to 3.80 
This
project aims at upgrading the current version MACESS.EXP from 3.40 SP5 to 3.70 for continued support from SunGard, MACESS.EXP product vendor. 
Lights On 
Unassigned 
TBD 
7/30/2014 
39 
Infrastructure 
Bart Keaney 
Active 
Approved 
Child 
14001 
17161 
14001 17161 
BPaaS 
Inflight—W O exists 
14001- 
17161_COG 
_W O_Ver_1. 1_08012013, 
14001- 
17161_COG 
_CR7_Ver 1 0,14001- 
17161_COG 
_CR6_Ver 1 0,14001- 
17161_COG 
_CR5_Ver 1 0,14001- 
17161_COG 
_CR4_Ver 1 0,14001- 
17161_COG 
_CR3_Ver 1 0,14001- 
17161_COG 
_CR2_Ver 1 0,14001- 
17161_COG 
_CR1_Ver 1 0 
No IBM 
14001 17161—W indows 7—Application remediation 
Windows 7 is the logical successor for XP. Industry experts suggest that organizations should plan to complete migrations by early 2012. This project is intended to prepare the
environment and deploy W in 7. 
Lights On 
Unassigned 
9/12/2014 
14R3 
3/24/2014 
40 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
14150 
14150 
14150 14150 
IBM 
In-Flight—No WO 
BARR WO 11-121 
Commercial Two Factor Authenticati on PID 14150 01-08- 
2014 
BTI WO 11- 121 
Commercial Two Factor Authenticati on v3 PID 14150 01-20- 
2014 
14150 14150—Commercial Two Factor Authentication 
Health Net Commercial has a requirement
to provide remote access to their associates. In order to meet strict customer security requirements and to meet industry best practices, Health Net Commercial must implement two-factor authnication for remote access users using the same tool as
implemented by HNFS. Health Net may be losing business due to answering RFI responses with a “NO” when it comes to two factor remote access 
Lights On

Unassigned 
8/30/2014 
14R3 
8/30/2014 
41 
Service Delivery 
Bart Keaney 
Active 
Approved 
Single 
14384 
14384 
14384 14384 
BPaaS 
In-Flight—No WO 
14384 14384—ABS outbound 837—Liabilitydenials 
There are delays and limitations in the current manual print and mailing process of Non- HN liability claims. This project request is to create an outbound 837-5010 file for
electronic routing for these claim denials. This enhancement would support timely compliant routing of denied liability services. MHN would be the first entity involved in the proejct and then a phased implementation to support electronic routing to
other PPG, hospitals, and other vendor liability claims. 
Confirmed Compliance

Compliance—Medicare 
Velma Thomas 
2/23/2015 
15R1 
Schedule X-1 
X-1-11 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
42 
Finance/Corpor ate 
Cynthia T Nguyen 
Active 
Approved 
Parent 
14421 
14421 
14421 14421 
BPaaS 
Inflight—W O exists 
14421- 
14421_COG 
_W O_Ver 1.1,14421- 
14421_COG 
_CR2_Ver 1.1,14421- 
14421_COG 
_CR1_Ver 1.0 
14421 14421—MLR Phase I 
n accordance with the Affordable Care Act, distribute Premium
Rebates with Rebate Notification (with Interest if late) to enrollees for 2011 by August 1, 2012 (and subsequent years), on a pro rata basis based on 2011 premium (and subsequent years), for those legal entities with business segments in certain
states, which do not meet the Medical Loss Ratio requirements. Retain Data, Ensure Data access and be capable of Reporting Requirements. 
Confirmed Compliance

Compliance—Affordable Care Act (ACA) 
Lauren Parsons 
9/22/2014 
14R3 
43 
Finance/Corpor ate 
Cynthia T Nguyen 
Active 
Approved 
Child 
14421 
17064 
14421 17064 
BPaaS 
Inflight—W O exists 
14421- 
17064_COG 
_W O_Ver 1.1,14421- 
17064_COG 
_CR3_Ver_1. 0,14421- 
17064_COG 
_CR2_Ver_1. 2,14421- 
17064_COG 
_CR1_Ver_1. 
0 
14421 17064—SAP 2012 MLR Rebate Payments Phse II 
In accordance with the Affordable Care Act, distribute Premium Rebates with Rebate Notification (with Interest if late) to enrollees for 2011 by August 1, 2012 (and subsequent
years), on a pro rata basis based on 2011 premium (and subsequent years), for those legal entities with business segments in certain states, which do not meet the Medical Loss Ratio requirements. Retain Data, Ensure Data access and be capable of
Reporting Requirements. 
Confirmed Compliance 
Compliance—Affordable Care
Act (ACA) 
Lauren Parsons 
9/22/2014 
14R3 
44

Service Delivery 
David Kosterman 
Active 
Approved 
Parent 
14693 
14693 
14693 14693 
BPaaS 
Inflight—W O exists 
14693- 
14693_COG 
_W O_Ver1.1 
_04172013,1 4693- 
14693_COG 
_CR2_Ver_1. 0,14693- 
14693_COG 
_CR1_Ver_4 0 
WO# 1016- OMNI- 
Summary of Benefits & Uniform Glossary Assessment 
14693 14693—Summary of Benefits and Coverage 
Beginning March 23, 2012, the Affordable
Care Act mandates group health plans and insurers to provide participants and beneficiaries with a summary of benefits and coverage (SBC) for each benefit package without charge. 
Confirmed Compliance 
Compliance—Affordable Care Act (ACA) 
Robert O’Reilly 
10/20/2015 
15R3 
45

Service Delivery 
David Kosterman 
Active 
Approved 
Child 
14693 
17102 
14693 17102 
BPaaS 
Inflight—W O exists 
WO# 1153- PCS 
Configuration Engagement; CR1-SBC 
PCS Sliver 2; 
CR2-SBC 
PCS Sliver 2 
14693 17102—SBC—Pega PCS Implementation 
Beginning March 23, 2012, the Affordable Care Act mandates group health plans and insurers to provide participants and beneficiaries with a summary of benefits and coverage (SBC)
for each benefit package without charge 
Confirmed Compliance

Compliance—Affordable Care Act (ACA) 
Robert O’Reilly 
8/1/2015 
15R3 
46 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
14693 
17273 
14693 17273 
BPaaS 
Inflight—W O exists 
14693- 
17273_COG 
_W O_Ver 1.1 
14693 17273—SBC Critical Enhancements 
Beginning March 23, 2012, the Affordable Care Act
mandates group health plans and insurers to provide participants and beneficiaries with a summary of benefits and coverage (SBC) for each benefit package without charge. 
Confirmed Compliance 
Compliance—Affordable Care Act (ACA) 
Robert O’Reilly 
11/17/2014 
14R4 
47

Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
14699 
14699 
14699 14699 
IBM 
In-Flight—No WO 
BARR W O 11-222 SAS 
Upgrade v2 PID 14699 06 25-2012 
BTI W O 11- 222 SAS 
Upgrade Project v2 PID 14699 03 27-2013 PCR01 11- 222 SAS 
Upgrade PID 14699 05-21- 
2013 
HN PO 7600009495 SAS 
Enterprise Guide Software 2014 
SAS—Svc Supp 21 SAS—Svc Supp 20 CGH152.3 
(Health Net Inc 3YrSupp) 07DEC12

14699 14699—SAS Upgrade 
SAS is Health Net¿s Business Intelligence
tool that provides historical, current and predictive views of operations and is considered business critical to the Actuarial team. There have been no software upgrades since 2001, and support for SAS software deployed at HN ends 12/31/2011. This
project brings SAS to current, supported software. New features will enable HNPS to reach 4 Star Rating, avoiding expensive alternatives and potential loss of $84M.

Lights On 
Unassigned 
9/1/2014 
14R3 
9/1/2014 
Schedule X-1 
X-1-12 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
48 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Parent 
14704 
14704 
14704 14704 
BPaaS 
Inflight—W O exists 
14704- 
14704_COG 
_W O_Ver_1. 1,14704- 
14704_COG 
_CR1_Ver1.0 
,14704- 14704_COG 
_CR2_Ver1.4 
,14704- 14704_COG 
_CR3_Ver1.1 
,14704- 14704_COG 
_CR4_Ver1.0 
,14704- 14704_COG 
_CR5_Ver1.0 
SOW# 520—   
CA Dual Eligible Demonstratio n;SOW# 520 
CR # 01-Dual Eligible’s Pilot Program – CA County; SOW# 520 
CR # 02-Dual
Eligible’s Pilot Program – CA County; SOW# 520 
CR # 03-Dual Eligible’s Pilot Program – CA County 
WO_1020_1 4704_14704_ 
Duals_W CO E_CR_8 V1.0.doc 
14704 14704—Cal MediConnect 
CMS and DHCS are implementing a pilot program for Dual
Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total estimated
revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County 
Government Programs 
Unassigned 
8/18/2014 
14R3 
49 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17289 
14704 17289 
BPaaS 
Inflight—W O exists 
14704- 
17289_COG 
_W O_V1 0,14704- 
17289_COG 
_CR1_Ver_1. 
1 
14704 17289—Cal MediConnect Encounters Vendor 
CMS and DHCS are implementing a pilot program for Dual Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot
program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total estimated revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee
for service option within LA County 
Government Programs 
Unassigned

8/18/2014 
14R3 
50 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17310 
14704 17310 
BPaaS 
Inflight—W O exists 
14704- 
17310_COG 
_CR1_V1.1,1 4704_17310_ COG_W O_V 
er 1.1 
14704 17310—Cal MediConnect ABS 
& Surround Syste 
CMS and DHCS are implementing a pilot program for Dual Eligibles
(Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total estimated revenue of
$6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County

Government Programs 
Unassigned 
11/17/2014 
14R4 
51 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17326 
14704 17326 
BPaaS 
Inflight—W O exists 
14704- 
17326_COG 
_W O_V1.2 
14704 17326—14R4 Cal MediConnect—Medical Manag 
CMS and DHCS are implementing a pilot
program for Dual Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total
estimated revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County 
Government Programs 
Unassigned 
11/17/2014 
14R4 
52 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17342 
14704 17342 
Non-BPaaS 
Inflight—W O exists 
14704- 
17342_COG 
_W O_Ver 1.2 
14704 17342—Cal MediConnect—MTM 14R4 
CMS and DHCS are implementing a pilot program
for Dual Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total
estimated revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County 
Government Programs 
Unassigned 
11/17/2014 
14R4 
53 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17345 
14704 17345 
BPaaS 
Inflight—W O exists 
14704- 
17345_COG 
_W O_V1.0 
14704 17345—Cal MediConnect—Encounters 
CMS and DHCS are implementing a pilot program
for Dual Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total
estimated revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County 
Government Programs 
Unassigned 
11/17/2014 
14R4 
54 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17346 
14704 17346 
BPaaS 
Inflight—W O exists 
14704_17346 
_COG_W O_ Ver 1.1 
14704 17346—Cal MediConnect—ABS 
& Surround Sys 
CMS and DHCS are implementing a pilot program for Dual Eligibles
(Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total estimated revenue of
$6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee for service option within LA County

Government Programs 
Unassigned 
2/23/2015 
15R1 
Schedule X-1 
X-1-13 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
55 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17269 
14704 17269 
BPaaS 
Inflight—W O exists 
14704- 
17269_COG 
_WO_V1.1,1 4704- 
17269_COG 
_CR3_Ver_1. 1,14704- 
17269_COG 
_CR2_Ver_1. 1,14704- 
17269_COG 
_CR1_Ver_1. 
0 
14704 17269—Cal MediConnect ABS 
& Surround Systm 
CMS and DHCS are implementing a pilot program for Dual Eligibles
(Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot program for Los Angeles 
Government Programs

Unassigned 
9/22/2014 
14R3 
56

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14704 
17325 
14704 17325 
BPaaS 
Inflight—W O exists 
14704- 
17325_COG 
_CR1_Ver 1.2,14704_17 
325_COG_W 
O_Ver 1.0 
14704 17325—14R3 Cal MediConnect—Medical Manag 
CMS and DHCS are implementing a pilot program for Dual Eligibles (Medicare/Medi- Cal) for CA.. We have the opportunity to be selected (along with LA Care) to implement a dual pilot
program for Los Angeles County. There are ~360,000 dual eligibles in LA County and the project has a total estimated revenue of $6—$8 billion, which will probably be split evenly between the two plans. There will be a capitated and managed fee
for service option within LA County 
Government Programs 
Unassigned

9/22/2014 
14R3 
57 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
14731 
14731 
14731 14731 
IBM 
In-Flight—No WO 
BTI WO 14- 
015 Aerojet Redesign v2 Project PID 14731 v2 08- 
08-2014 
14731 14731—Aerojet W AN Consolidation 
Standardize Aerojet Campus and Hazel Gold Point A
(GPA) like any other large remote office location Dissect and remove SONET circuit dependencies, then eliminate the SONET between Aerojet and Gold Point Campus.

Lights On 
Unassigned 
9/30/2014 
15R2 
9/30/2014 
58 
Business Development 
David Kosterman 
Active 
Approved 
Parent 
14758 
14758 
14758 14758 
BPaaS : No Work 
In-Flight—No WO 
No Work : Parent PID—will be closed once children are done 
14758 14758—HNOR
Contracts Automation 
The project’s objectives are as follow: 1) On-line access to HNOR group-specific contracts/EOCs; 2) W eb fulfillment capability for
members, employers, and consultants/brokers; and 3) Safe/secure document storage in the PSA Archive for ease of access by internal clients and to comply with the record retention requirement. This project will replace the current HNOR pick-and-pack
fulfillment process whereby generic contract documents are manually assembled and mailed to only groups/brokers. 
Lights On 
Unassigned 
11/17/2014 
14R4 
59

14758 
17122 
14758 17122 
BPaaS 
Inflight—W O exists 
14758_17122 
_COG_W O_ Ver 1.0 
WO# 1132- HN W COE 
OR Contracts(On Hold) 
14758 17122—HNOR Contracts—WCoE 
ok 
14R4

60 
Business Development 
David Kosterman 
Active 
Approved 
Parent 
14931 
14931 
14931 14931 
BPaaS 
Inflight—W O exists 
14931- 
14931_COG 
_W O_Ver 4.0,14931- 
14931_COG 
_CR1_Ver 1.0 
SOW# 511—   
ASO Self Flux Fund—JAD Session 
14931 14931—Self/Flex-Fund: Internal Build 
Employers need the ability to control their
overall premium costs and trends. Self- funding is an option to manage costs as employers are not subject certain benefit mandates and taxes. By assuming the risk, employers are not subject to benefit reserves and share any U/W profits and have
complete data transparency. We must add flex and ASO funding to our HMO & PPO products. Our current HMO flex funded product is not scalable to the business growth plan. 
Performance Improvements 
Unassigned 
11/17/2014 
14R4 
61 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Parent 
14941 
14941 
14941 14941 
BPaaS 
Inflight—W O exists 
14941- 
14941_COG 
_W O_Ver_1. 
2 
WO# 1023- HN W COE 
Medical Migration JAD 
14941 14941—SHP Enhancements to ABS 
As a corporate strategic direction with an intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management
initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans
Medicaid processing (QCare) to the ABS platform. 
Operations Strategy

Unassigned 
15R2 
62 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17151 
14941 17151 
BPaaS 
Inflight—W O exists 
WO# 1185- CA SHP 
Pega Env Installation & Config. 
14941 17151—ABS Infras upgrade for ABS / Surrou

As a corporate strategic direction with an intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall
cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the
State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
3/31/2014 
14R1 
63

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17312 
14941 17312 
BPaaS 
Inflight—W O exists 
WO_1144_1 4941- 
14941_W CO 
E_HN_SHP_ Enhancement s_in_ABS V1.2.doc 
WO_1144_1 4941- 
14941_W CO 
E_HN_SHP_ Enhancement s_in_ABS_C R_1 V1.1.doc 
14941 17312—SHP Enh2ABS—W eb Mar 2015 Rel 
As a corporate strategic direction with an
intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the
I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
3/26/2015 
15R1 
Schedule X-1 
X-1-14 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
64 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17152 
14941 17152 
BPaaS 
Inflight—W O exists 
14941- 
17152_COG 
_W O_Ver1.2 
,14941- 17152_COG 
_CR8_Ver 1.0,14941- 
17152_COG 
_CR7_V1.0,1 4941- 
17152_COG 
_CR6_Ver 1.1,14941- 
17152_COG 
_CR5_Ver 1.1,14941- 
17152_COG 
_CR4_V1.1,1 4941- 
17152_COG 
_CR3_V1.0,1 4941- 
17152_COG 
_CR2_V1.0,1 4941- 
17152_COG 
_CR13_v1.0, 14941- 
17152_COG 
_CR12_v1.1, 14941- 
17152_COG 
_CR11_v1.4, 14941- 
17152_COG 
_CR10_Ver 1.0,14941- 
17152_COG 
_CR1_V1.2,1 4941- 
14941 17152—SHP Enhc to ABS—CLM /OTR 
As a corporate strategic direction with an
intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the
I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
2/1/2015 
15R1 
65 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17266 
14941 17266 
BPaaS 
Inflight—W O exists 
14941- 
17152_COG 
_CR7_V1.0 
14941 17266—SHP Enhc to ABS—ABS-MBR/OMNI 
As a corporate strategic direction with an
intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the
I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
8/18/2014 
14R3 
66 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17286 
14941 17286 
BPaaS 
Inflight—W O exists 
14941- 
17152_COG 
_CR7_V1.0 
14941 17286—SHP Enhc to ABS—Conv 
As a corporate strategic direction with an intent
of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the I-series
(AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
11/17/2014 
14R4 
67 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17292 
14941 17292 
BPaaS 
Inflight—W O exists 
14941- 
17292_COG 
_CR7_V1.0,1 4941- 
17292_COG 
_CR6_Ver 1.0,14941- 
17292_COG 
_CR5_Ver2.0 
,14941- 17292_COG 
_CR2_Ver_1. 0,14941- 
17292_COG 
_CR1_Ver_1. 1,14941- 
17292_ COG_CR3_V er1.0,14941—17292_COG 
_W O_Ver 1.0 
14941 17292—SHP Enhc to ABS—QCare Enhc 
As a corporate strategic direction with an
intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the
I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans Medicaid processing (QCare) to the ABS platform. 
Operations Strategy 
Unassigned 
9/22/2014 
14R3 
68 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
14941 
17347 
14941 17347 
BPaaS 
Inflight—W O exists 
14941_17347 
_COG_W O_ Ver_1.2 
14941 17347—SHP Enhc to ABS- QCare Enhc 2 
As a corporate strategic direction with an intent of cost reduction, consolidation of information system platforms is being carried out. As part of the overall cost management
initiative, the key IT related programs are to re-platform the Z-series (mainframe) systems, re-platform the I-series (AS400) systems, and software standardization. This specific initiative drives toward the replatforming of the State Health Plans
Medicaid processing (QCare) to the ABS platform. 
Operations Strategy

Unassigned 
11/17/2014 
14R4 
Schedule X-1 
X-1-15 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
69 
Business Development 
David Kosterman 
Active 
Approved 
Parent 
14990 
14990 
14990 14990 
BPaaS 
Inflight—W O exists 
14990- 
14990_HSA HRA_CR7 - 
sub PID 17283_v1.3,1 
4990- 
14990_HSA HRA_CR6 - 
sub PID 17283_v2.0,1 
4990- 
14990_COG 
_CR5_v1.2,1 4990-14990_ HSA HRA_CR4_V 1.1,14990- 
14990 HSA 
HRA_CR2_v 1.1,14990- 
14990 HSA 
HRA_CR1_v 1.0_2013111 
1,14990- 
14990_HSA_ 
HRA_W O_v1 
.2_09102013, 14990— 
14990_COG 
_CR3_Ver1.1 
WO# 1133- 
HSA / HRA Account Integration; CR1-HSA / HRA Account Integration 
14990 14990 HSA/HRA TPA PPO 
Integration 
Employer groups are actively looking for HRA solutions. Health Net groups PG&E(6K lives) and the City of Sacramento(4K lives) are requesting a HRA product offering for
2012/2013. At this time, Health Net does not have a HRA product offering. Without a HRA solution, these groups could leave Health Net resulting in loss of membership and revenue. The development of HRA products will put HN in a position to retain or
increase its membership and revenue and sales opportunities. 
Customer Solutions

Unassigned 
2/23/2015 
15R1 
70

Service Delivery 
Robert E Oetken Jr 
Active 
Approved 
Single 
15271 
15271 
15271 15271 
BPaaS 
Inflight—W O exists 
15271- 
15271_COG 
_W O_Ver 3.0 
15271 15271—Adv. Diag. Imaging System Enhcmnts. 
As per the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 and as described in MLN Article MM7681, effective January 1, 2012, suppliers that furnish the
technical component of advanced diagnostic imaging (ADI) services must be accredited as a prerequisite of benefits and claims payment. Suppliers of ADI include but are not limited to: physicians, non-physician practitioners, and Independent
Diagnostic Testing Facilities. continued below¿ 
Confirmed Compliance

Compliance—Medicare 
Staci Newton 
9/1/2015 
15R3 
71 
15291

15291 
15291 15291 
IBM 
In-Flight—No WO 
15291 15291—EOL/EOSHW 
Infra 
72 
15451

15451 
15451 15451 
IBM 
In-Flight—No WO 
15451 15451—MyArchive 
Infra 
14R4 
73

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
15475 
17334 
15475 17334 
BPaaS 
In-Flight—No WO 
15475 17334—FFS Medi-cal @ Medicare Rates P6.5 W 
Section 1202 of the ACA requires payment
for certain E&M and immunization codes to be paid at Medicare rates effective January 1, 2013. Such increased reimbursement will apply to those PCPs with a specialty designation of: family medicine, general internal medicine, or pediatric
medicine when billing for specified CPT codes. Enhancments are required on QCare in order to comply with the law. Currently, QCare does not have the ability to reimburse FFS claims using the Medicare fee schedule. 
Confirmed Compliance 
Unassigned 
6/26/2014 
14R2 
74 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Parent 
15475 
15475 
15475 15475 
BPaaS : No Work 
In-Flight—No WO 
No Work : Parent PID—will be closed once children are done

15475 15475—FFS Medi-Cal Payment at Medicare 
Section 1202 of the ACA
requires payment for certain E&M and immunization codes to be paid at Medicare rates effective January 1, 2013. Such increased reimbursement will apply to those PCPs with a specialty designation of: family medicine, general internal medicine, or
pediatric medicine when billing for specified CPT codes. Enhancments are required on QCare in order to comply with the law. Currently, QCare does not have the ability to reimburse FFS claims using the Medicare fee schedule. 
Confirmed Compliance 
Compliance—State Health Programs 
Steven Tackett 
8/18/2014 
14R3 
75

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
15475 
17280 
15475 17280 
BPaaS 
Inflight—W O exists 
15475- 
17280_COG 
_CR1_Ver_1. 0,15475— 
17280_COG 
_W O_Ver 2.0,15475— 
17280_COG 
_CR1_Ver_1. 
0 
WO# 1191—   
FFS Medi-cal 
@ Medicare Rates Phase 6 W eb Provider Attestation 
15475 17280—FFS Medi-cal Medicare
Rates Phase V 
Section 1202 of the ACA requires payment for certain E&M and immunization codes to be paid at Medicare rates effective January 1, 2013. Such
increased reimbursement will apply to those PCPs with a specialty designation of: family medicine, general internal medicine, or pediatric medicine when billing for specified CPT codes. Enhancments are required on QCare in order to comply with the
law. Currently, QCare does not have the ability to reimburse FFS claims using the Medicare fee schedule. 
Confirmed Compliance 
Compliance—State Health Programs 
Steven Tackett 
6/9/2014 
14R2 
Schedule X-1 
X-1-16 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
76 
Infrastructure 
Bart Keaney 
Active 
Conditional Approval 
Single 
15510 
15510 
15510 15510 
IBM 
In-Flight—No WO 
BARR W O 1 2-085 EOLE 
OS Network Hardware PI D 15510 07-3 1-2012.pdf PCR01 BAR R W O 12-08 5 EOLEOS P ID 15510 11- 19-2012.pdf PCR02 BAR R W O 12-08 
5 Network-Te lecom Critical 
Upgrades PI D 15510 04-2 6-2013.pdf PCR03 BAR R W O 12-08

5 Network Te lecom Critical 
Upgrades (P ID 15510) 10 222013.pdf BTI W O 12-0

85 Network-T elecom Critic al Upgrades PID 15510 01 
-13-2014.pdf PCR01 12-08

5 Network-Te lecom Critical 
Upgrades PI D 15510 08-2 7-2014.pdf 
15510 15510—Network-Telecom Critical Uprades 
As a result of the Infrastructure
Stabilization Program, a number of network and telecom devices were discovered that are nearing End of Life (EOL) / End of Service (EOS). Uprade / replacement of these devices were not included within scope of the ISP. However, failure to upgrade
these devices will have an adverse effect on HNFS DIACAP (failure to maintain ATO) and will cause significant enterprise outages should they fail. 
Lights On

Unassigned 
8/15/2014 
14R3 
8/15/2014 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
15649 
15649 
15649 15649 
BPaaS 
Inflight—W O exists 
WO# 1005- 2011 ISA 
Remediation Program; CR1-2011 ISA 
Remediation Program; CR2-HN ISA 
Remediation; 
CR3-HN ISA 
Remediation; CR4-2011 ISA 
Remediation Program 
15649- 
15649_EXEC UTED BTI 
WO EXECUTED_ 20121011 EXECUTED 12-142 2011 ISA REMEDIATI 
ON V2.0_021520 13PCR01—

$23,978.65 
WO 105 CR2 
- PID 15649 ISA REMEDIATI 
ON PROGRAM v1.0_201303 25 
15649 15649—2011 ISA Remedation Program 
Health Net engaged Accuvant to perform a security
assessment of the organization’s IT assets and network environment in Dec. 2011. The objective was to assess the current information security posture within the organization’s IT environment, compare the results of the assessment with
industry best practices and identify vulnerabilities that could negatively impact the business. Health Net’s overall risk rating was HIGH. The project is to review, address or remediate the over 42,000 findings. 
Confirmed Compliance 
Compliance—Other Federal Legislation 
Cynthia Snyder 
9/30/2014 
14R3 
6/30/2014 
#REF! 
15666 
15666 
15666 15666 
BPaaS 
Inflight—W O exists 
15666- 
15666_COG 
_W O_Ver1.1 
,15666- 15666_COG 
_CR2_V1.1,1 5666- 
15666_COG 
_CR1_Ver 1.0 
15666 15666—openVMS v8.4 Upgrade 
Infra 
Unassigned 
#REF! 
Infrastructure 
Not available 
Active 
Approved 
Single 
15668 
15668 
15668 15668 
BPaaS 
Inflight—W O exists 
15668- 
15668_COG 
_W O_Ver 1.0,15668_15 
668_CO 
G_C R1_v1.0 
15668 15668—Informatica 9.5 upgrade 
Informatica is HN¿s strategic Data Integration
tool for rapid development & production processing. Duals project requires V9.5 upgrade to avoid production outages on unsupported version. Existing version is beyond End-of-Support. Continued use of existing version poses high risk for Duals
project. Extended support excludes development and bug fixes and adds $46K/year cost. Informatica non-prod capacity is inadequate for Duals and must be increased to remove risk to development & testing. 
Lights On 
Unassigned 
9/29/2014 
14R3 
Schedule X-1 
X-1-17 
Health Net / Cognizant Confidential 
  

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Not available 
Ready for Governance 
Not Approved 
Single 
15759 
15759 
15759 15759 
BPaaS 
In-Flight—No WO 
15759 15759—Business Resilency for Print Fullfil 
Currently, we do not have a business continuity plan for the Print Fulfillment services at our Chatsworth facility. In the event of a disaster affecting this facility, we will be
at great risk because we do not have a failover process/site to resume business processes. 
This project will address this risk through the use of an outside
Print—and—Mail recovery vendor in attempt to make this function resilient. 
Lights On 
Unassigned 
Unassigned 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
15788 
15788 
15788 15788 
BPaaS 
Inflight—W O exists 
15788_15788 
_COG_W O_ Ver 1.1 
WO# 1075—   
Medicare Part D COB application and Database 
15788 15788—Medicare Part D COB Application
and 
Create an application and enhanced database for managing the Coordination of Benefits (COB) for Part D. The current process is manual and distributed across
multiple groups. Having a single application for accessing the information and for triggering work actions will reduce the risk of errors and the overall work load of the groups. Desired state is also to include COB part D information on the
member’s web portal. 
Confirmed Compliance 
Compliance—Medicare

Kathleen Feiman 
11/17/2014 
15R1 
#REF!

Infrastructure 
Lisa Dobbert 
Active 
Conditional Approval 
Single 
15876 
15876 
15876 15876 
IBM 
In-Flight—No WO 
In Design. No WOs yet. 
15876 15876—Upgrade Velocity Server 
The current Velocity system is not backed up. In the event of a failure none of the card key systems for the enterprise will work and all data will belost. 
Lights On 
Unassigned 
3/31/2015 
15R1 
9/30/2014 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
15883 
15883 
15883 15883 
BPaaS 
Inflight—W O exists 
15883- 
15883_W O_ V1.1,15883- 15883_COG 
_CR1_Ver 1.1 
BTI W O 12- 154 
Commercial Oracle DB Upgrades PID 15883 12 19-2013 
15883 15883—Commercial Oracle DB
Upgrades 
All Oracle Enterprise Databases must be upgraded to the version 11gR2 as this initiative mirrors Health Net’s created Technology Plan. By upgrading
to version 11gR2, it will keep the Support Level for the Database at “Premier Support” which will help save on any additional charges introduced at a “Extended Support” Level. 
Lights On 
Unassigned 
8/15/2014 
14R3 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
15933 
15933 
15933 15933 
IBM 
In-Flight—No WO 
15933_BARR WO_SOX PASSW ORD 
_20140331 15933_PCR0 
1 BARR WO_SOX 
PASSW ORD 
_20140909 
15933 15933—SOX—Password Profile Compliance Ad 
This project addresses those systems
not identified for password profile remediation it the CTS Fixed Bid W O 14679, but identified as a result of additional analysis performed during W O executions. The additional systems could be subject to SOX findings (controls 1231, 1213 &
1214) in regards to password profiles and compliance with Health Net Info Sec Policy and ISEC in the SOX environment (ABS, HNCAP,HNMove, KBASE, MC400, PeopleSoft, Qcare, SAP, Symphony, Hyperion). 
Lights On 
Unassigned 
9/30/2014 
14R3 
9/30/2014 
#REF! 
Service Delivery 
Bart Keaney 
Active 
Approved 
Child 
16080 
17183 
16080 17183 
BPaaS 
Inflight—W O exists 
16080- 
17183_COG 
_W O_Ver 1.0 
WO# 1176- W COE D2C 
Payment Vendor 
WO_1207_1 6080 
17183_Paym ent_Vendor_ Web_Change s_V1.2.doc 
16080 17183—D2C Payment Vendor 
PROBLEM. Customer Care expects an 80% call rate for IFP Members due to ACA, resulting in ~$1.6 million in calls between Jan and Mar, 2014. 
Performance Improvements 
Unassigned 
9/25/2014 
14R3 
#REF! 
Business Development 
Bart Keaney 
Active 
Approved 
Child 
16080 
17332 
16080 17332 
BPaaS 
Inflight—W O exists 
WO# 1213- WCOE 
W elcome Center 
16080 17332—W elcome Center work- stream 
As a result of the Affordable Care Act, States are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on

& off the exchange will be “radically” disrupted. Insurance carriers are applying with their states to participate in the exchanges as Qualifed
Health Plans (QHP’s). Health Net is applying to the CA, OR, and AZ state exchanges in order to retain SBG/IFP membership and solicit new business. 
Customer
Solutions 
Unassigned 
11/20/2014 
14R4 
#REF!

Business Development 
David Kosterman 
Active 
Approved 
Parent 
16080 
16080 
16080 16080 
BPaaS 
Inflight—W O exists 
16080-16080- 
ACA_hCentiv e_COG_W O 
_Ver 1.0 
16080 16080—ACA Provisions Implementation 
As a result of the Affordable Care Act, States are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on

& off the exchange will be “radically” disrupted. Insurance carriers are applying with their states to participate in the exchanges as Qualifed
Health Plans (QHP’s). Health Net is applying to the CA, OR, and AZ state exchanges in order to retain SBG/IFP membership and solicit new business. 
Customer
Solutions 
Unassigned 
2/23/2015 
15R1 
#REF!

Business Development 
David Kosterman 
Active 
Approved 
Child 
16080 
17284 
16080 17284 
BPaaS 
Inflight—W O exists 
16080- 
17284_COG 
_W O_Ver 1.2,16080- 
17284_COG 
_WO_V1.2,1 6080- 
17284_COG 
_CR2_Ver 1.0,16080- 
17284_COG 
_CR1_Ver 1.0 
16080 17284—ACA Program Nov Release 
As a result of the Affordable Care Act, States are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on

& off the exchange will be “radically” disrupted. 
Customer
Solutions 
Unassigned 
11/17/2014 
14R4 
Schedule X-1 
X-1-18 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Business Development 
David Kosterman 
Active 
Approved 
Child 
16080 
17306 
16080 17306 
BPaaS 
Inflight—W O exists 
16080- 
17306_COG 
_W O_Ver 1.3,16080- 
17306_COG 
_CR3_Ver 1.3,16080_17 
306_COG_C R2_v1.1,160 80_17306_C OG_CR1_v1. 
1 
16080 17306—ACA Program- September Release 
As a result of the Affordable Care Act, States
are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on 
& off the exchange will be
“radically” disrupted. Insurance carriers are applying with their states to participate in the exchanges as Qualifed Health Plans (QHP’s). Health Net is applying to the CA, OR, and AZ state exchanges in order to retain SBG/IFP
membership and solicit new business. 
Customer Solutions 
Unassigned

9/22/2014 
14R3 
#REF! 
Health Care Delivery 
David Kosterman 
Active 
Approved 
Child 
16080 
17334 
16080 17334 
BPaaS 
In-Flight—No WO 
16080 17344—ACA Program 15R1 Feb Release 
As a result of the Affordable Care Act, States are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on

& off the exchange will be “radically” disrupted. Insurance carriers are applying with their states to participate in the exchanges as Qualifed
Health Plans (QHP’s). Health Net is applying to the CA, OR, and AZ state exchanges in order to retain SBG/IFP membership and solicit new business. 
Customer
Solutions 
Unassigned 
2/23/2015 
15R1 
#REF!

Business Development 
David Kosterman 
Active 
Approved 
Child 
16080 
17351 
16080 17351 
BPaaS 
Inflight—W O exists 
16080- 
17351_COG 
_W O_V1 0 
16080 17351—ACA 2015 Open Enrollment 
As a result of the Affordable Care Act, States are developing Health Exchanges to offer health insurance to small business and individual members. SBG and IFP markets on

& off the exchange will be “radically” disrupted. Insurance carriers are applying with their states to participate in the exchanges as Qualifed
Health Plans (QHP’s). Health Net is applying to the CA, OR, and AZ state exchanges in order to retain SBG/IFP membership and solicit new business. 
Customer
Solutions 
Unassigned 
11/17/2014 
14R4 
#REF!

Service Delivery 
Robert E Oetken Jr 
Active 
Approved 
Single 
16157 
16157 
16157 16157 
BPaaS 
Inflight—W O exists 
16157_16157 
_COG_W O_ Ver 1.3 
16157 16157—Automation of Custom PPG Cap Payment 
PNM has launched an initiative for
recontracting starting in 2013 and on a go forward basis to reduce ESRD-Dialyis cost for Medicare. An updated DOFR has been developed to contractually support this. PNM has been provided a strategy document and talking points to begin discussions
with PPGs. Strategy is to have PPGs to agree to a global rate of 55% to take on profiessional and facility plus drugs risk for ESRD- dialysis members. Currently the system is not capable of calculating and producing automated cap payments to support
the structure for CA and AZ regions.The manual work around would require member tracking for three years from their original effective date and significant number of weekly hours of maintenance, reconciliation and auditing. Potential impact to 51
participating PPGs and would not be sustainable as a manual workaround. Maximum savings for this particiular initiative are $3.8M in 2013, 
$15.2M in 2014 and $17M
in 2015. 
Lights On 
Unassigned 
8/18/2014 
14R3 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Conditional Approval 
Parent 
16176 
16176 
16176 16176 
IBM 
In-Flight—No WO 3subPIDscompletedandclosed2subPIDsonholdpendingcancelation 
16176
16176—Migrate Flex Server Jobs and Decom F 
Servers PSA-PRDAPP0 and PSA-TSTAPP0 are located at the Chatsworth Print Facility, and host several PSA/OCOE
applications including FlexServer. Servers has following key issues. 
These systems have been running short of disk space, which is impacting Production operations.

The existing storage array supporting the two PSA servers in Chatsworth is a SCSI- attached Sun StorEdge 3310. This array cannot support further expansion for the
following reasons. 
The array cannot be expanded beyond the existing capacity of 24 x 72GB drives Oracle no longer supports this array with effect from June 2011

The data cannot be encrypted The two Sun Enterprise 450 servers are approaching 14 years old, and Oracle will be terminating support for these servers with effect
from December 2012. The Flexserver application needs to be hosted on a server in close proximity to the printers in Chatsworth, which prevents the systems from being relocated out of the Chatsworth Print Facility to W oodland Hills or Boulder. The
version of Flexserver running on the PSA systems is only supported on Solaris 8, and therefore an upgrade is not possible 
Lights On 
Unassigned 
14R4 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Parent 
16230 
16230 
16230 16230 
BPaaS 
Inflight—W O exists 
16230- 
16230_COG 
_W O_Ver 1.0,16230- 
16230_COG 
_CR3_Ver 1 0,16230- 
16230_COG 
_CR2_Ver 1 1,16230- 
16230_COG 
_CR1_Ver 1.0 
WO# 1083—   
AZ Medicaid Implementati on JAD; CR1- HN Inc AZ Medicaid

16230 16230—Arizona Medicaidl Implementation (AH 
Health Net is bidding
on a proposal to deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful
AHCCCS bid allows HN to continue to offer coverage to Duals in CY 2014. 
Government Programs 
Unassigned 
11/17/2014 
14R4 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17229 
16230 17229 
BPaaS 
Inflight—W O exists 
16230- 
17229_COG 
_W O_Ver 1.1 
16230 17229—AZ Medicaid 14R3 
Health Net is bidding on a proposal to deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated
on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN to continue to offer coverage to Duals in CY 2014.

Government Programs 
Unassigned 
8/18/2014 
14R3 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17320 
16230 17320 
BPaaS 
Inflight—W O exists 
16230- 
17320_COG 
_W O_Ver_1. 
1 
16230 17320—AZ Medicaid HP Patch 
Health Net is bidding on a proposal to deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated
on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN to continue to offer coverage to Duals in CY 2014.

Government Programs 
Unassigned 
9/22/2014 
14R3 
Schedule X-1 
X-1-19 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
16230 
17337 
16230 17337 
BPaaS 
Inflight—W O exists 
16230- 
17337_COG 
_W O_Ver_1 0 
16230 17337—AZ Medicaid TOC Dis/En Report 
Health Net is bidding on a proposal to deliver
Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN to
continue to offer coverage to Duals in CY 2014. 
Government Programs

Unassigned 
9/22/2014 
14R3 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17321 
16230 17321 
BPaaS 
Inflight—W O exists 
16230- 
17321_COG 
_W O_Ver_1. 
1 
16230 17321—AZ Medicaid TOC DEF File 
Health Net is bidding on a proposal to deliver
Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN to
continue to offer coverage to Duals in CY 2014. 
Government Programs

Unassigned 
11/17/2014 
14R4 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17322 
16230 17322 
BPaaS 
Inflight—W O exists 
16230- 
17322_COG 
_W O_Ver_2. 
0 
16230 17322—AZ Medicaid PCP Site ID – Mass Provi 
Health Net is bidding on a proposal
to deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated on or before March 28, 2013 with 
Government Programs 
Unassigned 
11/17/2014 
14R4 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17323 
16230 17323 
BPaaS 
Inflight—W O exists 
16230- 
17323_COG 
_W O_Ver 1.1 
16230 17323—AZ Medicaid ASC Pricing Changes 
Health Net is bidding on a proposal to
deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN
to continue to offer coverage to Duals in CY 2014 
Government Programs

Unassigned 
11/17/2014 
14R4 
#REF!

Unassigned 
Robert E Oetken Jr 
Active 
Approved 
Child 
16230 
17324 
16230 17324 
BPaaS 
Inflight—W O exists 
16230- 
17324_COG 
_W O_Ver 1.0 
16230 17324—AZ Medicaid Accumulator Date Logic 
Health Net is bidding on a proposal to deliver Medicaid healthcare services within two Arizona Geographic Service Areas (GSA)—Pima and Maricopa. Contract award is anticipated
on or before March 28, 2013 with implementation / start date of 10/1/2013. A sucessful AHCCCS bid allows HN to continue to offer coverage to Duals in CY 2014.

Government Programs 
Unassigned 
11/17/2014 
14R4 
#REF! 
Infrastructure 
Not available 
Ready for Governance 
Not Approved 
Single 
16258 
16258 
16258 16258 
IBM 
In-Flight—No WO 
16258 16258—Install Tripwire Enterprise on Remai 
Health Net currently has Tripwire intalled on all Federal UNIX servers. This project is to identify the remaining corporate servers and install Tripwire on those corporate servers
that do not currently have Tripwire installed on them. 
Lights On 
Unassigned

Unassigned 
#REF! 
PPMO 
David Kosterman 
Active 
Approved 
Child 
16300 
17301 
16300 17301 
BPaaS 
In-Flight—No WO 
16300 17301—MR Replatform CR7 CSI 14R3 Implement 
iSeries Retirement Program will have all
applications executing on the iSeries platform migrated to allow the platform to be retired in Q2 2014. Applications are segregated on the platform. Applications are further segregated into production and non-production logical partitions (LPARs).
The decommission of each LPAR results in a saving. 
Lights On 
Unassigned

14R3 
#REF! 
Infrastructure 
David Kosterman 
Active 
Approved 
Child 
16300 
17134 
16300 17134 
BPaaS 
Inflight—W O exists 
16300 
17134_COG 
_W O_Ver 1.1 
BARR WO 
16300 17134—i-Series Encryption 
The purpose of this project is to encrypt all Health Net
(non-OS) data on the iSeries 
Lights On 
Unassigned 
9/30/2014 
14R3 
9/30/2014 
platform. Having unencrypted hard disk drives poses a risk to Health Net should
those 
13-075 I- 
assets become lost or stolen. 
Series 
Note that restrictions exist (can only encrypt User ASP pools, not system ASP pools),

Encryption PID 17134 07 22-2013 
BTI WO 13- 
075 I-Series 
so we cannot encrypt all data. Plus we cannot upgrade (and therefore cannot
encrypt) the SPIRIT LPAR. 
Encryption 
PID 17134 12 
17-2013 
#REF! 
PPMO 
David Kosterman 
Active 
Approved 
Child 
16300 
17228 
16300 17228 
BPaaS 
Inflight—W O exists 
16300- 
17228_COG 
_W O_Ver 1.0 
16300 17228—MC400 Coverage Code Process Replatfo 
iSeries Retirement Program will have all applications executing on the iSeries platform migrated to allow the platform to be retired in Q2 2014. Applications are segregated on the
platform. Applications are further segregated into production and non-production logical partitions (LPARs). The decommission of each LPAR results in a saving.

Lights On 
Unassigned 
11/17/2014 
14R4 
#REF! 
16370 
16370 
16370 16370 
BPaaS 
Inflight—W O exists 
WO# 1193—   
Phoenix Server Migration 
16370 16370—Phoenix Server Migration 
Infra 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16381 
16381 
16381 16381 
IBM 
In-Flight—No WO 
BTI WO 13- 040 DNS 
Infrastructur e v3 PID 16381 12-20- 
2013 
16381 16381—DNS Infrastructure Updates 
Several high-profile network outages in 2012 can
be linked to DNS issues Health Net must add geographical diversity to its DNS/DHCP infrastructure. 
It must also standardize remaining approved DNS servers on
supported INFOBLOX appliances. 
This is both a CTO requirement and best practice and the recommended solution to production service outages 
Lights On 
Unassigned 
9/30/2014 
14R3 
9/30/2014 
51 
16404 
16404 
16404 16404 
BPaaS 
Inflight—W O exists 
16404- 
16404_COG 
_W O_Ver 5.0,16404- 
16404_COG 
_CR2_Ver_2. 0,16404- 
16404_COG 
_CR1_Ver_2. 
0 
16404 16404—Modifications to eHealth Interface with IST 
ok 
Schedule X-1 
X-1-20 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
52 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16436 
16436 
16436 16436 
IBM 
In-Flight—No WO 
16436_BARR 
WO 10gE SOLUTION_ 201305508 
16436_BTI 
WO 10gE SOLUTIONv 2_20140115 
16436_PCR0 
2 W O 10gE SOLUTION_ 20140512 
16436_PCR0 
1 W O 10gE SOLUTION_ 20140211 
16436 16436—VMS 10gE solution 
Upgrade the network and the TSM servers 
Lights On 
Unassigned 
7/29/2014 
14R3 
7/29/2014 
53 
EPCO

Robert E Oetken Jr 
Active 
Approved 
Child 
16452 
17317 
16452 17317 
BPaaS 
In-Flight—No WO 
16452 17317—Medicare Monthly EOB Phase III 
CMS is requiring for the first time that Medicare Advantage Plans implement Part C Explanation of Benefits (EOBs) which are notices of claim determination. 
Currently, Medicare Advantage Plans administering Part C are not ¿required¿ to issue EOBs and therefore have been optionally issuing EOBs, on a proprietary format,
and not necessarily on all claim determinations (for example, HN only issues when there is patient responsibility). 
Plans (and in concert with their PPGs [in CA]
and vendors) are required to implement new EOBs no later than 10/1/13. 
Confirmed Compliance 
Unassigned 
2/23/2015 
15R1 
54

EPCO 
Robert E Oetken Jr 
Active 
Approved 
Parent 
16452 
16452 
16452 16452 
BPaaS : No Work 
In-Flight—No WO 
No Work : Parent PID—will be closed once children are done 
16452 16452—Part C EOB
Generation 
CMS is requiring for the first time that Medicare Advantage Plans implement Part C Explanation of Benefits (EOBs) which are notices of claim
determination. 
Currently, Medicare Advantage Plans administering Part C are not ¿required¿ to issue EOBs and therefore have been optionally issuing
EOBs, on a proprietary format, and not necessarily on all claim determinations (for example, HN only issues when there is patient responsibility). 
Plans (and in
concert with their PPGs [in CA] and vendors) are required to implement new EOBs no later than 10/1/13. 
Confirmed Compliance 
Compliance—Medicare 
Approved by EPCO 
2/23/2015 
15R1 
55 
EPCO

Robert E Oetken Jr 
Active 
Approved 
Child 
16452 
17349 
16452 17349 
BPaaS 
In-Flight—No WO 
16452 17349—Monthly EOB P4 New Template 
CMS is requiring for the first time that Medicare Advantage Plans implement Part C Explanation of Benefits (EOBs) which are notices of claim determination. 
Currently, Medicare Advantage Plans administering Part C are not ¿required¿ to issue EOBs and therefore have been optionally issuing EOBs, on a proprietary format,
and not necessarily on all claim determinations (for example, HN only issues when there is patient responsibility). 
Plans (and in concert with their PPGs [in CA]
and vendors) are required to implement new EOBs no later than 10/1/13. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/17/2014 
14R4 
56 
EPCO

Robert E Oetken Jr 
Active 
Approved 
Child 
16452 
17338 
16452 17338 
BPaaS 
Inflight—W O exists 
16452- 
17338_COG 
_W O_Ver1.3 
,16452- 17338_COG 
_CR1_V1.0 
16452 17338—Monthly EOB P2.5 Pharmacy Data 
CMS is requiring for the first time that
Medicare Advantage Plans implement Part C Explanation of Benefits (EOBs) which are notices of claim determination. 
Currently, Medicare Advantage Plans
administering Part C are not ¿required¿ to issue EOBs and therefore have been optionally issuing EOBs, on a proprietary format, and not necessarily on all claim determinations (for example, HN only issues when there is patient
responsibility). 
Plans (and in concert with their PPGs [in CA] and vendors) are required to implement new EOBs no later than 10/1/13. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
9/22/2014 
14R3 
57

16475 
16475 
16475 16475 
BPaaS 
Inflight—W O exists 
16475 HP 
QC 11 Upgrade_CO G_W O_Ver 1.0 
16475 16475—HP ALM 11x Upgrade 
Infra 
Unassigned 
58 
Service Delivery 
Not available 
Active 
Approved 
Child 
16555 
16280 
16555 16280 
BPaaS 
Inflight—W O exists 
16555-16280 
-COG_W O 
Ver 1.0 
16555 16280—Prov Mod—APA Phase I 
Current system producing Provider directories has
reached capacity as a result of the AZ migration, and unable to meet demands for memory additions. IT considers this system a business risk to the 2013 Open Enrollment reason. Project will enable geo- directories, essential to offsetting project
costs and producing a positive ROI for this Business Case 
Customer Solutions

Unassigned 
11/17/2014 
14R4 
59

PPMO 
David Kosterman 
Active 
Approved 
Child 
16555 
17181 
16555 17181 
BPaaS 
Inflight—W O exists 
16555- 
17181_COG 
_WO_v1.1,1 6555- 
17181_COG 
_CR1_Ver_1. 0,16555_171 
81_COG_CR 
3_Ver 1.1,16555_17 
181_COG_C 
R2_Ver 1.1 
WO# 1186- HN W COE 
Encounter Corrections Phase 3; CR1-HN 
WCOE 
Encounter Corrections Phase 3 
16555 17181—Encounters Modernization Phase III 
The program will enable modernization of the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
8/18/2014 
14R3 
Schedule X-1 
X-1-21 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
60 
PPMO

Robert E Oetken Jr 
Active 
Approved 
Child 
16555 
17290 
16555 17290 
BPaaS 
Inflight—W O exists 
16555- 
17290_COG 
_W O_Ver1.2 
,16555- 17290_COG 
_CR1_Ver 1.1 
16555 17290—Encounter Mod Phase IV—Void Adjust 
The program will enable modernization
of the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
11/17/2014 
14R4 
61

PPMO 
Robert E Oetken Jr 
Active 
Approved 
Child 
16555 
17294 
16555 17294 
BPaaS 
Inflight—W O exists 
16555- 
17294_COG 
_W O_Ver 1.3 
16555 17294—Enc Modernization PH V-a CSR-3R 
The program will enable modernization of the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
11/17/2014 
14R4 
62 
PPMO

Bart Keaney 
Active 
Approved 
Child 
16555 
17271 
16555 17271 
BPaaS 
Inflight—W O exists 
16555- 
17271_COG 
_WO_v1.3,1 6555- 
17271_COG 
_CR1_Ver_1. 
0 
16555 17271—Return Service Line Details on ERA 
The program will enable modernization of the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
9/22/2014 
14R3 
63 
Service Delivery 
Bart Keaney 
Active 
Approved 
Child 
16555 
18544 
16555 18544 
BPaaS 
Inflight—W O exists 
16555- 
18544_COG 
_W O_Ver 1.4,16555- 
18544_COG 
_CR2_Ver_1. 0,16555_185 
44_COG_CR 
1_Ver 1.0 
16555 18544—Return service line payment for COB 
The ERA’s generated out of ABS for
COB claims do not provide the service line adjustment and payment amounts. The COB adjustment is at the claim level and we do not provide the payment detail for each service line so that the provider can tell which service lines were paid by HN and
how to apply the payment to each individual line 
Confirmed Compliance

Compliance—HIPAA: 5010 
Bruce Anderson 
9/22/2014 
14R3 
64 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
16555 
16427 
16555 16427 
BPaaS 
Inflight—W O exists 
16555- 
16427_COG 
_W O_Ver 1.0 
16555 16427—ABS Advance Claims—Check & Remit 
Since the AZ migration from Mc400
to ABS, AZ Providers are complaining about the inability to consolidate payments and remittance advice at the TIN level while still identifying the rendering provider for groups. Providers that were accustomed to receiving 1-2 checks per week are
now receiving dozens of payments and remits separately which is causing them additional work to post the payments. 
Customer Solutions 
Unassigned 
10/20/2015 
15R3 
65

PPMO 
David Kosterman 
Active 
Approved 
Parent 
16555 
16555 
16555 16555 
BPaaS 
Inflight—W O exists 
16555- 
16555_COG 
_W O_Ver 1.0 
16555 16555—ABS Advance 
The program will enable modernization of the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
5/18/2015 
15R2 
66 
PPMO

David Kosterman 
Active 
Approved 
Child 
16555 
17107 
16555 17107 
BPaaS 
Inflight—W O exists 
16555- 
17107_COG 
_W O_Ver_1. 2,16555- 
17107_COG 
_CR2_Ver1.0 
,16555- 17107_COG 
_CR1_Ver1.2 
WO# 1184—   
Accumulator Rewrite Program—Pre Elaboration 
16555 17107—Accumulator Modernization Phase I 
The program will enable modernization of
the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
11/17/2014 
14R4 
67

PPMO 
Bart Keaney 
Active 
Approved 
Child 
16555 
17248 
16555 17248 
BPaaS 
Inflight—W O exists 
WO# 1184—   
Accumulator Rewrite Program—Pre Elaboration 
16555 17248—Accumulator Modernization Phase II 
The program will enable modernization of
the ABS platform through automation of business processes and upgrades of technology. 
Customer Solutions 
Unassigned 
5/18/2015 
15R2 
68

Business Development 
David Kosterman 
Active 
Approved 
Parent 
16641 
16641 
16641 16641 
BPaaS 
Inflight—W O exists 
16641- 
16641_COG 
_W O_Ver_1 2 
WO# 1078—   
For CalPERS 2014 
Implementati on 
16641 16641—CalPERS 
Implementation 
CalPERS awared Health Net 6 specific geographies using our tailored network solution 
- Salud
and SmartCare. This includes Kern, Los Angeles, Orange, Riverside, San Bernardino, and San Diego counties. This also includes Medicare Advantage/COB in the same 6 counties. The purpose of this brief is to implement all of the system related changes
to meet the CalPERS requirements. 
Customer Solutions 
Unassigned 
8/18/2014 
14R3 
69 
Business Development 
David Kosterman 
Active 
Approved 
Child 
16641 
17293 
16641 17293 
BPaaS 
Inflight—W O exists 
16641- 
17293_COG 
_W O_Ver 1.4,16641- 
17293_COG 
_CR1_v1.2 
16641 17293—CalPERS 
Implementation Ph. 12 
CalPERS awared Health Net 6 specific geographies using our tailored network solution 
- Salud
and SmartCare. This includes Kern, Los Angeles, Orange, Riverside, San Bernardino, and San Diego counties. This also includes Medicare Advantage/COB in the same 6 counties. The purpose of this brief is to implement all of the system related changes
to meet the CalPERS requirements. 
Customer Solutions 
Unassigned 
11/17/2014 
14R4 
Schedule X-1 
X-1-22 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
70 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16673 
16673 
16673 16673 
IBM 
In-Flight—No WO 
BTI W O 98- 
023 Upgrade VMware vSphere to v5.5 PID 16673 01-23- 
2014 
PCR01 98- 
023 Upgrade VMware vSphere to v5.1 Project PID 16673 05 05-2014 PCR02 98-

023 Upgrade VMware vSphere to v5.1 Project PID 16673 05 15-2014 
16673
16673—Upgrade VMware vSphere to v5.1 
This is a currency project. The software is currently 2 release versions behind the current release version and needs to
be upgraded to v5.1 in order to be compliant with the Health Net Technology plan. The End of Availability for vSphere ESX 4.x is August 15, 2013. After this date, the software licenses will no longer be available for purchase 
Lights On 
Unassigned 
9/30/2014 
14R3 
9/30/2014 
71 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16682 
16682 
16682 16682 
IBM 
In-Flight—No WO 
16682_BARR 
WO UPGRADE CITRIX ENVIRONME 
NT TO 2008_201310 
25 
BTI W O 13- 084 UPGRADE CITRIX ENVIRONME NT TO 2008 (PID 16682) 9-10-2014— 
pending

16682 16682 Upgrade Citrix Environment 
CITRIX Xenapp for W indows Server 2003
is at End of Life as of 3/31/2013. W e are currently on Extended support through 12/31/13. End of Extended Support is July 14th, 2015. After that, the vendor will not support the product at any price. The proposed solution to maintain vendor support
on a sustained basis is to upgrade the CITRIX Xenapp environment OS to Windows 2008. 
Lights On 
Unassigned 
11/19/2014 
14R4 
9/30/2014 
72 
16735

16735 
16735 16735 
IBM 
In-Flight—No WO 
16735 16735—Spectrum 
Infra 
73 
Service Delivery 
David Kosterman 
Active 
Approved 
Parent 
16741 
16741 
16741 16741 
BPaaS 
Inflight—W O exists 
16741- 
16741_COG 
_W O_Ver_1. 2,16741- 
16741_COG 
_CR4_Ver_1. 1,16741- 
16741_COG 
_CR3_Ver 1 1,16741- 
16741_COG 
_CR2_Ver_1. 0,16741- 
16741_COG 
_CR1_Ver 1.2,16741 
16741_COG 
_CR5_Ver 1.1 
16741 16741—DRG W eight for ERA 
The current ERA’s that are generated out of QCare
and ABS are not HIPAA compliant. The transaction standard requires that the DRG and DRG weight be returned in the ERA when the DRG is used to adjudicate the claim. With the APR_DRG project going into QCare in July, the DRG weight will not be present
in the ERA since its not stored in the system. ABS is currently not compliant either with either the DRG or DRG weight when applicable (Medicare/Medicaid).

Confirmed Compliance 
Compliance—HIPAA: 5010 
Approved by EPCO 
2/17/2014 
14R4 
74

Service Delivery 
David Kosterman 
Active 
Approved 
Child 
16741 
17250 
16741 17250 
BPaaS 
Inflight—W O exists 
16741- 
17250_COG 
_W O_Ver 1.2, 
16741_17250 
_COG_CR1_ V1.1 
16741 17250—DRG W eights for ERA PII—MS DRG in 
The current ERA’s that are generated out of QCare and ABS are not HIPAA compliant. The transaction standard requires that the DRG and DRG weight be returned in the ERA when
the DRG is used to adjudicate the claim. With the APR_DRG project going into QCare in July, the DRG weight will not be present in the ERA since its not stored in the system. ABS is currently not compliant either with either the DRG or DRG weight
when applicable (Medicare/Medicaid). 
Confirmed Compliance

Compliance—HIPAA: 5010 
Approved by EPCO 
11/17/2014 
14R4 
75 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16773 
16773 
16773 16773 
Non-BPaaS 
Inflight—W O exists 
WO# 1194—   
ServiceNow Implementati on 
BTI W O 13- 142 
ServiceNow Implementati on PID 16773 03-03-2014 
16773 16773—ServiceNow Implementation

Health Net is using Remedy v6 for incident, problem, and change mangement. This version is heavily customized and is at “end of life” support. The
service request management (SRM) system implemented in May 2009 was built on the latest Remedy v7 infrastructure but is not currently integrated with Remedy v6. Addition issues: 
¿ Upgrades are complex, costly and time consuming 
¿ SRM and ISR (Service Request
Systems) are not user friendly 
¿ Hardware end of life. Additional cost to upgrade 
¿ Security patching challenges 
Performance Improvements 
Unassigned 
8/18/2014 
14R3 
9/19/2014 
76 
16816

16816 
16816 16816 
IBM 
In-Flight—No WO 
16816 16816—Civerex and Argusology Terms 
Infra 
Unassigned 
Schedule X-1 
X-1-23 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
77 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16929 
16929 
16929 16929 
IBM 
In-Flight—No WO 
Completed 
16929 16929—(Currency) Upgrade Sysgem to SEM v3. 
Sysgem is used for account
creation/maintenance and security auditing on OpenVMS. IBM have previously discussed upgrading Sysgem and implementing HA to provide a more robust environment. The current version (2.1) is at EOL and is currently unsupported. An upgrade to version
3.x is required to bring this up to currency requirments and ensure continued vendor support. Note: this is the resubmission of PID 14777, previously cancelled with an intent to resubmit at a later date due to an overload of projects at the time.

Lights On 
Unassigned 
6/30/2014 
14R2 
5/20/2014 
78 
Gov’t Programs Operations 
Bart Keaney 
Active 
Conditional Approval 
Single 
16955 
16955 
16955 16955 
BPaaS 
Inflight—W O exists 
16995- 
16995_COG 
_W O_Ver1.2 
16955 16955—Payment Option Tranfer 
Currently in ABS, the enrollment team processes group to group transfers using the screen MMGRPXFR, the member’s payment option transfers over automatically. However there are
is main limitations to this, which will be discussed below. The impact of these limitations directly affect members on Automatic Bank Draft (ABD) or SSA W ithold.W hen a member on ABD goes through a group to group transfer, their ABD option is
cancelled in their old group and reprocessed in the new group. Depending on what time of the month this happens, the resulting factor is the members account gets drafted twice, which customers complain about. For member on SSA 
Withold that go through a group to group, their SSA W ithold can get cancelled. Once that happens CMS will not back-pay any outstandiing premiums once payments for the month has
been sent out 
Lights On 
Unassigned 
11/17/2014 
14R4 
79 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
16977 
16977 
16977 16977 
BPaaS 
Inflight—W O exists 
16977- 
16977_COG 
_W O_ Ver 1.0 
BTI W O 13- 135 2014 DR 
Exercise PID 16977 03-10- 
2014 
16977 16977—2014 Disaster Recovery Exercise 
The annual Disaster Recovery test simulates recovery of Health Net¿s data processing facility, (Bouder, CO), which is the resident location of Health Net¿s business
critical systems and applications. A physical loss of this facility, and the inability to recover business critical systems and applications within the stipulated time frame, would seriously impair Health Net¿s business operations. Health Net
is required to conduct the exercise to remain compliant with Govt and contractual obligations. 2014 DR Exercise is scheduled to commence on 6/17/2014. 
Lights On

Unassigned 
10/31/2014 
14R4 
80

16990 
16990 
16990 16990 
IBM 
In-Flight—No WO 
BTI W O 98- 015 TR 
Currency BLD- SQLCL10-11 
Refresh PID 16690 10-28- 
2013.pdf 
16990 16990—TR Unity BLD- SQLCL10/11 Refresh 
Infra 
Unassigned 
#REF! 
Unassigned 
Catherine Raneri 
Active 
Approved 
Child 
18043 
17336 
18043 17336 
BPaaS 
Inflight—W O exists 
WO# 1204—   
PureCare EPO 
18043 17336—PureCare EPO- Web. 
As a result of Health Net entering the California Exchange and filing with the DMHC, the regulator has said that Health Net must offer Bronze and Catastrophic benefits on the off
exchange which Health Net did not file for. In order to minimize the financial risk and not compete with its Exchange products the business has decided to develop a DMHC limited PPO network product. Failure to develop Bronze tiered benefits could
potentially jeopardize the future of SBG business in California. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
10/23/2014 
14R4 
#REF! 
Business Development 
Catherine Raneri 
Active 
Approved 
Child 
18043 
17288 
18043 17288 
BPaaS 
Inflight—W O exists 
18043- 
17288_COG 
_W O_Ver 1.5,18043- 
17288_COG 
_CR1_Ver 1.1 
18043 17288—PureCare EPO—Claims 
As a result of Health Net entering the California
Exchange and filing with the DMHC, the regulator has said that Health Net must offer Bronze and Catastrophic benefits on the off exchange which Health Net did not file for. In 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/17/2014 
14R4 
#REF!

Business Development 
Catherine Raneri 
Active 
Approved 
Child 
18043 
17307 
18043 17307 
BPaaS 
Inflight—W O exists 
18043- 
17307_COG 
_W O_Ver1.5 
18043 17307—PureCare EPO—Provider Directories 
As a result of Health Net entering the California Exchange and filing with the DMHC, the regulator has said that Health Net must offer Bronze and Catastrophic benefits on the off
exchange which Health Net did not file for. In order to minimize the financial risk and not compete with its Exchange products the business has decided to develop a DMHC limited PPO network product. Failure to develop Bronze tiered benefits could
potentially jeopardize the future of SBG business in California. 
Confirmed Compliance 
Compliance—Affordable Care Act (ACA) 
8/18/2014 
14R3 
#REF!

Business Development 
Catherine Raneri 
Active 
Approved 
Parent 
18043 
18043 
18043 18043 
BPaaS 
Inflight—W O exists 
18043- 
18043_COG 
_W O_Ver 1.3 
18043 18043—PureCare EPO 
As a result of Health Net entering the California Exchange and filing with the DMHC, the regulator has said that Health Net must offer Bronze and Catastrophic benefits on the off
exchange which Health Net did not file for. In order to minimize the financial risk and not compete with its Exchange products the business has decided to develop a DMHC limited PPO network product. Failure to develop Bronze tiered benefits could
potentially jeopardize the future of SBG business in California. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/17/2014 
14R4 
#REF! 
Business Development 
Catherine Raneri 
Active 
Approved 
Child 
18043 
17287 
18043 17287 
BPaaS 
Inflight—W O exists 
18043- 
17287_COG 
_W O_Ver 1.6,18043- 
17287_COG 
_CR1_Ver 1.1 
18043 17287—PureCare EPO—Membership 
Health Net entering the California Exchange and
filing with the DMHC, the regulator has said that Health Net must offer Bronze and Catastrophic benefits on the off exchange which Health Net did not file for. In order to minimize the financial risk and not compete with its Exchange products the
business has decided to develop a DMHC limited PPO network product. Failure to develop Bronze tiered benefits could potentially jeopardize the future of SBG business in California. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
10/20/2014 
14R4 
Schedule X-1 
X-1-24 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
18044 
18044 
18044 18044 
IBM 
In-Flight—No WO 
BTI W O 13- 
124 Migrate and Decom WH- 
IVRSW 01 v2 PID 18044 02 11-2014.pdf PCR01 13- 
124 Migrate and Decom WH- IVRSW 01 (PID
18044).pdf 
18044 18044—TR IVR—W H- IVRSW 01 
Infra 
Unassigned 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Child 
18076 
17328 
18076 17328 
BPaaS 
Inflight—W O exists 
18076- 
17328_COG 
_W O_Ver_1. 0,18076- 
17328_COG 
_CR1_Ver_1. 
0 
18076 17328—Medi-Cal Expansion 133s Phase 6 
Government Requirement? 
Lights On 
Unassigned 
10/20/2014 
14R4 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Parent 
18076 
18076 
18076 18076 
BPaaS 
Inflight—W O exists 
18076- 
18076_COG 
_W O_Ver_1. 1,18076- 
18076_COG 
_CR3_Ver_1 0,18076- 
18076_COG 
_CR2_Ver_1 0,18076- 
18076_COG 
_CR1_Ver_1 0,18076- 
18076_COG 
_ CR5_Ver_1 0,18076- 
18076_COG 
_ CR4_Ver_1. 1 
18076 18076—Medi-Cal Expansion 
Government Requirement? 
Lights On 
Unassigned 
8/18/2014 
14R3 
#REF! 
Gov’t Specialty Services 
Robert E Oetken Jr 
Active 
Approved 
Child 
18076 
17308 
18076 17308 
BPaaS 
Inflight—W O exists 
18076- 
17308_COG 
_W O_Ver_1. 1,18076- 
17308_COG 
_CR1_Ver_1. 
0 
18076 17308—Medi-cal 133’s Phase V 
Government Requirement 
Lights On 
Unassigned 
9/22/2014 
14R3 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
18078 
18078 
18078 18078 
BPaaS 
Inflight—W O exists 
18078- 
18078_COG 
_W O_Ver 1.4 
18078 18078—Medicare Encounter Data Exception Ha 
As of January 3, 2012, all MA Organizations are required to electronically submit all Medicare medical encounters/claims with subtypes for professional, institutional, and dental
varieties to CMS in the ANSI 837 5010 EDI X12 file format. Resubmitting corrected encounters will satisfy the Medicare Risk Adjustment reporting requirement in Section 42 of the Federal Code of Regulations and will ensure appropriate Risk Adjustment
reimbursement from CMS. 
Confirmed Compliance 
Compliance—Medicare

Approved by EPCO 
9/22/2014 
14R3 
#REF!

Infrastructure 
Cynthia T Nguyen 
Active 
Approved 
Single 
18119 
18119 
18119 18119 
IBM 
In-Flight—No WO 
BTI W O 13- 152 
International Drive Relocation v2 PID 18119 06 26-2014 
WO 13-152 
PCR01 v2 International Drive Relocation PCR02 13- 152 
International Drive Relocation (PID 18119) 09-11-2014 
18119 18119—International Dr -HNPS
Facility Move 
The project will be to move associates from 10834 International Drive Suite 200 to the proposed new location. 2868 Prospect Park Rancho Cordova CA.

Lights On 
Unassigned 
8/29/2014 
14R3 
8/29/2014 
Schedule X-1 
X-1-25 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
EPCO

David Kosterman 
Active 
Approved 
Child 
18240 
17316 
18240 17316 
Non-BPaaS 
In-Flight—No WO 
18240 17316—HN.com (web) OR HMO Name Change 
In accordance with ORS 750.005(5), (6) and 750.025(2), a requirement exists to remove all reference to HMO from Oregon documentation and system references and replace them with
EPO. 
The project objective in accordance with the regulation referenced above is to rename any ‘HMO’ product name references for OR Commercial products
to ‘EPO’ for any external facing systems output and revise any internal table descriptors. The effective regulatory date for this rename was 09/01/12.

Specific RMCs are impacted; provider network codes, Patient Physician Co- operative’s, and system logic that drives the administration of the RMCs will not
change. Systems that display ‘HMO’ as the product name will be replaced with ‘EPO’. Affected systems requiring programming are ID Cards, Provider Search, directories, Internal and External Schedule of Benefits, Sales Web
Portal(Connecture), SLU Rating Portfolio tool, SALSA, ESA, EOC cover sheets, Claims EOBs, Benefit Config, Membership, Data warehouse, Unity, PPC, Capitation, and Provider Database Mgt. 
Whenever possible, long and short table product descriptions should be changed. Internal SBG long/short product table descriptions may be revised to reflect ‘EPO’ to help
the internal business areas with the administration transition to the new product name. 
Group renewals and member ID card requests will generate ID cards with
‘EPO’ displayed. Membership bills, claims EOBs, W eb descriptors, and any other member/employer/provider facing materials will display the ‘EPO’ product name. Internal facing descriptors will display the ‘EPO’ product
name. 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/20/2014 
14R4 
#REF!

EPCO 
David Kosterman 
Active 
Approved 
Parent 
18240 
18240 
18240 18240 
Non-BPaaS 
Inflight—W O exists 
18240- 
18240_COG 
_W O_V10.0 
WO# 1183- W COE OR 
HMO to EPO Name Change 
18240 18240—OR HMO Name Change Project 
In accordance with ORS 750.005(5), (6) and 750.025(2), a requirement exists to remove all reference to HMO from Oregon documentation and system references and replace them with
EPO. 
The project objective in accordance with the regulation referenced above is to rename any ‘HMO’ product name references for OR Commercial products
to ‘EPO’ for any external facing systems output and revise any internal table descriptors. The effective regulatory date for this rename was 09/01/12.

Specific RMCs are impacted; provider network codes, Patient Physician Co- operative’s, and system logic that drives the administration of the RMCs will not
change. Systems that display ‘HMO’ as the product name will be replaced with ‘EPO’. Affected systems requiring programming are ID Cards, Provider Search, directories, Internal and External Schedule of Benefits, Sales Web
Portal(Connecture), SLU Rating Portfolio tool, SALSA, ESA, EOC cover sheets, Claims EOBs, Benefit Config, Membership, Data warehouse, Unity, PPC, Capitation, and Provider Database Mgt. 
Whenever possible, long and short table product descriptions should be changed. Internal SBG long/short product table descriptions may be revised to reflect ‘EPO’ to help
the internal business areas with the administration transition to the new product name. 
Group renewals and member ID card requests will generate ID cards with
‘EPO’ displayed. Membership bills, claims EOBs, W eb descriptors, and any other member/employer/provider facing materials will display the ‘EPO’ product name. Internal facing descriptors will display the ‘EPO’ product
name. 
Confirmed Compliance 
Compliance—State Legislation 
Approved by EPCO 
11/17/2014 
14R4 
#REF!

18294 
18294 
18294 18294 
IBM 
In-Flight—No WO 
18294 18294—(Currency) Upgrade zOS to v1.13 
Infra 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18304 
18304 
18304 18304 
IBM 
In-Flight—No WO 
BTI W O 98- 
025 Riverbed Steelhead Network Appliance Upgrade v4 PID 18304 08 19-2014

18304 18304—Riverbed Steelhead Network Appliance 
Several network
optimizing appliances will be reaching EOL in 2014, the soonest ocurring on 2/6/14. These devices are used to streamline network traffic to obtain optimal network response. These appliances need to be replaced with new devices in order to maintain
optimal network response and ensure ongoing manufacturer support. 
Lights On

Unassigned 
7/16/2014 
14R3 
7/16/2014 
#REF! 
Infrastructure 
Not available 
Intake in Progress 
Approved 
Single 
18350 
18350 
18350 18350 
IBM 
In-Flight—No WO 
Project Not Approved still in Requested Status 
18350 18350—Retire FireFox browser application 
Internet Explorer v8 (IE8) is the approved
standard browser for the HN environment. There are approximately 800 users of the browser FireFox and as their workstations get refreshed, IE8 is installed as the only browser. This prompts the users to open Remedy tickets to get the FireFox browser
installed. FireFox has a temporary A-Risc in force allowing it’s use as there were reported problems using IE8 with the Alere system, however subsequent testing with end users concluded that although IE8 has some minor character limitations
within some fields within the Alere system (in which Alere is addressing), IE8 can be effectively utilized to interface with the Alere system. Since FireFox has known security vulnerabilities that cannot be mitigated, the proposed solution is to
provide training / documentation to the users so they can migrate to IE8, discontinue use of FireFox, and remove it from the Health Net environment. 
Lights On

Unassigned 
Unassigned 
Schedule X-1 
X-1-26 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18352 
18352 
18352 18352 
IBM 
In-Flight—No WO 
BARR W O 13-172 
Upgrade RightFax to 10.6 Project PID 18352 06 09-2014 
BTI W O 13- 
172 Upgrade RightFax to 10.6 (PID 
18352) 09-8- 
2014.pdf—sent back for revision 18352— 
18352_BARR 
_ Assmt_2014 0603_V2.0— 
do not have WO yet endorsed but not approved 
18352 18352—Upgrade RightFax Application to v10. 
RightFax v9.4 will be EOL (End of Life)
as of 7/1/14 and will no longer be supported by the manufacturer from that day on. The RightFax system has also been experiencing issues surrounding fax document storage within Lotus Notes databases and it is recommended that fax document storage be
moved away from Lotus Notes in order to alleviate performance issues when locating and retreiving fax documents.The proposed solution to maintain ongoing manufacturer support and implement an alternative document storage solution is to upgrade the
RightFax application to v10.6 released on 11/11/13 which has a built in archive functionality called “RightFax Vault” that will enable us to migrate fax document storage off of the Lotus Notes databases. 
Lights On 
Unassigned 
14R4 
8/15/2014 
#REF! 
Service Delivery 
David Kosterman 
Active 
Approved 
Single 
18395 
18395 
18395 18395 
BPaaS 
In-Flight—No WO 
18395 18395—Vaden EOB backer 
EPO plans should be regulated by the CDI, however recently we discover that not only are tier benefits being paid at the DMHC required interest rates of 15% but the, members
EOB’s are also going out with the DMHC backer. Mean while claims processed at tier 2 are generating the CDI EOB backers when sent to the members and only paying 10% interest. 
Confirmed Compliance 
Compliance—State Legislation 
Approved by EPCO 
11/17/2014 
14R4 
#REF!

Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18461 
18461 
18461 18461 
IBM 
In-Flight—No WO 
BTI W O 14- 034 
MailGate Refresh and Secure Messenger Refresh PID 18461 8-12- 
2014.pdf 
18461 18461—MailGate Refresh & Secure Messenger 
This project is to replace existing MailGate appliances in the test environment and the Secure Messenger devices. These devices are all coming end-of-life in June 2014. The vendor
will not support the devices once they reach end-of-life. This project also includes Axway Professional Services to configure and modify customized changes by Health Net. 
Lights On 
Unassigned 
8/18/2014 
14R3 
#REF! 
Legal/OE/QA 
David Kosterman 
Active 
Approved 
Child 
18462 
17350 
18462 17350 
Non-BPaaS 
Inflight—W O exists 
18462-17350 
_COG_W O_ Ver_1 0 
18462 17350—HCM SAP Finance 
Key objectives of this project is to: Consolidate HR, Benefits, Time Reporting, and Talent Management solutions to an integrated SAAS solution in the cloud; Migrate off the
PeopleSoft mainframe platform and eliminate the need for costly software and hardware upgrades every 3-5 years; and Reduce operating costs and position OE and Payroll to operate from a modern/integrated set of systems and services from 3rd party
partners. 
Key benefits of this project include: Fully integrated systems will improve manager and associate experience and will enable better decisions without
requiring backroom support from OE and calls to the ASC; Best practice processes and improved functionality will eliminate repetitive data entry, improve workflows, provide dashboard analytics to the desktop, provide tools to enable
performance/compensation calibrations and succession planning, and more; Mobile capabilities for all associates (time reporting, approvals, self service, reporting, dashboards); More predictable IT cost structure for OE and Time Reporting
functionality because all application and infrastructure upgrades are included in the subscription fees, are regularly scheduled, and don’t require internal IT resources. There’s no infrastructure footprint to maintain and keep current.

Payroll will utilize an on-premise SAP solution which will improve integrations with Finance. Application and infrastructure upgrades will be included with SAP ERP
Finance on a go-forward basis. 
Operations Strategy 
Unassigned 
12/15/2014 
14R4 
#REF! 
Finance/Corpor ate 
David Kosterman 
Active 
Approved 
Child 
18462 
17240 
18462 17240 
Non-BPaaS 
Inflight—W O exists 
WO# 1195- HCM- HR; CR1-HN HCM-HR 
18462 17240—HCM—HR 
Key objectives of this project is to: Consolidate HR, Benefits,
Time Reporting, and Talent Management solutions to an integrated SAAS solution in the cloud; Migrate off the PeopleSoft mainframe platform and eliminate the need for costly software and hardware upgrades every 3-5 years; and Reduce operating costs
and position OE and Payroll to operate from a modern/integrated set of systems and services from 3rd party partners. 
Key benefits of this project include: Fully
integrated systems will improve manager and associate experience and will enable better decisions without requiring backroom support from OE and calls to the ASC; Best practice processes and improved functionality will eliminate repetitive data
entry, improve workflows, provide dashboard analytics to the desktop, provide tools to enable performance/compensation calibrations and succession planning, and more; Mobile capabilities for all associates (time reporting, approvals, self service,
reporting, dashboards); More predictable IT cost structure for OE and Time Reporting functionality because all application and infrastructure upgrades are included in the subscription fees, are regularly scheduled, and don’t require internal IT
resources. There’s no infrastructure footprint to maintain and keep current. 
Operations Strategy 
Unassigned 
11/17/2014 
14R4 
Schedule X-1 
X-1-27 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Legal/OE/QA 
David Kosterman 
Active 
Approved 
Child 
18462 
17238 
18462 17238 
Non-BPaaS 
Inflight—W O exists 
WO# 1208- HCM 
Success Factors Implementati on ADOIS Re- platform 
18462 17238—HCM—ADOIS 
Key objectives of this project is to: Consolidate HR, Benefits, Time Reporting, and Talent Management solutions to an integrated SAAS solution in the cloud; Migrate off the
PeopleSoft mainframe platform and eliminate the need for costly software and hardware upgrades every 3-5 years; and Reduce operating costs and position OE and Payroll to operate from a modern/integrated set of systems and services from 3rd party
partners. 
Operations Strategy 
Unassigned 
11/17/2014 
14R4 
#REF! 
Legal/OE/QA 
David Kosterman 
Active 
Approved 
Child 
18462 
17237 
18462 17237 
Non-BPaaS 
Inflight—W O exists 
18462- 
17237_COG 
_W O_Ver 1.0 ,18462- 
17237_COG 
_CR2_V1.1,1 8462- 
17237_COG 
_CR1_Ver_1. 2,18462 
17237_COG 
_CR3_V1.0 
18462 17237—HCM—Payroll/ Finance 
Key objectives of this project is to: Consolidate
HR, Benefits, Time Reporting, and Talent Management solutions to an integrated SAAS solution in the cloud; Migrate off the PeopleSoft mainframe platform and eliminate the need for costly software and hardware upgrades every 3-5 years; and Reduce
operating costs and position OE and Payroll to operate from a modern/integrated set of systems and services from 3rd party partners. 
Operations Strategy

Unassigned 
11/17/2014 
14R4 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
18470 
18470 
18470 18470 
BPaaS 
Inflight—W O exists 
18470- 
18470_COG 
_W O_Ver 1.3,18470- 
18470_COG 
_CR1_Ver_1. 
0 
18470 18470—Human Arc Data Extract 
Human Arc is a vendor that enhances revenue by working
with HN members to reclassify them from their current AID code to a higher one. The impact to HN is significant—once it is up and running, HN could realize as much as $4 million in additional annual revenue on our existing membership net of any
payments to Human Arc 
Government Programs 
Unassigned 
11/17/2014 
14R4 
#REF! 
Gov’t Specialty Services 
Lisa Dobbert 
Active 
Approved 
Single 
18479 
18479 
18479 18479 
Non-BPaaS 
In-Flight—No WO 
18479 18479—STARS system upgrade 
The 2013.1 release for STARSSentinel and STARSInformant includes enhancements required to achieve ICD-10 compliance.As part of the goal for ICD10 compliance for STARS and
STARS/Sentinel, a version upgrade to the application is required. 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Sandra Dorsett 
2/23/2015 
15R1 
#REF! 
18498 
18498 
18498 18498 
IBM 
In-Flight—No WO 
18498 18498—Upgrade DME TPM 101 
/ TRM 91 
Infra 
#REF! 
Health Care Delivery 
Joseph Cook 
Active 
Approved 
Single 
18549 
18549 
18549 18549 
BPaaS 
Inflight—W O exists 
18549— 
18549_COG 
_W O_Ver 1.6 
18549 18549—AZ Outpatient Facility Claims to iHe 
The intent of this project is to achieve savings on AZ outpatient facility claims through an automated program that detects and subsequently corrects or denies aberrant coding. To
accomplish this, it will be necessary to make ABS programming and configuration changes in order to start sending outpatient facility claims to iHealth and accept them back into ABS to apply iHealth recommendations. This is an existing process for
CA and OR and needs to be applied for AZ claims from being extracted from HN ABS system to iHT and back for both daily and history files. 
Operations Strategy

Unassigned 
9/22/2014 
14R3 
#REF!

Gov’t Specialty Services 
Lisa Dobbert 
Active 
Approved 
Single 
18570 
18570 
18570 18570 
BPaaS 
In-Flight—No WO 
18570 18570—Impact Pro Stand-Alone 7.1 Reimpleme 
Impact Pro v7.1 will include ICD-10
compliance and readiness with the Health Insurance Portability and Accountability Act (HIPAA): to include final rule mandating all covered entities (health care providers, health plans and health care clearing houses) comply with new code set
regulations, ICD-10, by October 2014. 
Confirmed Compliance 
Unassigned

2/23/2015 
15R1 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18614 
18614 
18614 18614 
IBM 
In-Flight—No WO 
BTI W O has not been completed 
18614 18614—HP Exstream Command Center Upgrade ( 
HP Exstream Command Center v1.1 is
currently being used by the OCoE to manage and execute document generation jobs. The current installed version is currently encountering increasing instances of extreme job slowness and job failure. The proposed solution as recommended by the
product manufacturer, HP, is to upgrade the application to v2.3 
Lights On

Unassigned 
9/26/2014 
14R3 
9/19/2014 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18643 
18643 
18643 18643 
IBM 
In-Flight—No WO 
BTI W O 14- 
031 AVPN v3 (PID 18643) 08-26- 
2014.pdf—pending endorsement and processing. 
18643 18643—AVPN 
Health Net WAN connectivity is heavily dependent on the MPLS IP Frame
Relay (IPFR) service, which AT&T announced is sunseting, and schedule to terminate on 4/30/2016 
Lights On 
Unassigned 
12/31/2015 
15R4 
12/31/2014 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18644 
18644 
18644 18644 
IBM 
In-Flight—No WO 
BTI W O 
requested 8/28/14, expected 9/19/14 
18644 18644—Recovery Manager for AD 
Health Net experienced 2 major outages (April 8th & Nov 26th) in 2013 due to accidental deletion of accounts in AD affecting thousands of associates and contractors in
Corporate and Federal Services 
Lights On 
Unassigned 
11/24/2014 
14R4 
#REF! 
Service Delivery 
David Kosterman 
Active 
Approved 
Child 
18651 
17331 
18651 17331 
BPaaS 
Inflight—W O exists 
WO# 1202—   
AON Hewitt Electronic File Processing 
18651 17331—Aon Hewitt Electronic Enrollment Fil

Aon Hewitt presents a new opportunity to receive Seniority Plus applications via an electronic file. A new process must be developed to receive and process the
file, capture and store new required fields within the file, and produce outbound weekly reports to be FTP’d to Aon Hewitt. 
Customer Solutions 
Unassigned 
9/25/2014 
14R3 
#REF!

Service Delivery 
David Kosterman 
Active 
Approved 
Parent 
18651 
18651 
18651 18651 
BPaaS 
Inflight—W O exists 
18651- 
18651_COG 
_W O_Ver 1.2,18651- 
18651_COG 
_CR1_Ver 1.0 
18651 18651—Aon Hewitt Electronic File Processin 
Aon Hewitt presents a new opportunity to receive Seniority Plus applications via an electronic file. A new process must be developed to receive and process the file, capture and
store new required fields within the file, and produce outbound weekly reports to be FTP’d to Aon Hewitt. 
Customer Solutions 
Unassigned 
9/25/2014 
14R3 
#REF!

18661 
18661 
18661 18661 
IBM 
In-Flight—No WO 
18661 18661—Huntington Beach Phone and Network Port Expansion

Infra 
Unassigned 
Schedule X-1 
X-1-28 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18668 
18668 
18668 18668 
IBM 
In-Flight—No WO 
BTI W O 14- 035 BDNA 
Software Implementati on PID 18668 05-05-2014 
18668 18668—BDNA Software Implementationl

This software is critical to the Currency program as it will enable HN to obtain a complete and accurate catalogue of all software and hardware within our
environments as well as all currency values and manufacturer support statuses (including EOS and EOL dates) that is crucial to identifying, prioritizing, forecasting, and scheduling hardware and software upgrades. If the hard due date is missed, we
will be unable to obtain an accurate forecast for high priority upgrades required for 2014 which will inhibit the Currency team from mitigating the risk of unsupported/obsolete hardware and software still in use within our environment. 
Lights On 
Unassigned 
8/22/2014 
14R3 
6/13/2014 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18683 
18683 
18683 18683 
BPaaS 
Inflight—W O exists 
PID 18683 
HP Quick Test Professional upgrade_W O 
_Ver1.0 
Completed 
18683 18683—HP QTP to HP Unified Functional Test 
The installed version of HP Quick Test
Professional (v11.0) will reach end of mainstream manufacturer support on 9/30/14 and will subsequently be out of compliance with HN Currency standards and will require extended support to be aquired.The proposed solution is to upgrade the
application to HP Unified Functional Testing v12.x 
Lights On 
Unassigned

8/18/2014 
14R3 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18742 
18742 
18742 18742 
IBM 
In-Flight—No WO 
Project complete as of 9/1 
18742 18742—Upgrade MySQL to version 5.6 -Curren 
We are currently running Oracle MySQL
5.1.7.3 in the STG environments and Oracle MySQL 5.1.4.6 in the PRD environments of which both are very old and are sitting in the Sustaining Support tier. With that Sustaining Support tier we basically get access to Oracle online support tools,
upgrade rights, only pre-existing fixes and assistance from technical support experts that generally will inform us to upgrade to the most current level when an issue pops up.The CTO’s recommended solution is to upgrade all MySQL databases to
version 5.6 
Lights On 
Unassigned 
8/29/2014 
14R3 
9/29/2014 
#REF! 
Finance/Corpor ate 
Cynthia T Nguyen 
Active 
Approved 
Single 
18766 
18766 
18766 18766 
BPaaS 
Inflight—W O exists 
18766- 
18766_COG 
_W O_Ver_1. 
5 
18766 18766—OCOE Enhancements – CAP of Dupe Chec 
Multiple issues involving OCOE
surfaced in Dec 2013 and Jan 2014. Duplicate Checks print 
Address Discrepancy due to MR Backlog Inaccurate status of jobs on OCOE portal Duplicate Check issue led
to E&Y Audit. 
Audit recommendation to put additional controls in place

Compliance and Finance wants to see the CAPs implemented asap to close open gaps and avoid recurrence of these issues 
Multiple issues involving OCOE surfaced in Dec 2013 and Jan 2014. Duplicate Checks print

Address Discrepancy due to MR Backlog Inaccurate status of jobs on OCOE portal Duplicate Check issue led to E&Y Audit. 
Audit recommendation to put additional controls in place 
Compliance and Finance wants to see
the CAPs implemented asap to close open gaps and avoid recurrence of these issues 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/17/2014 
14R4 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18773 
18773 
18773 18773 
IBM 
In-Flight—No WO 
18773 18773—W eb Application Firewall (WAF) 
Today, the out of band WAF architecture allows some traffic to occasionally bypass the security controls implemented by the W AF. W e have not had any known incidents as a result
of this architecture, but it is likely only a matter of time until we do. Such an incident could be minor, although there is also the potential for a PHI data breach. This project will greatly reduce that risk. 
Performance Improvements 
Unassigned 
8/18/2014 
14R3 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18774 
18774 
18774 18774 
IBM 
In-Flight—No WO 
18774 18774—Firewall / ACL Hardening 
The Infrastructure Security Domain of the Cyber Security Framework includes a Network / Application Firewall capability. InfoSec identified a high potential negative impact to the
business and a high potnential for loss of PHI related to Network / Application Firewalls. Current Access Control Lists do not adequately shape traffic within Health Net and are not providing the level of granular security required to protect
sensitive information from unauthorized access. Also, there is an ISA finding related to network egress filtering controls. 
Performance Improvements 
Unassigned 
11/17/2014 
14R4 
#REF!

Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18775 
18775 
18775 18775 
IBM 
In-Flight—No WO 
18775 18775—Secure Coding Validation Tool 
The Secure Development Lifecycle Domain of the
Cyber Security Framework includes a Secure Coding Guidelings capability. InfoSec identified this capability as having a critical gap between our current capability and desired capability. InfoSec also identified a high potential for loss of PHI
related to application development efforts not adhering to Secure Coding Guidelines as outlined in the Corporate Information Security Policy section 8. 
Performance
Improvements 
Unassigned 
9/22/2014 
14R3 
#REF!

Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18776 
18776 
18776 18776 
IBM 
In-Flight—No WO 
Initiation Phase, No Work Order 
18776 18776—Enterprise NAC 
The Infrastructure Security Domain of the Cyber Security Framework includes a Network Access Control (NAC) capability. InfoSec identified a critical gap between our current
maturity level and our desired maturity level for this capability. Currently, Health Net runs the risk of unauthorized systems being physically connected to Health Net’s internal network infrastructure. This poses a higher risk of unauthorized
access to sensitive data. 
Performance Improvements 
Unassigned 
9/30/2015 
15R3 
9/30/2015 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18825 
18825 
18825 18825 
Non-BPaaS 
Inflight—W O exists 
18825- 
BTI W O 14- 
18825 18825—Linux RHEL Upgrade to RHEL 6 & BO SP 
The current installed version of the
Linux operating system (OS) RHEL v4 is out of 
Lights On 
Unassigned

11/17/2014 
14R4 
11/17/2014 
Currency compliance. EOL was reached on 3/31/2009. In addition, the Business

Objects application is hosted on servers running the RHEL 4 OS. The current version 
051 RHEL 
of Business Objects (BOXI 3.1 SP4) contains known issues that are addressed in

18825_COG 
_W O_Ver_1. 
and BOXI Upgrade PID 
BOXI 3.1 SP6, however SP6 is incompatible with RHEL v4. The proposed
solution is to upgrade all servers with the RHEL v4 OS installed to RHEL v6 to bring the OS back 
1 
18825 08-29- 
into Currency compliance and then upgrade the Business Objects application to
BOXI 
2014 
3.1 SP6 in order to resolve the known issues with BOXI 3.1 SP4..

#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18827 
18827 
18827 18827 
IBM 
In-Flight—No WO 
N/A—no W O as of yet 
18827 18827—Send AS400, VMS & z- OS Syslogs to th 
This project is to identify a
product for IBM to use to export security data in a standard Syslog format from identified SOX VMS and z/OS systems to the Security Incident Event Management (SIEM) system. The SIEM system is now monitored and managed by the McAfee Security
Operations Center (SOC). 
Performance Improvements 
Unassigned 
12/18/2014 
14R4 
Schedule X-1 
X-1-29 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18828 
18828 
18828 18828 
IBM 
In-Flight—No WO 
N/A—no W O as of yet 
18828 18828—IBM Security Access Manager for Ente 
The Identity & Access Management
Domain of the Cyber Security Framework includes capabilities for Privileged User Management and Access Reporting / Audit. The Information Security team performed an assessement and found these capabilaties to have critical gaps between our current
maturity level and our desired maturity level for these capabilities. InfoSec also identified a high impact to the business, compliance requirements and a high risk of loss of PHI associated with these capabilities.This poses a higher risk of
unauthorized access to sensitive data. 
Performance Improvements 
Unassigned

TBD 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18829 
18829 
18829 18829 
IBM 
In-Flight—No WO 
18829 18829—Secure File Tranfer 
The Infrastructure Security Domain of the Cyber Security
Framework includes capabilities for Transmission Encryption. The Information Security team performed and assessment and found this capability to have compliance requirements and a high risk of loss of PHI associated with the capability. 
Health Net is currently using select non-secure file transfer protocols to move files internally, and externally to approved vendors. Non-secure protocols enable users to exchange
files unencrypted and send username and passwords in clear text. 
Performance Improvements 
Unassigned 
11/17/2014 
14R4 
#REF!

Service Delivery 
Bart Keaney 
Active 
Approved 
Single 
18866 
18866 
18866 18866 
BPaaS 
In-Flight—No WO 
18866 18866—ABS Zip Code_County 
& Address Modifi 
Background: There have been several issues identified with the way address and zip code information is currently stored and processed in ABS. As a result of different projects that
have been implemented in the last couple of years, there is now an urgent need to address these issues as this is resulting in non-Compliance and potential privacy breaches. 
ABS currently has a system limitation that only allows one zip code to be tied to one county. There are multiple scenarios where one zip code is tied to more than one county,
otherwise known as cross-over zips. In ABS, we believe the county with the highest member population is determined to be the defaulted county tied to the one zip code. The issues with this system limitation is there are members loaded in ABS whose
address of record does not reflect the “true” county of residence and therefore can cause multiple issues: 
There are two projects being submitted to
correct the above stated issue. This project brief is to support ABS changes that will have no downstream impact. 
1. Result in erroneous enrollment, erroneous
denial of enrollment or disenrollment. There have been 2-3 CMS Write-Ups in the last 2 years that ties to cross-over zip/county issues. 
2. . Post Enrollment Kit
and ANOC mappings are based on a member’s Group and Residential County. Having the wrong county in ABS could result in erroneous benefit information sent to the member. 
3. Incorrect or missing Bill of Material (BOM) mapping for both ANOC’s & PEK’s result in member records being dumped into the Error Work Basket in the Kit Information
Management system (KIM). These errors then require manual research by multiple teams to correct the problem and possibly re-trigger the PEK or ANOC. This currently causes delays and results in not meeting CMS turn-around guidelines. 
4. Sending incorrect PEK adds additional costs (i.e materials, postage, fullfillment costs, etc.) 
5. Increases Call Center volumes. 
6. Results in additonal group set-ups specific to cross-over
group. Implementing the ability to allow a zip code to have multiple counties will eliminate approximately 120 groups. 
7. Results in the Enrollment Eligibility
team contacting the BAS (Business Analyst Support) team to request a zip code be temporarily opened to add a “cross-over” county to allow the enrollment representative to add the member to a specific group. The issue with this process, is
if an Eligibility representative touches the member’s record in the future, the system will automatically change the county back to the original defaulted county for that zip code. 
In addition, there are several different ABS/Pre-Enrollment address enhancements we are asking to be tied to this project as this will ensure there are no mailing issues in

Confirmed Compliance 
Compliance—Medicare 
Approved by EPCO 
5/18/2015 
15R2 
#REF!

18867 
18867 
18867 18867 
IBM 
In-Flight—No WO 
18867 18867—Modesto Crows Landing Move 
Infra 
14R3

#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18904 
18904 
18904 18904 
BPaaS 
Inflight—W O exists 
18904- 
18904_COG 
_W O_Ver 1.3 
18904 18904—Protect all web services from un-aut 
Today all the internal facing web
services are not protected from an un-authorized access. If an individual knows the WS URL and how to construct a request they can access the WS and get access to all the data it provides. Each of the internal facing 
WS need to protected from un-authorized access. External facing WS are protected by SAML and RSA key exchange but once the partner is inside the network and aware of other internal
WS they can access them. Partners should be restricted to accessing only services they are authorized. 
Lights On 
Unassigned 
Unassigned 
#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Approved 
Parent 
18913 
18913 
18913 18913 
BPaaS 
In-Flight—No WO 
Should be rolled into a New Parent 
18913 18913—Service Maturity—Controls 
As requested by Bart K—related to Infogix

Lights On 
Unassigned 
Unassigned 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
18937 
18937 
18937 18937 
BPaaS 
In-Flight—No WO 
Pending BTI WO 
9/8 IBM/AT&T made additional changes to the TSD 
18937 18937—CA MediConnect PPC HELP Call Center 
he Public Programs Call Center’s
current infrastrucutre and staffing is not a scalable model, yet it is expected to take on a significant increase nearly double in expected call volum over the next two years as the Cal MediConnect and Coordinated Care Initiative Programs kick off
in April 2014. 
If the Public Programs Call Center’s 800 number is not converted into a standard call center functional model with the ability to manage
workflow, hold times, tracking and reporting; Health Net is at risk for non-complinace, financial shortfall, and sub par customer service. 
Project Effort approved
by Solution Board on 05/22/2014—Confirm w/ Jeff Holmes 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
8/18/2014 
14R3 
Schedule X-1 
X-1-30 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Lisa W olf 
Active 
Approved 
Single 
18977 
18977 
18977 18977 
IBM 
In-Flight—No WO 
This is a place holder PID for work done outside the project process, no
PM or Alfresco folder. Infor on BTI provided by Karen Correa 
18977 18977—RFS 09-040-BO and 
Informatica Augmen 
Placeholder created for IBM Time Reporting only 
Lights On 
Unassigned 
15R4 
#REF!

Strategic Program 
Bart Keaney 
Active 
Approved 
Single 
18978 
18978 
18978 18978 
BPaaS 
Inflight—W O exists 
WO# 1197- AMES AEP 
Readiness 
18978 18978—AMES Compliance Bundle 
The AMES tool requires 5 enhancements to remain
compliant for 2015 AEP 
The MEs process is not an efficient means of coordinating or accomplishing the work in a timely manner 
Confirmed Compliance 
Unassigned 
9/25/2014 
14R3 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
18986 
18986 
18986 18986 
BPaaS 
Inflight—W O exists 
18986- 
18986_COG 
_W O_Ver_1. 
1 
18986 18986—AHCCCS APR-DRG 
Supporting Efforts 
Current AHCCCS hospital inpatient reimbursement is based off a tiered per
diem methodology and fee schedule as required by Arizona law. 
Effective October 1, 2014, AHCCCS will transition from the tiered per diem inpatient reimbursement
system to an APR-DRG payment system, enhancing quality of member care and promoting efficient delivery of services. 
AHCCCS selected 3M’s All Patient Refined
(APR) DRG model with AZ state specific add-ons and adjustments. 
Confirmed Compliance 
Compliance—Medicare 
Approved by EPCO 
10/20/2014 
14R3 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
18987 
18987 
18987 18987 
IBM 
In-Flight—No WO 
N/A—no W O as of yet 
18987 18987—RRS Application Re- hosting 
RRS is the Retrospective Review System used by
CQM to review DRG and other claims 
The HNFS RRS application is currently hosted on TNEX servers running under Solaris 9. The TNEX hardware is obsolete and no
longer supported. This project will re-host the RRS application on Solaris branded zones and decommission the existing TNEX server hardware. 
Re-host the RRS
application on Solaris branded zones running under Solaris 9 and decommission the legacy TNEX systems 
The RRS application is currently hosted on the following TNEX
systems: 
Environment Server 
Development TNEX-DEVDB1 Test TNEX-TSTDB2

Production TNEX-PRDDB2 
REHOST RRS APPLICATION: 
1. IBM to identify existing servers or procure and install new hardware to serve as 
Lights On

Unassigned 
8/18/2014 
14R3 
#REF!

Service Delivery 
Bart Keaney 
Active 
Approved 
Child 
19005 
17341 
19005 17341 
BPaaS 
Inflight—W O exists 
WO_1203_1 9005_17341_ 
HN_Medicare 
_AEP_2015 V1.2 
WO# 1212—   
HN Medicare AEP 2015 
19005 17341—Medicare AEP 2015—Web and AMES 
Medicare Annual Enrollment consists of numerous components that must take place as part of a process that spans the period of May through December. In the past these efforts have
been grouped together loosely as a ‘program’ managed by a single project manager with oversight of a number of groupings of smaller efforts that have mostly been submitted as minor enhancements. This brief requests that the AEP oversight
structure be established to have management and oversight of the systems and production process changes and efforts needed to address Medicare Products and operational needs for the 2015 AEP period. It also requests that web oriented changes, which
have some of the longest lead time needs, be identified, assessed, and scheduled for work by the W COE and web production support teams as applicable. 
The brief
also specifically calls for the activities on the part of teams to perform the system modifications needed for fulfilling the product groups efforts for product expansions as defined in the detailed section, for work pertaining to the seasonal (AEP
season) production of Directories, ID Cards, and Letters which regularly change based on Health Net and CMS requirements. 
Some of the need for this project if all
inclusive is driven by compliance requirements, but most portions are driven by HN business need. As such this will not be submitted as a compliance effort. 
Lights
On 
Unassigned 
9/25/2014 
14R3 
Schedule X-1 
X-1-31 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Unassigned 
Bart Keaney 
Active 
Approved 
Parent 
19005 
19005 
19005 19005 
BPaaS 
Inflight—W O exists 
19005-19005 
& 19009- 19009 COG_W O_V 
er 1.1 
19005 19005—Medicare Open Enrollment (AEP) 2015 
Medicare Annual Enrollment consists of
numerous components that must take place as part of a process that spans the period of May through December. In the past these efforts have been grouped together loosely as a ‘program’ managed by a single project manager with oversight of
a number of groupings of smaller efforts that have mostly been submitted as minor enhancements. This brief requests that the AEP oversight structure be established to have management and oversight of the systems and production process changes and
efforts needed to address Medicare Products and operational needs for the 2015 AEP period. It also requests that web oriented changes, which have some of the longest lead time needs, be identified, assessed, and scheduled for work by the W COE and
web production support teams as applicable. 
The brief also specifically calls for the activities on the part of teams to perform the system modifications needed
for fulfilling the product groups efforts for product expansions as defined in the detailed section, for work pertaining to the seasonal (AEP season) production of Directories, ID Cards, and Letters which regularly change based on Health Net and CMS
requirements. 
Some of the need for this project if all inclusive is driven by compliance requirements, but most portions are driven by HN business need. As such
this will not be submitted as a compliance effort. 
Lights On 
Unassigned

9/22/2014 
14R3 
#REF! 
Gov’t Programs Operations 
Bart Keaney 
Active 
Approved 
Child 
19009 
17339 
19009 17339 
BPaaS 
Inflight—W O exists 
WO_1210_1 9009- 
17339_W CO 
E_Commerci al_Open_Enr ollment_V1.5 
WO_1210_1 9009- 
17339_W CO 
E_Commerci al_Open_Enr ollment_CR_ 1 V1.0.doc 
19009 17339—Comm’l Open Enrollment
2015—W eb 
Requesting a project manager to be assigned to oversee the annual Open Enrollment coordination for W estern Region Commercial Membership 
Lights On 
Unassigned 
10/23/2014 
14R4 
#REF! 
Service Delivery 
Bart Keaney 
Active 
Approved 
Parent 
19009 
19009 
19009 19009 
BPaaS 
Inflight—W O exists 
19005-19005 
& 19009- 19009 COG_W O_V 
er 1.1 
19009 19009—Commercial Open Enrollment 2015 
Requesting a project manager to be assigned
to oversee the annual Open Enrollment coordination for W estern Region Commercial Membership 
Lights On 
Unassigned 
11/17/2014 
14R4 
#REF!

Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19043 
19043 
19043 19043 
BPaaS 
Inflight—W O exists 
19043 19043—2015 CMS Call Letter Changes – ER-UC 
Claims/Accumulators System Logic
& Benefit Configuration 
BRCC (Ben Configuration) needs to allow configuration of the member cost share (co- pay / coinsurance) to accrue toward the plan Annual
Deductible Limit. 
Modification to current Claims system logic to acknowledge the new rule, which has a major impact to accumulator functionality. 
Accumulator System Impacts: Reporting: Over-Applied Report 
Transactions: 270/271 –
Remaining Deductible Screens: OMNI and W eb (currently disabled 
Confirmed Compliance 
Unassigned 
Approved by EPCO 
11/17/2014 
15R1 
#REF! 
Service Delivery 
Bart Keaney 
Active 
Approved 
Single 
19050 
19050 
19050 19050 
BPaaS 
Inflight—W O exists 
19050- 
19050_COG 
_W O_V 1.0 
19050 19050—Health Data Insights (HDI) Implement 
Health Net contracted with Health Data
Insights (HDI) to do audits on our Medicare members. HDI is a RAC auditor for Medicare and will perform audits to Medicare billing standards on our Medicare inpatient and outpatient claims, including reviewing appropriateness of setting and DRG. W e
are requiring HDI’s services to reduce our expenditures and implement cost savings. 
Operations Strategy 
Unassigned 
8/18/2014 
14R3 
#REF!

Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19060 
19060 
19060 19060 
BPaaS 
In-Flight—No WO 
19060 19060—Application Quality and Security Imp 
Establish a continuous improvement
program around people, process and technology for Application Services to increase productivity, improve quality and tighten security to deliver best in class software solutions for Health Net, on time and budget 
Lights On 
Unassigned 
Unassigned 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
19063 
19063 
19063 19063 
IBM 
In-Flight—No WO 
IBM TSD in progress due 09/22; no work orders yet. 
19063 19063—Load Runner Upgrade

Solution—HP has rebranded LoadRunner as Performance Center (PC) We upgraded to global access licenses in July 2013 
New architecture is client-server and requires virtual servers Procure 5 virtual machines and decommission 4 physical machines 
Install upgrade on 3 controller machines, and 2 licensing machines to support both HNFS and commercial 
Pending InfoSec analysis and approval, we may be able to combine the 2 licensing machines

Lights On 
Unassigned 
2/23/2015 
15R1 
#REF! 
Health Care Delivery 
Catherine Raneri 
Active 
Approved 
Single 
19108 
19108 
19108 19108 
BPaaS 
Inflight—W O exists 
19108— 
19108_COG 
_W O Ver 1.0 
19108 19108—Raytheon—Caremark Cross-Accumulati 
Raytheon has a direct contract
relationship with CVS Caremark 
Does not obtain their RX benefits through the HN/Caremark relationship 
HN receives the eligibility file for medical benefits only and does not send any eligibility file to Caremark on behalf of Raytheon 
Caremark receives the eligibility file for RX benefits only 
Performance Improvements

Unassigned 
11/17/2014 
14R4 
Schedule X-1 
X-1-32 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type 
Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19152 
19152 
19152 19152 
IBM 
In-Flight—No WO 
19152 19152—200 additional Citrix Accesses 
We need to be able to increase by the 200 available Citrix logins user accounts along with all the application that CSRs use to support our members as we enter into Open Enrollment
for our next ACA enrollment year. 
Lights On 
Unassigned 
Unassigned 
#REF! 
Business Development 
David Kosterman 
Active 
Approved 
Single 
19179 
19179 
19179 19179 
BPaaS 
Inflight—W O exists 
WO# 1209- 51-100 
Rating 
19179 19179—51-100 Rating 
This project is to build the 51—100 capability for new
sales and renewals through the vendor Connecture. Connecture currently supports the SBG new sales and renewal quoting engine on the Connecture platform. Currently Health Net does not have a solution that can quickly turnaround quotes for groups of
this size. Health Net will need a solution to support this segment in addition to the Health Care reform requirement increasing size of SBG groups from size from 2 -50 to 2—100 lives. 
Customer Solutions 
Unassigned 
8/18/2014 
14R3 
#REF! 
Service Delivery 
Bart Keaney 
Active 
Approved 
Single 
19214 
19214 
19214 19214 
BPaaS 
In-Flight—No WO 
19214 19214—ABS SNF Quick Pay Discount 
Need the ability for the systen to exclude AZ AHCCCS Skilled Nursing Facility claims from quick pay discount. Validations performed for discount percentage for Inpatient, and
outpatient institutional claims, should exclude SNF institutional claims, when the claim is paid earlier then 30 AHCCCS turned around time. 
Confirmed Compliance

#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19220 
19220 
19220 19220 
BPaaS 
In-Flight—No WO 
19220 19220—Interest for Commercial Lines of Bus 
ABS is unable to apply, differ product by ( % and date) provider TIN. W hen calculating interest new provider contracts have been negotiated to apply rules different than what is
regulator. W e currently only have the ability to apply par vs. non par by regulator. 
Confirmed Compliance 
#REF! 
EPCO

Bart Keaney 
Active 
Approved 
Single 
19226 
19226 
19226 19226 
BPaaS 
In-Flight—No WO 
19226 19226—Med 226 CY 2015 Final Rule Broke 
Currently, Health Net utilizes a ‘fast pay’ process whereby broker commission payments are sent shortly after receipt of the enrollment application year-round. Per the
CY2015 Final Rule, CMS has changed the timing of payments during the Annual Enrollment Period (AEP), which requires that payments may not be made until January 1 of the enrollment year and must be paid in full by December 31 of the enrollment year.
This will reduce the number of payments that need to be recouped based on changes made during AEP. 
Currently, the guidance regarding renewals is that the renewal
payment equal 50% of the Fair Market Value (FMV) for the year the member enrolled in the plan. Beginning in 2015, CMS has changed it to where the renewal payment is up to 50% of the FMV for the current enrollment year. 
MA organizations and Part D sponsors may decide the duration of their contract with agents, number of applicable renewals, and the actual rate for renewals for each year, subject
to the limits in this final rule. 
Confirmed Compliance 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
19227 
19227 
19227 19227 
IBM 
In-Flight—No WO 
19227 19227—Expand EIRT Intake, Tracking, Case M 
Each Enterprise Incident Response (EIR)
Core Team has specific requirements and timelines that their intake processes must meet. In order to make intake as efficient as possible, a central point of intake that can meet all of these requirements should be established. This central point of
intake needs to be highly configurable in order to meet the unique demands of the various EIR Core Teams while introducing little to no delay in the reporting process. Any tool or capability must also provide several key features for incident
tracking, correlation and reporting. A central intake point or process will not eliminate incident reporting through other channels, such as direct phone calls or email, so the process must also be able to handle intake exceptions. 
Performance Improvements 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
19228 
19228 
19228 19228 
IBM 
In-Flight—No WO 
19228 19228—Replace Vulnerability Scanning Techn 
Health Net’s current vulnerabiltiy
scanning solution has several technical limitations that are not able to be addressed by enhancing/upgrading the existing product/solution. The current vulnerability scanning tool has the following limitations: 
has an out of date vulnerability database, unable to scan for the latest threats. 
is unable to
run DOD Security Technical Implementation Guide (STIG) and Center for Internet Security (CIS) compliance scans for configuration management across the environment.

it’s reporting capabilities require a considerable amount of manual effort. 
it’s Asset Scan Lists require a considerable amount of manual effort to reflect an accurate system inventory to scan. 
it’s current solution does not provide for a useable policy compliance, web application scanning, and database scanning. 
Therefore, this project is to implement a new vulnerability scanning tool to address these limitations. 
Performance Improvements 
#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Not Approved 
Single 
19231 
19231 
19231 19231 
BPaaS 
In-Flight—No WO 
19231 19231—Chiropractic, Acupucture Auto Adjudi 
Currently Auto Adjudication is denying
and/or paying Chiro, Acupancture when claims need to be forwarded to ASH for processing or to be denied for non covered beneift. 
Confirmed Compliance 
#REF! 
Infrastructure 
Bart Keaney 
Active 
Approved 
Single 
19236 
19236 
19236 19236 
IBM 
In-Flight—No WO 
19236 19236—Patch Enterprise Desktops 
Health Net currently has a backlog of missing patches. These missing patches are to be applied to the entire Enterprise Desktop environment. Deploying software patches (or updates)
is essential to securing business critical systems, protecting sensitive company information, meeting government compliance and security best paractices. Secuirty updates from vendors for workstations must be prioritized for testing and deployment
in order to achieve a secure enterprise. 
Lights On 
Schedule X-1 
X-1-33 
Health Net / Cognizant Confidential 

	
	

  

 Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19272 
19272 
19272 19272 
BPaaS 
Inflight—W O exists 
19272- 
19272_COG 
_W O_Ver_1 0 
19272 19272—AZ AHCCCS Duplicate Vendor Claims 
The current process translates 837 files from our vendors into Health Net’s generic file format and loads them into ODW. Claims are identified by unique claim IDs. The
frequency code from the inbound 837 file is not currently used as part of the criteria that identifies the claim as an original, a replacement of a prior claim, or a cancel of a prior claim. W hen a claim is submitted as a replacement or void, these
claims are view as duplicates and are not accepted. 
Vendor adjusted or voided claims are not being extracted and submitted timely to AHCCCS resulting in
noncompliancy. 
Confirmed Compliance 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19308 
19308 
19308 19308 
BPaaS 
Inflight—W O exists 
19308- 
19308_COG 
_W O_Ver_1 0 
19308 19308—AHCCCS CA CIS2.b 
RA backer 
AHCCCS CAP CIS2.b was identified this deficiency during the CYE 2014 audit. The
claim remittance advise backer does not meet the state requirements. Backer needs to revision to provider clearer communication regarding provider rights for claim disputes and instructions on submitting claim disputes and corrected claims.

Confirmed Compliance 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19309 
19309 
19309 19309 
BPaaS 
Inflight—W O exists 
19309- 
19309_COG 
_W O_Ver_1. 
0 
19309 19309—AHCCCS CA CIS2.a 
Interest 
AHCCCS CAP CIS2.a was identified this deficinecy during the CYE 2014 audit. The claim remittance advise does not reflect the correct billed amount.The remittance advise total
includes the interest paid amount in the billed amount field. AHCCCS is expecting HN to display the accurate amount billed, accurate amount paid for all claim lines.

Confirmed Compliance 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19310 
19310 
19310 19310 
BPaaS 
In-Flight—No WO 
19310 19310—AHCCCS CIS.2c 
service line pricing 
AHCCCS CAP CIS2.c was identified this deficinecy during the CYE 2014 audit. ABS prorates the allowed amount entered into the contract selection prompt for each of the line items
and does not keep the actual accurate pricing per line. The claim system needs the ability to capture the actual amounts for each line item when applying the contract 
Confirmed Compliance 
#REF! 
Gov’t Specialty Services 
Robert E Oetken Jr 
Active 
Approved 
Single 
19311 
19311 
19311 19311 
BPaaS 
Inflight—W O exists 
19311- 
19311_COG 
_W O_Ver_1 0 
19311 19311—AHCCCS CA CIS4 
COB edits 
AHCCCS CAP CIS4.—was identified as a deficiency during the CYE 2014 audit. The
ABS claim adjudication system needs to be modified to include prompts and edit like logic to verify Primary insurance coverage. The Contractor must have claim payment system edits that look for primary insurance coverage based on AHCCCS supplied TPL
information, and must edit for primary insurance coverage when the claim contains a primary payment amount and is accompanied by an EOB but no segment of TPL is in the member file. 
Confirmed Compliance 
#REF! 
EPCO 
Bart Keaney 
Active 
Approved 
Single 
19316 
19316 
19316 19316 
BPaaS 
In-Flight—No WO 
19316 19316—Member Rights 
SB 138 clarifies requirement of Member’s rights, relative
to their Information effective 1/1/2015. 
These requirements are hinged on two primary concepts 
The Right to Separation of Medical Information. This ruling ensures a Member is not restricted or limited to receiving pertinent information, based on the Primary Subscriber’s
delivery address and preferences. 
The Right to Confidential Communications. This ruling ensures a Member confidentiality may be protected from anyone, including
the Primary Subscriber 
Confirmed Compliance 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19318 
19318 
19318 19318 
BPaaS 
In-Flight—No WO 
19318 19318—Medicare Sales Inside Contact Center 
The Medicare Inside Sales Call/Contact
Center is moving to a new vendor as current vendor cannot maintain satisfactory levels of service and the relationship with them is being terminated effective 09/30/2014. The actual infrastructure / connectivity transition is being supported through
PID 19103—Inside Sales—IVR-Service Provider Needs to move the responsibilities to a new service provider—Optum—requiring Health Net to transition support services; 
Contact Center Call Recording Data is required to be both captured and retained by Health Net to be compliant with CMS (Medicare) regulations requiring that data be retained for a
minimum of 10 years; 
Call recordings are used to respond to sales allegations of misconduct and misrepresentation. W ithout the recordings, responses will not be
possible. 
Call recordings are used for Quality Assurance purposes, and monthly and quarterly internal audits. 
Former Service Provider has 4+ years of recorded call data that needs to be moved back to Health Net at the end of the current contract period. Data needs to be securely
transferred back to Health Net and stored on an appropriate storage type, some of which needs to be readily accessible in order to respond to requests for content verification, responding to CTMs or complaints through CMS, or independent
verification and audits 
Confirmed Compliance 
#REF! 
Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19344 
19344 
19344 19344 
IBM 
In-Flight—No WO 
19344 19344—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Commercial Infrastructure servers to W indows server
2008 R2 which is currently supported until 1/14/2020. 
Lights On 
#REF!

Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19345 
19345 
19345 19345 
IBM 
In-Flight—No WO 
19345 19345—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Commercial Blended environments (Physical and
Virtual) application servers to W indows server 2008 R2 which is currently supported until 1/14/2020. 
Lights On 
Final 
Schedule X-1 
X-1-34 
Health Net / Cognizant Confidential 

	
	

  

 Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19346 
19346 
19346 19346 
IBM 
In-Flight—No WO 
19346 19346—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Commercial Physical application servers to W indows
server 2008 R2 which is currently supported until 1/14/2020. 
Lights On 
#REF!

Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19347 
19347 
19347 19347 
IBM 
In-Flight—No WO 
19347 19347—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Commercial virtual application servers to W indows
server 2008 R2 which is currently supported until 1/14/2020. 
Lights On 
#REF!

Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19348 
19348 
19348 19348 
IBM 
In-Flight—No WO 
19348 19348—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Federal Services Infrastructure servers to Windows
server 2008 R2 which is currently supported until 1/14/2020. 
Lights On 
#REF!

Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19349 
19349 
19349 19349 
IBM 
In-Flight—No WO 
19349 19349—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will
become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by having applications critical to business units day to day operations hosted on servers running an
obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed solution is to upgrade the W indows Server 2003 Federal Services physical application servers to W
indows server 2008 R2 which is currently supported until 1/14/2020. 
Lights On

#REF! 
Infrastructure 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19350 
19350 
19350 19350 
IBM 
In-Flight—No WO 
19350 19350—Upgrade W indows Server 2003 to W indo 
The W indows Server 2003 OS will become obsolete (No additional security patches or support provided from Microsoft) on 7/14/14.This poses a risk to the Healthnet environment by
having applications critical to business units day to day operations hosted on servers running an obsolete operating system with a high risk of security vulnerabilities if not mitigated prior to the end of extended support (7/14/15). The proposed
solution is to upgrade the W indows 2003 Federal Services virtual application servers to W indows server 2008 R2 which is currently supported until 1/14/2020.

Lights On 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19353 
19353 
19353 19353 
BPaaS 
In-Flight—No WO 
19353 19353—AHCCCS Membership Retention (Churn L 
Churn Letters – Transition Of Care
Category: 
AHCCCS requires plans to provide members a reminder message to renew Medicaid eligibility. A renewal letter will be sent to members 60 days prior to
their renewal date as indicated and transmitted by AHCCCS. The message will direct members to resources for renewing eligibility. The business intent of this reminder is to increase member retention, enhance revenue outcomes and minimize lapses in
medical management. 
Confirmed Compliance 
#REF! 
Gov’t Programs Operations 
Robert E Oetken Jr 
Active 
Approved 
Single 
19368 
19368 
19368 19368 
BPaaS 
Inflight—W O exists 
19368- 
19368_COG 
_W O_Ver_1 0 
19368 19368—AHCCCS CA CIS2.b 
SNF slow pay discou 
AHCCCS CAP CIS2.d was identified this deficiency during the CYE 2014
audit. The claim interest calculation is including SNFs, alternative residential setting, and home and communicty based providers when billed on a UB form with the hospital day and % rules. In these cases, the day rule should be 30 calendar days
instead of the 60 calendar days. System needs to be enhanced to correctly pay interest for these types. 
Confirmed Compliance 
#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19374 
19374 
19374 19374 
BPaaS 
In-Flight—No WO 
19374 19374—Adjustment reason code expansion 
Currently the adjustment reason code table is limited up to 359 codes. We are unable to request anymore adjustment reason codes untill the table is expanded 
Lights On 
#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Not Approved 
Single 
19377 
19377 
19377 19377 
BPaaS 
In-Flight—No WO 
19377 19377—BRCC Accum Validation 
The BRCC system does not currently have validation in
place to prevent the user from configuring accum scenarios that are problematic for claim adjudication. 
Performance Improvements 
#REF! 
Health Care Delivery 
Joseph Cook 
Active 
Approved 
Single 
16827 
16827 
16827 16827 
BPaaS 
In-Flight—No WO 
Work will be in progress at transition 
16827 16827—Pega MARS Security Enhancements 
This effort is intended to close security
gaps that went along with the implementation of the phase 1 of the Pega MARS implementation that whie not supported as a compliance effort in the oopinion of the EPCO, do present issues with associates using self governance and process work arounds
to ensure that we are not violating HIPAA guidelines and accessing member and other sensitive information inappropriately. 
Med Mgmt raised concern post
implementation of Phase I Pega MARS project due to the security role differences between Unity and Pega MARS. This critical project will correct those gaps and will align the security control points between the two applications. 
Prioritized List of Security Gaps : 
1. No common control point for controlling access requests
between Unity and Pega MARS 
2. Pega MARS role assignments are not aligned with Unity access rights 3. No centralized control point for maintaining staff
assignments 
4. No consistency for viewing restricted membership 
5. No
restriction for viewing membership information based on region 6. Denial reasons need to be restricted by user role 
7. Regional view to drop-down lists in Unity
but not in Pega MARS 
Lights On 
Unassigned 
2/23/2015 
15R1 
Final 
Schedule X-1 
X-1-35 
Health Net / Cognizant Confidential 

	
	

  

 Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
Service Delivery 
David Kosterman 
Active 
Approved 
Single 
18117 
18117 
18117 18117 
BPaaS 
In-Flight—No WO 
Work will be in progress at transition 
18117 18117—MR Dual Coverage Exceptions

Members with current eligibility that had dual coverage prior to the implementation of the MR (Membership Repository) are falling on to the MR error report because
the report cannot determine the correct eligibility timeline. This is due to the dual coverage restriction on the MR. 
The majority of the errors on the report are
old (prior to 2005) and Memberhip cannot process using the existing manual workaround due to downstream impacts to billing, correspondence etc. 
Confirmed
Compliance 
Compliance—SOX Audit 
Matthew Ciganek 
Unassigned 
#REF! 
Health Care Delivery 
Joseph Cook 
Active 
Approved 
Single 
19182 
19182 
19182 19182 
Non-BPaaS 
In-Flight—No WO 
19182 19182—CDS Reporting—Archive Old Data 
9-years worth of inception to date
Authorization data is being copied from Unity to ODW & CDS nightly. 
Processing time has grown commensurate with the amount of data, to the point where the
nightly window is commonly exceeded and / or the jobs fail finish. 
This impacts other processing windows or results in incomplete data loads and lack of timely
access to data, ultimately increasing cost and negatively impacting member access to care / customer experience 
Lights On 
Unassigned 
Unassigned 
#REF! 
Service Delivery 
Bart Keaney 
Intake in Progress 
Approved 
Single 
19243 
19243 
19243 19243 
BPaaS 
In-Flight—No WO 
Work will be in progress at transition 
19243 19243—Medicare Benefits Based on “Benefit 
The Medicare plans currently require
that we administer the IP facility and Skilled Nursing visit limitations and copayments based on “Benefit Period”. The Benefit Period begins on the first day a member is admitted to Medicare covered inpatient hospital or Skilled nursing
facility. The benefit period ends when the member hasn’t been inpatient at a hospital or skilled nursing facility for 60 consecutive days. The current method of administration is to manually change the admission date on the claim. This is a
data integrity issue and is problematic for many areas. 
1. Claims are being rejected by Medicare optum reporitng. The modified admission date represents the claims
as an interim billing when it is not. 
2. Viant is rejecting these claims since they are unable to price without the correct admission date and dropping for manual
adjudication. 
Lights On 
#REF! 
Service Delivery 
David Kosterman 
Active 
Approved 
Single 
19312 
19312 
19312 19312 
Non-BPaaS 
In-Flight—No WO 
Work will be in progress at transition 
19312 19312—Small Group 2-100 
Effective with 1/1/16 sales/renewals, the Affordable Care Act redefines small group to change from 2-50 to 2-100 employee sized groups. Neither the current 2-50 nor the 51-100
systems can be updated nor expanded to comply with this change. This is a re- do of process and supporting technology for the 2-100 small group segment of 2016

Performance Improvements 
#REF! 
Health Care Delivery 
Joseph Cook 
Intake in Progress 
Approved 
Single 
19352 
19352 
19352 19352 
BPaaS 
In-Flight—No WO 
Work will be in progress at transition 
19352 19352—ABS Medi-Cal Outpatient Facility Cla

The intent of this project is to achieve savings on Medi-Cal outpatient facility claims through an automated program that detects and subsequently corrects or
denies aberrant coding. To accomplish this, it will be necessary to make ABS programming changes to start sending Medi-Cal outpatient facility claims and ASC claims to iHealth and accept them back into ABS to apply iHealth recommendations. This is a
new file extract process that needs to be built in ABS and should follow the existing CA process. The project is dependent on the Qcare migration project on ABS (Scheduled for 04/01/15 Implementation). The file extract from HN to iHT implies for
both daily and history files. 
Operations Strategy 
#REF! 
Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
14766 
12245 14766 
Non-BPaaS : No W ork 
In-Flight—No WO 
Already in process—Business Only 
12245 14766—ICD-10 Training TRACK 
The scope of the training project is: 
¿ To provide Health Net employees with knowledge
about: 
o the difference between ICD-9 and ICD-10 code set and the impact the move will have on Health Net¿s business operations 
o the impact of the ICD-9 to ICD-10 code change across different business functions to ensure they can properly conduct work activities 
The training strategy/approach will be divided into 4 levels based on the needs of the employee:

Level-0: Awareness 
¿ Objective : Basic awareness about ICD-10 and
organization readiness 
¿ Training Mode: W eb-based methods. (e-learning and internal newsletters) 
¿ Duration : 2 hours on ICD-10 orientation Level-1: Familiarity 
¿ Objective :
Basic orientation about ICD-10 and differences between ICD-9 and ICD- 10 
¿ Training Mode : Web-based methods, e-learning, internal newsletters and on-going
communication 
¿ Duration: 6-10 hours across the entire implementation period Level-2: Expert 
¿ Objective: Understanding of ICD-10 from both a crosswalk and direct utilization perspective. Impact analysis of ICD-10 on Health net’s policies, workflow, procedural
documentation and business processes. 
¿ Training mode : Classroom sessions, ¿train-the-trainer¿ (the trainers would be trained initially by an
ICD-10 expert) 
¿ Duration: Completion and participation in Level-1 training plus an additional 20 hours of training 
Level-3: Super User 
¿ Objective: Detailed training program along with certification
from an accrediting body (AHIMA, AAPC) 
¿ Training mode: classroom sessions with prerequisites completed 
¿ Duration: 3 days classroom sessions with external certification and completion of Level 2 training 
Confirmed Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
11/17/2014 
14R4 
#REF!

Health Care Delivery 
Robert E Oetken Jr 
Active 
Approved 
Child 
12245 
15080 
12245 15080 
Non-BPaaS : No W ork 
In-Flight—No WO 
Already in process—Business Only 
12245 15080—Customer Service Policies &
Procedur 
The intent of this project is to analyze the existing Customer Service policies in Health Net and identify the ones that use ICD-9 codes. Those policies
that contain specific ICD-9 Diagnosis and/or Procedure Codes would be remediated to include the appropriate ICD-10 Diagnosis and/or Procedure Codes. 
Confirmed
Compliance 
Compliance—HIPAA: ICD10 
Joel Seguin 
8/30/2014 
14R3 
Final 
Schedule X-1 
X-1-36 
Health Net / Cognizant Confidential 

	
	

  

 Ref # 
TIER II 
Governance 
IT Solutions Director / Manager 
Project Intake Status 
Project Approval Status 
PID 
Type

Base PID 
Project ID 
BID PID 
CTS Sub Category 
CTS 
Disposition 
HN Disposition 
CTS AO WO Name 
CTS INC WO 
Name 
IBM BTI, PCR 
Project 
Work Description 
Strategic Impact 
Compliance Legislative Category 
Compliance Representative 
Implementation Date 
Governance Selected Release 
Infrastructure Last Release 
#REF! 
PPMO 
Bart Keaney 
Active 
Approved 
Child 
16555 
17249 
16555 17249 
BPaaS 
Inflight—W O exists 
To Be Done Prior to Phase II start 
16555 17249—Accumulator Modernization Phase III

The program will enable modernization of the ABS platform through automation

of business processes and upgrades of technology. 
Customer Solutions

Unassigned 
2/16/2015 
15R1 
#REF!

Finance/Corpor ate 
Cynthia T Nguyen 
Active 
Conditional Approval 
Single 
18288 
18288 
18288 18288 
BPaaS 
Inflight—W O exists 
To Be Done Prior to Phase II start 
18288 18288—Check Printing—Compliance with ANS

Industry standards for check processing have been upgraded. Banks now 
check
the location and size of the convience amount and the MICR line 
before checks are approved for production. The location of the convenience 
amount is now specifically prescribed. Health Net checks do not meet the 
current standard.
Health Net produces 2 million checks annually. W hen checks 
do not meet MICR standards, the bank charges an extra fee to process — as much as $3 per item. The
potential cost of non-compliant checks is large. 
Checks produced by all Health Net systems should meet all the ANSI standards. All Health Net checks should meet
the standard including Claims, Accounts Payable and Payroll. 
Lights On

Unassigned 
2/23/2015 
15R1 
Final

Schedule X-1 
X-1-37 
Health Net / Cognizant Confidential 

 Final 

SCHEDULE X-2 
 ACCELERATED
PROJECT LIST 

  

					
	Schedule X-2		X-2-1		Health Net / Cognizant Confidential

 Final 

													
	 Project
	  	 Description
	  	 Project ID
	  	 Work Order
	  	 Implementation
	  	Priority	 
	 IO Sliver
	  	Foundational build up of new data center and transition of initial key services to Cognizant.	  	19438 19438	  	WO_1216_19438_19438_IO_Sliver_V1.4	  	3/1/2016	  	 	1	  
						
	 Password Vault* IMS Project
	  	New Password Vault for security of user access to Health Net systems. Improvements to Identity and Access Management System (IMS) to support Information Security	  	19440 19440	  	 WO_1219_19440_19440_IMS_PUM_Imp

lementation_V1.0
	  	12/1/2015	  	 	2	  
						
	MHN to ABS [Excludes MHN-Unity Migration]*	  	Migration of Health Net’s MHN business to ABS	  	19388 19388	  	19388-19388_MHN to ABS Migration WO_V1.0	  	3/1/2016	  	 	3	  
						
	 VOIP
	  	Replacement of Health Net’s existing analog phones with voice over IP phones	  	19441 19441	  	WO_1217_19441_19441_VOIP_V1.3	  	7/1/2015	  	 	4	  
						
	 IST, FARE, GENELCO, ACRS and ECRS Migration*
	  	Replatform of IST, FARE, Genelco, ACRS and ECRS in support of retiring the z-series platform	  	 19432 19432
 19436 19436

19437 19437
	  	19432-19432_IST_Migration_COG_WO_V2.0 .docx 19436-19436_FARE_Migration_COG_WO_V2.0 .docx
19437-19437_Genelco_Migration_COG_WO_V1 .0.docx	  	7/1/2016	  	 	5	  
						
	 Provider Directory*
	  	Modernization of provider directories for improved accuracy and efficiency	  	19443 19443	  	19443_19443_PRV_Dir_COG_WO_V1.4	  	3/1/2016	  	 	6	  
						
	 iSeries & zSeries Data Archival & Retrieval*
	  	Archival of data from various applications on the i-series (excluding MC400 already in process) and z-series to a data storage system available for reporting and inquiry	  	19386 19386	  	19386–19386_IZ_Series Archive_COG_WO_V1.1 XXXXX–XXXXX_Z_Series Archive_COG_WO_V1.1	  	12/31/2016	  	 	7	  
						
	 RMC tool improvements*
	  	Enhancement to the existing RMC tool through alteration of the user questions and interface. Additional changes to user access and security are also in scope.	  	12803 17190	  	12803-17190_RMC_Modernization_Phase_2_W O_V1.3	  	3/1/2016	  	 	8	  
						
	 Imaging and Workflow Modernization
	  	Modernization of the current imaging and workflow performed through Macess with a to be determined replacement product or other solution as agreed to by Health Net and Cognizant.	  	TBD	  	TBD	  	1/1/2017	  	 	9	  
						
	 ACD/IVR
	  	Replacement of Health Net’s existing contact center phone infrastructure with a modernized and enhanced solution that will deliver operating efficiencies.	  	TBD	  	TBD	  		  			

  

					
	Schedule X-2	  	X-2-2	  	Health Net / Cognizant Confidential

 Final 

SCHEDULE Y 
 OFFSHORE
PROHIBITIONS AND REQUIREMENTS 

  

					
	Schedule Y		 		Health Net / Cognizant Confidential

 Final 

SCHEDULE Y 
 OFFSHORE
PROHIBITIONS AND REQUIREMENTS 
  

	1.	GENERAL 

  

	 	(a)	This Schedule Y (Offshore Prohibitions and Requirements) contains prohibitions and requirements regarding the provision of Services from Offshore which are in addition to those provisions set forth elsewhere in
the Agreement, including: 

  

	 	(i)	Section 4.3(d) (Regulatory and Customer Approvals) of the Terms and Conditions regarding restrictions on Offshoring arising out of Health Net’s contracts for federal business; 

 

	 	(ii)	Section 5.2 (Place of Performance) of the Terms and Conditions regarding the Services that may be provided from certain Offshore Supplier Facilities; 

 

	 	(iii)	Section 14.3(d) (Data Security) of the Terms and Conditions regarding storing and accessing of Health Net Data from Offshore; 

 

	 	(iv)	The provisions in Schedule C (Charges) regarding the Onshore / Offshore ratio; and 

  

	 	(v)	Any provisions in the Statements of Work that place restrictions on the location of the Services, including the terms in Statement of Work # 3 (Contact Center Services) regarding the location from where Supplier
may make or answer Voice Calls. 

  

	2.	DEFINED TERMS 

  

	 	(a)	“Offshore” (whether or not capitalized) means any location outside the fifty (50) United States of America and its territories and possessions. 

 

	 	(b)	“Onshore” (whether or not capitalized) means any location within the fifty (50) United States of America and its territories and possessions. 

 

	 	(c)	“Transition and Implementation Costs” means any non-recurring costs associated with implementing and standing up the transitioned service(s) in a new location that are
incurred prior to a new facility beginning live production. Some examples of Implementation Costs include initial staffing, initial recruiting, training and time spent in training, identifying and readying the new facility for production, networking
costs, infrastructure costs, etc. 

  

	 	(d)	“Voice Calls” means all inbound or outbound calls received or made by Supplier as part of the Services. 

  

	 	(e)	“Voice Call Service Levels” means the question in the Customer Satisfaction Service Level in Statement of Work #3 (Contact Center Services) Exhibit B-1 (Contact Center Operational Service
Levels) that asks customers “Are you satisfied with the service provided by the associate who assisted you today?” or such similar question(s) as the satisfaction survey may be modified during the Term. 

  

					
	Schedule Y		Y-1		Health Net / Cognizant Confidential

 Final 
  

	3.	PROHIBITED AND RESTRICTED OFFSHORE SERVICES 

  

	3.1	Offshoring Prohibitions 

 *** 

 

	 	(a)	*** 

  

	 	(b)	Supplier agrees that Supplier’s provision of the Services during the Term will remain in compliance with such Offshoring Prohibitions, including by performing all monitoring, support and other Services (with the
exception of production support and systems maintenance) used to support Offshore Restricted Entities from Supplier Facilities in the United States. 

  

	 	(c)	If Health Net desires to (i) add a new Exiting Offshore Restricted Entity, or (ii) modify the list of entities set forth in Section 3.1(a), then such modifications shall be changed via the Change Control Process,
provided that the Parties agree that the pricing impacts associated with such changes shall be subject to Section 8.4 (Change in Onshore / Offshore Requirements) of Schedule C (Charges). 

 

	3.2	Offshore Voice Call Restrictions 

  

	 	(a)	As of the Effective Date, Health Net has Offshoring Prohibitions in place for all Voice Calls regardless of the Tower or caller (e.g., Members, Providers, Employer Groups, Brokers or Regulatory Agencies). Supplier will
originate and answer all Voice Calls from the United States, Mexico and the Philippines (“Approved Voice Countries”). Supplier will only support Spanish language calls during business hours from Mexico or the United States,
after business hours support of Spanish language calls may be handled from the Philippines if Supplier uses a translation service. Supplier’s provision of the Services during the Term will remain in compliance with the Voice Call
restrictions set forth in this Section 3.2(a). 

  

	 	(b)	Supplier may propose alternative Approved Voice Countries during the Term, but Health Net reserves the right in its sole discretion to approve or reject such locations before inbound and outbound call support may
commence in the proposed country. 

  

	 	(c)	Additionally, if at any time during the Term Supplier fails to meet the same Voice Call Service Levels in any Approved Voice Country four times in a rolling six month period for the same root cause failure, Supplier
will upon Health Net’s request be required with 120 days’ notice to move the specific voice operations at issue to a different location to be mutually agreed upon by the Parties. Supplier will be responsible for all Transition and
Implementation Costs associated with moving and implementing the affected Services to the new location. The Parties will work through the Change Control Process to develop a transition plan for transitioning the affected services that includes
transition gates and addresses the potential impact on service levels during such transition. To the extent the move results in a change to the cost for Supplier of providing the fully transitioned and steady state Services in the new location, the
parties will equitably adjust the PMPM Charges through the Change Control Process to account the difference in such steady state costs. 

  

					
	Schedule Y		Y-2		Health Net / Cognizant Confidential

 Final 
  

	4.	PRIVACY AND SECURITY CONTROLS 

  

	 	(a)	Supplier will not store or transmit any Health Net Data Offshore. Supplier will only access Health Net Data from Offshore locations approved in accordance with Section 5.2 (Place of Performance) of the Terms
and Conditions. 

  

	 	(b)	Supplier Personnel will not be permitted to access Health Net Data from, or transmit it to, offshore locations except in compliance with Health Net’s privacy and security standards, policies, and requirements, as
set forth in the Terms and Conditions, and applicable Laws, including those relating to privacy, import- export controls, and information and data protection and security. 

 

	 	(c)	Supplier acknowledges that Health Net may establish additional special privacy and security requirements and controls for Offshore Supplier Facilities based on the specific Functions that will be performed Offshore and
the types of Health Net Data that will be disclosed to Supplier Personnel working there. 

  

	5.	GOVERNMENTAL FILINGS, AUTHORIZATIONS AND DISCLOSURES 

  

	 	(a)	If the government of any country in which a Supplier Facility is located requires a copy of the Agreement or any Statement of Work (or other document) to be filed, Supplier will be responsible for making the required
filing in a timely manner, at Supplier’s expense (including payment of any applicable stamp taxes or other charges). 

  

	 	(b)	Supplier will be responsible for, and will bear all costs and expenses associated with, obtaining and maintaining all necessary governmental permissions and authorizations required to perform the Services in the
designated locations and otherwise comply with the Agreement, including passports, visas, work permits and other immigration and customs documents. At Supplier’s reasonable request, Health Net will provide Supplier with such information,
attestations and other assistance as Health Net may deem appropriate to provide in connection with Supplier applying for and obtaining such governmental authorizations. If and when required by applicable Law, Supplier will identify to Health Net the
visa / immigration status of Supplier Personnel who are not U.S. citizens in connection with their performance of Services in the U.S. 

  

	 	(c)	Notwithstanding any other provision of the Agreement to the contrary, either Party may disclose the terms of this Schedule Y to relevant government entities, outside counsel or auditors for the purpose of complying (or
demonstrating compliance) with applicable Laws, which may include reporting any anti-corruption violations to U.S. or other government officials. 

  

					
	Schedule Y		Y-3		Health Net / Cognizant Confidential

 Final 

SCHEDULE Z 
 TRANSITION

  

					
	Schedule Z		 		Health Net / Cognizant Confidential

 Final 

Table of Contents 
  

							
	 	  	 	  	Page	 
	1.	  	INTRODUCTION	  	 	1	  
			
	2.	  	DEFINITIONS	  	 	1	  
			
	3.	  	OVERVIEW OF THE TRANSITION	  	 	3	  
			
	3.1	  	POINT OF DEPARTURE - HEALTH NET’S ‘AS-IS’ DELIVERY MODEL	  	 	3	  
			
	3.2	  	POINT OF ARRIVAL - SUPPLIER’S ‘TO-BE’ DELIVERY MODEL	  	 	5	  
			
	3.3	  	HIGH-LEVEL VIEW OF THE TRANSITION	  	 	6	  
			
	3.4	  	TRANSITION APPROACH	  	 	9	  
			
	3.5	  	TRANSITION FRAMEWORK	  	 	9	  
			
	3.6	  	TRANSITION FOCUS AREAS	  	 	10	  
			
	3.7	  	TRANSITION STAGES	  	 	11	  
			
	3.8	  	TRANSITION WAVES	  	 	13	  
			
	4.	  	ATTACHMENTS	  	 	14	  
			
	4.1	  	SCHEDULE Z-1 (ACCEPTANCE OF TRANSITION DELIVERABLES AND MILESTONES)	  	 	15	  
			
	4.2	  	SCHEDULE Z-2 (SUMMARY OF ONSHORE AND OFFSHORE COUNTS AND RATIOS)	  	 	15	  
			
	4.3	  	SCHEDULE Z-3 (HEALTH NET TRANSITION SUPPORT ROLE DESCRIPTIONS)	  	 	15	  
			
	4.4	  	SCHEDULE Z-4 (HEALTH NET TRANSITION SUPPORT PERSONNEL LEVELS)	  	 	15	  
			
	4.5	  	SCHEDULE Z-5 (HEALTH NET PROVIDED TRANSITION WORK SPACE)	  	 	15	  
			
	4.6	  	SCHEDULE Z-6 (RAMP-DOWN PLAN)	  	 	15	  
			
	4.7	  	SCHEDULE Z-7 (OFFSHORE RAMP-UP PLAN)	  	 	15	  
			
	4.8	  	SCHEDULE Z-8 (REQUIRED ONSHORE POSITIONS)	  	 	15	  
			
	4.9	  	SCHEDULE Z-9 (STAFF AUGMENTATION PLAN)	  	 	16	  
			
	4.10	  	SCHEDULE Z-10 (CONSOLIDATED BPAAS TRANSITION PLANS)	  	 	16	  
			
	4.11	  	SCHEDULE Z-11 (IT TRANSITION PLAN)	  	 	16	  
			
	4.12	  	SCHEDULE Z-12 (CALL CENTER TRANSITION PLAN)	  	 	16	  
			
	5.	  	RELATIONSHIP BETWEEN TRANSITION AND PERSONNEL REDEPLOYMENT	  	 	16	  

  

					
	Schedule Z	  	Z-i	  	Health Net / Cognizant Confidential

 Final 

ATTACHMENTS 

			
		
	Schedule Z-1		Acceptance of Transition Deliverables and Milestones
		
	Schedule Z-2		Summary of Onshore and Offshore Counts and Ratios
		
	Schedule Z-3		Health Net Transition Support Role Descriptions
		
	Schedule Z-4		Health Net Transition Support Personnel Levels
		
	Schedule Z-5		Health Net Provided Transition Work Space
		
	Schedule Z-6		Ramp-Down Plan
		
	Schedule Z-7		Offshore Ramp-Up Plan
		
	Schedule Z-8		Required Onshore Positions
		
	Schedule Z-9		Staff Augmentation Plan
		
	Schedule Z-10		Consolidated BPaaS Transition Plans
		
	Schedule Z-11		IT Transition Plan
		
	Schedule Z-12		Call Center Transition Plan

  

					
	Schedule Z		Z-ii		Health Net / Cognizant Confidential

 Final 

SCHEDULE Z 
 TRANSITION

  

	1.	INTRODUCTION 

 This Schedule Z (Transition) provides a consolidated overview of
Supplier’s approach to the Transition, from Health Net (or the incumbent provider, when not Health Net) to Supplier, of the BPaaS and Non- BPaaS IT Services (and associated personnel, processes, delivery systems and infrastructure) across all
Service Towers comprising the Initial SOWs, including the migration of all Functions comprising the BPaaS Services and the Non-BPaaS IT Services from the current ‘as-is’ delivery model to Supplier’s planned ‘to-be’
onshore/offshore delivery model. Unless expressly stated otherwise, the provisions of this Schedule Z shall apply (and be interpreted to apply) to all Transition activities under or pursuant to the Agreement, whether carried out or to be
carried out by Supplier or a Subcontractor. 
 This Schedule Z (Transition) reflects high-level ‘indicative’ (preliminary)
Transition plans - they are not yet developed at this stage with an actionable level of planning or detail. During Phase 1, which runs from the date of execution of the Agreement until the beginning of Phase 2 - at which time Health Net’s
Transitioned Employees will transfer to the employment of Supplier (or its Approved Subcontractor) and the Transition will commence - Supplier will plan and develop in close collaboration with Health Net (and in accordance with Section 13.3
(Transition Documents) of the Terms and Conditions) actionable (detailed) Transition Documents, which will be subject to Health Net’s prior written approval. Upon their approval by Health Net, they will supersede and replace their respective
counterparts in this Schedule Z (Transition). The actionable Transition Documents (which are Critical Deliverables for Phase 1) will include, as critical components, clear definitions of the waves, stages, and discrete work streams
that will comprise the Transition for each Initial SOW and a delineation of the Transition Deliverables and Transition Milestones, and their respective Acceptance Criteria, that will be used to determine, at logical stages of each Transition,
whether progress has been sufficient to warrant proceeding to the next stage, whether there are any corrective actions that must or should be taken before proceeding to the next stage or with other Transition activities, and what lessons (if any)
were learned from the current stage that should be applied to subsequent stages and the Transitions under other SOWs in order to minimize the recurrence of problems or other undesirable outcomes. Schedule Z-1 (Acceptance of Transition
Deliverables and Milestones) details the process by which Health Net will determine whether the Acceptance Criteria for each Transition Deliverable and Transition Milestone have been met. 

 

	2.	DEFINITIONS 

 The following terms, when used in this Schedule Z (Transition), will have the
meanings given them below unless otherwise specified or required by the context in which the term is used. Capitalized terms not defined herein shall have the meanings given them elsewhere in the Agreement. 

 

			
	Defined Term	  	Meaning
	 Acceptance
	  	In the context of the Transition, a written communication that Health Net has accepted either (i) a Transition Deliverable as having been properly completed and delivered in conformance with its requirements and specifications, or
(ii) a Transition Milestone as having been fully accomplished. See also Schedule Z-1 (Acceptance Procedures for Transition Deliverables and Transition Milestones), which details the process by which Acceptance shall be
determined.

  

					
	Schedule Z	  	Z-1	  	Health Net / Cognizant Confidential

 Final 

			
	Defined Term	  	Meaning
	Acceptance Criteria	  	In the context of the Transition, the criteria jointly developed by Health Net and Supplier Transition teams that will be used to determine whether and when (i) a Transition Deliverable has been properly completed and delivered in
conformance with its requirements and specifications or, alternatively, (ii) a Transition Milestone has been fully accomplished.
		
	Initial SOW Transition	  	Has the meaning given in Section 13.2(b) of the Terms and Conditions.
		
	Knowledge Transfer	  	The process and activities necessary to document and transfer knowledge and relevant subject matter expertise from one individual to one or more other individuals who are intended to assume responsibility for the Functions performed
by the incumbent from whom the knowledge is to be transferred.
		
	Personnel Group	  	A group of Supplier Personnel that it reflected in the onshore/offshore ramp plan and is assigned responsibility for certain Transition Deliverables and Transition Milestones.
		
	Phase 1	  	The period from the Effective Date of the Agreement until the BPaaS Services Commencement Date, and all activities that occur under or pursuant to the Agreement during that period.
		
	Phase 2 (sometimes also referred to as the “Transition Period”)	  	The period from the BPaaS Services Commencement Date until the completion of all of the Initial SOW Transitions - which is currently expected to be approximately a 24-month period - and all activities that occur under or pursuant to
the Agreement during that period.
		
	Phase 3	  	The period of ‘steady state’ performance of the Services - which commences upon the successful completion of the Transition and runs through the end of the Term - and all activities that occur under or pursuant to the
Agreement during that period.
		
	Ramp Up	  	The period of time from when a Supplier associate completes process training to the time when it has been confirmed through quality assurance monitoring of the associate’s performance of his or her assigned job functions for a
reasonable period of time that the associate is able to perform his or her job functions without external intervention in accordance with the requirements of the Agreement, including applicable Service Levels and productivity standards.
		
	Transition	  	Has the meaning given in Section 13.2 (“Transition” Defined) of the Terms and Conditions.

  

					
	Schedule Z	  	Z-2	  	Health Net / Cognizant Confidential

 Final 
  

			
	Defined Term	  	Meaning
	Transition Deliverables	  	Deliverables to be prepared as part of the Transition.
		
	Transition Documents	  	Has the meaning given in Section 13.3 (Transition Changes) of the Terms and Conditions.
		
	Transition Management Office (TMO)	  	The roles and personnel who will manage and oversee the conduct of the Transition.
		
	Transition Milestones	  	Checkpoint gates that will be used to determine, at logical stages of each SOW-level Transition, whether progress has been sufficient to warrant proceeding to the next stage, whether there are any corrective actions that must or
should be taken before proceeding to the next stage and what lessons (if any) were learned from the current stage that should be applied to subsequent stages and the Transitions under other SOWs in order to minimize the recurrence of problems or
other undesirable outcomes.
		
	Transition Period (sometimes also referred to as “Phase 2”)	  	The period from the BPaaS Services Commencement Date until the completion of all of the Initial SOW Transitions - which is currently expected to be approximately a 24-month period - and all activities that occur under or pursuant to
the Agreement during that period.
		
	Transition Program Manager	  	An individual appointed by Supplier who has overall responsibility for the Transition and who, as such, is responsible for overseeing all day-to-day strategic Transition activities by Tower and also for keeping apprised of
Transition operations to provide feedback back to key stakeholders.
		
	Transitioned Employees	  	Has the meaning given in Schedule E (Transitioned Employees).

  

	3.	OVERVIEW OF THE TRANSITION 

  

	3.1	POINT OF DEPARTURE - HEALTH NET’S ‘AS-IS’ DELIVERY MODEL 

 A summary of
each of the service Towers is provided below: 
  

	 	1.	Claims Management Services – The Claims Management Services are the Functions associated with the review, editing, validation and processing of a Claim from receipt through settlement for all geographies and
lines of business. Additional functions include Claims Audit, Recovery, Provider Dispute Resolution (excluding clinical review, which will be retained by Health Net) and Reporting. 

  

					
	Schedule Z	  	Z-3	  	Health Net / Cognizant Confidential

 Final 
  

	 	2.	Membership & Configuration Services - The Membership Services are the Functions associated with the provision of Group Setup Services, Group Maintenance, Renewal & Termination Services,
Enrollment Services, Accounts Receivable Services, Financial Reporting Services, Finance Operations Services, Broker Commissions Services, Sales Incentives Services, Cash Unit Services, Collections Services, Reporting Services, Miscellaneous
Membership Services, Audit Support Services, and Medicare OEV Outbound Calls Services and other membership-related services for all geographies and lines of business. 

The Configuration Services are the Functions associated with the provision of Configuration, Provider Data Management, and Capitation Functions
for all geographies and lines of business. 
  

	 	3.	Appeals and Grievances Services - The Appeals and Grievances (A&G) Services are the Functions associated with the intake, processing, resolution and archiving of Appeals and Grievances received from Members
or their representatives through all Channels for all regions and Lines of Business. The A&G Services do not include medical decision-making. 

  

	 	4.	Medical Management Services - The Medical Management Services are the Functions performed by the non-clinical intake and production teams consisting of the Prior Authorization unit, Hospital Notification unit,
Post Service Review unit and Concurrent Review unit. The Medical Management Services do not include medical decision-making. 

  

	 	5.	Quality Assurance Services - The Quality Assurance (QA) Services are the Functions associated with the post transaction auditing and reporting of finalized accuracy results (including the resolution of error
disputes) for Claims, Membership, Appeals & Grievances, Configuration, and Contact Center work for all geographies and lines of business. 

  

	 	6.	Contact Center Services – The Contact Center Services are the Functions associated with the intake, routing, and tracking of inquiries and requests received from Members, Providers, Brokers, Employer Groups
and Sales through all Channels for all Regions and Lines of Business. 

  

	 	7.	IT and ITIS – The IT and ITIS services are the Functions associated with Production Support Management, Change Management, IT Currency/Capacity Management, Production Support Analyst, IBM Oversight,
Physical/System/ Enterprise Security, Compliance / Risk Management, Federal Systems, Corporate Systems, IT 3rd party contract management, IT Finance – Portfolio/Spend management, Web, Mobile, Content management, Developers, System Analysts, IT
Architect, QA, UAT Support, and Release Management. 

 The table below provides an overview of delivery locations for Health
Net’s current (As Is) operating model, as well as the current providers of the respective Functions. 

  

					
	Schedule Z		Z-4		Health Net / Cognizant Confidential

 Final 
  

 
  

	3.2	POINT OF ARRIVAL - SUPPLIER’S ‘TO-BE’ DELIVERY MODEL 

 Supplier and Health Net have
agreed that Supplier will utilize a ‘Business Process-as-a-Service’ (BPaaS) delivery model for the BPaaS Services. The BPaaS model is a fully integrated vertical service model, in which Supplier is responsible for delivering agreed
business outcomes, and in the process of doing so providing all the associated resource and service layers that support Health Net’s business, which include IT infrastructure, tools, labor, applications development, maintenance &
support, and performance of the associated business operations. 
 Supplier’s point of arrival will be built on the following foundational aspects:

  

	 	•	 	Quality Focus – Supplier’s primary focus is to maintain continuity of services and operations while ensuring regulatory and contractual compliance. 

 

	 	•	 	Support Ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides personnel for supervision and Quality Assurance. 

 

	 	•	 	Continuous Improvement - Supplier will appoint dedicated “Six Sigma” process improvement resources during the Term to identify sustainable improvement opportunities. 

 

	 	•	 	Knowledge Capture & Retention – Supplier will deploy staff (existing and hired) with previous healthcare experience for key functions, including Operations, Transition, Training, Quality and
Compliance, who will create and/or update the Policy and Procedure Manual and training documents to enable knowledge capture and retention. 

  

					
	Schedule Z		Z-5		Health Net / Cognizant Confidential

 Final 

Supplier has considered the following criteria to define its delivery location strategy: 

 

	 	•	 	Regulatory requirements 

  

	 	•	 	Skills availability 

  

	 	•	 	Processes requiring voice support will be delivered out of US and/or Philippines and/or Mexico 

 This section
provides an overview of the geographical spread and the Service Delivery Centers Supplier will use to provide the Services, including Operations, Contact Center Services, IT, and ITIS. The ‘To be’ delivery model has been determined based
on multiple parameters such as availability of talent pool, skill requirements, Regulatory limitations, business continuity, and on-shore requirements. All Operations and IT related Functions will be performed by Supplier, while the Contact Center
Services will be provided by a Supplier Affiliate. Supplier will be overall accountable and responsible for all of the Services. 
  
 

 
  

	3.3	HIGH-LEVEL VIEW OF THE TRANSITION 

 This section provides an overview of Transition during Phases 1 and
2. The principal objectives during these phases are to understand the “As Is” operating model, and to design and implement the “To Be” operating model. Phase 1 of Transition encompasses the following stages: Transition Readiness,
Process Assessment & Transition Planning and Knowledge Management, and Phase 2 of Transition encompasses Re-badging, Offshore Knowledge Transfer and Offshore Ramp Up. 

  

					
	Schedule Z		Z-6		Health Net / Cognizant Confidential

 Final 

The Phase 1 aspects of Transition encompasses the following stages and activities, which are described further in Section 3.7 (Transition Stages) below:

  

			
	 Transition Stage
	  	 Activities

	Transition Readiness	  	 •    Define Project objectives and goals

 
 •    Agreement on
Project timelines, dependencies and deliverables
  

•    Agreement on Roles and Responsibilities

 
 •    Setting up a
Transition Management office
  

•    Transition kick off meeting

 
 •    Agreement of
Communication, Escalation and program governance routines

		
	Process Assessment
and Transition
Planning	  	 •    Validation of Processes and Roles to be offshored

 
 •    Agreement on
sequence of processes to be offshored
  

•    Readiness assessment for processes to Transitioned offshore

 
 •    Assessment of as-is
status of process and training documentation, and re-source availability
  

•    Design to-be process flow for Phase 2 with defined hand-offs and dependencies between
Supplier and Health Net
  

•    Detailed Transition Plan

		
	Knowledge
management	  	 •    Update process documentation for Training, P&P’s and desktop
procedures
  

•    Agreement on Phase 2 process flow and hand offs

 
 •    Validate Transition
plan training timelines and ramp period
  

•    Sign off on any updated Training, P&P and desktop procedure documents

 The Phase 2 aspects of Transition encompass the following stages and activities, which are described further in
Section 3.7 (Transition Stages) below: 
  

			
	 Transition Stage
	  	 Activities

	Re-badging	  	 •    Deployment of specialist senior HR resource with extensive knowledge
and prior experience in matters relating rebadging
  

•    Address employee change concerns and in providing rebadged employees with an embracing
work environment
  

•    Identification of relevant roles in the Supplier hierarchy and rolling out offer
letters

		
	Offshore Knowledge
Transfer	  	 •    Process training of Supplier’s offshore staff

		
	Offshore Ramp Up	  	 •    Increase in volume of work processed by the Supplier’s offshore team as per the Ramp Up
plan

  

					
	Schedule Z	  	Z-7	  	Health Net / Cognizant Confidential

 Final 

A pictorial representation (as below) provides a high level overview of the Transition (Phase 1 and 2) cutting across Operations, Contact Center Services, IT
and ITIS. 
 Operations and Contact Center Services: 
  

 
 IT and ITIS: 
  

 

  

					
	Schedule Z		Z-8		Health Net / Cognizant Confidential

 Final 
  

	3.4	TRANSITION APPROACH 

 With reference to Supplier’s proposed delivery Solution for each of the
Initial SOWs, as described in Exhibit A-2 of each Initial SOW, and considering the sensitivity associated with transfer of employees, the Transition of Services and people needs to be viewed as a comprehensive and end-to-end seamless
undertaking of activities across Supplier and Health Net, and not simply as an isolated list of activities that Supplier will perform. The Transition will be carried out using Supplier’s CARES Transition framework—a proven, risk-mitigated
and robust project management model that is aptly suited to provide the structure, discipline and governance required to successfully implement the proposed Transition on the scale required for Health Net. 

 

	3.5	TRANSITION FRAMEWORK 

 Supplier’s CARES transition framework has been successfully deployed for
large-scale Transitions, including those involving large-scale rebadging of employees, and is continuously upgraded from various learnings, experiences and market relevant expectations. The key elements of the methodology that will be deployed for
this Transition are as illustrated in Figure 1. 
  
 

 
 The following paragraphs describe the activities that will occur during each phase of the CARES transition framework
(Connect, Assess, Redesign, Execute and Stabilize): 
 Connect: During the Connect stage, which will occur during Phase 1, Supplier will engage with
Health Net to conduct Due Diligence and define the Transition program milestones, resource requirements, timelines and key deliverables, including an indicative Transition project plan. For the purposes of this program, the CARES Connect phase is a
pre-Transition stage , during which Supplier will conduct due diligence of Health Net operations and Transition Readiness activities as described in this Schedule Z (Transition). 

  

					
	Schedule Z		Z-9		Health Net / Cognizant Confidential

 Final 

Assess: During the Assess stage, which will occur during Phase 1, Supplier will conduct meetings with key Health Net operational leaders, review team
profiles, and identify training requirements and other operational nuances. Supplier will conduct focused group discussions with Health Net’s process owner(s) to identify specific requirements regarding compliance, security and data privacy
factors and policies. In context to this Transition, the activities and outcomes as described in Section 3.7 (Transition Stages) below will comprise the CARES Assess phase. 

Redesign: During the Redesign stage, which will occur during Phase 1, Supplier will develop the blue- print and configure the ‘To-Be’
Services operating environment. Supplier will analyze every aspect of the Services delivery (People, Process, Quality Assurance, Service Levels, Training, and Technology) and design the process flows necessary to perform the Services. In context to
this Transition, the outcomes described in Section 3.7 (Transition Stages) below will comprise the CARES Redesign phase. 
 Execute: In the
Execute stage, which will occur during Phase 2, Supplier will transition the Services with specific focus on people and knowledge transfer and retention. Supplier will take into account every aspect of process control to minimize disruption to
Health Net’s current operations. In context to this Transition, the activities and outcomes described in Section 3.7 (Transition Stages) below will comprise the CARES Execute phase. 

Stabilize: In the Stabilize stage, which will occur commence during Phase 2, Supplier will achieve operational effectiveness through careful
implementation and execution of operational rigor. In context to this Transition, the activities and outcomes as described in Section 3.7 (Transition Stages) below will comprise the CARES Stabilize phase. 

 

	3.6	TRANSITION FOCUS AREAS 

 Key areas of emphasis on which Supplier will focus attention during Transition
include the following: 
 Retaining Health Net Employees and Knowledge 
  

	 	•	 	Supplier will deploy a specialist senior HR resource with extensive knowledge and prior experience in matters relating rebadging, employee change concerns and in providing Transitioned Personnel with an embracing work
environment. In addition, Supplier will also deploy a dedicated Transition Program Manager with extensive experience in implementing large-scale projects and migrations 

 

	 	•	 	Heath Net will be responsible for retention of the Transitioned Personnel until the end of Phase 1. 

  

	 	•	 	All Transitioned Personnel will undergo new-hire orientation training delivered by Supplier. 

 Comprehensive
Knowledge Capture and Documentation 
  

	 	•	 	Supplier will conduct a comprehensive review of existing documentation to identify any gaps 

  

	 	•	 	Based on the gap analysis, Supplier will deploy a team to complete documentation of in-scope processes that require additional documentation 

  

					
	Schedule Z		Z-10		Health Net / Cognizant Confidential

 Final 

Guiding Principles 
 The following guiding principles will
be observed during the Transition: 
  

	 	•	 	Supplier will lead the planning and preparations for the Transition with active engagement and participation from Health Net 

  

	 	•	 	Supplier will have overall responsibility for the successful planning, orchestration and execution of the Transition, with Supplier and Health Net each having responsibility for managing specific elements of the
Transition within their respective control 

  

	 	•	 	Designated representatives from both Supplier and Health Net will work together to achieve the required outcomes and implementation of the Services 

 

	 	•	 	Supplier and Health Net will jointly manage and track issues, risks, assumptions and dependencies related to Transition 

  

	 	•	 	All Transition planning and execution activities will be undertaken consistent with an overriding objective to minimize disruption and risk to Health Net’s operations 

 

	3.7	TRANSITION STAGES 

 Following is a high-level description of the general stages of Transition. 

 

	1.	Transition Readiness: 

 The objective of Transition Readiness will be to define the
project goals and objectives, setting up a Transition Management Office (TMO), identifying tasks and how goals will be achieved, quantifying the resources needed, and determining budgets and timelines for completion. This will include conducting a
joint Supplier and Health Net workshop to align all parties on the Transition objectives, roles and responsibilities, methodology, tools, timelines & milestones, and key dependencies. The detailed planning and agenda for the Process
Assessment and Knowledge Management teams will be done as part of this stage. 
  

	2.	Staff Augmentation Team Deployment: 

 This stage of the Transition involves creating
additional capacity within Health Net operations to enable adequate availability of Health Net Transitioned Personnel with relevant process and domain experience to support Supplier’s offshore Transition with minimal disruption and risk to
Health Net’s ongoing operations. 
  

	3.	Process Assessment: 

 The objective of the Process Assessment stage of the Transition is
to enable Supplier to understand in greater detail all of the in-scope processes. Supplier will conduct a Process Assessment exercise to assess in greater detail the current as-is processes, current levels of process documentation, training
documentation, trainer availability, and quality assurance resources that are required to enable service cutover. The Process Assessment will also assess the in-scope processes that are to 

  

					
	Schedule Z		Z-11		Health Net / Cognizant Confidential

 Final 

be migrated to Supplier’s offshore locations with minimal disruption and risk to Health Net’s ongoing operations. This phase will
require the Supplier team to interact with identified key Health Net staff that have the required knowledge and access to such information. This team will consist of Supplier resources from operations, training and quality process excellence. 

 

	4.	Detailed Transition Planning: 

 Supplier’s Transition Management Office (TMO) will
engage with the Health Net Transition and business teams to jointly deliver detailed Transition plans for each Tower for Health Net’s approval that will at a minimum include: 

 

	 	•	 	Individual level roles and functions to be Transitioned 

  

	 	•	 	Sequencing of processes to be Transitioned 

  

	 	•	 	Key Transition Deliverables and Milestones, with associated completion dates and dependencies 

  

	 	•	 	Identification of Personnel Groups (including both Supplier Personnel Groups and Subcontractor Personnel Groups), together with the identities of the individuals assigned to each Personnel Group and a listing of the
Transition Deliverables and Transition Milestones for which each Personnel Group is responsible 

  

	 	•	 	Key tasks and activities with clearly defined responsibility between Supplier and Health Net. 

  

	 	•	 	A knowledge retention and transfer plan for each in-scope process 

  

	 	•	 	Identification of trainers & QA resources who could support the offshore Transition 

  

	 	•	 	Governance and review 

  

	5.	Knowledge Management: 

 After completion of the process assessment stage of the
Transition, Supplier will conduct a knowledge management process wherein Supplier will update any gaps in the process and training documentation and have it ready for use by its offshore teams. The Knowledge Management team will consist of Supplier
resources from operations and training. Post completion of this stage, the team will move into steady state (Phase 3) in support of offshore operations. 
  

	6.	Transfers of Transitioned Personnel: 

 Starting at the beginning of Phase 2, Supplier
will employ the Transitioned Personnel as per Schedule E (Employee Transfer) of the Agreement, and assume responsibility of all in-scope activities of Health Net’s operations as defined in Exhibit A of each of the Initial SOWs.

  

	7.	Knowledge Transfer and Ramp Up: 

 During this stage of Transition, Supplier will leverage
the deep process and domain experience of Health Net Transitioned Personnel to support offshore process training and Ramp Up. The details of specific number of trainers, duration of stay and accommodation etc will be determined as part of the
Process Assessment & Transition Planning stage. 

  

					
	Schedule Z		Z-12		Health Net / Cognizant Confidential

 Final 
  

	3.8	TRANSITION WAVES 

 The Transition of processes to Supplier’s offshore locations will be carried out
in multiple waves. The first wave of Transitions will consist of low complexity processes and the complexity of the processes in subsequent waves will be higher. This approach minimizes the risk of Service Level failures and other disruptions to
Health Net’s operations during the Transition. 
 The parameters used to determine processes within each of the Transition waves are as follows: 

 

	 	1.	Impact of any potential process failure on the overall business 

  

	 	2.	Process complexity and maturity in terms of process documentation and standard operating procedures 

  

	 	3.	Possible offshore-onshore mix at the point of arrival, as per findings of Process Assessment and Transition planning 

  

	 	4.	Overall timelines for Transition as per the findings of the Process Assessment and Transition planning 

 At a
high level the following processes (per tower) will be Transitioned in multiple waves on the principle of waving logic as described above. 
  

							
	Towers	 	Phase 2 - Wave 1	 	Phase 2 - Wave 2	 	Phase 2 - Wave 3
	 Claims
	 	 •    Claims Recovery
	 	 •    COB
	 	 •    Claims Compliance

		 	 •    Claims Adjudication
	 	 •    Provider Disputes
	 	 •    SOX and P&P

		 	 •    Reinsurance
	 	 •    Accum Research
	 	 •    Prepay Audit

		 	 •    Member Fallout
	 	 •    Claims Reporting
	 	 •    Legal/Adjustments

		 		 		 	 •    EDI

				
	 Membership
	 	 •    Commercial enrollment
	 	 •    Medicare enrollment
	 	 •    Group Employer set up

		 	 •    Commercial account
	 	 •    Medicare account
	 	 •    Broker commission

		 	 receivables
	 	 receivables
	 	 •    Financial reporting

				
	 Configuration
	 	 •    Contract
	 	 •    Benefit Configuration
	 	 •    PDM/Capitation

		 	 Configuration/Pricing
	 		 	
				
	 Appeals and
	 	 •    All LOB Triage
	 	 •    Medicare Part C
	 	NA
	 Grievance
	 	 •    HMO appeal
	 	 grievance
	 	
		 	 •    PPO appeal
	 	 •    Medicare Part D
	 	
		 	 •    Medicare Part C appeals
	 	 grievances
	 	
		 	 •    Medicare Part D appeals
	 	 •    SHP/Duals grievances
	 	
		 	 •    CA commercial
	 		 	
		 	 grievances
	 		 	
				
	 Medical
	 	 •    Concurrent Review
	 	 •    Medical Review Unit
	 	NA
	 Management
	 	 •    Hospital Notification Unit
	 	 (MRU)
	 	
		 		 	 •    Prior Authorization (PCU)
	 	
	 Quality
	 	 •    A&G and Contact Center
	 	 •    Claims
	 	 •    Membership

	 Assurance
	 		 		 	
	 Contact Center
	 	 •    Commercial Member and
	 	 •    Medicaid CA and AZ
	 	 •    Duals and MHN

	 Services
	 	 Provider
	 	 •    Correspondence
	 	
		 	 •    Medicare Member and
	 		 	
		 	 Provider
	 		 	
				
	 IT / ITIS
	 	 •    Production Support Services
	 	 •    Non-BPaaS Areas
	 	 •    System Analyst

				
		 		 	 •    IBM oversight
	 	 •    Business Analyst

				
		 		 	 •    Contract management
	 	 •    CTO

				
		 		 		 	 •    Project management office

				
		 		 		 	 •    All in-flight projects will be handled post wave 3

  

					
	Schedule Z	  	Z-13	  	Health Net / Cognizant Confidential

 Final 
  

	3.9	USE OF HEALTH NET FACILITIES 

 Health Net will work with Supplier to provide reasonable work space to
Supplier Personnel as outlined in Schedule Z-5 (Health Net Provided Transition Work Space), with respect to which the Parties agree as follows: 
  

	 	1.	Health Net will work to provide the seating necessary for shadowing Health Net personnel and a sufficient amount of available workstations to provide each Supplier associate a workspace within the vicinity of the Health
Net associate they will be “shadowing” (i.e. in the same building and in most cases on the same floor). However, the workstation locations may be scattered, and therefore Supplier associates may not be co-located in the same workstation
pod. 

  

	 	2.	Health Net’s available facilities space will be provided as a snapshot in time and available workspaces for Supplier may change as Health Net’s day-to-day requirements for staff are accommodated.

  

	 	3.	Workstations will be equipped with internet-only port connections. Network ports will not be enabled for use without protocol approval, including that of Health Net’s Information Security. 

 

	 	4.	Land line phones may be provided upon request to any workstation. 

  

	 	5.	Conference rooms may be booked by Supplier personnel via the Health Net scheduler. Conference rooms will not be dedicated to Supplier, but may be used by Supplier as needed and based on availability. 

 

	 	6.	Training rooms will be booked by Supplier personnel through Health Net’s operations training group. Training rooms will not be dedicated to Supplier, but may be used by Supplier as needed and based on availability.

  

	 	7.	Workspace can generally be made available on a week’s notice or less, depending on the IT requirements and based on availability. 

 

	 	8.	Supplier will be responsible for purchasing parking for the Supplier personnel. 

  

	4.	ATTACHMENTS 

 Following are brief descriptions of the attachments to this Schedule Z
(Transition), which are incorporated as part of this Schedule Z (Transition). 

  

					
	Schedule Z		Z-14		Health Net / Cognizant Confidential

 Final 
  

	4.1	SCHEDULE Z-1(ACCEPTANCE OF TRANSITION DELIVERABLES AND MILESTONES) 

 Schedule
Z-1 (Acceptance of Transition Deliverables and Milestones) sets forth the process that will be followed for Health Net to determine when Transition Deliverables and Transition Milestones have met the criteria for their Acceptance by
Health Net. 
  

	4.2	SCHEDULE Z-2 (SUMMARY OF ONSHORE AND OFFSHORE COUNTS AND RATIOS) 

 Schedule Z-2
(Summary of Onshore and Offshore Counts and Ratios) sets forth information about the current state and end state numbers of onshore and offshore positions and the current and end state onshore/offshore ratios. 

 

	4.3	SCHEDULE Z-3 (HEALTH NET TRANSITION SUPPORT ROLE DESCRIPTIONS) 

 Schedule
Z-3 (Health Net Transition Support Role Descriptions) sets forth role descriptions of the Health Net personnel that Health Net will provide in support of the Transition. 

 

	4.4	SCHEDULE Z-4 (HEALTH NET TRANSITION SUPPORT PERSONNEL LEVELS) 

 Schedule Z-4
(Health Net Transition Support Personnel Levels) sets forth the nature, amounts, and timing of personnel support from Health Net that Supplier has requested and Health Net has agreed to make available to support the Phase 1 staff augmentation
knowledge transfer activities and the conduct of the Transition during Phase 2. 
  

	4.5	SCHEDULE Z-5 (HEALTH NET PROVIDED TRANSITION WORK SPACE) 

 Schedule Z-5 (Health
Net Provided Transition Work Space) sets forth information about the work space that Health Net will make available for use by Supplier Personnel in support of the Transition, by time period. 

 

	4.6	SCHEDULE Z-6 (RAMP-DOWN PLAN) 

 Schedule Z-6 (Ramp-Down Plan) sets forth
information about the pace of the planned Ramp Down of onshore Supplier resources during Transition. 
  

	4.7	SCHEDULE Z-7 (OFFSHORE RAMP-UP PLAN) 

 Schedule Z-7 (Offshore Ramp-Up Plan)
sets forth information about the pace of the planned Ramp Up of offshore Supplier resources during Transition. 
  

	4.8	SCHEDULE Z-8 (REQUIRED ONSHORE POSITIONS) 

 Schedule Z-8 (Required
Onshore Positions) sets forth a listing of Supplier positions that Health Net requires remain onshore. 

  

					
	Schedule Z		Z-15		Health Net / Cognizant Confidential

 Final 
  

	4.9	SCHEDULE Z-9 (STAFF AUGMENTATION PLAN) 

 Schedule Z-9 (Staff Augmentation Plan)
sets forth information about the manner in which Supplier will augment the capacity of Health Net’s BPaaS Tower personnel in order to enable them to support Knowledge Transfer and other Transition activities. 

 

	4.10	SCHEDULE Z-10 (CONSOLIDATED BPAAS TRANSITION PLANS) 

 Schedule Z-10
(Consolidated Transition Plan) contains a consolidated Transition plan reflecting a rolled up view of the individual Transition plans for each of the Towers. 
  

	4.11	SCHEDULE Z-11 (IT TRANSITION PLAN) 

 Schedule Z-11 (IT Transition
Plan) sets forth the Transition Plan for the IT Tower. 
  

	4.12	SCHEDULE Z-12 (CALL CENTER TRANSITION PLAN) 

  

	4.13	SCHEDULE Z-12 (CALL CENTER TRANSITION PLAN) SETS FORTH THE TRANSITION PLAN FOR THE CALL CENTER TOWER. 

 

	5.	RELATIONSHIP BETWEEN TRANSITION AND PERSONNEL REDEPLOYMENT 

 As described in Sections 4.6 and 4.7
above, Schedule Z-6 (Ramp Down Plan) and Schedule Z-7 (Offshore Ramp Up Plan) set out the currently planned onshore/offshore ramp plan. That ramp plan is for Transition planning and monitoring purposes only, in that
Supplier and its Subcontractors are not permitted to reassign or otherwise redeploy or remove any Transitioned Personnel from their assigned Transition responsibilities, or to reassign or otherwise redeploy or remove any Supplier Personnel from
onshore roles that are being moved to another location (whether to an offshore, near shore, or alternate onshore location), until all of the following conditions (the “Transition Release Conditions”) have been met with
respect to the relevant Personnel Group: (i) Health Net has approved in writing Supplier’s (or, where applicable, a Subcontractor’s) Knowledge Transfer and onshore/offshore ramp plans as they pertain to the Personnel Group subject to
the same ramp down count as in Schedule Z-6 (Ramp Down Plan); (ii) all Transition Deliverables to be prepared by the Personnel Group have been completed and Accepted by Health Net; (iii) all Knowledge Transfer activities
involving the Personnel Group have been completed and confirmed through quality assurance to have been completed successfully, (iv) all Transition Milestones including Knowledge Transfer milestones that the Personnel Group has a role in
achieving have been achieved and Accepted by Health Net; (v) at least 30 days prior to Supplier’s (or its Subcontractor’s) proposed redeployment (or termination) of the members of the Personnel Group, Supplier has provided to Health
Net (in writing) a list or other notice identifying the individual employees comprising the Personnel Group and indicating which are to be redeployed while remaining employed with Supplier or its Subcontractor and which are to be terminated, and
Health Net has not, within the first 15 days of the 30-day notice period, objected to the proposed redeployment (or termination) on the basis that all Transition Release Conditions applicable to the relevant Personnel Group have not been met. For
the avoidance of doubt, nothing in this Schedule Z is intended to limit in any way the provisions of Schedule E (Employee Transfer) that relate to the termination or redeployment of Transitioned Employees. 

  

					
	Schedule Z		Z-16		Health Net / Cognizant Confidential

 Final 

SCHEDULE Z-1 
 ACCEPTANCE
PROCEDURES FOR TRANSITION DELIVERABLES AND MILESTONES 
  

	1.	GENERAL 

 (a) The successful completion of any Transition Deliverable prepared and
delivered pursuant to this Agreement or achievement of any Transition Milestone requires Acceptance of such Transition Deliverable or Transition Milestone by Health Net. Acceptance by Health Net requires that the Transition Deliverables and
Transition Milestones be confirmed in writing by Health Net to meet applicable Acceptance Criteria which, in the case of Transition Deliverables consisting of Software, will include the successful completion of agreed upon acceptance and performance
testing. In the case of Transition Deliverables that are component parts of larger Transition Deliverables, in addition to Acceptance of the component Transition Deliverables, the Transition Deliverable comprised of the component Transition
Deliverables will also be subject to Health Net’s Acceptance in its entirety. 
 (b) Upon completion of a Transition Deliverable or the
accomplishment of a Transition Milestone, Supplier shall notify Health Net in writing that it has been completed and ready for Acceptance by Health Net. Health Net will evaluate it for Acceptance in accordance with this Schedule Z-1. 

(c) Acceptance procedures for Transition Deliverables and Transition Milestones will be documented in the applicable Transition Plan (or
referenced therein to the extent the Parties agree on standard procedures). Acceptance procedures will be sufficiently rigorous so as to verify that the Transition Deliverables conform in all material respects to all applicable specifications,
Acceptance Criteria and performance requirements, as applicable, and, in the case of Transition Milestones, that their Acceptance Criteria have been accomplished. 

(d) Health Net will be responsible for performing acceptance testing it requires prior to Acceptance of Transition Deliverables under this
ScheduleZ-1. Supplier shall support Health Net’s Acceptance testing as reasonably requested by Health Net, including by preparing appropriate test data, making available test collateral or other applicable documentation, answering questions,
etc. 
 (e) The Acceptance process outlined below shall not be deemed to extend the scheduled completion date for any Transition Deliverable
specified in a Transition Plan. 
  

	2.	ACCEPTANCE PERIOD 

 Unless otherwise mutually agreed, Health Net shall notify Supplier
whether a Transition Deliverable or Transition Milestone has satisfied the applicable Acceptance Criteria no later than (a) ten (10) Business Days (unless otherwise mutually agreed by the Parties) after (i) Supplier notifies Health
Net that it has been completed and is ready for Health Net’s confirmation that the Acceptance Criteria have been met, and (ii) makes available to Health Net all applicable Transition Deliverables in order for Health Net to confirm that
Health Net has already completed all required acceptance testing on the Transition Deliverable(s) or (b) for Transition Deliverables that Health Net determines require acceptance testing by Health Net in the production environment, the Parties
shall mutually agree upon the Acceptance Period on a case by case basis (“Acceptance Period”). 

  

					
	Schedule Z-1		Z-1-1		Health Net / Cognizant Confidential

 Final 
  

	3.	ACCEPTANCE OF WRITTEN TRANSITION DELIVERABLES 

 (a) “Written
Transition Deliverables” are all Transition Deliverables other than Operational Transition Deliverables as defined in Section 4 below. Supplier may submit interim drafts of Written Transition Deliverables (e.g., system
designs and documentation, manuals) to Health Net for review. Health Net agrees to review and, if requested by Supplier, to reply to each interim draft within a reasonable period of time after receiving it from Supplier. 

(b) When Supplier delivers a final Written Transition Deliverable to Health Net, Health Net will complete its review of such Deliverable
within the Acceptance Period; provided that, if and to the extent any Written Transition Deliverable is delivered earlier or later than scheduled, the Acceptance Period shall be extended as reasonably necessary to accommodate the availability of the
Health Net personnel responsible for reviewing such Written Transition Deliverable. Similarly, if and to the extent multiple Written Transition Deliverables are delivered to Health Net within an Acceptance Period, the Acceptance Period shall be
extended for a mutually agreed upon period of time as reasonably necessary to accommodate the availability of Health Net personnel responsible for reviewing them. 

(c) Health Net will notify Supplier in writing by the end of the Acceptance Period stating that such Written Transition Deliverable is
accepted in the form delivered by Supplier or describing with reasonable particularity any deficiencies that must be corrected prior to acceptance of such Written Transition Deliverable. If Supplier does not receive any such notice from Health Net
by the end of the Acceptance Period, Supplier shall promptly notify Health Net in writing that no such notice has been received. If Supplier does not receive a notice specifying deficiencies within ten (10) Business Days , or as otherwise
mutually agreed by the Parties, after Health Net receives such written notification from Supplier, such Written Transition Deliverable will be deemed accepted by Health Net. 

(d) If Health Net delivers to Supplier a notice of deficiencies, Supplier will at no additional charge to Health Net, correct the described
deficiencies as quickly as possible and, in any event, unless otherwise mutually agreed by the Parties, within five (5) Business Days after Health Net notifies Supplier of the deficiencies. 

(e) Upon receipt of a corrected Written Transition Deliverable from Supplier, Health Net will have a reasonable additional period of time to
review the corrected Written Transition Deliverable. Supplier will, at no additional charge to Health Net, correct any further deficiencies identified by Health Net as quickly as possible and, in any event, unless otherwise mutually agreed by the
Parties, within five (5) Business Days after Health Net notifies Supplier of the further deficiencies. 
  

	4.	ACCEPTANCE OF OPERATIONAL TRANSITION DELIVERABLES 

 (a)
“Operational Transition Deliverables” are Transition Deliverables comprised in whole or in part of Software. Prior to the date on which Supplier is scheduled to deliver each Operational Transition Deliverable to Health Net,
Supplier and Health Net will (to the extent not previously set forth in the applicable Transition Plan) agree upon the testing procedures for the Operational Transition Deliverable, including detailed test criteria and expected results (the
“Acceptance Tests”). The Acceptance Tests will be designed to determine whether the Operational Transition Deliverable contains any Transition Deliverable Defects (as defined below). Health Net will have the opportunity
during the Acceptance Period to evaluate and test each Operational Transition Deliverable in accordance with the procedures set forth herein or in any Transition Plan. 

  

					
	Schedule Z-1		Z-1-2		Health Net / Cognizant Confidential

 Final 

(b) When Supplier has completed an Operational Transition Deliverable, Supplier will deliver the Operational Transition Deliverable to Health
Net’s designated site, notify the designated Health Net person of delivery, and if Supplier is responsible for installation, install such Operational Transition Deliverable and perform an installation test reasonably acceptable to Health Net to
verify that the Operational Transition Deliverable has been properly delivered and installed. Supplier shall notify Health Net in writing when the Operational Transition Deliverable is ready for Acceptance, provided that such notice shall not occur
prior to the successful completion by Supplier of any installation tests. Receipt of such notice by Health Net will start the Acceptance Period or such other period as is stated in the applicable Transition Plan or as otherwise agreed to by the
Parties. 
 (c) Health Net’s obligation to review any Operational Transition Deliverable within the applicable Acceptance Period will
be contingent on such Operational Transition Deliverable being delivered to Health Net as scheduled. If and to the extent any Operational Transition Deliverable is delivered earlier or later than scheduled, the Acceptance Period shall be extended as
reasonably necessary to accommodate the availability of the Health Net personnel responsible for reviewing such Operational Transition Deliverable. Similarly, if and to the extent multiple Operational Transition Deliverables are delivered to Health
Net within an Acceptance Period, the Acceptance Period shall be extended for a mutually agreed upon period of time as reasonably necessary to accommodate the availability of Health Net personnel responsible for reviewing them. 

(d) Health Net shall notify Supplier in writing before the end of the Acceptance Period stating that the Operational Transition Deliverable is
accepted in the form delivered by Supplier or describing the Transition Deliverable Defects as provided in Section 4(e) below. If Supplier does not receive any such notice from Health Net by the end of the Acceptance Period, Supplier shall promptly
notify Health Net in writing that no such notice has been received. If Supplier does not receive a notice of Transition Deliverable Defects within ten (10) Business Days, or as otherwise mutually agreed by the Parties, after Health Net receives
such written notification from Supplier, such Operational Transition Deliverable will be deemed accepted by Health Net. 
 (e) If Health Net
determines during the Acceptance Period that the Operational Transition Deliverable as delivered by Supplier deviates in any material respect from its Acceptance Criteria or otherwise fails in any noted respect to successfully complete applicable
Acceptance Tests (a “Transition Deliverable Defect”), Health Net will inform Supplier in writing, describing the Transition Deliverable Defect in sufficient detail to allow Supplier to recreate it. Supplier will correct any
Transition Deliverable Defects in an Operational Transition Deliverable as soon as possible after receiving Health Net’s notice of the Transition Deliverable Defects, but in any event within a period equal to the original Acceptance Period
(unless otherwise specified in the applicable Transition Plan). Supplier will provide the corrected Operational Transition Deliverables to Health Net for re-testing. 

(f) Health Net will have a reasonable additional period of time after receipt of the corrected Operational Transition Deliverable to re-test
it so as to confirm that it does not deviate in any material respect from its Acceptance Criteria. Supplier will, at no additional charge to Health Net, correct any further Transition Deliverable Defects identified by Health Net during the re-test
as quickly as possible, but in any event within a period equal to the original Acceptance Period (unless otherwise specified in the applicable Transition Plan). 
  

	5.	ACCEPTANCE OF TRANSITION MILESTONES 

 To the extent that any Transition Milestone
consists of or includes the delivery and Acceptance of Transition Deliverables, Acceptance of those aspects of the Transition Milestone will be as set forth in Sections 3 and 4 above, as applicable. Otherwise, when a Transition Milestone includes
the accomplishment of certain results other than the completion of Transition Deliverables, Supplier will 

  

					
	Schedule Z-1		Z-1-3		Health Net / Cognizant Confidential

 Final 

notify Health Net in writing when Supplier believes all results to be accomplished and Acceptance Criteria to be met for the Transition Milestone to have been
achieved. Upon receiving such a notice from Supplier, Health Net will respond in writing within ten (10) business days, or such other period as the Parties may agree to, either indicating Health Net’s Acceptance of the Transition Milestone
or describing what remains to be accomplished to meet its Acceptance Criteria. 

  

					
	Schedule Z-1		Z-1-4		Health Net / Cognizant Confidential

 Final 

SCHEDULES Z-2 - Z-12 

[See attached Excel Worksheets] 

  

					
	Schedule Z-2 – Z-12		 		Health Net / Cognizant Confidential

 Final 
  

SCHEDULE Z 
 SUBSCHEDULES

  

					
	Schedule Z Subschedules		Page 1		Health Net / Cognizant Confidential

 Final 

Z2 - Summary of Onshore and Offshore Counts and Ratios 
  

																																	
	 TOWER
	 	Onshore	 	 	Offshore	 	 	Onshore	 	 	Offshore	 	 	Approximate Current
State On Shore Ratio	 	 	Approximate
Current
State Off
Shore Ratio	 	 	Approximate
End State
(Phase 2) On	 	 	Approximate End State
(Phase 2) Off Shore	 
	 	Current	 	 	Current	 	 	(Phase 2) End State	 	 	(Phase 2) End State	 	 	 	 	 
	 Claims
	 	 	424	  	 	 	782	  	 	 	207	  	 	 	999	  	 	 	35	% 	 	 	65	% 	 	 	17	% 	 	 	83	% 
	 Membership
	 	 	510	  	 	 	120	  	 	 	268	  	 	 	362	  	 	 	81	% 	 	 	19	% 	 	 	43	% 	 	 	57	% 
	 Configuration
	 	 	202	  	 	 	0	  	 	 	94	  	 	 	108	  	 	 	100	% 	 	 	0	% 	 	 	46	% 	 	 	54	% 
	 Contact Center
	 	 	1318	  	 	 	46	  	 	 	67	  	 	 	1313	  	 	 	97	% 	 	 	3	% 	 	 	5	% 	 	 	95	% 
	 IT
	 	 	144	  	 	 	950	  	 	 	120	  	 	 	974	  	 	 	13	% 	 	 	87	% 	 	 	11	% 	 	 	89	% 
	 A & G
	 	 	130	  	 	 	9	  	 	 	57	  	 	 	82	  	 	 	94	% 	 	 	6	% 	 	 	41	% 	 	 	59	% 
	 Medical Management
	 	 	141	  	 	 	0	  	 	 	18	  	 	 	123	  	 	 	100	% 	 	 	0	% 	 	 	13	% 	 	 	87	% 
	 QA & Training
	 	 	100	  	 	 	0	  	 	 	98	  	 	 	2	  	 	 	100	% 	 	 	0	% 	 	 	98	% 	 	 	2	% 
		 				 				 				 				 				 				 				 			
	 TOTAL
	 	 	2969	  	 	 	1907	  	 	 	930	  	 	 	3962	  	 	 	61	% 	 	 	39	% 	 	 	19	% 	 	 	81	% 
		 	  
	  
	 	 	  
	  
	 	 	  
	  
	 	 	  
	  
	 	 	  
	  
	 	 	  
	  
	 	 	  
	  
	 	 	  
	  
	 

  

					
	Schedule Z2 - On-Off Summary		Page 2		Health Net / Cognizant Confidential

 Final 

Z3 -Health Net Transition Support Role Descriptions 
  

			
	 Role
	  	 Program Lead (Shared across all towers)

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    Authorized and mandated by Health Net to make decisions as may be
necessary.
  

•    Sound understanding of Health Net’s business operations

 
 •    Ability to provide
leadership for such large scale projects
  

•    Active Communication to Executive stakeholders

		
	Assigned Tasks	  	 Transition Readiness:
  

•    Communicate to key stakeholders about P5 initiative and objective

 
 •    Identify key
stakeholders across all functions who will work with Cognizant team to support this Transition.
  

•    Share roles and responsibilities of all identified stakeholders

 
 Process Assessment and Planning:

 
 •    Interact with the
Cognizant executive stakeholders to formally complete all relevant engagement and contractual documents
  

•    Collaborate with all teams within Health Net and ensure seamless migration of process to
Cognizant. Act as interface between Health Net and Cognizant delivery teams.
  
 Knowledge
Management:
  

•    Ensure that Knowledge Management Plan with timelines and expectations has been shared
with all key Health Net stakeholders

		
	 Role
	  	 Transition Manager

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    Extensive Project management skills and indepth understanding of
Health Net operations, people and overall organization environment
  

•    Ability to collaborate and design a joint Transition plan and take ownership of
deliverables
  

•    Ability to lead the project team towards defined goals

		
	Assigned Tasks	  	 Transition Readiness:
  

•    Provide inputs to identified stakeholders at Health Net on expectations during Process
Assessment Phase
  

•    Share details on key deliverables expected in PAT phase and share roles and
responsibilities of each of them in closure of those deliverables
  

•    Work with Program Lead and share expectations with Cognizant for different Transition
Phases
  
 •    Sign off
on high-level timelines
  
 Process Assessment and Planning:

 
 •    Co-ordinate with
Cognizant team and help them interact with process owners to understand As-Is process, people structure, technology, metrics, quality and all aspects of operational framework
  

•    Provide inputs to Cognizant team to help them perform Offshorability Analysis for in
scope Business and help them prepare Detailed Transition Plan at activity level
  

•    Closely track and ensure completion of all the engagement activities and related Health
Net deliverables throughout the Transition
  

•    Collaborate with all the key stakeholders across functions and ensure that Transition
Plan is executed seamlessly
  

•    Sign off on detailed Transition Plan

 
 Knowledge Management:

 
  

•    Identify key resources from process and documentation function who will work with
Cognizant in identifying the documentation gaps
  

•    Work with Cognizant and develop an update requirement plan (if documents are not 100%
updated)
  

•    Closely monitor KM Plan and ensure that all inputs have been shared by Health Net
stakeholders with no impact on timelines
  

•    Ensure completion of all Knowledge Management activities as per the plan prepared

 
 •    Review and validate
the final report on documentation gaps
  

•    Review and confirm the documentation update plan

		
	 Role
	  	 Supervisor

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    In-depth Process knowledge at an activity level

 
 •    In-depth knowledge
on SOP’s, Process and Training documentation, Desktop Procedures and other process nuances
  

•    Understanding of SLA’s and inputs that could potentially impact SLA
outputs

		
	Assigned Tasks	  	 Transition Readiness:
  

•    Identify and allocate subject matter experts who would be explaining the ‘as
is’ process
  

•    Review and provide inputs on Job Description for Cognizant team

 
 Process Assessment and Planning:

 
 •    Work closely with
Cognizant Team and give inputs from domain standpoint on all in scope processes
  

•    Provide a detailed list of in-scope and out of scope activity list

 
 •    Provide inputs on
current Operational Framework and related aspects and help them gather details pertaining to offshorable and on-shorable processes
  

•    Detailed walk through of the activities providing correlation between

 
 •    In-scope and out of
scope activities
  

•    Upstream and downstream process steps

 
 •    SOP’s, P &
P’s and Job Aids
  

•    Share details on As Is people profile and team structure and give inputs to prepare Job
Description
  

•    Share inputs on Key metrics and SLAs currently tracked at Health Net

 
 •    Sign off on
Documentation requirement and update plan
  
 Knowledge Management:

 
 •    Enable access to
Health Net’s subject matter experts who can demonstrate all in scope process scenarios to Cognizant team in a live or simulated production environment
  

•    Enable access to Cognizant team to view production systems, associate production process
to validate to be requirements
  

•    Review and provide inputs to Cognizant team on updated documents

 
 •    Sign off on updated
desktop procedures, P & Ps and Job aids

  

					
	Schedule Z3 - HN Role Descr.	  	Page 3	  	Health Net / Cognizant Confidential

 Final 

Z3 -Health Net Transition Support Role Descriptions 
  

			
	 Role
	  	 SME / QA

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    In-depth Process knowledge at an activity level

 
 •    In-depth knowledge
on SOP’s, Process and Training documentation, Desktop Procedures and other process nuances
  

•    Understanding of SLA’s and inputs that could potentially impact SLA outputs

 
 •    Process knowledge
at an activity level
  

•    Detailed knowledge on audit methodology and framework

 
 •    Thorough understand
of SLA and metrics
  

•    Management information system (MIS) reporting skills

		
	Assigned Tasks	  	 Transition Readiness:
  

•    Provide inputs pertaining Compliance and Regulatory requirements

 
 Process Assessment and Planning:

 
 •    Provide Inputs to
Cognizant team to develop
  

•    As Is Process maps

 
 •    Process related
documentation for in scope processes
  

•    List of In scope/out of scope activities, key handoffs, exceptions and key
dependencies
  

•    Help Cognizant team to identify and segregate all the sub processes into two areas -
Offshore and Onshore
  

•    Help Cognizant team to Identify key process areas that could potentially impact overall
SLA’s
  

•    Share details on As Is Training Framework in detail

 
 •    Interact with
Cognizant team to help them understand As Is quality framework and related aspects
  

•    Provide inputs on compliance related specific quality requirements (Legal, Statutory,
State specific, Federal, HIPAA, CMS etc.)
  

•    Give details on Job Description for Quality Auditor Role

 
 •    Provide inputs on
‘As Is’ understanding and help Cognizant team to capture detailed understanding of all performance related metrics and expectations from Health Net
  

Knowledge Management:
  

•    Demonstrate all in scope process scenarios to Cognizant team in a live or simulated
production environment
  

•    Review the updated documents through detailed walkthrough on SOP’s, P &
P’s and Job aids in a live or simulated production environment.
  

•    Provide detailed feedback to Cognizant team on updated training documents

 
 •    Demonstrate and
give detailed walkthrough to all documents related to Quality and Audit Framework to Cognizant’s team
  

•    Review, provide inputs and sign off on final updated audit documents

		
	 Role
	  	 Trainers

	Assigned Tasks	  	Train the Trainer, Training curriculum validation, Training shadowing guidance and feedback
		
	 Role
	  	 Quality Assurance

	 Assigned Tasks
	  	Quality Legend criteria design, calibration validation, reporting and feedback loop, QA standards review.
		
	 Role
	  	 SME

	 Assigned Tasks
	  	Agent shadowing, performance monitoring and validation, floor support, agent performance support, operations support.
		
	 Role
	  	 Production Support Services

		
	Health Net Personnel Role/
Job Description & Skill Set	  	 •    Ticket management

 
 •    Release
Management
  

•    Change Management

 
 •    Capacity
Planning

		
	 Assigned Tasks
	  	 •    Communicate to key stakeholders about P5 initiative and
objective
  

•    Identify key stakeholders across all functions who will work with Cognizant team to
support this Transition.
  

•    Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 Project / Program management

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    Project management

 
 •    Business
requirements
  

•    UAT Analysis

	 Assigned Tasks
	  	 •    Communicate to key stakeholders about P5 initiative and
objective
  

•    Identify key stakeholders across all functions who will work with Cognizant team to
support this Transition.
  

•    Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 Development Organization

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    Solutioning

 
 •    Development

 

•    Implementation

	 Assigned Tasks
	  	 •    Communicate to key stakeholders about P5 initiative and
objective
  

•    Identify key stakeholders across all functions who will work with Cognizant team to
support this Transition.
  

•    Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 Testing Services

	Health Net Personnel Role/
Job Description & Skill Set	  	 •    System Integration Testing

 
 •    UAT

	 Assigned Tasks
	  	 •    Communicate to key stakeholders about P5 initiative and
objective
  

•    Identify key stakeholders across all functions who will work with Cognizant team to
support this Transition.
  

•    Share roles and responsibilities of all identified stakeholders

  

					
	Schedule Z3 - HN Role Descr.	  	Page 4	  	Health Net / Cognizant Confidential

 Final 

Z3 -Health Net Transition Support Role Descriptions 
  

			
	 Role
	  	 Vendor Management

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Vendor management

 
 •     Contract
management
  

•     Invoicing

		
	Assigned Tasks	  	 •     Communicate to key stakeholders about P5 initiative and
objective
  

•     Identify key stakeholders across all functions who will work with Cognizant team
to support this Transition.
  

•     Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 System Architecture Services

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Technology Roadmap

 
 •     System
Analysis
  

•     Data Analytics Oversight

 

•     Architecture

		
	 Assigned Tasks
	  	 •     Communicate to key stakeholders about P5 initiative and
objective
  

•     Identify key stakeholders across all functions who will work with Cognizant team
to support this Transition.
  

•     Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 Security

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Physical

 
 •     System

 
 •     Audit and
Compliance

		
	 Assigned Tasks
	  	 •     Communicate to key stakeholders about P5 initiative and
objective
  

•     Identify key stakeholders across all functions who will work with Cognizant team
to support this Transition.
  

•     Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 IT Management

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Management

 

•     Communication

		
	 Assigned Tasks
	  	 •     Communicate to key stakeholders about P5 initiative and
objective
  

•     Identify key stakeholders across all functions who will work with Cognizant team
to support this Transition.
  

•     Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 ITO Transition Phases

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Database

 
 •     Desk Side

 
 •     Service
Desk
  

•     Active Directory

 
 •     Messaging
& Collaboration
  

•     Health Net Network Support

 
 •     Backup
Platform

		
	 Assigned Tasks
	  	 •     Communicate to key stakeholders about P5 initiative and
objective
  

•     Identify key HN and IBM stakeholders across all functions who will work with
Cognizant team to support this Transition.
  

•     Share roles and responsibilities of all identified stakeholders

		
	 Role
	  	 Knowledge transition planning

	Health Net Personnel Role/
Job Description & Skill Set	  	Preplanning
		
	Assigned Tasks	  	 •     Assist in pre-planning

 
 •     Assist in
transition oversight
  

•     Assist in escalation management

 
 •     Overall
responsibly to ensure all knowledge is shared from HN resources.

		
	 Role
	  	 Compliance POC

	Health Net Personnel Role/
Job Description & Skill Set	  	 •     Sound understanding of State and Federal Regulations and
Compliance
  

•     Sound understanding of Health Net’s internal polcies and procedures from a
compliance stand point
  

•     Active communication to onshore and offshore team about the changes to compliance
and implementation of the same

		
	Assigned Tasks	  	 •     Provide oversight on compliance to both onshore and offshore
team
  

•     Ensure adherence to compliance

 
 •     Report any
deviations on compliance and implement corrective and preventive actions

  

					
	Schedule Z3 - HN Role Descr.	  	Page 5	  	Health Net /Cognizant Confidential

 Final 

Z4 - Health Net Transition Support Personnel Levels 
  

																					
	 Tower(s)
	  	 Location
	  	 Role
	  	 Health Net Personnel Role/

Job Description & Skill Set
	  	 Transition Phase(s)
	  	 Start
Month
	  	 End Month
	  	 No. Resources
	  	 Per Resource % Time

Commitment
	  	 Seed Team

Support
	  	 Assigned Tasks

											
	 SOW#1 Claims

SOW#2 M&C

SOW#5 QA, Training

SOW#6 A&G

SOW#7 Med Mgmt
	  	Wood Land Hills / Rancho	  	Program Lead (Shared across all towers)	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Jul-15	  	1	  	Approx 100% (15% per Tower)	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	Transition Manager	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Apr-15	  	1	  	100%	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	Supervisor	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	20	  	 10% through Sep-14
 15% thereafter
	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	20	  	25%	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 1)	  	Nov-14	  	Feb-15	  	4+4 = 8	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 2)	  	Jan-15	  	Feb-15	  	4+4 = 8	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#1 Claims
	  	Wood Land Hills / Rancho	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 3)	  	Jul-15	  	Feb-15	  	1+1 = 2	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	Transition Manager	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Jul-15	  	1 for Membership 1 for Configuration	  	100%	  		  	See “Role Desc” tab
											
	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	Supervisor	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	18 for Membership 11 for Configuration	  	 10% through Sep-14
 15% thereafter
	  		  	See “Role Desc” tab
											
	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	18 for Membership 11 for Configuration	  	25%	  		  	See “Role Desc” tab

  

					
	Schedule Z4 - HN Pers. Supp.	  	Page 6	  	Health Net / Cognizant Confidential

 Final 

Z4 - Health Net Transition Support Personnel Levels 
  

																					
	 Tower(s)
	  	 Location
	  	 Role
	  	 Health Net
Personnel
Role/ Job
Description
&
Skill Set
	  	 Transition
Phase(s)
	  	 Start
Month
	  	 End
Month
	  	 No.
Resources
	  	 Per Resource %
Time Commitment
	  	 Seed
Team
Support
	  	 Assigned
Tasks

	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 1)	  	Nov-14	  	Feb-15	  	(2+2) = 4 for Membership (1+1) = 2 for Configuration	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 2)	  	Jan-15	  	Feb-15	  	(4+4) = 8 for Membership (1+1) = 2 for Configuration	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#2 M&C
	  	Wood Land Hills / Rancho / San Rafael	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 3)	  	Oct-15	  	Feb-15	  	(4+4) = 8 for Membership (1+1) = 2 for Configuration	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Knowledge transition planning	  	See “Role Desc” tab	  	Pre-planning	  	Nov-14	  	Oct-14	  	7	  	25%	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Production Support Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	11	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Project / Program management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	13	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Development Organization	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	7	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Testing Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	2	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Vendor Management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	System Architecture Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	8	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	Security	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab

  

					
	Schedule Z4 - HN Pers. Supp.	  	Page 7	  	Health Net / Cognizant Confidential

 Final 

Z4 - Health Net Transition Support Personnel Levels 
  

																					
	 Tower(s)
	  	 Location
	  	 Role
	  	 Health Net
Personnel
Role/ Job
Description
&
Skill Set
	  	 Transition
Phase(s)
	  	 Start
Month
	  	 End
Month
	  	 No.
Resources
	  	 Per Resource % Time
Commitment
	  	 Seed
Team
Support
	  	 Assigned
Tasks

	 SOW#4 IT
	  	Woodland Hills	  	IT Management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Woodland Hills	  	ITO Transition phases	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Oct-15	  	15	  	25% during first 2-3 weeks (2 hours/day during KT) of each phase 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Knowledge transition planning	  	See “Role Desc” tab	  	Pre-planning	  	Oct-14	  	Oct-14	  	7	  	25%	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Production Support Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	11	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Project / Program management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	2	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Development Organization	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	8	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Testing Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Vendor Management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	System Architecture Services	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	8	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	Security	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#4 IT
	  	Rancho Cordova	  	IT Management	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Nov-14	  	Feb-15	  	1	  	25% during first 2-3 weeks (2 hours/day during KT) 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab

  

					
	Schedule Z4 - HN Pers. Supp.	  	Page 8	  	Health Net / Cognizant Confidential

 Final 

Z4 - Health Net Transition Support Personnel Levels 
  

																					
	 Tower(s) 
	  	 Location
	  	 Role
	  	 Health Net
Personnel
Role/ Job
Description
&
Skill Set
	  	 Transition
Phase(s)
	  	 Start
Month
	  	 End Month
	  	 No.
Resources
	  	 Per Resource %
Time Commitment
	  	 Seed
Team
Support
	  	 Assigned
Tasks

											
	 SOW#4 IT
	  	Rancho Cordova	  	ITO Transition phases	  	See “Role Desc” tab	  	Knowledge transition Shadow and Reverse Shadow	  	Sep-14	  	Feb-15	  	15	  	25% during first 2-3 weeks (2 hours/day during KT) of each phase 12.5% thereafter (5 hours/week during shadow/reverse shadow)	  		  	See “Role Desc” tab
											
	 SOW#5 QA, Training
	  	Wood Land Hills / Rancho	  	Transition Manager	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Mar-15	  	1	  	100%	  		  	See “Role Desc” tab
											
	 SOW#5 QA, Training
	  	Wood Land Hills / Rancho	  	Supervisor	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	6	  	 10% through Sep-14
 15% thereafter
	  		  	See “Role Desc” tab
											
	 SOW#5 QA, Training
	  	Wood Land Hills / Rancho/San Rafael	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	11	  	25%	  		  	See “Role Desc” tab
											
	 SOW#6 A&G
	  	Wood Land Hills	  	Transition Manager	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Apr-15	  	1	  	100%	  		  	See “Role Desc” tab
											
	 SOW#6 A&G
	  	Wood Land Hills	  	Supervisor	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	11	  	 10% through Sep-14
 15% thereafter
	  		  	See “Role Desc” tab
											
	 SOW#6 A&G
	  	Wood Land Hills	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	11	  	25%	  		  	See “Role Desc” tab
											
	 SOW#6 A&G
	  	Tempe, AZ 85281	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	1	  	25%	  		  	See “Role Desc” tab
											
	 SOW#6 A&G
	  	Wood Land Hills	  	SME / QA	  	See “Role Desc” tab	  	Seed Team (wave 1)	  	Nov-14	  	Feb-15	  	2+2 = 4	  	 Month 1 - 50% SME & 50%
 Trainer

Month 2 - 25% SME & 25%
 Trainer

Month 3 to 6 - 25% SME &
 0% Trainer
	  		  	See “Role Desc” tab
											
	 SOW#7 Med Mgmt
	  	Wood Land Hills	  	Transition Manager	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Jul-15	  	1	  	100%	  		  	See “Role Desc” tab
											
	 SOW#7 Med Mgmt
	  	Wood Land Hills	  	Supervisor	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Feb-15	  	4	  	 10% through Sep-14
 15% thereafter
	  		  	See “Role Desc” tab
											
	 SOW#7 Med Mgmt
	  	Wood Land Hills	  	SME / QA	  	See “Role Desc” tab	  	 Transition Readiness
 Process Assessment and
Planning Knowledge Management
	  	Sep-14	  	Jul-15	  	4	  	25%	  		  	See “Role Desc” tab
											
	 All Towers
	  	All Locations	  	Compliance POC	  	See “Role Desc” tab	  	All Phase	  	Nov-14	  	Dec-16	  	1 per tower	  	On need basis	  		  	See “Role Desc” tab

  

					
	Schedule Z4 - HN Pers. Supp.	  	Page 9	  	Health Net / Cognizant Confidential

	
	

  

 Z5—Health Net Provided Transition Work Space 
Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference rooms. 
Number of Work Spaces by Month Location/ Tower Address/ Phase 
Sep-14 Oct-14 Nov-14 Dec-14
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 
Related Services Notes Combined Gold Pointe 
40 105 125 125 142 142 130 130 119 119 126 122 122
126 96 81 50 50 47 45 45 42 41 38 38 38 38 38 
Rancho 11931 Foundation Place Bldg D, Rancho Cordova CA 95670 
40 102 102 102 102 102 90 90 88 88 88 88 88 88 58 43 28 28 28 28 28 28 28 25 25 25 25 
Access
to Internet, Telephones, 25 Access to Cafeteria and Car parking 
Mimimal workstations required for Process Assessment team as most of them would carry laptops and
can work from Conference rooms. Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference rooms. Mimmal workstations required for Process Assessment team as most of them would carry
laptops and can work from Conference rooms. 
Configuration Process Assessment 2 2 2 
All resources concerned 
Configuration 
Knowledge Management 2 2 2 2 
Configuration 
Staff Augmentation team 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 
IT Assessment 10 
IT Knowledge Management 40 40 40 40 40 
IT Steady State 25 25 25 25 25 25 25 25 25 25 25 25

25 25 25 25 25 25 25 25 25 25 IT 
Additional FTE requested 30 60 60 60 60 60
60 60 60 60 60 60 60 60 30 15 
Rancho 11971 Foundation Place Bldg C—Rancho Cordova CA 95670 0 
23 23 40 40 40 40 31 31 38 34 34 38 38 38 22 22 19 17 17 14 13 13 13 13 13 
Access to Internet,
Telephones, 13 Access to Cafeteria and Car parking 
Membership Process Assessment 1 1 1 
All resources concerned Membership Knowledge Management (Count) 13 13 13 13 6 6 3 3 3 3 3 3 3 3 3 3 3 
Membership Staff Augmentation team 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 
Quality Assurance Knowledge
Management 4 4 6 6 6 6 6 6 9 5 5 3 3 3 3 3 3 1 1 1 
Claims Process Assessment 2 2 2 
Claims Knowledge Management 2 2 2 2 
Claims Staff Augmentation Team 16 16 19 19 19 19 19 19 26
26 26 26 26 26 10 10 7 7 7 7 7 7 7 7 7 7 
Combined LNR 10 58 104 104 147 147 231 231 211 197 206 201 201 186 154 134 84 84 63 62 62 56 53 38 38 38 38 38 
Woodland Hills 21271 Burbank Blvd. Building B — Floors 2-3 Woodland Hills CA 91367 10 47 47 47 47 47 103 103 103 103 103 103 103 103 71 51 31 31 31 31 31 31 31 31 31 31 31

Access to Internet, Telephones, 31 Access to Cafeteria and Car parking IT Assessment 10 All resources concerned IT Knowledge Management 47 47 47 47 47 IT

Steady State 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31

IT Additional FTE requested 72 72 72 72 72 72 72 72 40 20 
Woodland Hills

21271 Burbank Blvd. Building C — Floors 2-5 Woodland Hills CA 91367 0 7 34 34 77 91 91 75 61 55 50 50 54 54 54 24 24 17 16 10 7 7 7 7 7 Access to Internet,
Telephones, 
Medical Management 
Process Assessment 8 8 
Schedule Z5 - HN Work Space Page10 Health Net / Cognizant Confidential 

	
	

  

 Z5—Health Net Provided Transition Work Space 
Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference rooms. Mimimal workstations required for Process
Assessment team as most of them would carry laptops and can work from Conference rooms. Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference rooms. Mimimal workstations required
for Process Assessment team as most of them would carry laptops and can work from Conference rooms. Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference rooms. Number of Work
Spaces by Month Location/ Tower 
Address/ Phase Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 
Related Services Notes Medical Management Knowledge Management & Train
the Trainer 14 14 14 
All resources concerned Claims Process Assessment 3 3 3 Claims Knowledge Management 3 3 3 3 
Claims Staff Augmentation Team 2 2 9 9 9 9 9 9 9 9 9 9 9 9 7 7 Quality Assurance Process Assessment 2 2 2 Quality Assurance 
Knowledge Management 4 4 11 11 11 11 12 12 12 7 7 4 4 4 4 4 4 3 3 3 
Membership Process
Assessment 2 2 2 
Membership Knowledge Management (Count) 26 26 26 26 12 12 6 6 6 6 6 6 6 6 6 6 6 
Membership Staff Augmentation team 13 13 28 28 28 28 28 28 28 28 28 35 35 35 7 7 7 7 7 7 7 7 7 7 7 7 
Woodland Hills 21281 Burbank Blvd. Building B — Floors 1-5 Woodland Hills CA 91367 0 4 23 23 23 23 37 37 33 33 48 48 48 29 29 29 29 29 15 15 15 15 15 0 0 0 0 
Access to Internet, Telephones, 0 Access to Cafeteria and Car parking Appeals and Grievances Process Assessment 2 2 2 
All resources concerned Appeals and Grievances Knowledge Management 2 2 2 2 
Appeals and
Grievances Staff Augmentation Team 19 19 19 19 19 19 19 19 19 19 19 
Configuration Process Assessment 2 2 2 
Configuration Knowledge Management 2 2 2 2 
Configuration Staff Augmentation team 14 14 14 14
29 29 29 29 29 29 29 29 15 15 15 15 15 
San Rafael 2370 Kerner Boulevard San Rafael, CA 94901 0 3 3 3 3 3 3 3 0 0 0 0 0 3 3 3 3 3 3 3 3 3 2 2 2 2 2 2 
Access to Internet, Telephones, Access to Cafeteria and Car parking 
Appeals and Grievances
Process Assessment 2 2 2 

	
	

  

 Z5—Health Net Provided Transition Work Space 
Number of Work Spaces by Month 
Location/ Tower 
Address/ Phase 
Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15
Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 
Related Services Notes Appeals and
Grievances Knowledge Management 2 2 2 2 
Mimimal workstations required for Process Assessment team as most of them would carry laptops and can work from Conference
rooms. Membership Process Assessment 1 1 1 All resources concerned Membership Knowledge Management 1 1 1 1 Membership Staff Augmentation Team 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 Quality Assurance Knowledge Management 1 1 1 1 1 1 1 1 1 
Tempe 1230 W Washington St, Tempe, AZ 85281, United States 0 2 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 
Access to Internet, Telephones, Access to Cafeteria and Car parking 
Appeals and Grievances
Process Assessment 2 2 2 
Appeals and Grievances Knowledge Management 2 2 2 2

50168 234 234 294 294 366 366 330 316 332 323 323 315 253 218 137 137 113 110 110 101 96 78 78 78 78 78 

	
	

  

 Final 

Z6—Ramp-Down Plan 
FTE Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15
Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 TOWER M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12 M13 M14 M15 M16 M17 M18 M19 M20 M21 M22 M23 M24 
Claims 424 424 424 424 424 424 424 424 424 424 403 393 371 347 331 315 298 272 263 242 234 227 220 214 207 51% 49% 
Membership 510 510 510 510 510 510 510 510 510 510 493 484 458 431 414 396 379 361 343 335 326 326 307 297 268 47% 53% 
Configuration 202 202 202 202 202 202 202 202 202 202 202 202 202 193 189 184 177 168 149 134 125 117 108 99 94 54% 46% 
Contact Center 1318 1180 1005 780 649 535 475 440 365 205 123 123 123 123 123 123 123 123 123 123 123 123 123 123 123 91% 9% IT 144 144 144 144 144 144 144 140 138 137 133 133 133
131 131 131 131 131 131 127 127 127 125 123 120 17% 83% 
A & G 130 130 130 130 130 130 130 130 130 130 127 123 120 115 110 103 93 89 86 80 75 67 60 58 57 56%
44% 
Medical Management 141 141 141 141 141 141 141 117 117 81 51 20 19 18 18 18 18 18 18 18 18 18 18 18 18 87% 13% 
QA & Training 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 98 2% 98% 
TOTAL 2969 2831 2656 2431 2300 2186 2126 2063 1986 1789 1632 1578 1525 1459 1415 1370 1319 1262 1213 1158 1127 1105 1061 1032 985 67% 33% Aggregate Variance by Month 0 138 313 538
669 783 843 906 983 1180 1337 1391 1444 1510 1554 1599 1650 1707 1756 1811 1842 1864 1908 1937 1984 
Approximate (Phase 2) End 
State Off Shore Ratio** 
Approximate (Phase 2) End 
State On Shore Ratio** 
Resource ramp within the P5 structure to support transition and service
continuity will be managed as per the phase 2 solution and will not require staffing increases from a HealthNet perspective Normal attrition will be managed within the forecast (95% acceptance rates with 20% attrition in the first year) Redeployment
will be offered for each resource pool per month but will be dictated based on resource demand and released resource skill sets, location preferences and role applicability End state changes to the on shore / rebadged headcount post 24 months will
be managed by Cognizant and may change based on the detailed solution operating model Role by role definitions of on / off shore by tower and process category will be dependent on the detailed HR system data transfer and finalized post MSA signature
but prior to the start of phase 2 On shore resources will be required to support regulatory, voice and commercial contract requirements as per the on shore required tab General functional wave by wave transition schedules are outlined in each of the
SOW exhibit A-2 schedules 
** Does not include current state delivery from CTS

Schedule Z6 - Ramp-Down Plan 
Page 13 
Health Net / Cognizant Confidential 

	
	

  

 Z7—Offshore Ramp-Up Plan

Onshore 
Offshore 
Mar-15 
Apr-15 
May-15 
Jun-15 
Jul-15 
Aug-15 
Sep-15 
Oct-15 
Nov-15 
Dec-15 
Jan-16 
Feb-16 
Mar-16 
Apr-16 
May-16 
Jun-16 
Jul-16 
Aug-16 
Sep-16 
Oct-16 
TOWER 
Current 
Current 
M1

M2 
M3 
M4 
M5 
M6

M7 
M8 
M9 
M10

M11 
M12 
M13 
M14

M15 
M16 
M17 
M18

M19 
M20 
Claims 
424

782 
0 
0 
0 
0

0 
0 
0 
0 
0

21 
31 
53 
77 
93

109 
126 
152 
161

182 
190 
Membership 
510 
120 
0 
0

0 
0 
0 
0 
0

0 
0 
17 
26 
52

79 
96 
114 
131

149 
167 
175 
184

Configuration 
202 
0 
0 
0

0 
0 
0 
0 
0

0 
0 
0 
0 
0

9 
13 
18 
25 
34

53 
68 
77 
Contact Center 
1318 
0

95 
254 
339 
399

559 
705 
784 
824

824 
875 
875 
915

915 
974 
1034 
1084

1134 
1181 
1181 
1181

IT 
144 
950 
0 
0

0 
0 
0 
0 
4

6 
7 
11 
11 
11

13 
13 
13 
13 
13

13 
17 
17 
A & G 
130 
9 
0

0 
0 
0 
0 
0

0 
0 
0 
3 
7

10 
15 
20 
27 
37

41 
44 
50 
55

Medical Management 
141 
0 
0 
0

0 
0 
0 
0 
24

24 
60 
90 
121

122 
123 
123 
123

123 
123 
123 
123

123 
QA & Training 
100 
0 
0

0 
0 
0 
0 
0

0 
0 
0 
0 
0

0 
0 
0 
0 
0

0 
0 
0 
0

TOTAL 
2969 
1861 
95

254 
339 
399 
559

705 
812 
854 
891

1017 
1071 
1164 
1230

1333 
1438 
1539 
1646

1742 
1797 
1828 
Final

Aggregate Variance by Month (onshore) 
95 
254 
339

399 
559 
705 
812

854 
891 
1017 
1071

1164 
1230 
1333 
1438

1539 
1646 
1742 
1797

1828 
Schedule Z7 - Offshore Ramp-Up 
Page15 
Health Net / Cognizant Confidential 

	
	

  

 Z7 - Offshore Ramp-Up Plan 
Onshore
Offshore 
TOWER Current Current 
Claims 424 782 
Membership 510 120 
Configuration 202 0 
Contact Center 1318 0 
IT 144 950 
A & G 130 9 
Medical Management 141 0 
QA & Training 100 0 
TOTAL 2969 1861 
Aggregate Variance by Month (onshore) 
Nov-16 Dec-16 Jan-17 Feb-17 Onshore Offshore 
M21 M22 M23 M24 End State End State 
197 204 210 217 207 999 83% 17% 
184 203 213 242 268 362 57% 43% 
85 94 103 108 94 108 54% 46% 
1181 1181 1181 1181 153 1181 89% 11% 
17 19 21 24 120 974 89% 11% 
63 70 72 73 57 82 59% 41% 
123 123 123 123 18 123 87% 13% 
0 0 0 2 98 2 2% 98% 
1850 1894 1923 1970 1015 3831 79% 21% 
1850 1894 1923 1970 
** Does not include current state delivery from CTS 
Further optimization of workforce may exist post 24 months depending on final operating model

Approximate (Phase 2) 
End State Off Shore 
Ratio** 
Approximate (Phase 2) 
End State On Shore 
Ratio** 

	
	

  

 Z8—Required Onshore Positions

Resource Count Onshore by Location 
Tower 
Total Scope 
**HN Required Onshore 
Voice 
Regulatory / Commercial Contract 
Claims 
424

0 
70 
Membership (incl. Configuration) 
712 
0 
24

Appeals & Grievance 
130 
0 
15

Medical Management 
141 
0 
0 
QA
& Training 
100 
0 
24 
IT

144 
0 
0 
Call Center 
1318 
0

153 
Total 
2969 
0

286 
Schedule Z8 - Req’d Onshore Pos’ns 
Operations Tower 
M1 
M6 
M12

M18 
M24 
M30 
M36

1508 
1508 
1269 
960

744 
559 
508 
Woodland Hills 
59% 
892

892 
751 
568 
440

340 
309 
Glandale 
2% 
23 
23 
19

15 
11 
0 
0

Huntinton Beach 
0% 
4 
4 
3

3 
2 
0 
0

Rancho Cordova 
36% 
538 
538

452 
342 
265 
219

198 
San Rafael 
3% 
38 
38

32 
24 
19 
0 
0

Tempe, AZ 
1% 
8 
8 
7

5 
4 
0 
0

CT/Remote 
0% 
5 
5 
4

3 
2 
0 
0 
San
Diego 
0% 
1 
1 
1 
1

0 
0 
0 
Page 16

Health Net / Cognizant Confidential 

	
	

  

 Z9 - Staff Augmentation Plan 
Staff
augmentation team requirement by Tower 
M-6 
M-5 
M-4 
M-3

M-2 
M-1 
M-0 
M1

M2 
M3 
M4 
M5 
M6

M7 
M8 
M9 
M10

M11 
M12 
M13 
M14

M15 
M16 
M17 
M18

M19 
M20 
M21 
M22

M23 
M24 
M25 
Tower

Trainers for offshore KT 
QAs for offshore ramp 
Staff Augmentation Team required 
Jun 
Jul 
Aug

Sep 
Oct 
Nov 
Dec

Jan 
Feb 
Mar 
Apr

May 
Jun 
Jul 
Aug

Sep 
Oct 
Nov 
Dec

Jan 
Feb 
Mar 
Apr

May 
Jun 
Jul 
Aug

Sep 
Oct 
Nov 
Dec

Jan 
Claims 
12 
23 
35

18 
18 
28 
28 
28

28 
28 
28 
35 
35

35 
35 
35 
35 
17

17 
7 
7 
7 
7

7 
7 
7 
7 
0

0 
0 
Membership 
13 
30 
28 
13

13 
28 
28 
28 
28

28 
28 
28 
28 
28

43 
43 
43 
15 
15

15 
15 
15 
15 
15

15 
15 
15 
15 
15

0 
Benefits Config 
5 
27 
32

14 
14 
14 
14 
32

32 
32 
32 
32 
32

32 
32 
18 
18 
18

18 
0 
0 
0 
0

0 
0 
0 
A&G

4 
15 
19 
19 
19

19 
19 
19 
19 
19

19 
19 
19 
19 
0

0 
0 
0 
0 
0

0 
0 
0 
0 
0

0 
0 
0 
0 
0

Medical Management 
14 
14 
14 
14

TOTAL 
48 
95 
114 
0

0 
0 
0 
0 
50

50 
75 
75 
103

103 
103 
89 
114

114 
114 
110 
110

110 
64 
64 
40 
40

40 
40 
22 
22 
22

22 
15 
15 
0

Notes 
Trainers required to train the staff augmentation team 
M-6 
M-5

M-4 
M-3 
M-2 
M-1

M-0 
M1 
M2 
M3 
M4

M5 
M6 
M7 
M8 
M9

M10 
M11 
M12 
M13

M14 
M15 
M16 
M17

M18 
M19 
M20 
M21

M22 
M23 
M24 
M25

Tower 
Trainer/SME required for Seed team 
Jun 
Jul

Aug 
Sep 
Oct 
Nov

Dec 
Jan 
Feb 
Mar

Apr 
May 
Jun 
Jul

Aug 
Sep 
Oct 
Nov

Dec 
Jan 
Feb 
Mar

Apr 
May 
Jun 
Jul

Aug 
Sep 
Oct 
Nov

Dec 
Jan 
Claims 
1044888844222222 
Membership 
16 
3 
3 
10

10 
10 
10 
7 
7

0 
0 
0 
6 
6

6 
6 
6 
6

Benefits Config 
3 
1 
1 
1

1 
3 
3 
2 
2

2 
2 
A&G 
2

2 
2 
2 
2 
2

2 
TOTAL 
31 
9 
9

20 
20 
21 
21 
12

12 
5 
5 
4 
10

10 
10 
6 
6 
6

0 
0 
0 
1 Staff Augmentation team will consist of processors who will be trained and deployed by HN
in its onshore operations 
2 Staff Augmentation team will create additional capacity for HN, enabling the release of more experienced resources to support offshore
knowledge transfer and ramp up 
3 The Staff Augmentation team needs to be deployed by Nov 2014 to allow sufficient time for the seed to learn the processes and
become fully productive, to enable release of more experienced HN resources for offshore Transition 
4 No Staff Augmentation team required for Medical Management
and the QA/Training tower 
5 Trainer ratios assumed in the above estimation are ~ 1:20-25 
6 QA Ratios assumed in the above estimation are ~ 1:10 for Claims, ~ 1: 6-8 for Membership, ~ 1:5 for A&G and ~ 1: 3-5 for Configuration area 
7 Number of Trainers required to train the Staff Augmentation team are based on the number of processes within tower in which the Staff Augmentation team needs to be deployed

8 Trainers needed to train the Medical Management trainers is not listed 
1

Schedule Z9 - Staff Augmentation 
Page 17 
Health Net / Cognizant Confidential 

	
	

  

 Schedule Z10 - BPaaS Transition

Medical Management 
Jul-14 
Aug-14 
Sep-14 
Oct-14 
Nov-14 
Dec-14 
Jan-15 
Feb-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Jul-14 
4-Aug-14 
11-Aug-14 
18-Aug-14 
25-Aug-14 
1-Sep-14 
8-Sep-14 
15-Sep-14 
22-Sep-14 
29-Sep-14 
6-Oct-14 
13-Oct-14 
20-Oct-14 
27-Oct-14 
3-Nov-14 
10-Nov-14 
17-Nov-14 
24-Nov-14 
1-Dec-14 
8-Dec-14 
15-Dec-14 
22-Dec-14 
29-Dec-14 
5-Jan-15 
12-Jan-15 
19-Jan-15 
26-Jan-15 
2-Feb-15 
9-Feb-15 
16-Feb-15 
23-Feb-15 
2-Mar-15 
9-Mar-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
Gather & Finalize Technology requirements – applications required

CTS 
8-Dec-14 
26-Dec-14 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
23-Jan-15 
Capture Documentation gap - Training Documents 
CTS 
5-Jan-15 
30-Jan-15 
Capture Documentation gap - Process PnP’s Documents 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
26-Jan-15 
27-Feb-15 
Accommodate Changes Suggested by Health Net 
CTS 
26-Jan-15 
27-Feb-15 
Evaluate Health Net Trainer availability to train Supplier Trainers 
CTS 
9-Feb-15 
27-Feb-15 
Evaluate Transaction Quality Auditor availability to audit offshore staff

CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
HN & CTS 
2-Feb-15 
27-Mar-15 
Create or update the available SOPs, P&Ps 
CTS 
16-Feb-15 
27-Feb-15 
Create or update the Training docs 
CTS 
2-Mar-15 
13-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
16-Mar-15 
27-Mar-15 
Accommodate Changes based on HN review 
CTS 
16-Mar-15 
27-Mar-15 
Page19 
Health Net / Cognizant Confidential 

	
	

  

 Medical Management 
Mar-15

Apr-15 
May-15 
Jun-15 
Jul-15 
Aug-15 
Sep-15 
Oct-15 
Nov-15 
Dec-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
16-Mar-15 
23-Mar-15 
30-Mar-15 
6-Apr-15 
13-Apr-15 
20-Apr-15 
27-Apr-15 
4-May-15 
11-May-15 
18-May-15 
25-May-15 
1-Jun-15 
8-Jun-15 
15-Jun-15 
22-Jun-15 
29-Jun-15 
6-Jul-15 
13-Jul-15 
20-Jul-15 
27-Jul-15 
3-Aug-15 
10-Aug-15 
17-Aug-15 
24-Aug-15 
31-Aug-15 
7-Sep-15 
14-Sep-15 
21-Sep-15 
28-Sep-15 
5-Oct-15 
12-Oct-15 
19-Oct-15 
26-Oct-15 
2-Nov-15 
9-Nov-15 
16-Nov-15 
23-Nov-15 
30-Nov-15 
7-Dec-15 
14-Dec-15 
21-Dec-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
Gather & Finalize Technology requirements – applications required

CTS 
8-Dec-14 
26-Dec-14 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
23-Jan-15 
Capture Documentation gap - Training Documents 
CTS 
5-Jan-15 
30-Jan-15 
Capture Documentation gap - Process PnP’s Documents 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
26-Jan-15 
27-Feb-15 
Accommodate Changes Suggested by Health Net 
CTS 
26-Jan-15 
27-Feb-15 
Evaluate Health Net Trainer availability to train Supplier Trainers 
CTS 
9-Feb-15 
27-Feb-15 
Evaluate Transaction Quality Auditor availability to audit offshore staff

CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
HN & CTS 
2-Feb-15 
27-Mar-15 
Create or update the available SOPs, P&Ps 
CTS 
16-Feb-15 
27-Feb-15 
Create or update the Training docs 
CTS 
2-Mar-15 
13-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
16-Mar-15 
27-Mar-15 
Accommodate Changes based on HN review 
CTS 
16-Mar-15 
27-Mar-15 

	
	

  

 Schedule Z10 - BPaaS Transition

Medical Management 
Jan-16 
Feb-16 
Mar-16 
Apr-16 
May-16 
Jun-16 
Jul-16 
Aug-16 
Sep-16 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Dec-15 
4-Jan-16 
11-Jan-16 
18-Jan-16 
25-Jan-16 
1-Feb-16 
8-Feb-16 
15-Feb-16 
22-Feb-16 
29-Feb-16 
7-Mar-16 
14-Mar-16 
21-Mar-16 
28-Mar-16 
4-Apr-16 
11-Apr-16 
18-Apr-16 
25-Apr-16 
2-May-16 
9-May-16 
16-May-16 
23-May-16 
30-May-16 
6-Jun-16 
13-Jun-16 
20-Jun-16 
27-Jun-16 
4-Jul-16 
11-Jul-16 
18-Jul-16 
25-Jul-16 
1-Aug-16 
8-Aug-16 
15-Aug-16 
22-Aug-16 
29-Aug-16 
5-Sep-16 
12-Sep-16 
19-Sep-16 
26-Sep-16 
3-Oct-16 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
Gather & Finalize Technology requirements – applications required 
CTS 
8-Dec-14 
26-Dec-14 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
23-Jan-15 
Capture Documentation gap - Training Documents 
CTS 
5-Jan-15 
30-Jan-15 
Capture Documentation gap - Process PnP’s Documents 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
26-Jan-15 
27-Feb-15 
Accommodate Changes Suggested by Health Net 
CTS 
26-Jan-15 
27-Feb-15 
Evaluate Health Net Trainer availability to train Supplier Trainers 
CTS 
9-Feb-15 
27-Feb-15 
Evaluate Transaction Quality Auditor availability to audit offshore staff 
CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
HN & CTS 
2-Feb-15 
27-Mar-15 
Create or update the available SOPs, P&Ps 
CTS 
16-Feb-15 
27-Feb-15 
Create or update the Training docs 
CTS 
2-Mar-15 
13-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
16-Mar-15 
27-Mar-15 
Accommodate Changes based on HN review 
CTS 
16-Mar-15 
27-Mar-15 
Page 20 
Health Net / Cognizant Confidential 

	
	

  

 Schedule Z10 - BPaaS Transition

Medical Management 
Oct-16 
Nov-16 
Dec-16 
Jan-17 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
10-Oct-16 
17-Oct-16 
24-Oct-16 
31-Oct-16 
7-Nov-16 
14-Nov-16 
21-Nov-16 
28-Nov-16 
5-Dec-16 
12-Dec-16 
19-Dec-16 
26-Dec-16 
2-Jan-17 
9-Jan-17 
16-Jan-17 
23-Jan-17 
30-Jan-17 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
Gather & Finalize Technology requirements – applications required

CTS 
8-Dec-14 
26-Dec-14 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
23-Jan-15 
Capture Documentation gap - Training Documents 
CTS 
5-Jan-15 
30-Jan-15 
Capture Documentation gap - Process PnP’s Documents 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
26-Jan-15 
27-Feb-15 
Accommodate Changes Suggested by Health Net 
CTS 
26-Jan-15 
27-Feb-15 
Evaluate Health Net Trainer availability to train Supplier Trainers 
CTS 
9-Feb-15 
27-Feb-15 
Evaluate Transaction Quality Auditor availability to audit offshore staff

CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
HN & CTS 
2-Feb-15 
27-Mar-15 
Create or update the available SOPs, P&Ps 
CTS 
16-Feb-15 
27-Feb-15 
Create or update the Training docs 
CTS 
2-Mar-15 
13-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
16-Mar-15 
27-Mar-15 
Accommodate Changes based on HN review 
CTS 
16-Mar-15 
27-Mar-15 
Page29 
Health Net / Cognizant Confidential 

	
	

  

 Transition Activities 
5 
Phase :- Re-badging Health Net Staff 
2-Mar-15 
2-Mar-15 
6

Phase :-TTT Phase @ Health Net USA 
6-Apr-15 
29-May-15 
TTT @ Health NET (Class Room) 
HN 
6-Apr-15 
17-Apr-15 
On Job Training 
HN 
20-Apr-15 
29-May-15 
7 
Phase :-Offshore Knowledge Transfer :- MM Wave 1-Intake Process - CCR & HNU 
1-Jun-15

19-Jun-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 1 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 1 
CTS 
19-Oct-15 
Phase :-Offshore Knowledge Transfer :- MM Wave 2-Intake Process - MRU & PCU 
CTS

1-Jun-15 
24-Jul-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 2 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 2 
CTS 
19-Oct-15 

	
	

  

 Transition Activities 
5 
Phase :- Re-badging Health Net Staff 
2-Mar-15 
2-Mar-15 
6

Phase :-TTT Phase @ Health Net USA 
6-Apr-15 
29-May-15 
TTT @ Health NET (Class Room) 
HN 
6-Apr-15 
17-Apr-15 
On Job Training 
HN 
20-Apr-15 
29-May-15 
7 
Phase :-Offshore Knowledge Transfer :- MM Wave 1-Intake Process - CCR & HNU 
1-Jun-15

19-Jun-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 1 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 1 
CTS 
19-Oct-15 
Phase :-Offshore Knowledge Transfer :- MM Wave 2-Intake Process - MRU & PCU 
CTS

1-Jun-15 
24-Jul-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 2 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 2 
CTS 
19-Oct-15 

	
	

  

 Transition Activities 
5 
Phase :- Re-badging Health Net Staff 
2-Mar-15 
2-Mar-15 
6

Phase :-TTT Phase @ Health Net USA 
6-Apr-15 
29-May-15 
TTT @ Health NET (Class Room) 
HN 
6-Apr-15 
17-Apr-15 
On Job Training 
HN 
20-Apr-15 
29-May-15 
7 
Phase :-Offshore Knowledge Transfer :- MM Wave 1-Intake Process - CCR & HNU 
1-Jun-15

19-Jun-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 1 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 1 
CTS 
19-Oct-15 
Phase :-Offshore Knowledge Transfer :- MM Wave 2-Intake Process - MRU & PCU 
CTS

1-Jun-15 
24-Jul-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 2 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 2 
CTS 
19-Oct-15 

	
	

  

 Transition Activities 
5 
Phase :- Re-badging Health Net Staff 
2-Mar-15 
2-Mar-15 
6

Phase :-TTT Phase @ Health Net USA 
6-Apr-15 
29-May-15 
TTT @ Health NET (Class Room) 
HN 
6-Apr-15 
17-Apr-15 
On Job Training 
HN 
20-Apr-15 
29-May-15 
7 
Phase :-Offshore Knowledge Transfer :- MM Wave 1-Intake Process - CCR & HNU 
1-Jun-15

19-Jun-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 1 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 1 
CTS 
19-Oct-15 
Phase :-Offshore Knowledge Transfer :- MM Wave 2-Intake Process - MRU & PCU 
CTS

1-Jun-15 
24-Jul-15 
Boot Camps- 
CTS 
4-May-15 
29-May-15 
Classroom 
CTS 
1-Jun-15 
12-Jun-15 
Hands on Training 
CTS 
15-Jun-15 
24-Jul-15 
Assessment week 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- MM Wave 2 
CTS 
27-Jul-15 
16-Oct-15 
25% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
50% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
100% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
Go Live Wave 2 
CTS 
19-Oct-15 

	
	

  

 Appeals and Grievances- USA to Philippines S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
Jul-14 28-Jul-14 
Aug-14 4-Aug-14 
11-Aug-14 
18-Aug-14 
25-Aug-14 
Sep-14 1-Sep-14 
8-Sep-14 
15-Sep-14 
22-Sep-14 
29-Sep-14 
Oct-14 6-Oct-14 
13-Oct-14 
20-Oct-14 
27-Oct-14 
Nov-14 3-Nov-14 
10-Nov-14 
17-Nov-14 
24-Nov-14 
Dec-14 1-Dec-14 
8-Dec-14 
15-Dec-14 
22-Dec-14 
29-Dec-14 
Jan-15 5-Jan-15 
12-Jan-15 
19-Jan-15 
26-Jan-15 
Feb-15 2-Feb-15 
9-Feb-15 
16-Feb-15 
23-Feb-15 
2-Mar-15 
9-Mar-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
5-Dec-14 
3

Phase :- Process Assessment and Detailed Transition Planning 
10-Nov-14

27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
10-Nov-14 
14-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
10-Nov-14 
14-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
10-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 

	
	

  

 Appeals and Grievances- USA to Philippines S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
Mar-15 16-Mar-15 
23-Mar-15 
30-Mar-15 
Apr-15 6-Apr-15 
13-Apr-15 
20-Apr-15 
27-Apr-15 
May-15 4-May-15 
11-May-15 
18-May-15 
25-May-15 
Jun-15 1-Jun-15 
8-Jun-15 
15-Jun-15 
22-Jun-15 
29-Jun-15 
Jul-15 6-Jul-15 
13-Jul-15 
20-Jul-15 
27-Jul-15 
Aug-15 3-Aug-15 
10-Aug-15 
17-Aug-15 
24-Aug-15 
31-Aug-15 
Sep-15 7-Sep-15 
14-Sep-15 
21-Sep-15 
28-Sep-15 
Oct-15 5-Oct-15 
12-Oct-15 
19-Oct-15 
26-Oct-15 
Nov-15 2-Nov-15 
9-Nov-15 
16-Nov-15 
23-Nov-15 
30-Nov-15 
Dec-15 7-Dec-15 
14-Dec-15 
21-Dec-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
5-Dec-14 
3

Phase :- Process Assessment and Detailed Transition Planning 
10-Nov-14

27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
10-Nov-14 
14-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
10-Nov-14 
14-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
10-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 

	
	

  

 Appeals and Grievances- USA to Philippines S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Dec-15 
Jan-16 4-Jan-16 
11-Jan-16 
18-Jan-16 
25-Jan-16 
Feb-16 1-Feb-16 
8-Feb-16 
15-Feb-16 
22-Feb-16 
29-Feb-16 
Mar-16 7-Mar-16 
14-Mar-16 
21-Mar-16 
28-Mar-16 
Apr-16 4-Apr-16 
11-Apr-16 
18-Apr-16 
25-Apr-16 
May-16 2-May-16 
9-May-16 
16-May-16 
23-May-16 
30-May-16 
Jun-16 6-Jun-16 
13-Jun-16 
20-Jun-16 
27-Jun-16 
July-16 4-Jul-16 
11-Jul-16 
18-Jul-16 
25-Jul-16 
Aug-16 1-Aug-16 
8-Aug-16 
15-Aug-16 
22-Aug-16 
29-Aug-16 
Sept-16 5-Sep-16 
12-Sep-16 
19-Sep-16 
26-Sep-16 
3-Oct-16 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
5-Dec-14 
3

Phase :- Process Assessment and Detailed Transition Planning 
10-Nov-14

27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
10-Nov-14 
14-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
10-Nov-14 
14-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
10-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 

	
	

  

 Appeals and Grievances- USA to Philippines S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
Oct-16 10-Oct-16 
17-Oct-16 
24-Oct-16 
31-Oct-16 
Nov-16 7-Nov-16 
14-Nov-16 
21-Nov-16 
28-Nov-16 
Dec-16 5-Dec-16 
12-Dec-16 
19-Dec-16 
26-Dec-16 
Mar-16 #REF! 
#REF! 
#REF! 
#REF! 
#REF! 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
3-Nov-14 
5-Dec-14 
3

Phase :- Process Assessment and Detailed Transition Planning 
10-Nov-14

27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
10-Nov-14 
14-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
10-Nov-14 
14-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
10-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 

	
	

  

 Schedule Z10 - BPaaS Transition 
5

Phase :- Seed Team activities 
3-Nov-14 
19-Jun-15 
5.1 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
5.2 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
5.3 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
5.4 
Hiring

CTS 
8-Dec-14 
26-Dec-14 
5,5 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
5.5 
Training 
HN 
5-Jan-15 
3-Apr-15 
5.5.1 
Overview of AnG business and systems 
HN 
5-Jan-15 
9-Jan-15 
5.5.2 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
5.5.3 
Theory - Class Room :- AnG process training 
HN 
12-Jan-15 
30-Jan-15 
5.5.4 
Practical - Hands on Training :- AnG process training 
HN 
2-Feb-15 
20-Feb-15 
5.5.5 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
5.6 
Deployment into Operations 
HN 
2-Mar-15 
19-Jun-15 
5.6.1 
20% Volume Ramp - Capacity 
HN 
2-Mar-15 
27-Mar-15 
5.6.2 
40% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
5.6.3 
60% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
5.6.4 
100% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8

Phase :-Offshore Knowledge Transfer :- A&G 
CTS 
4-May-15 
31-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of AnG business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- AnG process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- AnG process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Re-Training on gaps based on Assessment week results - 2nd 
CTS 
20-Jul-15 
24-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
27-Jul-15 
31-Jul-15 
Phase Details:-Ramp :- A&G 
CTS 
3-Aug-15 
22-Aug-16 
Member inquiry/member warnings-3 weeks 
CTS 
3-Aug-15 
21-Aug-15 
All LOB Triage/ Front End Review- 6 weeks 
CTS 
3-Aug-15 
11-Sep-15 
Ca HMO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Ca PPO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Medicare Part C appeals- 6 weeks 
CTS 
26-Oct-15 
4-Dec-15 
Medicare Part D appeals-5 weeks 
CTS 
26-Oct-15 
4-Dec-15 
SHP / Duals Appeals- 5 weeks 
CTS 
18-Jan-16 
19-Feb-16 
CA commercial grievances-4 weeks 
CTS 
22-Feb-16 
18-Mar-16 
Medicare Part C grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
Medicare Part D grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
SHP/Duals grievances-6 weeks 
CTS 
18-Apr-16 
27-May-16 
Final letter review-4 weeks 
CTS 
30-May-16 
24-Jun-16 
Maximus- 4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Expedites, benefit determs-4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Executive Review Unit (ERU) - 4 weeks 
CTS 
25-Jul-16 
19-Aug-16 
Go Live 
CTS 
22-Aug-16 
Page 30 
Health Net / Cognizant Confidential 

	
	

  

 Schedule Z10 - BPaaS Transition 
5

Phase :- Seed Team activities 
3-Nov-14 
19-Jun-15 
5.1 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
5.2 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
5.3 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
5.4 
Hiring

CTS 
8-Dec-14 
26-Dec-14 
5,5 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
5.5 
Training 
HN 
5-Jan-15 
3-Apr-15 
5.5.1 
Overview of AnG business and systems 
HN 
5-Jan-15 
9-Jan-15 
5.5.2 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
5.5.3 
Theory - Class Room :- AnG process training 
HN 
12-Jan-15 
30-Jan-15 
5.5.4 
Practical - Hands on Training :- AnG process training 
HN 
2-Feb-15 
20-Feb-15 
5.5.5 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
5.6 
Deployment into Operations 
HN 
2-Mar-15 
19-Jun-15 
5.6.1 
20% Volume Ramp - Capacity 
HN 
2-Mar-15 
27-Mar-15 
5.6.2 
40% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
5.6.3 
60% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
5.6.4 
100% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8

Phase :-Offshore Knowledge Transfer :- A&G 
CTS 
4-May-15 
31-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of AnG business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- AnG process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- AnG process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Re-Training on gaps based on Assessment week results - 2nd 
CTS 
20-Jul-15 
24-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
27-Jul-15 
31-Jul-15 
Phase Details:-Ramp :- A&G 
CTS 
3-Aug-15 
22-Aug-16 
Member inquiry/member warnings-3 weeks 
CTS 
3-Aug-15 
21-Aug-15 
All LOB Triage/ Front End Review- 6 weeks 
CTS 
3-Aug-15 
11-Sep-15 
Ca HMO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Ca PPO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Medicare Part C appeals- 6 weeks 
CTS 
26-Oct-15 
4-Dec-15 
Medicare Part D appeals-5 weeks 
CTS 
26-Oct-15 
4-Dec-15 
SHP / Duals Appeals- 5 weeks 
CTS 
18-Jan-16 
19-Feb-16 
CA commercial grievances-4 weeks 
CTS 
22-Feb-16 
18-Mar-16 
Medicare Part C grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
Medicare Part D grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
SHP/Duals grievances-6 weeks 
CTS 
18-Apr-16 
27-May-16 
Final letter review-4 weeks 
CTS 
30-May-16 
24-Jun-16 
Maximus- 4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Expedites, benefit determs-4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Executive Review Unit (ERU) - 4 weeks 
CTS 
25-Jul-16 
19-Aug-16 
Go Live 
CTS 
22-Aug-16 
Page32 
Health Net / Cognizant Confidential 

	
	

  

 5 
Phase :- Seed Team activities

3-Nov-14 
19-Jun-15 
5.1 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
5.2 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
5.3 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
5.4 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
5,5 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
5.5 
Training 
HN 
5-Jan-15 
3-Apr-15 
5.5.1 
Overview of AnG business and systems 
HN 
5-Jan-15 
9-Jan-15 
5.5.2 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
5.5.3 
Theory - Class Room :- AnG process training 
HN 
12-Jan-15 
30-Jan-15 
5.5.4 
Practical - Hands on Training :- AnG process training 
HN 
2-Feb-15 
20-Feb-15 
5.5.5 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
5.6 
Deployment into Operations 
HN 
2-Mar-15 
19-Jun-15 
5.6.1 
20% Volume Ramp - Capacity 
HN 
2-Mar-15 
27-Mar-15 
5.6.2 
40% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
5.6.3 
60% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
5.6.4 
100% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- A&G 
CTS 
4-May-15 
31-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of AnG business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- AnG process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- AnG process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Re-Training on gaps based on Assessment week results - 2nd 
CTS 
20-Jul-15 
24-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
27-Jul-15 
31-Jul-15 
Phase Details:-Ramp :- A&G 
CTS 
3-Aug-15 
22-Aug-16 
Member inquiry/member warnings-3 weeks 
CTS 
3-Aug-15 
21-Aug-15 
All LOB Triage/ Front End Review- 6 weeks 
CTS 
3-Aug-15 
11-Sep-15 
Ca HMO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Ca PPO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Medicare Part C appeals- 6 weeks 
CTS 
26-Oct-15 
4-Dec-15 
Medicare Part D appeals-5 weeks 
CTS 
26-Oct-15 
4-Dec-15 
SHP / Duals Appeals- 5 weeks 
CTS 
18-Jan-16 
19-Feb-16 
CA commercial grievances-4 weeks 
CTS 
22-Feb-16 
18-Mar-16 
Medicare Part C grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
Medicare Part D grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
SHP/Duals grievances-6 weeks 
CTS 
18-Apr-16 
27-May-16 
Final letter review-4 weeks 
CTS 
30-May-16 
24-Jun-16 
Maximus- 4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Expedites, benefit determs-4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Executive Review Unit (ERU) - 4 weeks 
CTS 
25-Jul-16 
19-Aug-16 
Go Live 
CTS 
22-Aug-16 

	
	

  

 Final 
 5

Phase :- Seed Team activities 
3-Nov-14 
19-Jun-15 
5.1 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
5.2 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
5.3 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
5.4 
Hiring

CTS 
8-Dec-14 
26-Dec-14 
5,5 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
5.5 
Training 
HN 
5-Jan-15 
3-Apr-15 
5.5.1 
Overview of AnG business and systems 
HN 
5-Jan-15 
9-Jan-15 
5.5.2 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
5.5.3 
Theory - Class Room :- AnG process training 
HN 
12-Jan-15 
30-Jan-15 
5.5.4 
Practical - Hands on Training :- AnG process training 
HN 
2-Feb-15 
20-Feb-15 
5.5.5 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
5.6 
Deployment into Operations 
HN 
2-Mar-15 
19-Jun-15 
5.6.1 
20% Volume Ramp - Capacity 
HN 
2-Mar-15 
27-Mar-15 
5.6.2 
40% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
5.6.3 
60% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
5.6.4 
100% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8

Phase :-Offshore Knowledge Transfer :- A&G 
CTS 
4-May-15 
31-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of AnG business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- AnG process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- AnG process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Re-Training on gaps based on Assessment week results - 2nd 
CTS 
20-Jul-15 
24-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
27-Jul-15 
31-Jul-15 
Phase Details:-Ramp :- A&G 
CTS 
3-Aug-15 
22-Aug-16 
Member inquiry/member warnings-3 weeks 
CTS 
3-Aug-15 
21-Aug-15 
All LOB Triage/ Front End Review- 6 weeks 
CTS 
3-Aug-15 
11-Sep-15 
Ca HMO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Ca PPO appeals-6 weeks 
CTS 
14-Sep-15 
23-Oct-15 
Medicare Part C appeals- 6 weeks 
CTS 
26-Oct-15 
4-Dec-15 
Medicare Part D appeals-5 weeks 
CTS 
26-Oct-15 
4-Dec-15 
SHP / Duals Appeals- 5 weeks 
CTS 
18-Jan-16 
19-Feb-16 
CA commercial grievances-4 weeks 
CTS 
22-Feb-16 
18-Mar-16 
Medicare Part C grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
Medicare Part D grievances-4 weeks 
CTS 
21-Mar-16 
15-Apr-16 
SHP/Duals grievances-6 weeks 
CTS 
18-Apr-16 
27-May-16 
Final letter review-4 weeks 
CTS 
30-May-16 
24-Jun-16 
Maximus- 4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Expedites, benefit determs-4 weeks 
CTS 
27-Jun-16 
22-Jul-16 
Executive Review Unit (ERU) - 4 weeks 
CTS 
25-Jul-16 
19-Aug-16 
Go Live 
CTS 
22-Aug-16 
Schedule Z10 - BPaaS Transition 
Page 33 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Membership

S. NO. 
Jul-14 
Aug-14 
Sep-14 
Oct-14 
Nov-14 
Dec-14 
Jan-15 
Feb-15 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Jul-14 
4-Aug-14 
11-Aug-14 
18-Aug-14 
25-Aug-14 
1-Sep-14 
8-Sep-14 
15-Sep-14 
22-Sep-14 
29-Sep-14 
6-Oct-14 
13-Oct-14 
20-Oct-14 
27-Oct-14 
3-Nov-14 
10-Nov-14 
17-Nov-14 
24-Nov-14 
1-Dec-14 
8-Dec-14 
15-Dec-14 
22-Dec-14 
29-Dec-14 
5-Jan-15 
12-Jan-15 
19-Jan-15 
26-Jan-15 
2-Feb-15 
9-Feb-15 
16-Feb-15 
23-Feb-15 
2-Mar-15 
9-Mar-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
21-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
2.2 
Team Charter 
HN & CTS 
10-Nov-14 
21-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
10-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

10-Nov-14 
21-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
26-Jan-15 
6-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 
Schedule Z10 - BPaaS Transition 
Page 34 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Membership

Sep-15 
Oct-15 
Nov-15 
Dec-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
16-Mar-15 
23-Mar-15 
30-Mar-15 
6-Apr-15 
13-Apr-15 
20-Apr-15 
27-Apr-15 
4-May-15 
11-May-15 
18-May-15 
25-May-15 
1-Jun-15 
8-Jun-15 
15-Jun-15 
22-Jun-15 
29-Jun-15 
6-Jul-15 
13-Jul-15 
20-Jul-15 
27-Jul-15 
3-Aug-15 
10-Aug-15 
17-Aug-15 
24-Aug-15 
31-Aug-15 
7-Sep-15 
14-Sep-15 
21-Sep-15 
28-Sep-15 
5-Oct-15 
12-Oct-15 
19-Oct-15 
26-Oct-15 
2-Nov-15 
9-Nov-15 
16-Nov-15 
23-Nov-15 
30-Nov-15 
7-Dec-15 
14-Dec-15 
21-Dec-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
21-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
2.2 
Team Charter 
HN & CTS 
10-Nov-14 
21-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
10-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

10-Nov-14 
21-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
26-Jan-15 
6-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 
Schedule Z10 - BPaaS Transition 
Page 35 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Membership

Jan-16 
Feb-16 
Mar-16 
Apr-16 
May-16 
Jun-16 
Jul-16 
Aug-16 
Sep-16 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Dec-15 
4-Jan-16 
11-Jan-16 
18-Jan-16 
25-Jan-16 
1-Feb-16 
8-Feb-16 
15-Feb-16 
22-Feb-16 
29-Feb-16 
7-Mar-16 
14-Mar-16 
21-Mar-16 
28-Mar-16 
4-Apr-16 
11-Apr-16 
18-Apr-16 
25-Apr-16 
2-May-16 
9-May-16 
16-May-16 
23-May-16 
30-May-16 
6-Jun-16 
13-Jun-16 
20-Jun-16 
27-Jun-16 
4-Jul-16 
11-Jul-16 
18-Jul-16 
25-Jul-16 
1-Aug-16 
8-Aug-16 
15-Aug-16 
22-Aug-16 
29-Aug-16 
5-Sep-16 
12-Sep-16 
19-Sep-16 
26-Sep-16 
3-Oct-16 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
21-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
2.2 
Team Charter 
HN & CTS 
10-Nov-14 
21-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
10-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management

CTS 
10-Nov-14 
21-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
26-Jan-15 
6-Feb-15 
4

Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
27-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 
Schedule Z10 - BPaaS Transition 
Page 36 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Membership

Oct-16 
Nov-16 
Dec-16 
Jan-17 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
10-Oct-16 
17-Oct-16 
24-Oct-16 
31-Oct-16 
7-Nov-16 
14-Nov-16 
21-Nov-16 
28-Nov-16 
5-Dec-16 
12-Dec-16 
19-Dec-16 
26-Dec-16 
2-Jan-17 
9-Jan-17 
16-Jan-17 
23-Jan-17 
30-Jan-17 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
21-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
2.2 
Team Charter 
HN & CTS 
10-Nov-14 
21-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
10-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

10-Nov-14 
21-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
27-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
24-Nov-14 
12-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
1-Dec-14 
19-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
1-Dec-14 
19-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
22-Dec-14 
9-Jan-15 
Documentation gap - Training 
CTS 
5-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
5-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
2-Feb-15 
27-Feb-15 
3.8 
Evaluate Trainer availability 
CTS 
9-Feb-15 
27-Feb-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
9-Feb-15 
27-Feb-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
26-Jan-15 
6-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
24-Apr-15 
4.1 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
30-Jan-15 
4.2 
create or update the available SOPs, P&Ps 
CTS 
2-Feb-15 
4.3 
create or update the Training docs 
CTS 
2-Mar-15 
27-Mar-15 
4.4 
Sign off on updated SOP’s and Training Documentation 
HN 
30-Mar-15 
24-Apr-15 
4.5 
Accommodate Changes based on HN review 
CTS 
30-Mar-15 
24-Apr-15 
Schedule Z10 - BPaaS Transition 
Page 37 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 5

Phase :- Staff Augmentation team activities - Wave 1 
3-Nov-14 
30-Dec-16 
Seed Wave 1 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
16-Feb-15 
20-Feb-15 
Deployment into Operations 
HN 
23-Feb-15 
8-Jun-15 
20% Volume Ramp - Capacity 
CTS 
23-Feb-15 
20-Mar-15 
40% Volume Ramp - Capacity 
CTS 
23-Mar-15 
17-Apr-15 
60% Volume Ramp - Capacity 
CTS 
20-Apr-15 
15-May-15 
100% Volume Ramp - Capacity 
CTS 
18-May-15 
12-Jun-15 
Fully Productive Timelines 
CTS 
15-Jun-15 
30-Dec-16 
Seed Wave 2 
Phase :- Staff Augmentation team activities - Wave 2 
3-Nov-14 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
12-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
Deployment into Operations 
2-Mar-15 
19-Jun-15 
20% Volume Ramp - Capacity 
CTS 
2-Mar-15 
27-Mar-15 
40% Volume Ramp - Capacity 
CTS 
30-Mar-15 
24-Apr-15 
60% Volume Ramp - Capacity 
CTS 
27-Apr-15 
22-May-15 
100% Volume Ramp - Capacity 
CTS 
25-May-15 
19-Jun-15 
Fully Productive Timelines 
CTS 
22-Jun-15 
30-Dec-16 
Seed Wave 3 
Phase :- Staff Augmentation team activities - Wave 3 
6-Jul-15 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
CTS 
6-Jul-15 
17-Jul-15 
Job Description of the Staff Augmentation team 
HN & CTS 
20-Jul-15 
31-Jul-15 
Validation of JD 
CTS 
3-Aug-15 
7-Aug-15 
Hiring 
CTS 
10-Aug-15 
28-Aug-15 
Onboarding 
CTS 
31-Aug-15 
4-Sep-15 
Training 
CTS 
7-Sep-15 
27-Nov-15 
Overview of Membership business and systems 
CTS 
7-Sep-15 
11-Sep-15 
Access Enablement 
CTS 
7-Sep-15 
2-Oct-15 
Theory - Class Room :- Membership process training 
CTS 
14-Sep-15 
2-Oct-15 
Practical - Hands on Training :- Membership process training 
CTS 
5-Oct-15 
23-Oct-15 
Assessment week - 1st 
CTS 
26-Oct-15 
30-Oct-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
2-Nov-15 
13-Nov-15 
Assessment week - 2nd 
CTS 
16-Nov-15 
20-Nov-15 
Final Hands on training and Monitoring before production kick off 
CTS 
30-Nov-15 
27-Nov-15 
Deployment into Operations 
CTS 
30-Nov-15 
30-Dec-16 
20% Volume Ramp - Capacity 
CTS 
30-Nov-15 
25-Dec-15 
40% Volume Ramp - Capacity 
CTS 
28-Dec-15 
22-Jan-16 
60% Volume Ramp - Capacity 
CTS 
25-Jan-16 
19-Feb-16 
100% Volume Ramp - Capacity 
CTS 
22-Feb-16 
18-Mar-16 
Fully Productive Timelines 
CTS 
21-Mar-16 
30-Dec-16 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 38 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 5

Phase :- Staff Augmentation team activities - Wave 1 
3-Nov-14 
30-Dec-16 
Seed Wave 1 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
16-Feb-15 
20-Feb-15 
Deployment into Operations 
HN 
23-Feb-15 
8-Jun-15 
20% Volume Ramp - Capacity 
CTS 
23-Feb-15 
20-Mar-15 
40% Volume Ramp - Capacity 
CTS 
23-Mar-15 
17-Apr-15 
60% Volume Ramp - Capacity 
CTS 
20-Apr-15 
15-May-15 
100% Volume Ramp - Capacity 
CTS 
18-May-15 
12-Jun-15 
Fully Productive Timelines 
CTS 
15-Jun-15 
30-Dec-16 
Seed Wave 2 
Phase :- Staff Augmentation team activities - Wave 2 
3-Nov-14 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
12-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
Deployment into Operations 
2-Mar-15 
19-Jun-15 
20% Volume Ramp - Capacity 
CTS 
2-Mar-15 
27-Mar-15 
40% Volume Ramp - Capacity 
CTS 
30-Mar-15 
24-Apr-15 
60% Volume Ramp - Capacity 
CTS 
27-Apr-15 
22-May-15 
100% Volume Ramp - Capacity 
CTS 
25-May-15 
19-Jun-15 
Fully Productive Timelines 
CTS 
22-Jun-15 
30-Dec-16 
Seed Wave 3 
Phase :- Staff Augmentation team activities - Wave 3 
6-Jul-15 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
CTS 
6-Jul-15 
17-Jul-15 
Job Description of the Staff Augmentation team 
HN & CTS 
20-Jul-15 
31-Jul-15 
Validation of JD 
CTS 
3-Aug-15 
7-Aug-15 
Hiring 
CTS 
10-Aug-15 
28-Aug-15 
Onboarding 
CTS 
31-Aug-15 
4-Sep-15 
Training 
CTS 
7-Sep-15 
27-Nov-15 
Overview of Membership business and systems 
CTS 
7-Sep-15 
11-Sep-15 
Access Enablement 
CTS 
7-Sep-15 
2-Oct-15 
Theory - Class Room :- Membership process training 
CTS 
14-Sep-15 
2-Oct-15 
Practical - Hands on Training :- Membership process training 
CTS 
5-Oct-15 
23-Oct-15 
Assessment week - 1st 
CTS 
26-Oct-15 
30-Oct-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
2-Nov-15 
13-Nov-15 
Assessment week - 2nd 
CTS 
16-Nov-15 
20-Nov-15 
Final Hands on training and Monitoring before production kick off 
CTS 
30-Nov-15 
27-Nov-15 
Deployment into Operations 
CTS 
30-Nov-15 
30-Dec-16 
20% Volume Ramp - Capacity 
CTS 
30-Nov-15 
25-Dec-15 
40% Volume Ramp - Capacity 
CTS 
28-Dec-15 
22-Jan-16 
60% Volume Ramp - Capacity 
CTS 
25-Jan-16 
19-Feb-16 
100% Volume Ramp - Capacity 
CTS 
22-Feb-16 
18-Mar-16 
Fully Productive Timelines 
CTS 
21-Mar-16 
30-Dec-16 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 39 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 5

Phase :- Staff Augmentation team activities - Wave 1 
3-Nov-14 
30-Dec-16 
Seed Wave 1 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
16-Feb-15 
20-Feb-15 
Deployment into Operations 
HN 
23-Feb-15 
8-Jun-15 
20% Volume Ramp - Capacity 
CTS 
23-Feb-15 
20-Mar-15 
40% Volume Ramp - Capacity 
CTS 
23-Mar-15 
17-Apr-15 
60% Volume Ramp - Capacity 
CTS 
20-Apr-15 
15-May-15 
100% Volume Ramp - Capacity 
CTS 
18-May-15 
12-Jun-15 
Fully Productive Timelines 
CTS 
15-Jun-15 
30-Dec-16 
Seed Wave 2 
Phase :- Staff Augmentation team activities - Wave 2 
3-Nov-14 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
12-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
Deployment into Operations 
2-Mar-15 
19-Jun-15 
20% Volume Ramp - Capacity 
CTS 
2-Mar-15 
27-Mar-15 
40% Volume Ramp - Capacity 
CTS 
30-Mar-15 
24-Apr-15 
60% Volume Ramp - Capacity 
CTS 
27-Apr-15 
22-May-15 
100% Volume Ramp - Capacity 
CTS 
25-May-15 
19-Jun-15 
Fully Productive Timelines 
CTS 
22-Jun-15 
30-Dec-16 
Seed Wave 3 
Phase :- Staff Augmentation team activities - Wave 3 
6-Jul-15 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
CTS 
6-Jul-15 
17-Jul-15 
Job Description of the Staff Augmentation team 
HN & CTS 
20-Jul-15 
31-Jul-15 
Validation of JD 
CTS 
3-Aug-15 
7-Aug-15 
Hiring 
CTS 
10-Aug-15 
28-Aug-15 
Onboarding 
CTS 
31-Aug-15 
4-Sep-15 
Training 
CTS 
7-Sep-15 
27-Nov-15 
Overview of Membership business and systems 
CTS 
7-Sep-15 
11-Sep-15 
Access Enablement 
CTS 
7-Sep-15 
2-Oct-15 
Theory - Class Room :- Membership process training 
CTS 
14-Sep-15 
2-Oct-15 
Practical - Hands on Training :- Membership process training 
CTS 
5-Oct-15 
23-Oct-15 
Assessment week - 1st 
CTS 
26-Oct-15 
30-Oct-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
2-Nov-15 
13-Nov-15 
Assessment week - 2nd 
CTS 
16-Nov-15 
20-Nov-15 
Final Hands on training and Monitoring before production kick off 
CTS 
30-Nov-15 
27-Nov-15 
Deployment into Operations 
CTS 
30-Nov-15 
30-Dec-16 
20% Volume Ramp - Capacity 
CTS 
30-Nov-15 
25-Dec-15 
40% Volume Ramp - Capacity 
CTS 
28-Dec-15 
22-Jan-16 
60% Volume Ramp - Capacity 
CTS 
25-Jan-16 
19-Feb-16 
100% Volume Ramp - Capacity 
CTS 
22-Feb-16 
18-Mar-16 
Fully Productive Timelines 
CTS 
21-Mar-16 
30-Dec-16 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 40 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 5

Phase :- Staff Augmentation team activities - Wave 1 
3-Nov-14 
30-Dec-16 
Seed Wave 1 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
16-Feb-15 
20-Feb-15 
Deployment into Operations 
HN 
23-Feb-15 
8-Jun-15 
20% Volume Ramp - Capacity 
CTS 
23-Feb-15 
20-Mar-15 
40% Volume Ramp - Capacity 
CTS 
23-Mar-15 
17-Apr-15 
60% Volume Ramp - Capacity 
CTS 
20-Apr-15 
15-May-15 
100% Volume Ramp - Capacity 
CTS 
18-May-15 
12-Jun-15 
Fully Productive Timelines 
CTS 
15-Jun-15 
30-Dec-16 
Seed Wave 2 
Phase :- Staff Augmentation team activities - Wave 2 
3-Nov-14 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
HN 
3-Nov-14 
12-Nov-14 
Job Description of the Staff Augmentation team 
HN & CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS

8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
29-Dec-14 
2-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Membership business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Membership process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Membership process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week 
HN 
23-Feb-15 
27-Feb-15 
Deployment into Operations 
2-Mar-15 
19-Jun-15 
20% Volume Ramp - Capacity 
CTS 
2-Mar-15 
27-Mar-15 
40% Volume Ramp - Capacity 
CTS 
30-Mar-15 
24-Apr-15 
60% Volume Ramp - Capacity 
CTS 
27-Apr-15 
22-May-15 
100% Volume Ramp - Capacity 
CTS 
25-May-15 
19-Jun-15 
Fully Productive Timelines 
CTS 
22-Jun-15 
30-Dec-16 
Seed Wave 3 
Phase :- Staff Augmentation team activities - Wave 3 
6-Jul-15 
30-Dec-16 
Roles and Location at which Staff Augmentation team to be hired 
CTS 
6-Jul-15 
17-Jul-15 
Job Description of the Staff Augmentation team 
HN & CTS 
20-Jul-15 
31-Jul-15 
Validation of JD 
CTS 
3-Aug-15 
7-Aug-15 
Hiring 
CTS 
10-Aug-15 
28-Aug-15 
Onboarding 
CTS 
31-Aug-15 
4-Sep-15 
Training 
CTS 
7-Sep-15 
27-Nov-15 
Overview of Membership business and systems 
CTS 
7-Sep-15 
11-Sep-15 
Access Enablement 
CTS 
7-Sep-15 
2-Oct-15 
Theory - Class Room :- Membership process training 
CTS 
14-Sep-15 
2-Oct-15 
Practical - Hands on Training :- Membership process training 
CTS 
5-Oct-15 
23-Oct-15 
Assessment week - 1st 
CTS 
26-Oct-15 
30-Oct-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
2-Nov-15 
13-Nov-15 
Assessment week - 2nd 
CTS 
16-Nov-15 
20-Nov-15 
Final Hands on training and Monitoring before production kick off 
CTS 
30-Nov-15 
27-Nov-15 
Deployment into Operations 
CTS 
30-Nov-15 
30-Dec-16 
20% Volume Ramp - Capacity 
CTS 
30-Nov-15 
25-Dec-15 
40% Volume Ramp - Capacity 
CTS 
28-Dec-15 
22-Jan-16 
60% Volume Ramp - Capacity 
CTS 
25-Jan-16 
19-Feb-16 
100% Volume Ramp - Capacity 
CTS 
22-Feb-16 
18-Mar-16 
Fully Productive Timelines 
CTS 
21-Mar-16 
30-Dec-16 
6 
Regulatory Approvals 
HN 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 41 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Wave 1 
CTS 
11-May-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Membership business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Membership process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Membership process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp Wave 1 
CTS 
27-Jul-15 
4-Mar-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
40% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
50% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
65% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
75% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
100% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
Go Live Wave 1 
CTS 
7-Mar-16 
Phase :-Offshore Knowledge Transfer :- Wave 2A 
CTS 
6-Jul-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Schedule Z10 - BPaaS Transition 
Page 42 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Wave 1 
CTS 
11-May-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Membership business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Membership process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Membership process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp Wave 1 
CTS 
27-Jul-15 
4-Mar-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
40% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
50% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
65% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
75% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
100% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
Go Live Wave 1 
CTS 
7-Mar-16 
Phase :-Offshore Knowledge Transfer :- Wave 2A 
CTS 
6-Jul-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Schedule Z10 - BPaaS Transition 
Page 43 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Wave 1 
CTS 
11-May-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Membership business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Membership process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Membership process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp Wave 1 
CTS 
27-Jul-15 
4-Mar-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
40% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
50% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
65% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
75% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
100% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
Go Live Wave 1 
CTS 
7-Mar-16 
Phase :-Offshore Knowledge Transfer :- Wave 2A 
CTS 
6-Jul-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Schedule Z10 - BPaaS Transition 
Page 44 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Wave 1 
CTS 
11-May-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Membership business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Membership process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Membership process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp Wave 1 
CTS 
27-Jul-15 
4-Mar-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
40% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
50% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
65% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
75% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
100% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
Go Live Wave 1 
CTS 
7-Mar-16 
Phase :-Offshore Knowledge Transfer :- Wave 2A 
CTS 
6-Jul-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Schedule Z10 - BPaaS Transition 
Page 45 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Ramp Wave 2A 
CTS 
21-Sep-15 
29-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
40% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
50% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
65% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
75% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
100% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
Go Live Wave 2A 
CTS 
2-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 2B 
CTS 
6-Jul-15 
16-Oct-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
3-Aug-15 
28-Aug-15 
Assessment week - 1st 
CTS 
31-Aug-15 
4-Sep-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
7-Sep-15 
25-Sep-15 
Assessment week - 2nd 
CTS 
28-Sep-15 
2-Oct-15 
Final Hands on training and Monitoring before production kick off 
CTS 
5-Oct-15 
16-Oct-15 
Phase :-Ramp Wave 2B 
CTS 
19-Oct-15 
27-May-16 
10% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
20% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
30% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
40% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
50% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
65% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
75% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
100% Volume Ramp - Capacity 
CTS 
2-May-16 
27-May-16 
Go Live Wave 2B 
CTS 
30-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 3A 
CTS 
11-Apr-16 
24-Jun-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
29-Apr-16 
Practical - Hands on Training :- Membership process training 
CTS 
2-May-16 
20-May-16 
Assessment week - 1st 
CTS 
23-May-16 
27-May-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
30-May-16 
10-Jun-16 
Assessment week - 2nd 
CTS 
13-Jun-16 
17-Jun-16 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jun-16 
24-Jun-16 
Schedule Z10 - BPaaS Transition 
Page 46 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Ramp Wave 2A 
CTS 
21-Sep-15 
29-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
40% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
50% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
65% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
75% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
100% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
Go Live Wave 2A 
CTS 
2-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 2B 
CTS 
6-Jul-15 
16-Oct-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
3-Aug-15 
28-Aug-15 
Assessment week - 1st 
CTS 
31-Aug-15 
4-Sep-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
7-Sep-15 
25-Sep-15 
Assessment week - 2nd 
CTS 
28-Sep-15 
2-Oct-15 
Final Hands on training and Monitoring before production kick off 
CTS 
5-Oct-15 
16-Oct-15 
Phase :-Ramp Wave 2B 
CTS 
19-Oct-15 
27-May-16 
10% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
20% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
30% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
40% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
50% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
65% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
75% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
100% Volume Ramp - Capacity 
CTS 
2-May-16 
27-May-16 
Go Live Wave 2B 
CTS 
30-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 3A 
CTS 
11-Apr-16 
24-Jun-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
29-Apr-16 
Practical - Hands on Training :- Membership process training 
CTS 
2-May-16 
20-May-16 
Assessment week - 1st 
CTS 
23-May-16 
27-May-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
30-May-16 
10-Jun-16 
Assessment week - 2nd 
CTS 
13-Jun-16 
17-Jun-16 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jun-16 
24-Jun-16 
Schedule Z10 - BPaaS Transition 
Page 47 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Ramp Wave 2A 
CTS 
21-Sep-15 
29-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
40% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
50% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
65% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
75% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
100% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
Go Live Wave 2A 
CTS 
2-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 2B 
CTS 
6-Jul-15 
16-Oct-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
3-Aug-15 
28-Aug-15 
Assessment week - 1st 
CTS 
31-Aug-15 
4-Sep-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
7-Sep-15 
25-Sep-15 
Assessment week - 2nd 
CTS 
28-Sep-15 
2-Oct-15 
Final Hands on training and Monitoring before production kick off 
CTS 
5-Oct-15 
16-Oct-15 
Phase :-Ramp Wave 2B 
CTS 
19-Oct-15 
27-May-16 
10% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
20% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
30% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
40% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
50% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
65% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
75% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
100% Volume Ramp - Capacity 
CTS 
2-May-16 
27-May-16 
Go Live Wave 2B 
CTS 
30-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 3A 
CTS 
11-Apr-16 
24-Jun-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
29-Apr-16 
Practical - Hands on Training :- Membership process training 
CTS 
2-May-16 
20-May-16 
Assessment week - 1st 
CTS 
23-May-16 
27-May-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
30-May-16 
10-Jun-16 
Assessment week - 2nd 
CTS 
13-Jun-16 
17-Jun-16 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jun-16 
24-Jun-16 
Schedule Z10 - BPaaS Transition 
Page 48 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Ramp Wave 2A 
CTS 
21-Sep-15 
29-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
40% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
50% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
65% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
75% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
100% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
Go Live Wave 2A 
CTS 
2-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 2B 
CTS 
6-Jul-15 
16-Oct-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Membership business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Membership process training 
CTS 
6-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Membership process training 
CTS 
3-Aug-15 
28-Aug-15 
Assessment week - 1st 
CTS 
31-Aug-15 
4-Sep-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
7-Sep-15 
25-Sep-15 
Assessment week - 2nd 
CTS 
28-Sep-15 
2-Oct-15 
Final Hands on training and Monitoring before production kick off 
CTS 
5-Oct-15 
16-Oct-15 
Phase :-Ramp Wave 2B 
CTS 
19-Oct-15 
27-May-16 
10% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
20% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
30% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
40% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
50% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
65% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
75% Volume Ramp - Capacity 
CTS 
4-Apr-16 
29-Apr-16 
100% Volume Ramp - Capacity 
CTS 
2-May-16 
27-May-16 
Go Live Wave 2B 
CTS 
30-May-16 
Phase :-Offshore Knowledge Transfer :- Wave 3A 
CTS 
11-Apr-16 
24-Jun-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
29-Apr-16 
Practical - Hands on Training :- Membership process training 
CTS 
2-May-16 
20-May-16 
Assessment week - 1st 
CTS 
23-May-16 
27-May-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
30-May-16 
10-Jun-16 
Assessment week - 2nd 
CTS 
13-Jun-16 
17-Jun-16 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jun-16 
24-Jun-16 
Schedule Z10 - BPaaS Transition 
Page 49 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Phase :-Ramp Wave 3A

CTS 
27-Jun-16 
3-Feb-17 
10% Volume Ramp - Capacity 
CTS 
27-Jun-16 
22-Jul-16 
20% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
30% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
40% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
50% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
65% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
75% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
100% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
Go Live Wave 3A 
CTS 
6-Feb-17 
Phase :-Offshore Knowledge Transfer :- Wave 3B 
CTS 
11-Apr-16 
22-Jul-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
6-May-16 
Practical - Hands on Training :- Membership process training 
CTS 
9-May-16 
3-Jun-16 
Assessment week - 1st 
CTS 
6-Jun-16 
10-Jun-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
13-Jun-16 
1-Jul-16 
Assessment week - 2nd 
CTS 
4-Jul-16 
8-Jul-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Jul-16 
22-Jul-16 
Phase :-Ramp Wave 3B 
CTS 
25-Jul-16 
3-Mar-17 
10% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
20% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
30% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
40% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
50% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
65% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
75% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
100% Volume Ramp - Capacity 
CTS 
6-Feb-17 
3-Mar-17 
Go Live Wave 3B 
CTS 
6-Mar-17 
Schedule Z10 - BPaaS Transition 
Page 50 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Phase :-Ramp Wave 3A

CTS 
27-Jun-16 
3-Feb-17 
10% Volume Ramp - Capacity 
CTS 
27-Jun-16 
22-Jul-16 
20% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
30% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
40% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
50% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
65% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
75% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
100% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
Go Live Wave 3A 
CTS 
6-Feb-17 
Phase :-Offshore Knowledge Transfer :- Wave 3B 
CTS 
11-Apr-16 
22-Jul-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
6-May-16 
Practical - Hands on Training :- Membership process training 
CTS 
9-May-16 
3-Jun-16 
Assessment week - 1st 
CTS 
6-Jun-16 
10-Jun-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
13-Jun-16 
1-Jul-16 
Assessment week - 2nd 
CTS 
4-Jul-16 
8-Jul-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Jul-16 
22-Jul-16 
Phase :-Ramp Wave 3B 
CTS 
25-Jul-16 
3-Mar-17 
10% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
20% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
30% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
40% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
50% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
65% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
75% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
100% Volume Ramp - Capacity 
CTS 
6-Feb-17 
3-Mar-17 
Go Live Wave 3B 
CTS 
6-Mar-17 
Schedule Z10 - BPaaS Transition 
Page 51 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Phase :-Ramp Wave 3A

CTS 
27-Jun-16 
3-Feb-17 
10% Volume Ramp - Capacity 
CTS 
27-Jun-16 
22-Jul-16 
20% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
30% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
40% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
50% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
65% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
75% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
100% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
Go Live Wave 3A 
CTS 
6-Feb-17 
Phase :-Offshore Knowledge Transfer :- Wave 3B 
CTS 
11-Apr-16 
22-Jul-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
6-May-16 
Practical - Hands on Training :- Membership process training 
CTS 
9-May-16 
3-Jun-16 
Assessment week - 1st 
CTS 
6-Jun-16 
10-Jun-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
13-Jun-16 
1-Jul-16 
Assessment week - 2nd 
CTS 
4-Jul-16 
8-Jul-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Jul-16 
22-Jul-16 
Phase :-Ramp Wave 3B 
CTS 
25-Jul-16 
3-Mar-17 
10% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
20% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
30% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
40% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
50% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
65% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
75% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
100% Volume Ramp - Capacity 
CTS 
6-Feb-17 
3-Mar-17 
Go Live Wave 3B 
CTS 
6-Mar-17 
Schedule Z10 - BPaaS Transition 
Page 52 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Phase :-Ramp Wave 3A

CTS 
27-Jun-16 
3-Feb-17 
10% Volume Ramp - Capacity 
CTS 
27-Jun-16 
22-Jul-16 
20% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
30% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
40% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
50% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
65% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
75% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
100% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
Go Live Wave 3A 
CTS 
6-Feb-17 
Phase :-Offshore Knowledge Transfer :- Wave 3B 
CTS 
11-Apr-16 
22-Jul-16 
Boot Camps 
CTS 
7-Mar-16 
1-Apr-16 
Access Enablement 
CTS 
4-Apr-16 
29-Apr-16 
Overview of Membership business and systems 
CTS 
4-Apr-16 
8-Apr-16 
Theory - Class Room :- Membership process training 
CTS 
11-Apr-16 
6-May-16 
Practical - Hands on Training :- Membership process training 
CTS 
9-May-16 
3-Jun-16 
Assessment week - 1st 
CTS 
6-Jun-16 
10-Jun-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
13-Jun-16 
1-Jul-16 
Assessment week - 2nd 
CTS 
4-Jul-16 
8-Jul-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Jul-16 
22-Jul-16 
Phase :-Ramp Wave 3B 
CTS 
25-Jul-16 
3-Mar-17 
10% Volume Ramp - Capacity 
CTS 
25-Jul-16 
19-Aug-16 
20% Volume Ramp - Capacity 
CTS 
22-Aug-16 
16-Sep-16 
30% Volume Ramp - Capacity 
CTS 
19-Sep-16 
14-Oct-16 
40% Volume Ramp - Capacity 
CTS 
17-Oct-16 
11-Nov-16 
50% Volume Ramp - Capacity 
CTS 
14-Nov-16 
9-Dec-16 
65% Volume Ramp - Capacity 
CTS 
12-Dec-16 
6-Jan-17 
75% Volume Ramp - Capacity 
CTS 
9-Jan-17 
3-Feb-17 
100% Volume Ramp - Capacity 
CTS 
6-Feb-17 
3-Mar-17 
Go Live Wave 3B 
CTS 
6-Mar-17 
Schedule Z10 - BPaaS Transition 
Page 53 
Health Net / Cognizant Confidential 

	
	

  

 Final 
Configuration 
Jul-14 
Aug-14 
Sep-14 
Oct-14 
Nov-14 
Dec-14 
Jan-15 
Feb-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Jul-14 
4-Aug-14 
11-Aug-14 
18-Aug-14 
25-Aug-14 
1-Sep-14 
8-Sep-14 
15-Sep-14 
22-Sep-14 
29-Sep-14 
6-Oct-14 
13-Oct-14 
20-Oct-14 
27-Oct-14 
3-Nov-14 
10-Nov-14 
17-Nov-14 
24-Nov-14 
1-Dec-14 
8-Dec-14 
15-Dec-14 
22-Dec-14 
29-Dec-14 
5-Jan-15 
12-Jan-15 
19-Jan-15 
26-Jan-15 
2-Feb-15 
9-Feb-15 
16-Feb-15 
23-Feb-15 
2-Mar-15 
9-Mar-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
5-Dec-14 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
Team Charter 
HN & CTS 
10-Nov-14 
5-Dec-14 
Transition Milestones and timelines 
CTS 
10-Nov-14 
5-Dec-14 
Agenda and resource requirements for Process Assessment and 
CTS 
10-Nov-14 
5-Dec-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
8-Dec-14 
24-Apr-15 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
8-Dec-14 
12-Dec-14 
Governance, communication & escalation plan 
HN & CTS 
8-Dec-14 
12-Dec-14 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
8-Dec-14 
19-Dec-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
22-Dec-14 
9-Jan-15 
Gather & Finalize Technology requirements – applications required 
CTS 
29-Dec-14 
16-Jan-15 
Staffing validation & Capacity Planning 
CTS 
29-Dec-14 
16-Jan-15 
Review Training documentation and SOP readiness 
CTS 
19-Jan-15 
6-Feb-15 
Documentation gap - Training - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Process PnP’s - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Training - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
Documentation gap - Process PnP’s - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
KM Team Deliverable listing & Briefing to KM team 
CTS 
23-Feb-15 
6-Mar-15 
Gap documentation for HN review and Sign off 
HN 
30-Mar-15 
24-Apr-15 
Evaluate Trainer availability 
CTS 
6-Apr-15 
24-Apr-15 
Evaluate Quality Auditor avail 
CTS 
6-Apr-15 
24-Apr-15 
4 
Phase Knowledge Management 
5-Jan-15 
31-Jul-15 
Process Shadowing and Understanding (Phase 1) 
CTS 
5-Jan-15 
30-Jan-15 
create or update the available SOPs, P&Ps (Phase 1) 
CTS 
2-Feb-15 
27-Feb-15 
create or update the Training docs (Phase 1) 
CTS 
2-Mar-15 
27-Mar-15 
Sign off on updated SOP’s and Training Documentation (Phase 1) 
HN 
30-Mar-15 
24-Apr-15 
Accommodate Changes based on HN review ( Phase 1) 
CTS 
30-Mar-15 
24-Apr-15 
Process Shadowing and Understanding (Phase 2) 
CTS 
27-Apr-15 
8-May-15 
create or update the available SOPs, P&Ps (Phase 2) 
CTS 
11-May-15 
5-Jun-15 
create or update the Training docs (Phase 2) 
CTS 
8-Jun-15 
3-Jul-15 
Sign off on updated SOP’s and Training Documentation (Phase 2) 
HN 
6-Jul-15 
31-Jul-15 
Accommodate Changes based on HN review ( Phase 2) 
CTS 
6-Jul-15 
31-Jul-15 
Schedule Z10 - BPaaS Transition 
Page 54 
Health Net / Cognizant Confidential 

	
	

  

 Final 

Configuration 
Mar-15 
Apr-15 
May-15 
Jun-15 
Jul-15 
Aug-15 
Sep-15 
Oct-15 
Nov-15 
Dec-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
16-Mar-15 
23-Mar-15 
30-Mar-15 
6-Apr-15 
13-Apr-15 
20-Apr-15 
27-Apr-15 
4-May-15 
11-May-15 
18-May-15 
25-May-15 
1-Jun-15 
8-Jun-15 
15-Jun-15 
22-Jun-15 
29-Jun-15 
6-Jul-15 
13-Jul-15 
20-Jul-15 
27-Jul-15 
3-Aug-15 
10-Aug-15 
17-Aug-15 
24-Aug-15 
31-Aug-15 
7-Sep-15 
14-Sep-15 
21-Sep-15 
28-Sep-15 
5-Oct-15 
12-Oct-15 
19-Oct-15 
26-Oct-15 
2-Nov-15 
9-Nov-15 
16-Nov-15 
23-Nov-15 
30-Nov-15 
7-Dec-15 
14-Dec-15 
21-Dec-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
5-Dec-14 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
Team Charter 
HN & CTS 
10-Nov-14 
5-Dec-14 
Transition Milestones and timelines 
CTS 
10-Nov-14 
5-Dec-14 
Agenda and resource requirements for Process Assessment and 
CTS 
10-Nov-14 
5-Dec-14 
3

Phase :- Process Assessment and Detailed Transition Planning 
8-Dec-14

24-Apr-15 
Transition Kick off Activity + Stake holder identification

HN & CTS 
8-Dec-14 
12-Dec-14 
Governance, communication & escalation plan 
HN & CTS 
8-Dec-14 
12-Dec-14 
Process Assessment Agenda Finalization and dependency matrix 
HN & CTS 
8-Dec-14 
19-Dec-14 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
22-Dec-14 
9-Jan-15 
Gather & Finalize Technology requirements – applications required

CTS 
29-Dec-14 
16-Jan-15 
Staffing validation & Capacity Planning 
CTS 
29-Dec-14 
16-Jan-15 
Review Training documentation and SOP readiness 
CTS 
19-Jan-15 
6-Feb-15 
Documentation gap - Training - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Process PnP’s - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Training - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
Documentation gap - Process PnP’s - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
KM Team Deliverable listing & Briefing to KM team 
CTS 
23-Feb-15 
6-Mar-15 
Gap documentation for HN review and Sign off 
HN 
30-Mar-15 
24-Apr-15 
Evaluate Trainer availability 
CTS 
6-Apr-15 
24-Apr-15 
Evaluate Quality Auditor avail 
CTS 
6-Apr-15 
24-Apr-15 
4 
Phase Knowledge Management 
5-Jan-15 
31-Jul-15 
Process Shadowing and Understanding (Phase 1) 
CTS 
5-Jan-15 
30-Jan-15 
create or update the available SOPs, P&Ps (Phase 1) 
CTS 
2-Feb-15 
27-Feb-15 
create or update the Training docs (Phase 1) 
CTS 
2-Mar-15 
27-Mar-15 
Sign off on updated SOP’s and Training Documentation (Phase 1) 
HN 
30-Mar-15 
24-Apr-15 
Accommodate Changes based on HN review ( Phase 1) 
CTS 
30-Mar-15 
24-Apr-15 
Process Shadowing and Understanding (Phase 2) 
CTS 
27-Apr-15 
8-May-15 
create or update the available SOPs, P&Ps (Phase 2) 
CTS 
11-May-15 
5-Jun-15 
create or update the Training docs (Phase 2) 
CTS 
8-Jun-15 
3-Jul-15 
Sign off on updated SOP’s and Training Documentation (Phase 2) 
HN 
6-Jul-15 
31-Jul-15 
Accommodate Changes based on HN review ( Phase 2) 
CTS 
6-Jul-15 
31-Jul-15 
Schedule Z10 - BPaaS Transition 
Page 55 
Health Net / Cognizant Confidential 

	
	

  

 Final 

Configuration 
Jan-16 
Feb-16 
Mar-16 
Apr-16 
May-16 
Jun-16 
Jul-16 
Aug-16 
Sep-16 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Dec-15 
4-Jan-16 
11-Jan-16 
18-Jan-16 
25-Jan-16 
1-Feb-16 
8-Feb-16 
15-Feb-16 
22-Feb-16 
29-Feb-16 
7-Mar-16 
14-Mar-16 
21-Mar-16 
28-Mar-16 
4-Apr-16 
11-Apr-16 
18-Apr-16 
25-Apr-16 
2-May-16 
9-May-16 
16-May-16 
23-May-16 
30-May-16 
6-Jun-16 
13-Jun-16 
20-Jun-16 
27-Jun-16 
4-Jul-16 
11-Jul-16 
18-Jul-16 
25-Jul-16 
1-Aug-16 
8-Aug-16 
15-Aug-16 
22-Aug-16 
29-Aug-16 
5-Sep-16 
12-Sep-16 
19-Sep-16 
26-Sep-16 
3-Oct-16 
Pre- Transition Activities 
Review Training documentation and SOP readiness 
CTS 
19-Jan-15 
6-Feb-15 
Documentation gap - Training - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Process PnP’s - Wave 1 
CTS 
2-Feb-15 
27-Feb-15 
Documentation gap - Training - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
Documentation gap - Process PnP’s - Wave 2 
CTS 
2-Mar-15 
27-Mar-15 
KM Team Deliverable listing & Briefing to KM team 
CTS 
23-Feb-15 
6-Mar-15 
Gap documentation for HN review and Sign off 
HN 
30-Mar-15 
24-Apr-15 
Evaluate Trainer availability 
CTS 
6-Apr-15 
24-Apr-15 
Evaluate Quality Auditor avail 
CTS 
6-Apr-15 
24-Apr-15 
4 
Phase Knowledge Management 
5-Jan-15 
31-Jul-15 
Process Shadowing and Understanding (Phase 1) 
CTS 
5-Jan-15 
30-Jan-15 
create or update the available SOPs, P&Ps (Phase 1) 
CTS 
2-Feb-15 
27-Feb-15 
create or update the Training docs (Phase 1) 
CTS 
2-Mar-15 
27-Mar-15 
Sign off on updated SOP’s and Training Documentation (Phase 1) 
HN 
30-Mar-15 
24-Apr-15 
Accommodate Changes based on HN review ( Phase 1) 
CTS 
30-Mar-15 
24-Apr-15 
Process Shadowing and Understanding (Phase 2) 
CTS 
27-Apr-15 
8-May-15 
create or update the available SOPs, P&Ps (Phase 2) 
CTS 
11-May-15 
5-Jun-15 
create or update the Training docs (Phase 2) 
CTS 
8-Jun-15 
3-Jul-15 
Sign off on updated SOP’s and Training Documentation (Phase 2) 
HN 
6-Jul-15 
31-Jul-15 
Accommodate Changes based on HN review ( Phase 2) 
CTS 
6-Jul-15 
31-Jul-15 
Schedule Z10 - BPaaS Transition 
Page 56 
Health Net / Cognizant Confidential 

	
	

  

 Final 

Configuration 
Oct-16 
Nov-16 
Dec-16 
Jan-17 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
10-Oct-16 
17-Oct-16 
24-Oct-16 
31-Oct-16 
7-Nov-16 
14-Nov-16 
21-Nov-16 
28-Nov-16 
5-Dec-16 
12-Dec-16 
19-Dec-16 
26-Dec-16 
2-Jan-17 
9-Jan-17 
16-Jan-17 
23-Jan-17 
30-Jan-17 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
24-Oct-14 
Organization Announcement at HN 
HN 
27-Oct-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
10-Nov-14 
5-Dec-14 
Validate Solution Assumptions 
CTS 
10-Nov-14 
14-Nov-14 
Team Charter 
HN & CTS 
10-Nov-14 
5-Dec-14 
Transition Milestones and timelines 
CTS 
10-Nov-14 
5-Dec-14 

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

	
	

  

 Final 
 Phase :-
Seed Team activities - wave 2 
3-Nov-14 
17-Jul-15 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS and HN 
8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
5-Jan-15 
9-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Claims business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Claims process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Claims process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
23-Feb-15 
27-Feb-15 
Re-Training on gaps based on Assessment week results- 1st 
HN 
2-Mar-15 
13-Mar-15 
Assessment week - 2nd 
HN 
16-Mar-15 
20-Mar-15 
Final Hands on training and Monitoring before production kick off 
HN 
23-Mar-15 
27-Mar-15 
Deployment into Operations 
HN 
30-Mar-15 
17-Jul-15 
20% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
40% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
60% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
100% Volume Ramp - Capacity 
HN 
22-Jun-15 
17-Jul-15 
Phase :- Seed Team activities - wave 3 
4-May-15 
15-Jan-16 
Roles and Location at which Seed team to be hired 
CTS 
4-May-15 
15-May-15 
Job Description of the Seed Team 
CTS 
18-May-15 
29-May-15 
Validation of JD 
CTS 
1-Jun-15 
5-Jun-15 
Hiring 
CTS and HN 
8-Jun-15 
26-Jun-15 
Onboarding 
CTS 
29-Jun-15 
3-Jul-15 
Training 
CTS 
6-Jul-15 
25-Sep-15 
Overview of Claims business and systems 
CTS 
6-Jul-15 
10-Jul-15 
Access Enablement 
CTS 
6-Jul-15 
31-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
13-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
3-Aug-15 
21-Aug-15 
Assessment week - 1st 
CTS 
24-Aug-15 
28-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
31-Aug-15 
11-Sep-15 
Assessment week - 2nd 
CTS 
14-Sep-15 
18-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
21-Sep-15 
25-Sep-15 
Deployment into Operations 
CTS 
28-Sep-15 
15-Jan-16 
20% Volume Ramp - Capacity 
CTS 
28-Sep-15 
23-Oct-15 
40% Volume Ramp - Capacity 
CTS 
26-Oct-15 
20-Nov-15 
60% Volume Ramp - Capacity 
CTS 
23-Nov-15 
18-Dec-15 
100% Volume Ramp - Capacity 
CTS 
21-Dec-15 
15-Jan-16 
6 
Regulatory Approvals 
HN 
4-Aug-14 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 70 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase :-
Seed Team activities - wave 2 
3-Nov-14 
17-Jul-15 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS and HN 
8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
5-Jan-15 
9-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Claims business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Claims process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Claims process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
23-Feb-15 
27-Feb-15 
Re-Training on gaps based on Assessment week results- 1st 
HN 
2-Mar-15 
13-Mar-15 
Assessment week - 2nd 
HN 
16-Mar-15 
20-Mar-15 
Final Hands on training and Monitoring before production kick off 
HN 
23-Mar-15 
27-Mar-15 
Deployment into Operations 
HN 
30-Mar-15 
17-Jul-15 
20% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
40% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
60% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
100% Volume Ramp - Capacity 
HN 
22-Jun-15 
17-Jul-15 
Phase :- Seed Team activities - wave 3 
4-May-15 
15-Jan-16 
Roles and Location at which Seed team to be hired 
CTS 
4-May-15 
15-May-15 
Job Description of the Seed Team 
CTS 
18-May-15 
29-May-15 
Validation of JD 
CTS 
1-Jun-15 
5-Jun-15 
Hiring 
CTS and HN 
8-Jun-15 
26-Jun-15 
Onboarding 
CTS 
29-Jun-15 
3-Jul-15 
Training 
CTS 
6-Jul-15 
25-Sep-15 
Overview of Claims business and systems 
CTS 
6-Jul-15 
10-Jul-15 
Access Enablement 
CTS 
6-Jul-15 
31-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
13-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
3-Aug-15 
21-Aug-15 
Assessment week - 1st 
CTS 
24-Aug-15 
28-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
31-Aug-15 
11-Sep-15 
Assessment week - 2nd 
CTS 
14-Sep-15 
18-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
21-Sep-15 
25-Sep-15 
Deployment into Operations 
CTS 
28-Sep-15 
15-Jan-16 
20% Volume Ramp - Capacity 
CTS 
28-Sep-15 
23-Oct-15 
40% Volume Ramp - Capacity 
CTS 
26-Oct-15 
20-Nov-15 
60% Volume Ramp - Capacity 
CTS 
23-Nov-15 
18-Dec-15 
100% Volume Ramp - Capacity 
CTS 
21-Dec-15 
15-Jan-16 
6 
Regulatory Approvals 
HN 
4-Aug-14 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 71 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase :-
Seed Team activities - wave 2 
3-Nov-14 
17-Jul-15 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS and HN 
8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
5-Jan-15 
9-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Claims business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Claims process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Claims process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
23-Feb-15 
27-Feb-15 
Re-Training on gaps based on Assessment week results- 1st 
HN 
2-Mar-15 
13-Mar-15 
Assessment week - 2nd 
HN 
16-Mar-15 
20-Mar-15 
Final Hands on training and Monitoring before production kick off 
HN 
23-Mar-15 
27-Mar-15 
Deployment into Operations 
HN 
30-Mar-15 
17-Jul-15 
20% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
40% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
60% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
100% Volume Ramp - Capacity 
HN 
22-Jun-15 
17-Jul-15 
Phase :- Seed Team activities - wave 3 
4-May-15 
15-Jan-16 
Roles and Location at which Seed team to be hired 
CTS 
4-May-15 
15-May-15 
Job Description of the Seed Team 
CTS 
18-May-15 
29-May-15 
Validation of JD 
CTS 
1-Jun-15 
5-Jun-15 
Hiring 
CTS and HN 
8-Jun-15 
26-Jun-15 
Onboarding 
CTS 
29-Jun-15 
3-Jul-15 
Training 
CTS 
6-Jul-15 
25-Sep-15 
Overview of Claims business and systems 
CTS 
6-Jul-15 
10-Jul-15 
Access Enablement 
CTS 
6-Jul-15 
31-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
13-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
3-Aug-15 
21-Aug-15 
Assessment week - 1st 
CTS 
24-Aug-15 
28-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
31-Aug-15 
11-Sep-15 
Assessment week - 2nd 
CTS 
14-Sep-15 
18-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
21-Sep-15 
25-Sep-15 
Deployment into Operations 
CTS 
28-Sep-15 
15-Jan-16 
20% Volume Ramp - Capacity 
CTS 
28-Sep-15 
23-Oct-15 
40% Volume Ramp - Capacity 
CTS 
26-Oct-15 
20-Nov-15 
60% Volume Ramp - Capacity 
CTS 
23-Nov-15 
18-Dec-15 
100% Volume Ramp - Capacity 
CTS 
21-Dec-15 
15-Jan-16 
6 
Regulatory Approvals 
HN 
4-Aug-14 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 72 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Phase :- Seed Team activities - wave 2 
3-Nov-14 
17-Jul-15 
Roles and Location at which Seed team to be hired 
HN 
3-Nov-14 
14-Nov-14 
Job Description of the Seed Team 
CTS 
17-Nov-14 
28-Nov-14 
Validation of JD 
HN 
1-Dec-14 
5-Dec-14 
Hiring 
CTS and HN 
8-Dec-14 
26-Dec-14 
Onboarding 
CTS 
5-Jan-15 
9-Jan-15 
Training 
HN 
5-Jan-15 
27-Mar-15 
Overview of Claims business and systems 
HN 
5-Jan-15 
9-Jan-15 
Access Enablement 
HN 
5-Jan-15 
30-Jan-15 
Theory - Class Room :- Claims process training 
HN 
12-Jan-15 
30-Jan-15 
Practical - Hands on Training :- Claims process training 
HN 
2-Feb-15 
20-Feb-15 
Assessment week - 1st 
HN 
23-Feb-15 
27-Feb-15 
Re-Training on gaps based on Assessment week results- 1st 
HN 
2-Mar-15 
13-Mar-15 
Assessment week - 2nd 
HN 
16-Mar-15 
20-Mar-15 
Final Hands on training and Monitoring before production kick off 
HN 
23-Mar-15 
27-Mar-15 
Deployment into Operations 
HN 
30-Mar-15 
17-Jul-15 
20% Volume Ramp - Capacity 
HN 
30-Mar-15 
24-Apr-15 
40% Volume Ramp - Capacity 
HN 
27-Apr-15 
22-May-15 
60% Volume Ramp - Capacity 
HN 
25-May-15 
19-Jun-15 
100% Volume Ramp - Capacity 
HN 
22-Jun-15 
17-Jul-15 
Phase :- Seed Team activities - wave 3 
4-May-15 
15-Jan-16 
Roles and Location at which Seed team to be hired 
CTS 
4-May-15 
15-May-15 
Job Description of the Seed Team 
CTS 
18-May-15 
29-May-15 
Validation of JD 
CTS 
1-Jun-15 
5-Jun-15 
Hiring 
CTS and HN 
8-Jun-15 
26-Jun-15 
Onboarding 
CTS 
29-Jun-15 
3-Jul-15 
Training 
CTS 
6-Jul-15 
25-Sep-15 
Overview of Claims business and systems 
CTS 
6-Jul-15 
10-Jul-15 
Access Enablement 
CTS 
6-Jul-15 
31-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
13-Jul-15 
31-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
3-Aug-15 
21-Aug-15 
Assessment week - 1st 
CTS 
24-Aug-15 
28-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
31-Aug-15 
11-Sep-15 
Assessment week - 2nd 
CTS 
14-Sep-15 
18-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
21-Sep-15 
25-Sep-15 
Deployment into Operations 
CTS 
28-Sep-15 
15-Jan-16 
20% Volume Ramp - Capacity 
CTS 
28-Sep-15 
23-Oct-15 
40% Volume Ramp - Capacity 
CTS 
26-Oct-15 
20-Nov-15 
60% Volume Ramp - Capacity 
CTS 
23-Nov-15 
18-Dec-15 
100% Volume Ramp - Capacity 
CTS 
21-Dec-15 
15-Jan-16 
6 
Regulatory Approvals 
HN 
4-Aug-14 
30-Jan-15 
Schedule Z10 - BPaaS Transition 
Page 73 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Claims Wave 1 
CTS 
6-Apr-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Claims business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Claims process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Claims process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- Claims Wave 1 
CTS 
27-Jul-15 
5-Feb-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
50% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
65% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
75% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
100% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
Go Live Wave 1 
CTS 
8-Feb-16 
Phase :-Offshore Knowledge Transfer :- Claims Wave 2 
CTS 
1-Jun-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Claims business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Phase :-Ramp :- Claims Wave 2 
CTS 
21-Sep-15 
1-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
50% Volume Ramp - Capacity 
CTS 
14-Dec-15 
4-Jan-16 
65% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
75% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
100% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
Go Live Wave 2 
CTS 
4-Apr-16 
Schedule Z10 - BPaaS Transition 
Page 74 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Claims Wave 1 
CTS 
6-Apr-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Claims business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Claims process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Claims process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- Claims Wave 1 
CTS 
27-Jul-15 
5-Feb-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
50% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
65% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
75% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
100% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
Go Live Wave 1 
CTS 
8-Feb-16 
Phase :-Offshore Knowledge Transfer :- Claims Wave 2 
CTS 
1-Jun-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Claims business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Phase :-Ramp :- Claims Wave 2 
CTS 
21-Sep-15 
1-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
50% Volume Ramp - Capacity 
CTS 
14-Dec-15 
4-Jan-16 
65% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
75% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
100% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
Go Live Wave 2 
CTS 
4-Apr-16 
Schedule Z10 - BPaaS Transition 
Page 75 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Transition
Activities 
7 Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8 
Phase :-Offshore Knowledge Transfer :- Claims Wave 1 
CTS 
6-Apr-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Claims business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Claims process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Claims process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- Claims Wave 1 
CTS 
27-Jul-15 
5-Feb-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
50% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
65% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
75% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
100% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
Go Live Wave 1 
CTS 
8-Feb-16 
Phase :-Offshore Knowledge Transfer :- Claims Wave 2 
CTS 
1-Jun-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Claims business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Phase :-Ramp :- Claims Wave 2 
CTS 
21-Sep-15 
1-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
50% Volume Ramp - Capacity 
CTS 
14-Dec-15 
4-Jan-16 
65% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
75% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
100% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
Go Live Wave 2 
CTS 
4-Apr-16 
Schedule Z10 - BPaaS Transition 
Page 76 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Transition
Activities 
7 
Phase :- Re-badging HealthNet Staff 
CTS 
2-Mar-15 
2-Mar-15 
8

Phase :-Offshore Knowledge Transfer :- Claims Wave 1 
CTS 
6-Apr-15 
24-Jul-15 
Boot Camps 
CTS 
6-Apr-15 
1-May-15 
Access Enablement 
CTS 
4-May-15 
29-May-15 
Overview of Claims business and systems 
CTS 
4-May-15 
8-May-15 
Theory - Class Room :- Claims process training 
CTS 
11-May-15 
15-May-15 
Practical - Hands on Training :- Claims process training 
CTS 
1-Jun-15 
19-Jun-15 
Assessment week - 1st 
CTS 
22-Jun-15 
26-Jun-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
29-Jun-15 
10-Jul-15 
Assessment week - 2nd 
CTS 
13-Jul-15 
17-Jul-15 
Final Hands on training and Monitoring before production kick off 
CTS 
20-Jul-15 
24-Jul-15 
Phase :-Ramp :- Claims Wave 1 
CTS 
27-Jul-15 
5-Feb-16 
10% Volume Ramp - Capacity 
CTS 
27-Jul-15 
21-Aug-15 
20% Volume Ramp - Capacity 
CTS 
24-Aug-15 
18-Sep-15 
30% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
50% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
65% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
75% Volume Ramp - Capacity 
CTS 
14-Dec-15 
8-Jan-16 
100% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
Go Live Wave 1 
CTS 
8-Feb-16 
Phase :-Offshore Knowledge Transfer :- Claims Wave 2 
CTS 
1-Jun-15 
18-Sep-15 
Boot Camps 
CTS 
1-Jun-15 
26-Jun-15 
Access Enablement 
CTS 
29-Jun-15 
24-Jul-15 
Overview of Claims business and systems 
CTS 
29-Jun-15 
3-Jul-15 
Theory - Class Room :- Claims process training 
CTS 
6-Jul-15 
24-Jul-15 
Practical - Hands on Training :- Claims process training 
CTS 
27-Jul-15 
14-Aug-15 
Assessment week - 1st 
CTS 
17-Aug-15 
21-Aug-15 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
24-Aug-15 
4-Sep-15 
Assessment week - 2nd 
CTS 
7-Sep-15 
11-Sep-15 
Final Hands on training and Monitoring before production kick off 
CTS 
14-Sep-15 
18-Sep-15 
Phase :-Ramp :- Claims Wave 2 
CTS 
21-Sep-15 
1-Apr-16 
10% Volume Ramp - Capacity 
CTS 
21-Sep-15 
16-Oct-15 
20% Volume Ramp - Capacity 
CTS 
19-Oct-15 
13-Nov-15 
30% Volume Ramp - Capacity 
CTS 
16-Nov-15 
11-Dec-15 
50% Volume Ramp - Capacity 
CTS 
14-Dec-15 
4-Jan-16 
65% Volume Ramp - Capacity 
CTS 
11-Jan-16 
5-Feb-16 
75% Volume Ramp - Capacity 
CTS 
8-Feb-16 
4-Mar-16 
100% Volume Ramp - Capacity 
CTS 
7-Mar-16 
1-Apr-16 
Go Live Wave 2 
CTS 
4-Apr-16 
Schedule Z10 - BPaaS Transition 
Page 77 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Offshore Knowledge Transfer :- Claims Wave 3 
CTS 
7-Dec-15 
22-Apr-16 
Boot Camps 
CTS 
7-Dec-15 
1-Jan-16 
Access Enablement 
CTS 
4-Jan-16 
29-Jan-16 
Overview of Claims business and systems 
CTS 
4-Jan-16 
8-Jan-16 
Theory - Class Room :- Claims process training 
CTS 
11-Jan-16 
5-Feb-16 
Practical - Hands on Training :- Claims process training 
CTS 
8-Feb-16 
4-Mar-16 
Assessment week - 1st 
CTS 
7-Mar-16 
11-Mar-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
14-Mar-16 
1-Apr-16 
Assessment week - 2nd 
CTS 
4-Apr-16 
8-Apr-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Apr-16 
22-Apr-16 
Phase :-Ramp :- Claims Wave 3 
CTS 
25-Apr-16 
2-Dec-16 
10% Volume Ramp - Capacity 
CTS 
25-Apr-16 
20-May-16 
20% Volume Ramp - Capacity 
CTS 
23-May-16 
17-Jun-16 
30% Volume Ramp - Capacity 
CTS 
20-Jun-16 
15-Jul-16 
40% Volume Ramp - Capacity 
CTS 
18-Jul-16 
12-Aug-16 
50% Volume Ramp - Capacity 
CTS 
15-Aug-16 
9-Sep-16 
65% Volume Ramp - Capacity 
CTS 
12-Sep-16 
7-Oct-16 
75% Volume Ramp - Capacity 
CTS 
10-Oct-16 
4-Nov-16 
100% Volume Ramp - Capacity 
CTS 
7-Nov-16 
2-Dec-16 
Go Live Wave 3 
CTS 
5-Dec-16 
Schedule Z10 - BPaaS Transition 
Page 78 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Offshore Knowledge Transfer :- Claims Wave 3 
CTS 
7-Dec-15 
22-Apr-16 
Boot Camps 
CTS 
7-Dec-15 
1-Jan-16 
Access Enablement 
CTS 
4-Jan-16 
29-Jan-16 
Overview of Claims business and systems 
CTS 
4-Jan-16 
8-Jan-16 
Theory - Class Room :- Claims process training 
CTS 
11-Jan-16 
5-Feb-16 
Practical - Hands on Training :- Claims process training 
CTS 
8-Feb-16 
4-Mar-16 
Assessment week - 1st 
CTS 
7-Mar-16 
11-Mar-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
14-Mar-16 
1-Apr-16 
Assessment week - 2nd 
CTS 
4-Apr-16 
8-Apr-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Apr-16 
22-Apr-16 
Phase :-Ramp :- Claims Wave 3 
CTS 
25-Apr-16 
2-Dec-16 
10% Volume Ramp - Capacity 
CTS 
25-Apr-16 
20-May-16 
20% Volume Ramp - Capacity 
CTS 
23-May-16 
17-Jun-16 
30% Volume Ramp - Capacity 
CTS 
20-Jun-16 
15-Jul-16 
40% Volume Ramp - Capacity 
CTS 
18-Jul-16 
12-Aug-16 
50% Volume Ramp - Capacity 
CTS 
15-Aug-16 
9-Sep-16 
65% Volume Ramp - Capacity 
CTS 
12-Sep-16 
7-Oct-16 
75% Volume Ramp - Capacity 
CTS 
10-Oct-16 
4-Nov-16 
100% Volume Ramp - Capacity 
CTS 
7-Nov-16 
2-Dec-16 
Go Live Wave 3 
CTS 
5-Dec-16 
Schedule Z10 - BPaaS Transition 
Page 79 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Offshore Knowledge Transfer :- Claims Wave 3 
CTS 
7-Dec-15 
22-Apr-16 
Boot Camps 
CTS 
7-Dec-15 
1-Jan-16 
Access Enablement 
CTS 
4-Jan-16 
29-Jan-16 
Overview of Claims business and systems 
CTS 
4-Jan-16 
8-Jan-16 
Theory - Class Room :- Claims process training 
CTS 
11-Jan-16 
5-Feb-16 
Practical - Hands on Training :- Claims process training 
CTS 
8-Feb-16 
4-Mar-16 
Assessment week - 1st 
CTS 
7-Mar-16 
11-Mar-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
14-Mar-16 
1-Apr-16 
Assessment week - 2nd 
CTS 
4-Apr-16 
8-Apr-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Apr-16 
22-Apr-16 
Phase :-Ramp :- Claims Wave 3 
CTS 
25-Apr-16 
2-Dec-16 
10% Volume Ramp - Capacity 
CTS 
25-Apr-16 
20-May-16 
20% Volume Ramp - Capacity 
CTS 
23-May-16 
17-Jun-16 
30% Volume Ramp - Capacity 
CTS 
20-Jun-16 
15-Jul-16 
40% Volume Ramp - Capacity 
CTS 
18-Jul-16 
12-Aug-16 
50% Volume Ramp - Capacity 
CTS 
15-Aug-16 
9-Sep-16 
65% Volume Ramp - Capacity 
CTS 
12-Sep-16 
7-Oct-16 
75% Volume Ramp - Capacity 
CTS 
10-Oct-16 
4-Nov-16 
100% Volume Ramp - Capacity 
CTS 
7-Nov-16 
2-Dec-16 
Go Live Wave 3 
CTS 
5-Dec-16 
Schedule Z10 - BPaaS Transition 
Page 80 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Phase
:-Offshore Knowledge Transfer :- Claims Wave 3 
CTS 
7-Dec-15 
22-Apr-16 
Boot Camps 
CTS 
7-Dec-15 
1-Jan-16 
Access Enablement 
CTS 
4-Jan-16 
29-Jan-16 
Overview of Claims business and systems 
CTS 
4-Jan-16 
8-Jan-16 
Theory - Class Room :- Claims process training 
CTS 
11-Jan-16 
5-Feb-16 
Practical - Hands on Training :- Claims process training 
CTS 
8-Feb-16 
4-Mar-16 
Assessment week - 1st 
CTS 
7-Mar-16 
11-Mar-16 
Re-Training on gaps based on Assessment week results- 1st 
CTS 
14-Mar-16 
1-Apr-16 
Assessment week - 2nd 
CTS 
4-Apr-16 
8-Apr-16 
Final Hands on training and Monitoring before production kick off 
CTS 
11-Apr-16 
22-Apr-16 
Phase :-Ramp :- Claims Wave 3 
CTS 
25-Apr-16 
2-Dec-16 
10% Volume Ramp - Capacity 
CTS 
25-Apr-16 
20-May-16 
20% Volume Ramp - Capacity 
CTS 
23-May-16 
17-Jun-16 
30% Volume Ramp - Capacity 
CTS 
20-Jun-16 
15-Jul-16 
40% Volume Ramp - Capacity 
CTS 
18-Jul-16 
12-Aug-16 
50% Volume Ramp - Capacity 
CTS 
15-Aug-16 
9-Sep-16 
65% Volume Ramp - Capacity 
CTS 
12-Sep-16 
7-Oct-16 
75% Volume Ramp - Capacity 
CTS 
10-Oct-16 
4-Nov-16 
100% Volume Ramp - Capacity 
CTS 
7-Nov-16 
2-Dec-16 
Go Live Wave 3 
CTS 
5-Dec-16 
Schedule Z10 - BPaaS Transition 
Page 81 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Quality
Assurance 
Jul-14 
Aug-14 
Sep-14 
Oct-14 
Nov-14 
Dec-14 
Jan-15 
Feb-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Jul-14 
4-Aug-14 
11-Aug-14 
18-Aug-14 
25-Aug-14 
1-Sep-14 
8-Sep-14 
15-Sep-14 
22-Sep-14 
29-Sep-14 
6-Oct-14 
13-Oct-14 
20-Oct-14 
27-Oct-14 
3-Nov-14 
10-Nov-14 
17-Nov-14 
24-Nov-14 
1-Dec-14 
8-Dec-14 
15-Dec-14 
22-Dec-14 
29-Dec-14 
5-Jan-15 
12-Jan-15 
19-Jan-15 
26-Jan-15 
2-Feb-15 
9-Feb-15 
16-Feb-15 
23-Feb-15 
2-Mar-15 
9-Mar-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
20-Oct-14 
Organization Announcement at HN 
HN 
15-Aug-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
13-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
8-Dec-14 
26-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
16-Jan-15 
Documentation gap - Training 
CTS 
12-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
12-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
19-Jan-15 
30-Jan-15 
3.8 
Evaluate Trainer availability 
CTS 
26-Jan-15 
30-Jan-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
26-Jan-15 
30-Jan-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
2-Feb-15 
13-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
3-Apr-15 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
16-Jan-15 
create or update the available SOPs, P&Ps - Group 1 
CTS 
19-Jan-15 
30-Jan-15 
create or update the Training docs - Group 1 
CTS 
2-Feb-15 
13-Feb-15 
create or update the available SOPs, P&Ps - Group 2 
CTS 
16-Feb-15 
6-Mar-15 
create or update the Training docs - Group 2 
CTS 
9-Mar-15 
20-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
9-Mar-15 
3-Apr-15 
Accommodate Changes based on HN review 
CTS 
9-Mar-15 
3-Apr-15 
5 
Phase:- Process Documentation Validation Exercise 
4-Jul-16 
26-Aug-16 
5.1 
Process Documentation Revalidation 
CTS 
4-Jul-16 
29-Jul-16 
5.2 
Policy and Procedure documentation, review and sign off 
CTS 
1-Aug-16 
26-Aug-16 
Schedule Z10 - BPaaS Transition 
Page 82 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Quality
Assurance 
Mar-15 
Apr-15 
May-15 
Jun-15 
Jul-15 
Aug-15 
Sep-15 
Oct-15 
Nov-15 
Dec-15 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
16-Mar-15 
23-Mar-15 
30-Mar-15 
6-Apr-15 
13-Apr-15 
20-Apr-15 
27-Apr-15 
4-May-15 
11-May-15 
18-May-15 
25-May-15 
1-Jun-15 
8-Jun-15 
15-Jun-15 
22-Jun-15 
29-Jun-15 
6-Jul-15 
13-Jul-15 
20-Jul-15 
27-Jul-15 
3-Aug-15 
10-Aug-15 
17-Aug-15 
24-Aug-15 
31-Aug-15 
7-Sep-15 
14-Sep-15 
21-Sep-15 
28-Sep-15 
5-Oct-15 
12-Oct-15 
19-Oct-15 
26-Oct-15 
2-Nov-15 
9-Nov-15 
16-Nov-15 
23-Nov-15 
30-Nov-15 
7-Dec-15 
14-Dec-15 
21-Dec-15 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
20-Oct-14 
Organization Announcement at HN 
HN 
15-Aug-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
13-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
3.3 
Process Assessment Agenda Finalization and dependency matrix 
CTS 
17-Nov-14 
28-Nov-14 
3.4 
Gather or Create / Validate AS-IS & TO-BE SIPOC & Process Maps 
CTS 
1-Dec-14 
19-Dec-14 
3.5 
Gather & Finalize Technology requirements – applications required 
CTS 
8-Dec-14 
26-Dec-14 
3.6 
Staffing validation & Capacity Planning 
CTS 
8-Dec-14 
26-Dec-14 
3.7 
Review Training documentation and SOP readiness 
CTS 
29-Dec-14 
16-Jan-15 
Documentation gap - Training 
CTS 
12-Jan-15 
30-Jan-15 
Documentation gap - Process PnP’s 
CTS 
12-Jan-15 
30-Jan-15 
Gap documentation for HN review and Sign off 
HN 
19-Jan-15 
30-Jan-15 
3.8 
Evaluate Trainer availability 
CTS 
26-Jan-15 
30-Jan-15 
3.9 
Evaluate Quality Auditor avail 
CTS 
26-Jan-15 
30-Jan-15 
3.10 
KM Team Deliverable listing & Briefing to KM team 
CTS 
2-Feb-15 
13-Feb-15 
4 
Phase Knowledge Management 
5-Jan-15 
3-Apr-15 
Process Shadowing and Understanding 
CTS 
5-Jan-15 
16-Jan-15 
create or update the available SOPs, P&Ps - Group 1 
CTS 
19-Jan-15 
30-Jan-15 
create or update the Training docs - Group 1 
CTS 
2-Feb-15 
13-Feb-15 
create or update the available SOPs, P&Ps - Group 2 
CTS 
16-Feb-15 
6-Mar-15 
create or update the Training docs - Group 2 
CTS 
9-Mar-15 
20-Mar-15 
Sign off on updated SOP’s and Training Documentation 
HN 
9-Mar-15 
3-Apr-15 
Accommodate Changes based on HN review 
CTS 
9-Mar-15 
3-Apr-15 
5 
Phase:- Process Documentation Validation Exercise 
4-Jul-16 
26-Aug-16 
5.1 
Process Documentation Revalidation 
CTS 
4-Jul-16 
29-Jul-16 
5.2 
Policy and Procedure documentation, review and sign off 
CTS 
1-Aug-16 
26-Aug-16 
Schedule Z10 - BPaaS Transition 
Page 83 
Health Net / Cognizant Confidential 

	
	

  

 Final 
 Schedule
Z10 - BPaaS Transition 
Quality Assurance 
Jan-16 
Feb-16 
Mar-16 
Apr-16 
May-16 
Jun-16 
Jul-16 
Aug-16 
Sep-16 
S. NO. 
Project Tasks 
Ownership 
Start Date 
End Date 
28-Dec-15 
4-Jan-16 
11-Jan-16 
18-Jan-16 
25-Jan-16 
1-Feb-16 
8-Feb-16 
15-Feb-16 
22-Feb-16 
29-Feb-16 
7-Mar-16 
14-Mar-16 
21-Mar-16 
28-Mar-16 
4-Apr-16 
11-Apr-16 
18-Apr-16 
25-Apr-16 
2-May-16 
9-May-16 
16-May-16 
23-May-16 
30-May-16 
6-Jun-16 
13-Jun-16 
20-Jun-16 
27-Jun-16 
4-Jul-16 
11-Jul-16 
18-Jul-16 
25-Jul-16 
1-Aug-16 
8-Aug-16 
15-Aug-16 
22-Aug-16 
29-Aug-16 
5-Sep-16 
12-Sep-16 
19-Sep-16 
26-Sep-16 
3-Oct-16 
Pre- Transition Activities 
1 
Contract Sign off 
HN & CTS 
28-Jul-14 
20-Oct-14 
Organization Announcement at HN 
HN 
15-Aug-14 
31-Oct-14 
2 
Phase :- Transition Readiness Phase 
3-Nov-14 
28-Nov-14 
2.1 
Validate Solution Assumptions 
CTS 
3-Nov-14 
7-Nov-14 
2.2 
Team Charter 
HN & CTS 
3-Nov-14 
14-Nov-14 
2.3 
Transition Milestones and timelines 
CTS 
3-Nov-14 
21-Nov-14 
2.4 
Agenda and resource requirements for Process Assessment and Knowledge Management 
CTS

3-Nov-14 
28-Nov-14 
3 
Phase :- Process Assessment and Detailed Transition Planning 
17-Nov-14 
13-Feb-15 
3.1 
Transition Kick off Activity + Stake holder identification 
HN & CTS 
17-Nov-14 
21-Nov-14 
3.2 
Governance, communication & escalation plan 
CTS 
17-Nov-14 
21-Nov-14 
Documentation gap - Process PnP’s 
CTS 
12-Jan-15 
30-Jan-15 

	
	

  

	
	

  

 Final 
  

Transition Activities 
6 
7 
Phase :- Re-badging HealthNet Staff 
2-Mar-15 
2-Mar-15 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 1 (AnG 
5-Sep-16

30-Sep-16 
Access Enablement 
CTS 
5-Sep-16 
12-Sep-16 
Overview of QA business and systems 
CTS 
5-Sep-16 
9-Sep-16 
QA process training 
CTS 
12-Sep-16 
30-Sep-16 
Assessment 
CTS 
30-Sep-16 
30-Sep-16 
Phase :-Ramp :- Wave 1 
3-Oct-16 
23-Dec-16 
25% Volume Ramp - Capacity 
CTS 
3-Oct-16 
28-Oct-16 
50% Volume Ramp - Capacity 
CTS 
31-Oct-16 
25-Nov-16 
100% Volume Ramp - Capacity 
CTS 
28-Nov-16 
23-Dec-16 
Go Live Wave 1 
CTS 
26-Dec-16 
Phase :-Offshore Knowledge Transfer Auditors & Business Analyst Wave 2 (Claims)

6-Feb-17 
3-Mar-17 
Access Enablement 
CTS 
6-Feb-17 
17-Feb-17 
Overview of QA business and systems 
CTS 
6-Feb-17 
10-Feb-17 
QA process training 
CTS 
13-Feb-17 
3-Mar-17 
Assessment 
CTS 
27-Feb-17 
3-Mar-17 
Phase :-Ramp :- Wave 2 
6-Mar-17 
22-May-17 
25% Volume Ramp - Capacity 
CTS 
6-Mar-17 
31-Mar-17 
50% Volume Ramp - Capacity 
CTS 
3-Apr-17 
28-Apr-17 
100% Volume Ramp - Capacity 
CTS 
1-May-17 
26-May-17 
Go Live Wave 2 
CTS 
29-May-17 
Schedule Z10 - BPaaS Transition 
Page 86 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
6 
7 
Phase :- Re-badging HealthNet Staff 
2-Mar-15 
2-Mar-15 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 1 (AnG 
5-Sep-16

30-Sep-16 
Access Enablement 
CTS 
5-Sep-16 
12-Sep-16 
Overview of QA business and systems 
CTS 
5-Sep-16 
9-Sep-16 
QA process training 
CTS 
12-Sep-16 
30-Sep-16 
Assessment 
CTS 
30-Sep-16 
30-Sep-16 
Phase :-Ramp :- Wave 1 
3-Oct-16 
23-Dec-16 
25% Volume Ramp - Capacity 
CTS 
3-Oct-16 
28-Oct-16 
50% Volume Ramp - Capacity 
CTS 
31-Oct-16 
25-Nov-16 
100% Volume Ramp - Capacity 
CTS 
28-Nov-16 
23-Dec-16 
Go Live Wave 1 
CTS 
26-Dec-16 
Phase :-Offshore Knowledge Transfer Auditors & Business Analyst Wave 2 (Claims)

6-Feb-17 
3-Mar-17 
Access Enablement 
CTS 
6-Feb-17 
17-Feb-17 
Overview of QA business and systems 
CTS 
6-Feb-17 
10-Feb-17 
QA process training 
CTS 
13-Feb-17 
3-Mar-17 
Assessment 
CTS 
27-Feb-17 
3-Mar-17 
Phase :-Ramp :- Wave 2 
6-Mar-17 
22-May-17 
25% Volume Ramp - Capacity 
CTS 
6-Mar-17 
31-Mar-17 
50% Volume Ramp - Capacity 
CTS 
3-Apr-17 
28-Apr-17 
100% Volume Ramp - Capacity 
CTS 
1-May-17 
26-May-17 
Go Live Wave 2 
CTS 
29-May-17 
Schedule Z10 - BPaaS Transition 
Page 87 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
6 
7 
Phase :- Re-badging HealthNet Staff 
2-Mar-15 
2-Mar-15 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 1 (AnG 
5-Sep-16

30-Sep-16 
Access Enablement 
CTS 
5-Sep-16 
12-Sep-16 
Overview of QA business and systems 
CTS 
5-Sep-16 
9-Sep-16 
QA process training 
CTS 
12-Sep-16 
30-Sep-16 
Assessment 
CTS 
30-Sep-16 
30-Sep-16 
Phase :-Ramp :- Wave 1 
3-Oct-16 
23-Dec-16 
25% Volume Ramp - Capacity 
CTS 
3-Oct-16 
28-Oct-16 
50% Volume Ramp - Capacity 
CTS 
31-Oct-16 
25-Nov-16 
100% Volume Ramp - Capacity 
CTS 
28-Nov-16 
23-Dec-16 
Go Live Wave 1 
CTS 
26-Dec-16 
Phase :-Offshore Knowledge Transfer Auditors & Business Analyst Wave 2 (Claims)

6-Feb-17 
3-Mar-17 
Access Enablement 
CTS 
6-Feb-17 
17-Feb-17 
Overview of QA business and systems 
CTS 
6-Feb-17 
10-Feb-17 
QA process training 
CTS 
13-Feb-17 
3-Mar-17 
Assessment 
CTS 
27-Feb-17 
3-Mar-17 
Phase :-Ramp :- Wave 2 
6-Mar-17 
22-May-17 
25% Volume Ramp - Capacity 
CTS 
6-Mar-17 
31-Mar-17 
50% Volume Ramp - Capacity 
CTS 
3-Apr-17 
28-Apr-17 
100% Volume Ramp - Capacity 
CTS 
1-May-17 
26-May-17 
Go Live Wave 2 
CTS 
29-May-17 
Schedule Z10 - BPaaS Transition 
Page 88 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Transition Activities 
6 
7 
Phase :- Re-badging HealthNet Staff 
2-Mar-15 
2-Mar-15 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 1 (AnG 
5-Sep-16

30-Sep-16 
Access Enablement 
CTS 
5-Sep-16 
12-Sep-16 
Overview of QA business and systems 
CTS 
5-Sep-16 
9-Sep-16 
QA process training 
CTS 
12-Sep-16 
30-Sep-16 
Assessment 
CTS 
30-Sep-16 
30-Sep-16 
Phase :-Ramp :- Wave 1 
3-Oct-16 
23-Dec-16 
25% Volume Ramp - Capacity 
CTS 
3-Oct-16 
28-Oct-16 
50% Volume Ramp - Capacity 
CTS 
31-Oct-16 
25-Nov-16 
100% Volume Ramp - Capacity 
CTS 
28-Nov-16 
23-Dec-16 
Go Live Wave 1 
CTS 
26-Dec-16 
Phase :-Offshore Knowledge Transfer Auditors & Business Analyst Wave 2 (Claims)

6-Feb-17 
3-Mar-17 
Access Enablement 
CTS 
6-Feb-17 
17-Feb-17 
Overview of QA business and systems 
CTS 
6-Feb-17 
10-Feb-17 
QA process training 
CTS 
13-Feb-17 
3-Mar-17 
Assessment 
CTS 
27-Feb-17 
3-Mar-17 
Phase :-Ramp :- Wave 2 
6-Mar-17 
22-May-17 
25% Volume Ramp - Capacity 
CTS 
6-Mar-17 
31-Mar-17 
50% Volume Ramp - Capacity 
CTS 
3-Apr-17 
28-Apr-17 
100% Volume Ramp - Capacity 
CTS 
1-May-17 
26-May-17 
Go Live Wave 2 
CTS 
29-May-17 
Schedule Z10 - BPaaS Transition 
Page 89 
Health Net / Cognizant Confidential 

	
	

  

 Final 

ITO /Infrastructure 
Phase :-Offshore Knowledge Transfer :- Auditors &
Business Analyst Wave 3 
1-May-17 
26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp :- Wave 3 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 3 
CTS 
21-Aug-17 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 4 
1-May-17

26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp : Wave 4 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 4 
CTS 
21-Aug-17 
Appeals and Grievances - India to Philippines 
Re-badging 
Pre-Process Training 
Process Training 
Ramp Up 
Go Live 
Wrappers 
Schedule Z10 - BPaaS Transition 
Page 90 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 3

1-May-17 
26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp :- Wave 3 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 3 
CTS 
21-Aug-17 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 4 
1-May-17

26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp : Wave 4 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 4 
CTS 
21-Aug-17 
Appeals and Grievances - India to Philippines 
ITO /Infrastructure 
Re-badging 
Pre-Process Training 
Process Training 
Ramp Up 
Go Live 
Wrappers 
Schedule Z10 - BPaaS Transition 
Page 91 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 3

1-May-17 
26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp :- Wave 3 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 3 
CTS 
21-Aug-17 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 4 
1-May-17

26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp : Wave 4 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 4 
CTS 
21-Aug-17 
Appeals and Grievances - India to Philippines 
ITO /Infrastructure 
Re-badging 
Pre-Process Training 
Process Training 
Ramp Up 
Go Live 
Wrappers 
Schedule Z10 - BPaaS Transition 
Page 92 
Health Net / Cognizant Confidential 

	
	

  

 Final 
  

Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 3

1-May-17 
26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp :- Wave 3 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 3 
CTS 
21-Aug-17 
Phase :-Offshore Knowledge Transfer :- Auditors & Business Analyst Wave 4 
1-May-17

26-May-17 
Access Enablement 
CTS 
1-May-17 
12-May-17 
Overview of QA business and systems 
CTS 
1-May-17 
5-May-17 
QA process training 
CTS 
8-May-17 
26-May-17 
Assessment 
CTS 
22-May-17 
26-May-17 
Phase :-Ramp : Wave 4 
29-May-17 
18-Aug-17 
25% Volume Ramp - Capacity 
CTS 
29-May-17 
23-Jun-17 
50% Volume Ramp - Capacity 
CTS 
26-Jun-17 
21-Jul-17 
100% Volume Ramp - Capacity 
CTS 
24-Jul-17 
18-Aug-17 
Go Live Wave 4 
CTS 
21-Aug-17 
Appeals and Grievances - India to Philippines 
ITO /Infrastructure 
Re-badging 
Pre-Process Training 
Process Training 
Ramp Up 
Go Live 
Wrappers 
Schedule Z10 - BPaaS Transition 
Page 93 
Health Net / Cognizant Confidential 

	
	

  

	
	

  

	
	

  

	
	

  

 Final 
Period Highlight:

15 
Plan 
Actual 
% Complete 
Actual (beyond plan) 
% Complete (beyond plan) 
Phase 2 Begins 
Number = month of the year (Jan. =
1, 13, 25 )
Actual Duration = 30 days for nesting and performance 
PLAN 
TRAINING 
ACTUAL 
ACTUAL 
PERCENT 
2014 
2015 
2016

ACTIVITY 
START 
DURATION 
START 
DURATION 
COMPLETE 
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 
20 
21 22 
23 24 
25 26 
27 28 
29 30 31 
32 33 
34 35 
36

Commercial PG (within CA) 
Member English to 
Shreveport (from HN)
18 
1.1 
0 
2

0% 
CA Commercial Member English to 
Philippines (from HN) 
15 
5.5 
0

6.5 
0% 
CA Commercial Member English to Philippines (from HN) 
0 
0 
0 
0

0% 
AZ Commercial Member
English to Philippines (from HN) 
16 
1.1 
0

2.1 
0% 
OR Commercial Member/Provider English to
Phillippines (from HN)

17 
1.1 
0 
2.1 
0%

CA Commercial Member
Spanish to Mexico (from HN)

10 
1.1 
10 
2.1

0% 
AZ Commercial Member
Spanish to Mexico (from HN) 
10 
1.1 
9

2.1 
OR Commercial Member
Spanish to Mexico (from HN) 
0 
CA Commercial Provider
English to Philippines
(from Kelly) 
10 
3.3 
0

4.3 
0% 
AZ Commercial Provider
English to Philippines
(from HN) 
10 
1.1 
0

2.1 
0% 
OR Commercial Provider
English to Philippines (from HN)

15 
1.1 
0 
2.1 
0%

0% 
ACA - CA - English to
Philippines ( from HN)
15 
5.5 
0

6.5 
0% 
ACA - AZ - English to
Philippines (from HN)
16 
1.1 
0

2.1 
0% 
ACA - OR English to
Philippines )from HN)
ACA - CA - Spanish to
Mexico (from HN) 
10 
1.1 
8

2.1 
0% 
ACA - OR - Spanish to
Mexico (from HN) 
0% 
ACA AZ - Spanish to
Mexico (from HN) 
CA Medicare Member English to
Philippines (from Sykes) 
15 
4 
0 
5

0% 
AZ Medicare Member English to
Philippines (from Sykes) 
15 
1 
0 
2

0% 
OR Medicare Member English to 
Philippines (from Sykes) 
15 
2 
0 
3

0% 
CA Medicare Member Spanish to
Monterrey (from Sykes) 
15 
1 
2 
0%

AZ Medicare Member Spanish to
Monterrey (from 
Sykes)

OR Medicare Member Spanish to
Monterrey (from 
Sykes)

CA Medicare Provider English to
Philippines 
(from Sykes) 
0% 
AZ Medicare Provider English to 
Philippines (from Sykes) 
OR Medicare Provider English to 
Philippines (from Sykes)

Mental Health (Member/Provider/Claims) English 
to
Philippines (from HN) 
30 
4.8 
0

5.8 
0% 
Mental Health (Member/Provider/Claims) Spanish to Monterrey (from HN) 
30 
1.2 
0 
3

0% 
Correspondence to Philippines (from HN) 
18 
1.2 
0

3 
0% 
Medicaid CA Member English to Philippines (from HN) SHP 
21 
5 
0 
2

0% 
Medicaid AZ Member English to Shreveport (from HN) 
19 
2.2 
0

4 
0% 
Schedule Z10 - BPaaS Transition 
Page 97 
Health Net / Cognizant Confidential 

	
	

  

 Final 

ASSUMPTIONS: 
Period Highlight: 
15 
Plan

Actual 
% Complete 
Actual (beyond plan) 
% Complete (beyond plan) 
Phase 2 Begins 
Number = month of the year (Jan. = 1, 13, 25 )
Actual Duration = 30 days for nesting and performance 
PLAN

TRAINING 
ACTUAL 
ACTUAL 
PERCENT 
2014 
2015

2016 
ACTIVITY 
START 
DURATION 
START 
DURATION 
COMPLETE 
1 2 3 4 5 6 7 8 9 10 11 12 
13 14 15 16 17 18 19 
20 
21 22 
23 24 
25 26 
27 28 
29 30 31 
32 33 
34 35 
36

Medicaid CA Member
Spanish to Mexico
(from HN) 
19 
2 
0 
3

0% 
Medicaid AZ Member
Spanish to Shreveport
(from HN) 
19 
2.2 
0

4 
0% 
Medicaid CA Provider
English to Philippines
(from HN) 
21 
2 
0 
3

0% 
Medicaid AZ Provider 
English to Shreveport
(from HN) 
17 
2.2 
0

4 
0% 
Broker English to
Philippines (from HN) 
16 
1.2 
0

3 
0% 
Broker Spanish to
Monterrey (from HN) 
16 
1.2 
0

3 
0% 
CA Duals Member
to Philippines 
26 
4 
0

10 
0% 
CA Duals Provider
to Philippines 
22 
0 
0

0 
0% 
CA Duals Spanish
to Mexico 
23 
4 
0

7 
0% 
0 
0 
0

0 
0% 
IRT; PPG (Retain for
minimum 2 years -7 years) 
15 
Support Staff (transition
with ramp over 2 years) 
15 
Management Staff (Transition
with ramp of 2 years) 
15 
Ancillary (Medi-CAL)
(retain minimum of 2-7 years) 
15 
ASSUMPTIONS:

1. FTE numbers by HN in 3+9 as of August 8, 2014 
2. FTE migration is after hire date starting with training 
3. Assume BAU on all technology during 
transition
(Aspect, Routing, Omni, Citrix)

4. Life and Shift no performance improvement other than
meeting current SLAs as defined in Schedule B 
5. Training
is in weeks. If there are 100 FTE there will be 4 
waves of 25 FTE per training week. For example commercial 
is 5 weeks training or 1.1 month. If 100
FTE are trained, it
will take 4.4 months to complete. 
6. At the request of Health Net, one month is added for
OJT and stabiliization for each LOB. 
Final 
Z12 - Call Center Transition Plan 
Schedule Z10 - BPaaS Transition 
Page 98 
Health Net / Cognizant Confidential 

 Final 

 ANNEX 1 

SUPPLEMENTAL TERMS AND CONDITIONS 

for 
 BPaaS SERVICES

  

					
	Annex 1 – Supplemental Terms		 		Health Net / Cognizant Confidential
	and Conditions for BPaaS Services				

 Final 

 TABLE OF CONTENTS 

 

					
	 	  	Page	 
	 1. INTRODUCTION
	  	 	1	  
		
	 1.1 Structure of Supplemental Terms and Conditions
	  	 	1	  
		
	 2. DEFINITIONS
	  	 	1	  
		
	 2.1 Defined Terms
	  	 	1	  
		
	 3. TECHNOLOGY PLATFORM
	  	 	2	  
		
	 4. LICENSES TO THE TECHNOLOGY PLATFORM SOFTWARE
	  	 	5	  
		
	 5. ESCROW OF THE TECHNOLOGY PLATFORM SOFTWARE
	  	 	7	  
		
	 5.1 Execution by Escrow Agent
	  	 	7	  
		
	 5.2 Cost
	  	 	7	  
		
	 5.3 Bankruptcy of Supplier
	  	 	7	  
		
	 5.4 Initial Deposit
	  	 	7	  
		
	 5.5 Quarterly deposits
	  	 	8	  
		
	 5.6 Failure to make deposit
	  	 	8	  
		
	 5.7 License to Escrowed Materials
	  	 	8	  
		
	 5.8 Replacement Escrow Agent
	  	 	9	  
		
	 5.9 Terms relating to Licenses granted under this BPaaS Supplemental Terms
	  	 	9	  

  

					
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 ANNEX 1 

SUPPLEMENTAL TERMS AND CONDITIONS FOR BPAAS SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	Structure of Supplemental Terms and Conditions 

 This Supplemental Terms and Conditions
for BPaaS Services (the “BPaaS Supplemental Terms”) sets forth additional terms and conditions (in addition to those in the remainder of this Agreement) which are applicable to the BPaaS Services. 

This BPaaS Annex includes the following: 

Schedule 1-A (Escrow Agreement) 
  

	2.	DEFINITIONS 

  

	2.1	Defined Terms 

 The following capitalized terms, when used in this Agreement, will have
the meanings given them below: 
  

	 	(a)	“Escrow Agent” has the meaning given in Section 5. 

  

	 	(b)	“Escrow Agreement” has the meaning given in Section 5. 

  

	 	(c)	“Escrowed Materials” means the Technology Platform Software (as it evolves over the Term), in both Object Code form and Source Code form. For clarity, “Escrowed Materials” includes:

  

	 	(i)	Source Code, Object Code, programming interfaces, Documentation, artifacts, manuals and other materials useful in connection with the Use of the Technology Platform Software, 

 

	 	(ii)	any and all Software Updates to the Technology Platform Software used to provide the Services, and 

  

	 	(iii)	any new Software in the Technology Platform Software, or new items of the type described in clause (i) or (ii), used to provide the BPaaS Services. 

“Escrowed Materials” does not include any Commercially Available Third Party Software that is part of the Technology
Platform Software, although it does include any interfaces between such Commercially Available Third Party Software and the Technology Platform Software. 
  

	 	(d)	“Technology Platform Software” means that part of the Technology Platform that is Software. 

  

					
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	 	(e)	“Software Update” means any modification, enhancement, patch, upgrade, update, version, release or Derivative Work of any Software. 

 

	 	(f)	“Technology Platform” means the Equipment and Software (including Source Code, programming interfaces, Documentation, artifacts, manuals and other materials useful in connection with the Use of
such Equipment or Software) used by Supplier to deliver the BPaaS Services, as the same may be modified or replaced over the Term. It is the intent of the Parties that the initial Technology Platform Software shall be based on the ABS Platform
Software acquired by Supplier from Health Net, or a derivative work thereof developed by Supplier. 

  

	3.	TECHNOLOGY PLATFORM 

  

	 	3.1	Health Net’s own instance of the Technology Platform Software and access to Source Code and Configuration Layer. 

  

	 	(a)	Supplier shall maintain and operate for Health Net a separate instance of the Technology Platform Software (the “Health Net Instance”). 

 

	 	(b)	The Parties agree that Health Net, its Affiliates and (subject to Section 3.1(b)(iii) below) their respective contractors, shall have the right to access and Use the Technology Platform Software (including Source
Code, technical interfaces, Documentation, artifacts, manuals and other materials useful in connection with the Use of such Licensed Technology Platform Software) in a development and pre-production environment furnished by Supplier to develop
enhancements, modifications, interfaces and extensions to the Licensed Technology Platform Software (collectively “Modifications”), during the Term and Disengagement Assistance Period. Supplier agrees to promote such Modifications into the
production environment, subject to the following restrictions: 

  

	 	(i)	Supplier shall have the right to review any Modification that Health Net proposes to promote into production (such review shall be conducted as promptly as is practicable). If Supplier, acting reasonably and in good
faith, identifies in writing any performance, security, operational risk, ongoing maintenance or other reasonable Technology Platform Software integrity concerns relating to such Modification, the Parties shall meet and discuss the same. The Parties
will work in good faith to identify ways to mitigate such risks. If the Parties are unable to agree on ways to mitigate such risks, and if a reasonable person with IT experience in such matters would agree that such Modification should not be
promoted to production due to such risk, then such Modification shall not be moved into production, provided however that the “reasonable person with IT experience” standard set forth above shall not extend to security concerns and
Supplier shall in all cases have sole authority to approve security related elements of a Modification. 

  

	 	(ii)	Notwithstanding the requirements of Section 8.3 of the Agreement, if a root cause analysis determines that such Modification results or resulted in performance or other operational issues with the Health Net
Instance or the Services, Supplier shall be excused to the extent such issue was caused by the Modification, provided however such excuse shall not extend to a Security Breach. 

  

					
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	 	(iii)	Supplier shall have the right to approve any contractor that would have access to the Source Code if such contractor: (A) has a platform that competes with the Technology Platform, or (B) is listed on Schedule
M, provided that Health Net shall have the right to utilize, without Supplier’s approval, the following suppliers: ***. 

  

	 	(iv)	Any resulting increase in costs resulting from the Modifications including; development, integration, testing, upgrade, infrastructure, software and support cost shall be charged back to Health Net. To the extent
practicable, Supplier shall provide Health Net with estimates of any identifiable expenditures for which Health Net will be responsible. All work shall be done using the AO T&M Rates. 

 

	 	(c)	The Parties agree that Health Net, its Affiliates and their respective contractors shall also have the right to access and Use the configuration layer of any portion of the Technology Platform Software (including
technical interfaces, Documentation, artifacts, manuals and other materials useful in connection with the Use of such configuration layer), including such configuration layer in HP extreme, in a development and pre-production environment furnished
by Supplier to make configuration changes to the Licensed Technology Platform Software, during the Term and Disengagement Assistance Period. 

  

	 	(d)	Any Modification shall be understood to be an “other item” as those words are used in Section 23.3(g)(2) of the Agreement. 

 

	 	3.2	Users Group 

 Supplier shall organize a user group for Supplier’s customers for whom
Supplier is utilizing the Technology Platform to provide services (“Users Group”), and shall permit Health Net an opportunity to review and provide input into the organization and rights of the users prior to the formalization and
establishment of the Users Group. Health Net shall have a seat on the Users Group and voting rights as outlined in Section 3.4(b) below. 
  

	 	3.3	Roadmap 

 Supplier shall maintain a written description of Supplier’s product strategy for
the Technology Platform, which will include at least the following (the “Technology Platform Roadmap” or “Roadmap”): 

(a) a description of Supplier’s long-term strategy for each major component of the Technology Platform, 

(b) a plan that shows all enhancements, upgrades and investments planned for the Technology Platform on a prospective twenty-four
(24) month rolling basis, 
 (c) a review of the prior year’s activities relative to items (a) and (b) above, 

(d) a description and reconciliation of BPaaS Roadmap Projects and BPaaS Non- Discretionary Projects to be invested by Supplier each Contract
Year on the Technology Platform, as further described in Schedule C (Charges), 

  

					
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 (e) a mapping of the new features and functionality on a release calendar (including those
paid for out of the Discretionary Projects pool described in Schedule C (Charges) and those paid for by Supplier pursuant to Supplier’s roadmap investment obligations set forth in Schedule C (Charges)). 

Supplier shall provide to Health Net and other members of the Users Group a copy of such Roadmap in January of each calendar year, and Supplier
shall also make the Roadmap available to Health Net upon Health Net’s request from time to time. 
  

	 	3.4	Technology Platform Roadmap Committee and Voting: 

 (a) Composition of the Committee.
Supplier shall form a team made up of technology experts, business leaders, the User Group and other subject matters experts to design and draft the Technology Platform Roadmap (the “Technology Platform Roadmap Committee”). All
members of the User Group, including Health Net, shall hold a seat on the Technology Platform Roadmap Committee in order to consult with Supplier regarding enhancements and new functionality to be added by Supplier to the Technology Platform as part
of the Technology Platform Roadmap. 
 (b) Voting Rights. 

The enhancements and new functionality to be added by Supplier to the Technology Platform utilizing funds from Supplier’s
$*** required investment in BPaaS Roadmap Projects set forth in Section 12.4 of Schedule C (Charges) shall be determined based on votes as follows: 
  

	 	(i)	The User Group shall have an equal vote with Supplier on the Technology Platform Roadmap Committee in order to decide upon which enhancements to make to the Technology Platform, provided however that a Supplier
executive officer shall at all times hold the tie breaking vote on the Technology Platform Roadmap Committee; 

  

	 	(ii)	Each customer that is a member of the User Group shall have a share of the vote that is based on the respective number of members each customer has installed on the Technology Platform; and 

 

	 	(iii)	In all cases, the BPaaS Roadmap Projects must benefit the lines of business of the then-existing members of the Users Group and planned future lines of business of such then-existing User Group members.

  

	 	3.5	Compliance 

 Supplier shall be responsible for enhancing the Technology Platform as necessary
for Supplier and Health Net to comply with all applicable Laws. Supplier’s obligations in this regard are further described in the Terms and Conditions and Schedule C (Charges). 

 

	 	3.6	Releases 

 Supplier shall provide releases of the Technology Platform Software no less than
quarterly. 

  

					
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	 	3.7	Governance of the Technology Platform 

  

The Technology Platform shall be governed by the Governance Committee, as described in Schedule G (Governance). The Roadmap and input
from the Technology Platform Roadmap Committee will drive the discussions. 
  

	4.	LICENSES TO THE TECHNOLOGY PLATFORM SOFTWARE 

  

	 	(a)	Option to License the Technology Platform Software. 

  

	 	(i)	During the Term and until twenty four (24) months after the end of the Term, Health Net shall have the option, by sending written notice to Supplier, to license all or any portion of the Technology Platform
Software. Health Net shall have the right to license all of the Technology Platform Software or any portion of the Technology Platform Software, at different times, so long as Health Net does so within the timeframe described in the preceding
sentence. Supplier shall provide reasonable cooperation to Health Net in connection with Health Net’s exercise of its option rights set forth in this Section. 

 

	 	(ii)	For clarity, this Section 4(a) shall not apply to those portions of the Technology Platform Software that are Commercially Available Third Party Software. Upon receipt of Health Net’s notice pursuant to
Section 4(a)(i) above or any other written notice received from Health Net, Supplier shall provide written notice to Health Net identifying any such Commercially Available Third Party Software. Health Net shall be obligated to obtain its own
licenses for any such Software. 

  

	 	(b)	Process. Health Net shall exercise such option by sending written notice to Supplier. Such notice shall identify whether Health Net is licensing all of the Technology Platform Software or only a portion of it (in
either case, the “Licensed Technology Platform Software”). Upon receipt of such notice, the Parties shall meet to discuss the terms of the license. Such license shall be on the following terms, unless the Parties agree
otherwise: 

  

	 	(i)	Scope of License. Supplier hereby grants to Health Net and its Affiliates (and - for the sole purpose of providing services to Health Net, its Affiliates, Former Health Net Affiliates and Service Recipients - to
Health Net’s and its Affiliates’ respective service providers) (collectively, the “Health Net Licensees”) a perpetual (unless Health Net designates a shorter period of time), world-wide, irrevocable, fully paid-up
(except for payment of the applicable charge for such license (if any) as determined pursuant to Section 4(b)(ii) below), royalty-free, non-exclusive license to Use the Licensed Technology Platform Software (including technical interfaces,
Documentation, artifacts, manuals and other materials useful in connection with the Use of such Licensed Technology Platform Software”) in order for any Health Net Licensee to perform services for Health Net, its Affiliates, Former Health Net
Affiliates and Service Recipients, and the receipt and use of such services. The term of such license shall be (as requested by Health Net) (1) during the Term and any Disengagement Assistance Periods for which any Services for which such
Software is used, and/or (2) after any such Disengagement Assistance Periods. 

  

	 	(ii)	Charges for the Foregoing License. The license granted in Section 4(b)(i) shall be provided at no charge during the Term and any Disengagement Assistance Periods. Thereafter, subject to
Section 4(b)(iv), Supplier shall be permitted to charge Health Net a license fee for the foregoing license, the amount of which shall be determined as follows: 

  

					
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	 	(A)	Health Net shall pay a license fee amount that is determined by an independent third party (“Independent Third Party”) and in accordance with the following to be a fair and reasonable license fee
for such Licensed Technology Platform Software or such portion thereof identified by Health Net: 

  

	 	(1)	The Independent Third Party shall be designated by Health Net and approved by Supplier. Supplier agrees that Pricewaterhouse Coopers is acceptable as an Independent Third Party. The Parties shall each be responsible for
fifty percent (50%) of the charges for the Independent Third Party. 

  

	 	(2)	The Independent Third Party shall perform an analysis and recommendation of what the fair and reasonable license fee for the Licensed Technology Platform Software (or portion thereof requested by Health Net) should be,
in accordance with its professional judgment and its own procedures and methodologies. The Independent Third Party shall prepare and provide to the Parties a preliminary report setting forth its findings regarding the license fee for the applicable
Software (a “Preliminary License Fees Report”). 

  

	 	(3)	Each Party shall be provided a reasonable opportunity to review, comment on and request changes in the Preliminary License Fees Report. Following such review and comment, the Independent Third Party shall issue a final
report of its findings and conclusions regarding the license fees (“Final License Fees Report”). 

  

	 	(B)	In the event of a dispute between Health Net and Supplier regarding the amount of the license fees described in this Section 4(b)(ii) or the Final License Fees Report that the Parties are unable to resolve, then
the matter shall be escalated to the informal dispute resolution procedure described in Section 26 (Dispute Resolution) of the Terms and Conditions. If the dispute is not resolved pursuant to such procedure described in the preceding
sentence, the Independent Third Party shall proceed to resolve the dispute as it deems reasonable and appropriate in its professional judgment, and such resolution shall be binding on the Parties. Absent fraud, the Final License Fees Report (and its
findings regarding the license fee) shall be final and binding on the Parties. 

  

	 	(iii)	Maintenance and Support. In addition, if requested by Health Net and subject to Section 4(b)(iv), the Parties will mutually agree upon applicable terms for Supplier’s maintenance and support of such
Licensed Technology Platform Software licensed by Health Net pursuant to this Section, provided that if Health Net elects, such maintenance and support shall be performed (1) pursuant to the AO Agreement, in which event the Parties shall
negotiate in good faith an appropriate amendment to the AO Agreement, or (2) on a time and materials basis, including using the professional services rates set forth in Schedule C (Charges). 

  

					
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	 	(iv)	For clarity, license rights granted in this Section 4 are in addition to, and not in lieu of, the rights of use and licenses granted in Sections 12.3 and 15 of the Terms and Conditions, and charges (if any) payable
by Health Net under this Section 4 shall only apply to the extent Health Net’s use of the Licensed Technology Platform Software (both in terms of its purpose and its duration) is not covered by the rights of use granted in
Section 12.3 and 15 of the Terms and Conditions. 

  

	5.	ESCROW OF THE TECHNOLOGY PLATFORM SOFTWARE. 

 Health Net and Supplier shall execute
concurrently with the execution of this Agreement a software escrow agreement with Iron Mountain (the “Escrow Agent”), the form of which escrow agreement is attached hereto as Schedule 1-A (the “Escrow
Agreement”). Supplier shall maintain the Escrow Agreement in effect until two *** after the Disengagement Assistance Period. Under the Escrow Agreement, Supplier shall place the Escrowed Materials into escrow upon the terms set forth in
the Escrow Agreement and the following terms: 
  

	5.1	Execution by Escrow Agent. 

 The Parties shall submit the Escrow Agreement to the Escrow
Agent for execution by the Escrow Agent within fifteen (15) days after the Effective Date, and work diligently and cooperate in good faith to have the Escrow Agreement signed by the Escrow Agent. If the Escrow Agent requires changes to the
Escrow Agreement, the Parties shall cooperate in good faith to accommodate such requested changes and upon agreement by the Parties and the Escrow Agent on such revised terms, shall re-execute the Escrow Agreement. The Parties shall maintain the
Escrow Agreement during the Term (including renewal periods and extensions pursuant to Section 16.3 and any Disengagement Assistance Periods). The Parties shall comply in all respects with the Escrow Agreement. 

 

	5.2	Cost. 

 Supplier shall be responsible for all costs associated with the Escrow Agreement,
except as otherwise provided within the Escrow Agreement. 
  

	5.3	Bankruptcy of Supplier. 

 The Escrow Agreement is an “agreement supplementary”
to this Agreement (as that term is used in 11 U.S.C. Section 365(n), as amended). 
  

	5.4	Initial Deposit. 

 Supplier shall deposit the then-current version of all Escrowed
Materials into the escrow established by the Escrow Agreement on or before the later of: ten (10) says after execution of the Escrow Agreement by the Escrow Agent, or ten (10) days after the sale of the Acquired Assets by Health Net to
Supplier under the Asset Purchase Agreement. 

  

					
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	5.5	Quarterly deposits. 

 Supplier shall deposit, within ten days (10) after the first
day of each calendar quarter (i.e., by
January 10th, April 10th, July 10th and October 10th - each such date a “Deposit Date”), the then-current versions of all Escrowed Materials. Supplier shall provide Health Net with written notice promptly after making each such deposit,
notifying Health Net that a deposit has been made into escrow in accordance with this Section, which notice shall identify the items placed into escrow. 
  

	5.6	Failure to make deposit. 

 If Supplier fails to make any deposit as required by this
Section 5 and/or the Escrow Agreement within thirty (30) days after receipt of written notice (which notice may come from Iron Mountain or Health Net), such failure shall be deemed a material breach of this Agreement, and Supplier shall
pay to Health Net liquidated damages in the amount of *** dollars ($***) per day for each day thereafter that such failure continues. Additionally, upon Health Net’s request from time to time, Supplier shall provide to Health Net a statement
signed by a Supplier executive indicating whether Supplier is in compliance with the terms of this Section 5 (including its obligation to update the escrow pursuant to Section 5.5 and the Escrow Agreement. For clarity, payment of the
amounts set forth in this Section shall not relieve Supplier from its obligation to make escrow deposits as contemplated herein. 
  

	5.7	License to Escrowed Materials. 

  

	 	(a)	Supplier hereby grants to Health Net and its Affiliates a perpetual, worldwide, irrevocable, fully paid-up, royalty-free, non-exclusive license (and - for the sole purpose of providing services to Health Net, its
Affiliates, Former Health Net Affiliates and Service Recipients - to Health Net’s and its Affiliates’ service providers) to Use the Escrowed Materials, at no additional charge, as may be required to meet Health Net’s and its
Affiliates’ business and operational needs; provided, however, that Health Net’s right to exercise the foregoing right and license shall be deferred until the occurrence of a Release Condition (as defined in the Escrow Agreement), as
further described in Section 5.7(b) below. Such license shall be transferable by Health Net to any entity that is a successor to Health Net under this Agreement or an assignee of Health Net pursuant to Section 27.1 (Binding Nature and
Assignment) of the Terms and Conditions. 

  

	 	(b)	Upon the occurrence of one or more events specified in the Escrow Agreement as “Release Conditions”: 

  

	 	(i)	Health Net shall be entitled to the release of the Escrowed Materials from the Escrow Agent (and the Escrow Agent shall release the Escrowed Materials to Health Net) pursuant to the terms of the Escrow Agreement and
Health Net shall be permitted to exercise the right and license granted in Section 5.7(a) with respect to such Escrowed Materials; and 

  

	 	(ii)	if (upon such occurrence) the most recently escrowed forms of any Escrowed Materials is not the version of such Escrowed Materials that Supplier is then using to provide the Services (e.g., Supplier is using a
version of the Technology Platform Software with some non-escrowed modifications or enhancements), then Health Net (A) shall have the right to obtain from Supplier (and Supplier shall provide to Health Net within ten (10) days from the
date of Health Net’s request), the versions of the Escrowed Materials then being operated or used by Supplier to provide the Services, and (B) shall be permitted to exercise the rights and license granted in Section 5.7(a) with
respect to such. 

  

					
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	5.8	Replacement Escrow Agent. 

 If (i) the Escrow Agent resigns or withdraws from its
role as escrow agent, or (ii) the Escrow Agreement is otherwise terminated, then Health Net and Supplier shall negotiate and execute a replacement escrow agreement, and each Party shall negotiate such in good faith, provided that neither Party
shall have the right to object to terms and conditions within the replacement escrow agreement that are substantially similar to those in the original Escrow Agreement. If (A) the Parties do not execute a replacement escrow agreement within
thirty (30) days after the occurrence of item (i) or (ii) in the previous sentence, and (B) there occurs one or more events which constitute a “Release Condition” pursuant to the Escrow Agreement, prior to such time
that the Parties have executed a replacement escrow agreement, then Health Net (x) shall have the right to obtain from Supplier (and Supplier shall release to Health Net within ten (10) days from the date of Health Net’s request) the
then-current versions of the Escrowed Materials being used by Supplier to provide the Services, and (y) shall be permitted to exercise the rights and license granted in Section 5.7(a) with respect to such. 

 

	5.9	Terms relating to Licenses granted under this BPaaS Supplemental Terms 

  

	 	(a)	Relationship to other License rights 

 The licenses in this BPaaS Supplemental Terms and those
in the Escrow Agreement are separate and independent from the other licenses granted to Health Net pursuant to Sections 12.3 and 15 of the Terms and Conditions, and Schedule L (Disengagement Assistance). 

 

	 	(b)	Transferability of licenses. 

 All licenses granted to Health Net pursuant to this BPaaS
Supplemental Terms and those in the Escrow Agreement shall be transferable by Health Net and its Affiliates to any entity that is a successor to Health Net under this Agreement or an assignee of Health Net pursuant to Section 27 (Binding
Nature and Assignment) of the Terms and Conditions. 

  

					
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 ANNEX 1 SCHEDULE 1-A 

ESCROW AGREEMENT 

  

					
	Annex 1 Schedule 1-A		 		Health Net / Cognizant Confidential

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 ANNEX 1 SCHEDULE 1-A 

ESCROW AGREEMENT 
 The form of the Escrow
Agreement referenced in Section 5 (Escrow of the Technology Platform Software) of Annex 1 (Supplemental Terms and Conditions for BPaaS Services) consists of the following pages. 

 
 

 
  

					
					                    Effective Date
					Deposit Account Number
			
					 *  Effective Date and Deposit Account Number to be supplied by Iron Mountain only.

 Three-Party Escrow Service Agreement 

 

	1.	Introduction 

 This Three Party Escrow Service Agreement (the
“Agreement”) is entered into by and between Cognizant Healthcare Services, LLC (the “Depositor”), and by Health Net, Inc. (the “Beneficiary”) and by Iron Mountain Intellectual Property Management,
Inc. (“Iron Mountain”). Depositor, Beneficiary, and Iron Mountain may be referred to individually as a “Party” or collectively as the “Parties” throughout this Agreement. 

 

	 	(a)	The use of the term services in this Agreement shall refer to Iron Mountain services that facilitate the creation, management, and enforcement of software or other technology escrow accounts as described in Exhibit A
attached hereto, including any services provided by Iron Mountain under any Work Request (collectively, “Services”). A Party shall request Services under this Agreement by selecting such Service on Exhibit A upon execution of the
Agreement or by submitting a work request for certain Iron Mountain Services (“Work Request”) via written instruction or the online portal maintained at the website located at www.ironmountainconnect.com or other websites
owned or controlled by Iron Mountain that are linked to that website (collectively the “Iron Mountain Website”). 

  

	 	(b)	The Beneficiary and Depositor have entered into a Master Services Agreement dated November 2, 2014 (“BPaaS Agreement”) conveying intellectual property rights to the Beneficiary, and the Parties intend
this Agreement to be considered as supplementary to such agreement, pursuant to Title 11 United States [Bankruptcy] Code, Section 365(n). 

  

	2.	Depositor Responsibilities and Representations 

  

	 	(a)	It shall be solely the Depositor’s responsibility to: (i) make an initial deposit of all proprietary technology and other materials defined as “Escrowed Materials” under the BPaaS Agreement
(“Deposit Material”) to Iron Mountain on or before ten (10) days after the later to occur of the Effective Date or the sale of the Acquired Assets by Health Net to Beneficiary under the Asset Purchase Agreement; (ii) make
updates to the Deposit Material during the Term (as defined below) of this Agreement within ten (10) days after the first day of each calendar quarter (i.e., by
January 10th, April 10th, July 10th and October 10th); and (iii) ensure that a minimum of one (1) copy of Deposit Material is deposited with Iron Mountain at all times. At the time of each deposit or update, Depositor will provide to Iron
Mountain and Beneficiary an accurate and complete description of all Deposit Material sent to Iron Mountain using the form attached hereto as Exhibit B. 

  

	 	(b)	Depositor represents that it lawfully possesses all Deposit Material provided to Iron Mountain under this Agreement and that any current or future Deposit Material liens or encumbrances will not prohibit, limit, or
alter the rights and obligations of Iron Mountain or Beneficiary under this Agreement. Depositor warrants that with respect to the Deposit Material, Iron Mountain’s proper administration of this Agreement, and Beneficiary’s Use (as defined
in the BPaaS Agreement) of the Deposit Materials in the event such Deposit Materials are released to Beneficiary, will not violate the rights of any third parties. 

 

	 	(c)	Depositor represents that all Deposit Material is readable and useable in its then current form; if any portion of such Deposit Material is encrypted, the necessary decryption tools and keys to read such material are
deposited contemporaneously. 

  

					
	Annex 1 Schedule 1-A		1-A-1		Health Net / Cognizant Confidential

	3.	Beneficiary Responsibilities and Representations 

  

	 	(a)	Beneficiary acknowledges that, as between Iron Mountain and Beneficiary, Iron Mountain’s obligation is to maintain the Deposit Material as delivered by the Depositor and that, other than Iron Mountain’s
inspection of the Deposit Material (as described in Section 4) and the performance of any of the optional verification Services listed in Exhibit A or as agreed by Iron Mountain to be performed pursuant to a Work Request, Iron Mountain has no
other obligation regarding the completeness, accuracy, or functionality of the Deposit Material. 

  

	 	(b)	Unless Depositor or Beneficiary submits a Work Request for “Deposit Tracking Notification” as described in Exhibit A , it shall be solely the Beneficiary’s responsibility to monitor whether a
deposit or deposit update has been accepted by Iron Mountain. 

  

	4.	Iron Mountain Responsibilities and Representations 

  

	 	(a)	Iron Mountain agrees to use commercially reasonable efforts to provide the Services requested by Authorized Person(s) (as identified in the “Authorized Person(s)/Notices Table” below) representing the
Depositor or Beneficiary in a Work Request. Iron Mountain may reject a Work Request (in whole or in part) that does not contain all required information at any time upon notification to the Party originating the Work Request. 

 

	 	(b)	Iron Mountain will conduct a visual inspection upon receipt of any Deposit Material and associated Exhibit B. If Iron Mountain determines that the Deposit Material does not match the description provided by Depositor
represented in Exhibit B, Iron Mountain will notify Depositor of such discrepancy. 

  

	 	(c)	Iron Mountain will provide written notice to the Beneficiary of all Deposit Material that is accepted and deposited into the escrow account under this Agreement. Unless Depositor or Beneficiary submits a Work Request
for “Deposit Tracking Notification” as described in Exhibit A, Iron Mountain shall not have any obligation to prompt the Depositor to make a deposit, nor shall it have an obligation to notify the Beneficiary of the Depositor’s
failure to make a deposit or deposit update. Notwithstanding the forgoing, either Depositor or Beneficiary may obtain information regarding deposits or deposit updates upon request or through the Iron Mountain Website. 

 

	 	(d)	Iron Mountain will follow the provisions of Exhibit C attached hereto in administering the release of Deposit Material. 

  

	 	(e)	Iron Mountain will hold and protect Deposit Material in physical or electronic vaults that are either owned or under the control of Iron Mountain, unless otherwise agreed to by the Parties in writing. 

 

	 	(f)	Upon receipt of written instructions by both Depositor and Beneficiary, Iron Mountain will permit the replacement or removal of previously submitted Deposit Material. The Party making such request shall be responsible
for getting the other Party to approve the joint instructions. Any Deposit Material that is removed from the deposit account will be either returned to Depositor or destroyed in accordance with Depositor’s written instructions.

  

	 	(g)	Should transport of Deposit Material be necessary for Iron Mountain to perform Services requested by Beneficiary under this Agreement or following the termination of this Agreement, Iron Mountain will use a commercially
recognized overnight carrier such as Federal Express or United Parcel Service. Iron Mountain will not be responsible for any loss or destruction of, or damage to, such Deposit Material while in the custody of the common carrier. 

 

	5.	Deposit Material Verification 

  

	 	(a)	Beneficiary may submit a verification Work Request to Iron Mountain for one or more of the Services defined in Exhibit A attached hereto and Depositor consents to Iron Mountain’s performance of any level(s) of such
Services. Upon request by Iron Mountain and in support of Beneficiary’s request for verification Services, Depositor shall promptly complete and return the Escrow Deposit Questionnaire attached hereto as Exhibit Q and reasonably cooperate with
Iron Mountain by providing reasonable access to its technical personnel whenever reasonably necessary. 

  

	 	(b)	The Parties consent to Iron Mountain’s use of a subcontractor to perform verification Services [Note to Iron Mountain: Which subcontractor(s) do you use to perform these Services?]. Such subcontractor shall
be bound by the same confidentiality obligations as Iron Mountain and shall not be a direct competitor to either Depositor or Beneficiary. The Parties agree that the following entities shall be deemed acceptable to perform verification Services:
[TBD]. Iron Mountain shall be responsible for the delivery of Services of any such subcontractor as if Iron Mountain had performed the Services. Depositor warrants and Beneficiary warrants that any material it supplies for verification Services is
lawful, does not violate the rights of any third parties and is provided with all rights necessary for Iron Mountain to perform verification of the Deposit Material. 

 

	 	(c)	Iron Mountain will work with a Party should submits any verification Work Request for Deposit Material covered under this Agreement to either fulfill any standard verification Services Work Request or develop a custom
Statement of Work (“SOW”), including requests to have a third party auditor inspect the Deposit Materials to verify the accuracy, completeness and proper compilation of the Deposit Materials. Iron Mountain and the requesting Party
will mutually agree in writing to an SOW on terms and conditions that include but are not limited to: description of Deposit Material to be tested; description of verification testing; the requesting Party responsibilities; Iron Mountain
responsibilities; Service Fees; invoice payment instructions; designation of the paying Party; designation of authorized SOW representatives for both the requesting Party and Iron Mountain with name and contact information; and description of any
final deliverables prior to the start of any fulfillment activity. Provided that the requesting Party has identified in the verification Work Request or SOW that the Deposit Material is subject to the regulations of the International Traffic in Arms
Regulations (22 CFR 120)(hereinafter “ITAR”), Iron Mountain shall ensure that any subcontractor who is granted access to the Deposit Material for the performance of verification Services shall be a U.S. Person as defined in 8 U.S.C.
1101(a)(20) or who is a protected person as defined in 8 U.S.C. 1324b(a)(3). After the start of fulfillment activity, each SOW may only be amended or modified in writing with the mutual agreement of both Parties. If the verification Services extend
beyond those described in Exhibit A, the Depositor shall be a necessary Party to the SOW governing the Services, provided that the Depositor shall cooperate in good faith with Beneficiary’s request and shall not unreasonably withhold or delay
its consent to or execution of such SOW. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 2 of 14

	 	(d)	During the term of this Agreement, Depositor and Beneficiary each shall have the right to inspect the written records of Iron Mountain pertaining to this Agreement. 

 

	6.	Payment 

 The Party responsible for payment designated in Exhibit A
(“Paying Party”) shall pay to Iron Mountain all fees as set forth in the Work Request (“Service Fees”). All Service Fees are due within thirty (30) calendar days from the date of invoice in U.S. currency and
are non-refundable. Iron Mountain may update Service Fees with a ninety (90) calendar day written notice to the Paying Party during the Term of this Agreement (as defined below). The Paying Party is liable for any taxes (other than Iron
Mountain income taxes) related to Services purchased under this Agreement or shall present to Iron Mountain an exemption certificate acceptable to the taxing authorities. Applicable taxes shall be billed as a separate item on the invoice. Any
Service Fees not collected by Iron Mountain when due shall bear interest until paid at a rate of one percent (1%) per month (12% per annum) or the maximum rate permitted by law, whichever is less. Notwithstanding the non-performance of any
obligations of Depositor to deliver Deposit Material under the BPaaS Agreement or this Agreement, Iron Mountain is entitled to be paid all Service Fees that accrue during the Term of this Agreement. 

 

	7.	Term and Termination 

  

	 	(a)	The term of this Agreement is for a period of one (1) year from the Effective Date (“Initial Term”) and will automatically renew for additional one (1) year terms (“Renewal
Term”) (collectively the “Term”). This Agreement shall continue in full force and effect until one of the following events occur: (i) Depositor and Beneficiary provide Iron Mountain with sixty
(60) days’ prior written joint notice of their intent to terminate this Agreement; (ii) Beneficiary provides Iron Mountain and Depositor with sixty (60) days’ prior written notice of its intent to terminate this Agreement;
(iii) the Agreement terminates under another provision of this Agreement; or (iv) any time after the Initial Term, Iron Mountain provides sixty (60) days’ prior written notice to the Depositor and Beneficiary of Iron
Mountain’s intent to terminate this Agreement. The Effective Date and the Deposit Account Number shall be supplied by Iron Mountain only. The Effective Date supplied by Iron Mountain and specified above shall be the date Iron Mountain sets up
the escrow account. 

  

	 	(b)	Unless the express terms of this Agreement provide otherwise, upon termination of this Agreement, Iron Mountain shall return physical Deposit Material to the Depositor and erase electronically submitted Deposit
Material. If reasonable attempts to return the physical Deposit Material to Depositor are unsuccessful, Iron Mountain shall destroy the Deposit Material. 

  

	 	(c)	In the event of the nonpayment of undisputed Service Fees owed to Iron Mountain, Iron Mountain shall provide all Parties to this Agreement with written notice of Iron Mountain’s intent to terminate this Agreement.
Any Party to this Agreement shall have the right to make the payment to Iron Mountain to cure the default. If the past due payment is not received in full by Iron Mountain within thirty (30) calendar days of the date of such written notice,
then Iron Mountain shall have the right to terminate this Agreement at any time thereafter by sending written notice to all Parties. Iron Mountain shall have no obligation to perform the Services under this Agreement (except those obligations that
survive termination of this Agreement, which includes the confidentiality obligations in Section 10) so long as any undisputed Service Fees due Iron Mountain under this Agreement remain unpaid. 

 

	8.	Infringement Indemnification 

 Anything in this Agreement to the contrary
notwithstanding, Depositor at its own expense shall defend, indemnify and hold Iron Mountain fully harmless against any claim or action asserted against Iron Mountain (specifically including costs and reasonable attorneys’ fees associated with
any such claim or action) to the extent such claim or action is based on an assertion that Iron Mountain’s proper administration of this Agreement infringes any patent, copyright, license or other proprietary right of any third party. When Iron
Mountain has notice of a claim or action, it shall promptly notify Depositor in writing. Depositor may elect to control the defense of such claim or action or enter into a settlement agreement, provided that no such settlement or defense shall
include any admission or implication of wrongdoing on the part of Iron Mountain without Iron Mountain’s prior written consent, which consent shall not be unreasonably delayed or withheld. Iron Mountain shall have the right to employ separate
counsel and participate in the defense of any claim at its own expense. 
  

	9.	Warranties 

 IRON MOUNTAIN WARRANTS ANY AND ALL SERVICES PROVIDED HEREUNDER SHALL
BE PERFORMED IN A COMMERCIALLY REASONABLE MANNER CONSISTENT WITH INDUSTRY STANDARDS. EXCEPT AS SPECIFIED IN THIS SECTION, ALL CONDITIONS, REPRESENTATIONS, AND WARRANTIES INCLUDING, WITHOUT LIMITATION, ANY IMPLIED WARRANTIES OR CONDITIONS OF
MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, SATISFACTORY QUALITY, OR ARISING FROM A COURSE OF DEALING, USAGE, OR TRADE PRACTICE, ARE HEREBY EXCLUDED TO THE EXTENT ALLOWED BY APPLICABLE LAW. AN AGGRIEVED PARTY MUST NOTIFY IRON MOUNTAIN
PROMPTLY UPON LEARNING OF ANY CLAIMED BREACH OF ANY WARRANTY AND, TO THE EXTENT ALLOWED BY APPLICABLE LAW, SUCH PARTY’S REMEDY FOR BREACH OF THIS WARRANTY SHALL BE SUBJECT TO THE LIMITATION OF LIABILITY AND CONSEQUENTIAL DAMAGES WAIVER IN THIS
AGREEMENT. THIS DISCLAIMER AND EXCLUSION SHALL APPLY EVEN IF THE EXPRESS WARRANTY AND LIMITED REMEDY SET FORTH ABOVE FAILS OF ITS ESSENTIAL PURPOSE. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 3 of 14

	10.	Confidential Information 

 Iron Mountain shall have the obligation to implement
and maintain safeguards designed to protect the confidentiality of the Deposit Material and use at least the same degree of care to safeguard the confidentiality of the Deposit Material as it uses to protect its own confidential information, but in
no event less than a reasonable degree of care. Except as provided in this Agreement Iron Mountain shall not use or disclose the Deposit Material. Iron Mountain shall not disclose the terms of this Agreement to any third party other than its
financial, technical, or legal advisors, or its administrative support service providers. Any such third party shall be bound by the same confidentiality obligations as Iron Mountain. If Iron Mountain receives a subpoena or any other order from a
court or other judicial tribunal pertaining to the disclosure or release of the Deposit Material, Iron Mountain will promptly notify the Parties to this Agreement unless prohibited by law. After notifying the Parties, Iron Mountain may comply in
good faith with such order. It shall be the responsibility of Depositor or Beneficiary to challenge any such order; provided, however, that Iron Mountain does not waive its rights to present its position with respect to any such order. Iron Mountain
will cooperate with the Depositor or Beneficiary, as applicable, to support efforts to quash or limit any subpoena, at such Party’s expense. 
  

	11.	Limitation of Liability 

 EXCEPT FOR: (I) LIABILITY FOR DEATH OR BODILY
INJURY; (II) PROVEN GROSS NEGLIGENCE OR WILLFUL MISCONDUCT; OR (III) THE INFRINGEMENT INDEMNIFICATION OBLIGATIONS OF SECTION 8, ALL OTHER LIABILITY RELATED TO THIS AGREEMENT, IF ANY, WHETHER ARISING IN CONTRACT, TORT (INCLUDING NEGLIGENCE) OR
OTHERWISE, OF (A) DEPOSITOR OR BENEFICIARY TO IRON MOUNTAIN, AND (B) IRON MOUNTAIN TO DEPOSITOR OR BENEFICIARY, SHALL BE LIMITED TO THE AMOUNT EQUAL TO ONE YEAR OF FEES PAID TO IRON MOUNTAIN UNDER THIS AGREEMENT. IF CLAIM OR LOSS IS MADE
IN RELATION TO A SPECIFIC DEPOSIT OR DEPOSITS, SUCH LIABILITY OF (A) DEPOSITOR OR BENEFICIARY TO IRON MOUNTAIN, AND (B) IRON MOUNTAIN TO DEPOSITOR OR BENEFICIARY, SHALL BE LIMITED TO THE FEES RELATED SPECIFICALLY TO SUCH DEPOSITS. FOR
CLARITY, ALL LIABILITY BETWEEN DEPOSITOR AND BENEFICIARY UNDER THIS AGREEMENT SHALL BE GOVERNED BY SECTION 24 (LIABILITY) OF THE BPAAS AGREEMENT. 
  

	12.	Consequential Damages Waiver 

 IN NO EVENT SHALL (A) DEPOSITOR OR BENEFICIARY
BE LIABLE TO IRON MOUNTAIN, AND (B) IRON MOUNTAIN BE LIABLE TO DEPOSITOR OR BENEFICIARY, FOR ANY INCIDENTAL, SPECIAL, PUNITIVE OR CONSEQUENTIAL DAMAGES, LOST PROFITS, ANY COSTS OR EXPENSES FOR THE PROCUREMENT OF SUBSTITUTE SERVICES (EXCLUDING
SUBSTITUTE ESCROW SERVICES), OR ANY OTHER INDIRECT DAMAGES, WHETHER ARISING IN CONTRACT, TORT (INCLUDING NEGLIGENCE) OR OTHERWISE EVEN IF THE POSSIBILITY THEREOF MAY BE KNOWN IN ADVANCE TO ONE OR MORE PARTIES. FOR CLARITY, ALL LIABILITY BETWEEN
DEPOSITOR AND BENEFICIARY UNDER THIS AGREEMENT SHALL BE GOVERNED BY SECTION 24 (LIABILITY) OF THE BPAAS AGREEMENT. 
  

	13.	General 

  

	 	(a)	Purchase Orders. In the event that the Paying Party issues a purchase order or other instrument used to pay Service Fees to Iron Mountain, any terms and conditions set forth in the purchase order which constitute
terms and conditions which are in addition to those set forth in this Agreement or which establish conflicting terms and conditions to those set forth in this Agreement are expressly rejected by Iron Mountain. 

 

	 	(b)	Right to Make Copies. Iron Mountain shall have the right to make copies of all Deposit Material as reasonably necessary to perform the Services. Iron Mountain shall copy all copyright, nondisclosure, and other
proprietary notices and titles contained on Deposit Material onto any copies made by Iron Mountain. Any copying expenses incurred by Iron Mountain as a result of a Work Request to copy will be borne by the requesting Party. Iron Mountain may request
Depositor’s reasonable cooperation in promptly copying Deposit Material in order for Iron Mountain to perform this Agreement. 

  

	 	(c)	Choice of Law. The validity, interpretation, and performance of this Agreement shall be construed under the laws of the Commonwealth of Massachusetts, USA, without giving effect to the principles of conflicts of
laws. 

  

	 	(d)	Authorized Person(s). Depositor and Beneficiary must each authorize and designate one person whose actions will legally bind such Party (“Authorized Person” who shall be identified in the Authorized
Person(s) Notices Table of this Agreement or such Party’s legal representative) and who may manage the Iron Mountain escrow account through the Iron Mountain website or written instruction. Depositor and Beneficiary warrant that they shall
maintain the accuracy of the name and contact information of their respective designated Authorized Person during the Term of this Agreement by providing Iron Mountain and the other Party with a written request to update its records for the
Party’s respective Authorized Person which includes the updated information and applicable deposit account number(s). 

  

	 	(e)	Right to Rely on Instructions. With respect to release of Deposit Material or the destruction of Deposit Material, Iron Mountain shall rely on instructions from a Party’s Authorized Person, provided that it
is in accordance with Exhibit C. In all other cases, Iron Mountain may act in reliance upon any instruction, instrument, or signature reasonably believed by Iron Mountain to be genuine and from an Authorized Person, officer, or other employee of a
Party. Iron Mountain may assume that such representative of a Party to this Agreement who gives any written notice, request, or instruction has the authority to do so. Iron Mountain will not be required to inquire into the truth of, or evaluate the
merit of, any statement or representation contained in any notice or document reasonably believed to be from such representative. 

  

	 	(f)	Force Majeure. No Party shall be liable for any delay or failure in performance under this Agreement due to events outside the defaulting Party’s reasonable control, including without limitation acts of God,
strikes, riots, war, acts of terrorism, fire, epidemics, or delays of common carriers or other circumstances beyond its reasonable control. The obligations and rights of the excused Party shall be extended on a day-to-day basis for the time period
equal to the period of the excusable delay. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 4 of 14

	 	(g)	Notices. Iron Mountain shall have the right to rely on the last known notice address provided by each of the Depositor and Beneficiary, which are as follows as of the Effective Date: 

 

			
	 DEPOSITOR
	  	 BENEFICIARY

	 Cognizant Technology Solutions US Corporation

500 Frank W. Burr Blvd.
 Teaneck, New Jersey 07666

Attn: General Counsel
	  	 Health Net, Inc.
 21650 Oxnard Street

Woodland Hills, CA 91367
 Attn: Vendor Management Officer

 
 With a copy to:

Health Net, Inc.
 21650 Oxnard Street

Woodland Hills, CA 91367
 Attn: General Counsel

 Iron Mountain’s notice address as of the Effective Date is set forth on page 7 of this Agreement. Iron
Mountain, Beneficiary, and Depositor may change their respective notice addresses by sending written notice to the other Parties in accordance with this Section identifying such new address. If Depositor or Beneficiary changes their Authorized
Person, Depositor and Beneficiary shall also provide notice of the change to the other Parties. All notices regarding Exhibit C (Release of Deposit Material) shall be sent by commercial express mail or other commercially appropriate means that
provide prompt delivery and require proof of delivery. All other correspondence, including but not limited to invoices and payments, may be sent electronically or by regular mail. The Parties shall have the right to rely on the last known notice
address of the other Parties set forth above, or as may be changed as provided above. Any correctly addressed notice to the last known address of the other Parties, that is refused, unclaimed, or undeliverable shall be deemed effective as of the
first date that said notice was refused, unclaimed, or deemed undeliverable by the postal authorities or commercial express mail. 
  

	 	(h)	No Waiver. No waiver of any right under this Agreement by any Party shall constitute a subsequent waiver of that or any other right under this Agreement. 

 

	 	(i)	Assignment. No assignment of this Agreement by Depositor or any rights or obligations of Depositor under this Agreement is permitted without the written consent of Iron Mountain and Beneficiary. Any assignment by
Deposit by operation of law, order of any court, or pursuant to any plan of merger, consolidation, or liquidation, shall be deemed an assignment for which prior consent is required and any assignment by Depositor made without any such consent shall
be void and of no effect as between the Parties. Iron Mountain shall have no obligation in performing this Agreement to recognize any successor or assign of Depositor unless Iron Mountain receives clear, authoritative and conclusive written evidence
of the change of Parties. Beneficiary may assign its rights and obligations under this Agreement without the approval of Iron Mountain or Depositor to the extent that Beneficiary may assign its interest in the BPaaS Agreement without such consent.

  

	 	(j)	Severability. In the event any of the terms of this Agreement become or are declared to be illegal or otherwise unenforceable by any court of competent jurisdiction, such term(s) shall be null and void and shall
be deemed deleted from this Agreement. All remaining terms of this Agreement shall remain in full force and effect. 

  

	 	(k)	Independent Contractor Relationship. Depositor and Beneficiary understand, acknowledge, and agree that Iron Mountain’s relationship with Depositor and Beneficiary will be that of an independent contractor
and that nothing in this Agreement is intended to or should be construed to create a partnership, joint venture, or employment relationship. 

  

	 	(l)	Attorneys’ Fees. Any costs and fees incurred by Iron Mountain in the performance of obligations imposed upon Iron Mountain solely by virtue of its role as escrow service provider including, without
limitation, compliance with subpoenas, court orders, discovery requests, and disputes arising solely between Depositor and Beneficiary, including, but not limited to, disputes concerning a release of the Deposit Material shall, unless adjudged
otherwise, be divided equally and paid by Depositor and Beneficiary. In any suit or proceeding between the Parties relating to this Agreement, the prevailing Party will have the right to recover from the other(s) its costs and reasonable fees and
expenses of attorneys, accountants, and other professionals incurred in connection with the suit or proceeding, including costs, fees and expenses upon appeal, separately from and in addition to any other amount included in such judgment, except
that in no event shall Iron Mountain be liable for any costs or fees incurred by either Depositor or Beneficiary. This provision is intended to be severable from the other provisions of this Agreement, and shall survive and not be merged into any
such judgment. 

  

	 	(m)	No Agency. No Party has the right or authority to, and shall not, assume or create any obligation of any nature whatsoever on behalf of the other Parties or bind the other Parties in any respect whatsoever.

  

	 	(n)	Disputes. Any dispute, difference or question arising among (i) Iron Mountain and (ii) any of the Parties, concerning the construction, meaning, effect or implementation of this Agreement or the rights
or obligations of any Party under this Agreement will be submitted to, and settled by arbitration by a single arbitrator chosen by the corresponding Regional Office of the American Arbitration Association in accordance with the Commercial Rules of
the American Arbitration Association. The Parties shall submit briefs of no more than 10 pages and the arbitration hearing shall be limited to two (2) days maximum. Arbitration will take place in Boston, Massachusetts, USA. Any court having
jurisdiction over the matter may enter judgment 

  

					
	3P.US/IPM/07.01.13	  	©2013 Iron Mountain Incorporated	  	Page 5 of 14

	 	
on the award of the arbitrator. Service of a petition to confirm the arbitration award may be made by regular mail or by commercial express mail, to the attorney for the Party or, if
unrepresented, to the Party at the last known business address. Notwithstanding the foregoing, any dispute, difference or question arising between Beneficiary and Depositor will be governed by the dispute resolution provisions of the BPaaS
Agreement. 

  

	 	(o)	Interpleader. Anything to the contrary notwithstanding, in the event of any dispute regarding the interpretation of this Agreement, or the rights and obligations with respect to the Deposit Material in escrow or
the propriety of any action contemplated by Iron Mountain hereunder, then Iron Mountain may, in its sole discretion, file an interpleader or similar action in any court of competent jurisdiction to resolve any such dispute. 

 

	 	(p)	Regulations. Depositor and Beneficiary are responsible for and warrant, to the extent of their individual actions or omissions, compliance with all applicable laws, rules and regulations, including but not
limited to: customs laws; import; export and re-export laws; and government regulations of any country from or to which the Deposit Material may be delivered in accordance with the provisions of this Agreement. Depositor represents and warrants that
the establishment of a deposit account containing ITAR regulated Deposit Material for the Beneficiary, and Iron Mountain’s subsequent release of such Deposit Material under the terms of this Agreement will be lawful under any applicable U.S.
export control regulations and laws, including ITAR. Conversely, Depositor shall refrain from establishing a deposit account containing ITAR regulated Deposit Material for the Beneficiary if the release of such Deposit Material to the Beneficiary,
under the terms of this Agreement, would be in violation of any applicable U.S export control regulations and laws, including ITAR. With respect to Deposit Material containing personal information and data, Depositor agrees to (i) procure all
necessary consents in relation to personal information and data; and (ii) otherwise comply with all applicable privacy and data protection laws as they relate to the subject matter of this Agreement. Iron Mountain is responsible for and
warrants, to the extent of their individual actions or omissions, compliance with all applicable laws, rules and regulations to the extent that it is directly regulated by the law, rule or regulation and to the extent that it knows or has been
advised that, as a result of this Agreement, its activities are subject to the law, rule or regulation. Notwithstanding anything in this Agreement to the contrary, if an applicable law or regulation exists or should be enacted which is contrary to
the obligations imposed upon Iron Mountain hereunder, and results in the activities contemplated hereunder unlawful, Depositor and/or Beneficiary will notify Iron Mountain and Iron Mountain will be relieved of its obligations hereunder unless and
until such time as such activity is permitted. 

  

	 	(q)	No Third Party Rights. This Agreement is made solely for the benefit of the Parties to this Agreement and their respective permitted successors and assigns under this Agreement or the BPaaS Agreement, and no
other person or entity shall have or acquire any right by virtue of this Agreement unless otherwise agreed to by all the Parties hereto. 

  

	 	(r)	Entire Agreement. The Parties agree that this Agreement, which includes all attached Exhibits and all valid Work Requests and SOWs submitted by the Parties, is the complete agreement between the Parties
concerning the subject matter of this Agreement and replaces any prior or contemporaneous oral or written communications between the Parties. There are no conditions, understandings, agreements, representations, or warranties, expressed or implied,
which are not specified herein. Each of the Parties warrant that the execution, delivery, and performance of this Agreement has been duly authorized and signed by a person who meets statutory or other binding approval to sign on behalf of its
organization as named in this Agreement. This Agreement may be modified only by mutual written agreement of all the Parties. 

  

	 	(s)	Counterparts. This Agreement may be executed electronically in accordance with applicable law or in any number of counterparts, each of which shall be an original, but all of which together shall constitute one
instrument. 

  

	 	(t)	Survival. Sections 7 (Term and Termination), 8 (Infringement Indemnification), 9 (Warranties), 10 (Confidential Information), 11 (Limitation of Liability), 12 (Consequential Damages Waiver), and 13 (General) of
this Agreement shall survive termination of this Agreement or any Exhibit attached hereto. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 6 of 14

 IN WITNESS WHEREOF, the Parties have duly executed this Agreement as of the Effective Date by their authorized
representatives: 
  

							
	 DEPOSITOR
	 	 	  	 BENEFICIARY
	  	 
				
	Signature	 		  	Signature	  	
				
	Print Name	 		  	Print Name	  	
				
	Title	 		  	Title	  	
				
	Date	 		  	Date	  	

  

			
	IRON MOUNTAIN
	INTELLECTUAL PROPERTY MANAGEMENT, INC.
		
	Signature	 	
		
	Print Name	 	
		
	Title	 	
		
	Date	 	

 [Note to CTS: Please identify who the person will be in the tables below.] 

 

							
	Authorized Person Notices Table
		
	Please provide the names and contact information of the Authorized Persons under this Agreement. Please complete all information as applicable. Incomplete information may result in a delay of processing.	  	
		
	 DEPOSITOR (Required information)
	  	BENEFICIARY (Required information)
				
	 Print Name
	 		  	Print Name	  	
				
	 Title
	 		  	Title	  	
				
	 Email Address
	 		  	Email Address	  	
				
	 Street Address
	 		  	Street Address	  	
				
	 City
	 		  	City	  	
				
	 State/Province
	 		  	State/Province	  	
				
	 Postal/Zip Code
	 		  	Postal/Zip Code	  	
				
	 Phone Number
	 		  	Phone Number	  	
				
	 Fax Number
	 		  	Fax Number	  	
	
	 Billing Contact Information Table (Required information)

	
	Please provide the name and contact information of the Billing Contact under this Agreement. All Invoices will be sent to this individual at the address set forth below. Incomplete information may result in a delay of
processing.
		
	DEPOSITOR	  	BENEFICIARY
		
	  ̈  Check if same as Authorized Person
above or provide below
	  	
 ̈  Check if same as 
Authorized Person
 above or provide below

				
	 Company Name
	 		  	Company Name	  	
				
	 Print Name
	 		  	Print Name	  	
				
	 Title
	 		  	Title	  	
				
	 Email Address
	 		  	Email Address	  	
				
	 Street Address
	 		  	Street Address	  	
				
	 City
	 		  	City	  	
				
	 State/Province
	 		  	State/Province	  	
				
	 Postal/Zip Code
	 		  	Postal/Zip Code	  	
				
	 Phone Number
	 		  	Phone Number	  	
				
	 Fax Number
	 		  	Fax Number	  	
				
	 Purchase Order #
	 		  	Purchase Order #	  	

 IRON MOUNTAIN INTELLECTUAL PROPERTY MANAGEMENT, INC. 

All notices should be sent to ipmclientservices@ironmountain.com OR Iron Mountain Intellectual Property Management, Inc., Attn: Client Services, 2100
Norcross Parkway, Suite 150, Norcross, Georgia, 30071, USA. Telephone: 800-875-5669. Facsimile: 770-239-9201 

  

					
	3P.US/IPM/07.01.13	  	©2013 Iron Mountain Incorporated	  	Page 7 of 14

 Exhibit A 

Escrow Services Fee Schedule – Work Request 

Deposit Account Number                 

 

									
	 Service

Check box(es) to order
service
	  	 Service Description - Three-Party Escrow Service Agreement

All services are listed below. Check the requested service and submit a Work

Request to Iron Mountain for services requested after agreement signature.
	  	One-Time
Fees	  	Annual
Fees	  	Paying Party
Check box to
identify the Paying
Party
	 x  Setup Fee

(Required)
	  	Iron Mountain will setup a new escrow deposit account using a standard escrow agreement.	  	$1,550	  		  	x  Depositor

 ̈  Beneficiary

					
	x  Deposit Account Fee (Required)	  	Iron Mountain will set up one deposit account to manage and administrate access to Deposit Material to be secured in a controlled storage environment. Iron Mountain will provide account services that include unlimited deposits,
electronic vaulting, access to Iron Mountain ConnectTM Escrow Management Center for secure online account management, submission of electronic Work Requests, and communication of status. Release of deposit material is also included in the annual
fee. An oversize fee of $200 USD per 1.2 cubic foot will be charged for deposits that exceed 2.4 cubic feet.	  		  	$1,050	  	x  Depositor

 ̈  Beneficiary

					
	 x  Beneficiary

Fee
 (Required)
	  	Iron Mountain will fulfill a Work Request to add a Beneficiary to an escrow deposit account and manage account access rights. Beneficiary will have access to Iron Mountain ConnectTM Escrow Management Center for secure online
account management, submission of electronic Work Requests, and communication of status.	  		  	$800	  	x  Depositor

 ̈  Beneficiary

					
	  ̈  File List

Report
	  	Iron Mountain will perform a File List Test, which includes a Deposit Material media readability analysis, a file listing, a file classification table, virus scan outputs, and confirmation of the presence or absence of a completed
Exhibit Q – Deposit Questionnaire. A final report will be sent to the requesting Party regarding the Deposit Material. Deposit must be provided on CD, DVD-R, or deposited electronically.	  	$2,500	  	N/A	  	 ̈  Depositor

 ̈  Beneficiary

					
	  ̈  Level 1 -

Inventory and
 Analysis Test
	  	Iron Mountain will perform an Inventory and Analysis Test on the initial deposit, which includes the outputs of the File Listing test, identifying the presence/absence of build, setup and design documentation (including the presence
or absence of a completed Exhibit Q), and identifying materials required to recreate the Depositor’s application development and production environments. Output includes a report that includes compile and setup documentation, file
classification tables and file listings. The report will list required software development materials, including, without limitation, required source code languages and compilers, third-party software, libraries, operating systems, and hardware, and
Iron Mountain’s analysis of the deposit. A final report will be sent to the requesting Party regarding the Deposit Material.	  	$5,000
 orbased on

SOW if
custom
work
required
	  	N/A	  	 ̈  Depositor

 ̈  Beneficiary

					
	 ̈  Level 2 – Deposit Compile Test	  	Iron Mountain will fulfill a Statement of Work (SOW) to perform a Deposit Compile Test, which includes the outputs of the Level 1 - Inventory and Analysis Test, plus recreating the Depositor’s software development environment,
compiling source files and modules, linking libraries and recreating executable code, providing a pass/fail determination, and creation of comprehensive compilation documentation with a final report sent to the Paying Party regarding the Deposit
Material. The requesting Party and Iron Mountain will agree on a custom SOW prior to the start of fulfillment. A completed Exhibit Q is required for execution of this test.	  	Based on
 SOW
	  	N/A	  	 ̈  Depositor

 ̈  Beneficiary

					
	  ̈  Level 3 -

Binary
 Comparison
	  	Iron Mountain will fulfill a Statement of Work (SOW) to perform one Binary Comparison Test - Binary Comparison, which includes the outputs of the Level 2 test, a comparison of the executable files built from the Deposit Compile Test
to the actual executable files in use by the Beneficiary to ensure a full binary-level match, with a final report sent to the Requesting Party regarding the Deposit Material. The Paying Party and Iron Mountain will agree on a custom SOW prior to the
start of fulfillment. A completed Exhibit Q is required for execution of this test.	  	Based on
 SOW
	  	N/A	  	 ̈  Depositor

 ̈  Beneficiary

					
	  ̈  Level 4 - Full

Usability
	  	Iron Mountain will fulfill a Statement of Work (SOW) to perform one Deposit Usability Test - Full Usability, which includes which includes the outputs of the Level 1 and Level 2 tests (if applicable). Iron Mountain will confirm that
the deposited application can be setup, installed and configured and, when installed, will execute functional tests, based on pre-determined test scripts provided by the Parties, and create comprehensive setup and installation documentation. A final
report will be sent to the Paying Party regarding the Deposit Material. The Paying Party and Iron Mountain will agree on a custom SOW prior to the start of fulfillment. A completed Exhibit Q is required for execution of this test.	  	Based on
 SOW
	  	N/A	  	 ̈  Depositor

 ̈  Beneficiary

					
	x  Deposit Tracking	  	At least semi-annually, Iron Mountain will send a reminder to Depositor to update Deposit Material. Thereafter, Beneficiary will be notified of last deposit.	  	N/A	  	$450	  	x  Depositor
 ̈  Beneficiary

  

					
	3P.US/IPM/07.01.13	  	©2013 Iron Mountain Incorporated	  	Page 8 of 14

									
					
	 ̈  Dual Vaulting	  	Iron Mountain will fulfill a Work Request to store and manage a redundant copy of the Deposit Material in one (1) additional location. All Deposit Material (original and copy) must be provided by the Depositor.	  	N/A	  	$500	  	 ̈  Depositor

 ̈  Beneficiary

					
	  ̈  Remote

Vaulting
	  	Iron Mountain will fulfill a Work Request to store and manage the Deposit Material in a remote location, designated by the client, outside of Iron Mountain’s primary escrow vaulting location. All Deposit Material (original and
copy) must be provided by the Depositor.	  	N/A	  	$500	  	 ̈  Depositor

 ̈  Beneficiary

					
	 x  Custom

Contract Fee
	  	Custom contracts are subject to the Custom Contract Fee, which covers the review and processing of custom or modified contracts.	  	$750	  	N/A	  	x  Depositor
 ̈  Beneficiary

 Pursuant to the Agreement, the undersigned hereby issues this Work Request for performance of the Service(s) selected above.

  

							
	 Paying Party – For Future Work Request Use Only
	  	 Party Requesting Work – For Future Work Request Use Only

	Paying Party Name	 		  	 Party Requesting
  

Work Name
	  	
				
	Signature	 		  	Signature	  	
				
	Print Name	 		  	Print Name	  	
				
	Title	 		  	Title	  	
				
	Date	 		  	Date	  	

 IRON MOUNTAIN INTELLECTUAL PROPERTY MANAGEMENT, INC. 

All work requests should be sent to ipmclientservices@ironmountain.com OR Iron Mountain Intellectual Property Management, Inc., Attn: Client Services,
2100 Norcross Parkway, Suite 150, Norcross, Georgia, 30071, USA. Telephone: 800-875-5669. Facsimile: 770-239-9201 

  

					
	3P.US/IPM/07.01.13	  	©2013 Iron Mountain Incorporated	  	Page 9 of 14

 Exhibit B 

Deposit Material Description 

(This document must accompany each submission of Deposit Material) 
  

							
	Company Name	 		  	Deposit Account Number	  	
	Deposit Name	 		  	Deposit Version	  	

 (Deposit Name will appear in account history reports) 

Deposit Media 
 (Please Label All Media with the Deposit
Name Provided Above) 
  

							
	 Media Type
	  	 Quantity
	  	 Media Type
	  	Quantity
	 ̈  CD-ROM / DVD	  		  	 ̈  USB Drive	  	
	 ̈  DLT Tape	  		  	 ̈  Documentation	  	
	 ̈  DAT Tape (4mm/8mm)	  		  	 ̈  Hard Drive / CPU	  	
	 ̈  LTO Tape	  		  	 ̈  Circuit Board	  	
	 ̈  Other (please describe):	  		  		  	

  

							
	 	  	Total Size of Transmission
(specify in bytes)	  	# of Files	  	# of Folders
	  ̈  Electronic Deposit
	  		  		  	

 Deposit Encryption 

(Please check either “Yes” or “No” below and complete as appropriate) 

Is the media or are any of the files encrypted?     ̈   Yes or   ̈   No 
 If yes, please include any passwords and decryption tools description below. Please also
deposit all necessary encryption software with this deposit. Depositor at its option may submit passwords on a separate Exhibit B. 
  

			
	Encryption tool name	  	Version
	Hardware required	  	
	Software required	  	
	Other required information	  	

 Deposit Certification (Please check the box below to certify and provide your contact information) 

 

			
	  ̈  I certify for Depositor that the above described Deposit

Material has been transmitted electronically or sent via commercial express mail carrier to Iron Mountain at the address below.
	  	  ̈  Iron Mountain has inspected and accepted the above

described Deposit Material either electronically or physically. Iron Mountain will notify Depositor of any discrepancies.

		
	Print Name	  	Name
	Date	  	Date
	Email Address	  	
	Telephone Number	  	

 Note: If Depositor is physically sending Deposit Material to Iron Mountain, please label all media and mail all Deposit
Material with the appropriate Exhibit B via commercial express carrier to the following address: 
 Iron Mountain Intellectual Property Management,
Inc. 
 Attn: Vault Administration 
 2100 Norcross Parkway,
Suite 150 
 Norcross, GA 30071 
 Telephone: 800-875-5669 

Facsimile: 770-239-9201 

  

					
	3P.US/IPM/07.01.13	  	©2013 Iron Mountain Incorporated	  	Page 10 of 14

 Exhibit C 

Release of Deposit Material 

Deposit Account
Number                     
 Iron Mountain will use
the following procedures to process any written notice from Beneficiary to release the Deposit Material. [Note to Iron Mountain: Why is a Work Request necessary for Iron Mountain just to release the Deposit Material? Would it be sufficient for
Beneficiary to provide written notice? There should be no negotiation of terms related to a request to release Deposit Materials.] All notices under this Exhibit C shall be sent pursuant to the terms of Section 13(g) Notices. 

 

	 	1.	Release Conditions. 

 Depositor and Beneficiary agree that a Request for Release
Notice (defined below) from Beneficiary for the release of the Deposit Material shall be based solely on one or more of the following conditions (defined as “Release Conditions”): 

 

	 	(i)	Depositor’s material breach of the BPaaS Agreement or other agreement between the Depositor and Beneficiary regulating the use of the Deposit Material covered under this Agreement, provided that such material
breach has not been cured within thirty (30) days of receipt of notice of such material breach; 

  

	 	(ii)	Failure of the Depositor to function as a going concern or operate in the ordinary course or Depositor fails to carry on its business or the part of its business which relates to the Deposit Materials;

  

	 	(iii)	Depositor (a) files any petition in bankruptcy, (b) has an involuntary petition in bankruptcy filed against it which is not challenged in thirty (30) days and dismissed within ninety (90) days,
(c) becomes insolvent, (d) makes a general assignment for the benefit of creditors, or (e) has a receiver appointed for its assets; 

  

	 	(iv)	The BPaaS Agreement is terminated by Beneficiary pursuant to Section 16.1(a) (Termination for Cause), 16.1(c) (Termination for Certain Service Level Failures), 16.1(e) (Termination Following a
Change of Control of Supplier), 16.1(i) (Termination Due To Adverse Changes in Supplier’s Financial Circumstances), 16.1 (k) (Termination if Supplier Becomes a Competitor of Health Net), 16.1(l) (Termination Relating
to Supplier’s Liability Cap), or 16.1(m) (Termination Relating to Business Associate Agreement); or 

  

	 	(v)	Depositor fails to make a deposit in accordance with this Agreement within thirty (30) days of written notice to Depositor. 

  

	 	2.	Request for Release Notice. 

 Beneficiary may submit a written notice to Iron
Mountain to release the Deposit Material covered under this Agreement (a “Request for Release Notice”). To the extent that the Deposit Material is subject to applicable U.S. export control regulations and laws, including ITAR, the Request
for Release Notice must include Beneficiary’s certification that such release would be compliant with the applicable U.S. export control regulations and laws, including ITAR. Beneficiary shall send concurrently a copy of any such Request for
Release Notice to Depositor. 
  

	 	3.	Release of Deposit Material. 

 Iron Mountain shall release the Deposit Material to
the Beneficiary promptly after the fifth (5th) business day following its receipt of a Request for Release Notice; provided that Iron Mountain has not been enjoined by a court of competent jurisdiction from doing so. Iron Mountain shall also
promptly release the Deposit Materials to the Beneficiary upon written instructions from Depositor, or joint written instructions from Depositor and Beneficiary. Iron Mountain is entitled to receive any undisputed, unpaid Service Fees due Iron
Mountain from the Parties before fulfilling the Work Request for Release Notice to release Deposit Material covered under this Agreement. If any Service Fees are owed to Iron Mountain when Iron Mountain receives a Request for Release Notice, or
joint written instructions from Depositor and Beneficiary, Iron Mountain shall promptly give notice to the Beneficiary of the amount of such unpaid Service Fees. Any Party may cure a default of payment of Service Fees. 

 

	 	4.	Termination of Agreement Upon Release. 

 This Agreement will terminate upon the
release of Deposit Material held by Iron Mountain. 
  

	 	5.	Right to Use Following Release. 

 Beneficiary has the right under this Agreement
to use the Deposit Material for the sole purpose set forth in the BPaaS Agreement. Notwithstanding, the Beneficiary shall not have access to the Deposit Material under this Agreement unless there is a release of the Deposit Material in accordance
with this Agreement. Beneficiary shall be obligated to maintain the confidentiality of the Deposit Material released under this Agreement in accordance with the BPaaS Agreement. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 11 of 14

 Exhibit Q 

Escrow Deposit Questionnaire 

Deposit Account
Number                     
 Purpose of
Questionnaire 
 In order for Iron Mountain to determine the deposit material requirements and to quote fees associated with verification Services, a
completed Deposit Questionnaire is requested. It is the responsibility of the escrow depositor to complete the questionnaire. 
 Technical Contact
Information 
 List the appropriate technical person(s) Iron Mountain may contact regarding this set of escrow deposit materials. 

 

			
	Company Name		
	Print Contact Name		
	Address 1		
	City		
	State/Province		
	Postal/Zip Code		
	Telephone		
	Email Address		

 Instructions 
 Complete
the questionnaire in its entirety by answering every question accurately. Upon completion, return the questionnaire to the beneficiary asking for its completion, or e-mail it to your Iron Mountain Solution Sales Representative. 

General Description (Required) – Please answer all questions. 
  

			
	 What is the general function of the software (i.e. the deposit)

to be placed into escrow?
		
		
	On what media will the source and object code be delivered?		
		
	 If the deposit is on magnetic tape media, what tape format

(e.g. DAT DDS4, DLT 8000, LTO-3, etc.) will be used for the

deposit?
		
		
	 If the deposit is on tape, what operating system and version

was used to create the tape and what tools (either native OS (e.g. tar, cpio, etc.) or commercial (e.g. Backup Exec, NetBackup, ArcServ etc.) were used to load
the data; if a third
 party or commercial software tool was used, specify the vendor and exact version of the tool used.
		
		
	 Will the deposit be in the format of a database/repository of any type of Versioning or Configuration Management Tool (e.g. Visual Source
Safe, Clearcase, Perforce, etc.) or will the software in the deposit be in a clear text/native file system
 format? If a Versioning or CM tool will be
necessary to examine
 any part the deposit contents, specify the Vendor and tool and exact version used.
		
		
	 Is the deposit encrypted, including password protected

archives, in any way? If so, what tool and version will be used to perform the encryption and will all necessary userid’s, passwords or encryption keys be
provided to extract the software?
		
		
	 What is the total uncompressed size of the deposit in

megabytes?
		

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 12 of 14

 Requirements for the Assembly of the Deposit (Required) – Please answer all questions. 

 

			
	 Describe the nature of the source and object code in the

deposit. (Does the deposit include interpreted code, compiled source, object code, or a mixture? How do the different parts

of the deposit relate to each other?) What types of source code

and object code make up the deposit (e.g. – C++, Java, etc.)
		
		
	How many build processes are there?		
		
	 How many unique build environments are required to

assemble the material in the deposit into the deliverables?
		
		
	What hardware is required for each build environment to compile the software (including memory, disk space, etc.)?		
		
	 What operating systems (including versions) are used during

compilation? Is the software executed on any other operating systems/version?
		
		
	How many separate deliverable components (executables, share libraries, etc.) are built?		
		
	 What compilers/linkers/other tools (brand and version) are

necessary to build the application?
		
		
	 What, if any, third-party libraries are used to build the

software? Specify vendor, tool name and exact or minimum required version. If multiple build environments are required, specify for which environment each tool
is required.
		
		
	 If a database of any kind is necessary to support compilation, is

a running instance of the database necessary or is a static instance consisting of the static and shared libraries and/or header files installed by the
database sufficient to support compilation? If not already identified above, provide the vendor and version of the required database.
		
		
	 How long does a complete build of the software take? How

much of that time requires some form of human interaction and how much is automated?
		
		
	 Does the deposit contain formal build document(s) describing

the necessary steps for build system configuration and

compilation?
		

 Requirements for the Execution of the Software Protected by the Deposit - (Required) – Please answer all
questions. 
  

			
	 What are the system hardware requirements to successfully

execute the software? (memory, disk space, etc.); include any

additional peripheral devices that may be necessary to support correct function of the software/system.
		
		
	 What is the minimum number of machines required to

completely set up the software sufficient to support functional

testing? What Operating systems and version are required for each machine?
		
		
	 Beyond the operating systems, what additional third party

software and tools are required to execute the software and verify correct operation? Please provide vendor and versions of all third party tools or libraries
required to completely
 configure a system suitable to support functional testing. If multiple machines are required to support testing, identify the
software to be installed to each machine.
		

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 13 of 14

			
		
	Is a database of any kind required to support functional testing of the software? If so, provide the vendor and version required.		
		
	 If a database is required, does the deposit contain or can the

depositor provide scripts and backups/imports necessary to create a database instance suitable to support functional testing.

Note: a database containing test data is satisfactory to support functional testing so long as the data is realistic.
		
		
	Including the installation of any software tools required to support the function of the software, approximately how much time is required to setup and configure a system suitable to support functional testing?		
		
	Approximately how much time would be required to perform a set of limited tests once a test system is configured?		
		
	 Does the deposit contain or can the depositor provide test

plans, scripts or procedures to facilitate testing?
		
		
	 With the exception of any database identified above, are any

connections to external data sources, feeds or sinks required to support the proper functioning of the software and to support software testing?
		

 For additional information about Iron Mountain Technical Verification Services, please contact our Iron Mountain Solution
Sales Representative. 

  

					
	3P.US/IPM/07.01.13		©2013 Iron Mountain Incorporated		Page 14 of 14

 Final 

 BUSINESS ASSOCIATE AGREEMENT 

Between 
 Health Net,
Inc. 
 and 

Cognizant Healthcare Services, LLC 

and 
 Cognizant
Technology Solutions U.S. Corporation 
 Dated 

November 21, 2014 

  

					
	Business Associate Agreement		 		Health Net / Cognizant Confidential

 Final 

 BUSINESS ASSOCIATE AGREEMENT 

This Business Associate Agreement (“Agreement”) is dated November 21, 2014, but is effective as of November 2, 2014, by and
between Health Net, Inc., and/or one or more of its affiliates or subsidiaries (“Covered Entity” or “Health Net”) and Cognizant Technology Solutions U.S. Corporation (“CTS US”) and Cognizant Healthcare Services, LLC
(“CH LLC”). CTS US and CH LLC are each sometimes referred to herein as “Business Associate” or “Vendor”. Health Net and Business Associates are sometimes referred to individually in this Agreement as a “Party”
and collectively as the “Parties”. This Business Associate Agreement replaces and supersedes in all respects the Business Associate Agreement dated November 2, 2014. 

RECITALS 
 A. On
September 30, 2008, CTS US and Health Net entered into a Master Services Agreement for the provision of services (“AO Agreement”). On or around the date of this Agreement or shortly thereafter, Health Net and CH LLC entered (or will
enter) into a contract or contracts for the provision of services, software or some other business arrangement, as amended. Such contracts and the AO Agreement are collectively referred to hereinafter as the “Current Contract(s)”. 

B. The Parties contemplate that they may enter into additional agreements in the future pursuant to which Vendors may provide services to
Health Net, license software to Health Net or enter into some other business arrangement (“Future Contracts”). 
 C. In connection
with the Current Contracts(s) and the Future Contracts (collectively, the “Health Net – Vendor Contracts” and individually, a “Health Net – Vendor Contract”), Vendors may, on Health Net’s behalf, access, use,
create and/or disclose Protected Health Information (“PHI”) or Electronic Protected Health Information (“ePHI”), as defined in the federal regulations set forth at 45 C.F.R. §§ 160 and 164. 

D. Health Net and Vendors intend to protect the privacy and provide for the security of PHI and/or ePHI disclosed to Vendors in compliance with
the HIPAA Requirements. 
 NOW THEREFORE, in consideration of the mutual promises set forth below and in the Health Net – Vendor Contracts and
the exchange of information pursuant to this Agreement, the Parties hereto agree as follows: 
  

	I.	DEFINITIONS 

  

	a.	“Breach” shall mean (i) any actual circumstance that compromises the privacy and/or security of any Health Net data or Health Net software or systems which are possessed or operated by (or for) or
are under the control of Vendor or a third party that received such Health Net data (directly or indirectly) through Vendor (with the exception of a third party to which Health Net directs Vendor in writing to provide Health Net data, including
auditors, regulators and contractors but excluding Subcontractors); or (ii) any loss or unauthorized acquisition, access, destruction, alteration, disclosure or use (in all cases whether intentional or not) of, or the inability to locate,
Health Net data which was delivered to, created, maintained or accessed by, Vendor or a third party that received such Health Net data (directly or indirectly) through Vendor (with the exception of a third party to which Health Net directs Vendor in
writing to provide 

  

					
	Business Associate Agreement		1		Health Net / Cognizant Confidential

 Final 

  

	 	Health Net data, but excluding Subcontractors). For purposes of defining “in control” as that term is used in clause (i) of this definition, Vendor shall be deemed to be in control of Health Net data,
Health Net software or systems in the IBM data center to the extent (A) Vendor provides or is required to provide systems monitoring or related management or other services that affect the security of such Health Net data, Health Net software
or systems, (B) Vendor is obligated to manage IBM or any third party under this Agreement, or (C) any other circumstance in which Supplier’s acts or omissions could have prevented the Breach if Vendor had exercised due care and
complied with is obligations under this Agreement. 

  

	b.	“Breach Notification Rule” shall refer to the provisions set forth in 45 C.F.R. Part 160 and Part 164, Subpart D. 

  

	c.	“Business Associate” shall have the meaning given to such term at 45 C.F.R. § 160.103 and. includes a person or entity that creates, receives, maintains, or transmits PHI on behalf of a covered
entity. For the purposes of this Agreement, Vendors are Business Associates. 

  

	d.	“Covered Entity” shall have the meaning given to such term at 45 C.F.R. § 160.103. For the purposes of this Agreement, the Covered Entity is Health Net. 

 

	e.	“Designated Record Set” shall have the meaning given to such term in 45 C.F.R. § 164.501. f. “Discovery” shall mean the first day on which a Breach is known to Business Associate
(including any person, other than the individual committing the breach, that is an employee, officer, or Subcontractor of Business Associate), or should reasonably have been known to Business Associate, to have occurred. 

 

	g.	“Final Omnibus HIPAA/HITECH Rules” shall mean the rules published on January 25, 2013 at 78 Fed. Reg. 5566. 

  

	h.	“HIPAA” or “Health Insurance Portability and Accountability Act of 1996” shall refer to Public Law 104-191 and its implementing regulations. 

 

	i.	“HIPAA Rules” shall mean the Privacy, Security, Breach Notification, and Enforcement Rules at 45 C.F.R. Part 160 and Part 164. 

 

	j.	“HIPAA Requirements” shall mean collectively HIPAA, the HIPAA Rules, the HITECH Act and the Final Omnibus HIPAA/HITECH Rules. 

 

	k.	“HITECH Act” or “Health Information Technology for Economic and Clinical Health Act” are those provisions set forth in Title XIII of Public Law 111-5 as enacted on February 17,
2009 and its implementing regulations. 

  

	l.	“Individual” shall have the meaning given to such term at 45 C.F.R. § 160.103, and shall include a person who qualifies as a personal representative in accordance with 45 C.F.R. § 164.502(g).

  

					
	Business Associate Agreement		2		Health Net / Cognizant Confidential

 Final 

  

	m.	“Privacy Rule” is the regulation entitled “Standards for Privacy of Individually Identifiable Health Information,” promulgated under HIPAA and/or the HITECH Act that is codified at 45 C.F.R.
Parts 160 and 164, Subparts A and E. 

  

	n.	“Protected Health Information” (“PHI”) and “Electronic Protected Health Information” (“ePHI”) shall have the meaning given to such terms at 45 C.F.R. § 160.103;
provided, such PHI or ePHI shall be limited to the information Business Associate creates, receives, maintains or transmits on behalf of Covered Entity. Unless specifically delineated otherwise, references herein to PHI shall include ePHI.

  

	o.	“Required by Law” shall have the meaning given to such term at 45 C.F.R. § 164.103. 

  

	p.	“Secretary” shall mean the Secretary of the United States Department of Health and Human Services or her designee. 

  

	q.	“Security Rule” is the regulation entitled “Security Standards for the Protection of Electronic Protected Health Information,” promulgated under HIPAA and/or the HITECH Act that is codified at
45 C.F.R. parts 160 and 164, Subparts A and C. 

  

	r.	“Subcontractor” shall mean any entity (including an agent) that creates, receives, maintains, or transmits PHI on behalf of a Business Associate. 

 

	s.	“Unsecured Protected Health Information” or “Unsecured PHI” means Protected Health Information that is not secured through the use of a technology or methodology specified by guidance
issued by the Secretary from time to time. 

  

	t.	Catch-all definitions: The following terms used in this Agreement shall have the same meaning as those terms in the HIPAA Rules: Data Aggregation, Disclosure, Health Care Operations, Individual, Minimum
Necessary, Notice of Privacy Practices, Required By Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use. 

  

	II.	OBLIGATIONS OF BUSINESS ASSOCIATES 

  

	a.	Business Associates agree to not access, use, maintain and/or disclose PHI other than as permitted or required by this Agreement, the Health Net – Vendor Contracts or as Required by Law. Business Associates may not
further use or disclose PHI in a manner that would violate the HIPAA Requirements if done by Covered Entity. Business Associates shall also comply with any further limitations on uses and disclosures agreed to by Covered Entity provided that such
agreed upon limitations have been communicated to the Business Associate in writing. 

 If either Business Associate
subcontracts some or all of the services set forth in the Health Net – Vendor Contracts that require an entity to access, create, receive, maintain, transmit, or use PHI, on behalf of Covered Entity, any such entities are Subcontractors and are
subject to the HIPAA Requirements. Each Business Associate, accordingly, must, within a reasonable time following the execution of this Agreement, enter into written Business Associate Agreements with all such Subcontractors (i) that comply
with the HIPAA Requirements, (ii) that include restrictions, conditions, requirements and obligations at least as stringent as those set forth in this Agreement, and (iii) that describe the Subcontractors’ permitted uses and
disclosures of PHI. Any such uses and disclosures may not include uses and disclosures not permitted by Business Associates. 

  

					
	Business Associate Agreement		3		Health Net / Cognizant Confidential

 Final 

 Each Business Associate and its Subcontractors must keep records and submit compliance
reports to HHS, when HHS requires such disclosure, in order to investigate Business Associates’ and their Subcontractors’ compliance with the HIPAA Requirements, and to cooperate with complaint investigations and compliance reviews in
compliance with 45 C.F.R. § 160.310(a), (b). Each Business Associate and its Subcontractors must make reasonable efforts to limit use and disclosure of PHI and requests for PHI to the minimum necessary. To the extent either Business Associates
are to carry out one or more of Health Net’s obligation(s) under Subpart E of 45 C.F.R. Part 164 (the Privacy Rule), such Business Associate will comply with the requirements of Subpart E that apply to the Covered Entity in the performance of
such obligation(s). 
  

	b.	Permitted Uses and Disclosures. Business Associates may use and disclose PHI created or received pursuant to this Agreement as follows: 

 

	 	i.	To carry out the purposes of this Agreement or the applicable Health Net – Vendor Contracts. Each Business Associate may access, use and/or disclose Covered Entity’s PHI received or created by Business
Associate (or its Subcontractors) in performing its obligations pursuant to this Agreement or the applicable Health Net - Vendor Contract(s), solely in accordance with the specifications set forth in this Agreement and the Health Net – Vendor
Contract(s), or as Required by Law. 

  

	 	ii.	Use for Management and Administration. Each Business Associate may use PHI created or received in its capacity as a Business Associate of Covered Entity for the proper management and administration of Business
Associate, if such use is necessary (i) for the proper management and administration of Business Associate or (ii) to carry out the legal responsibilities of Business Associate. 

 

	 	iii.	Disclosure for Management and Administration. Each Business Associate may disclose PHI created or received in its capacity as a Business Associate of Covered Entity for the proper management and administration of
Business Associate if (i) the disclosure is Required by Law or (ii) Business Associate (a) obtains reasonable assurances in writing from the person to whom the PHI is disclosed that it will be held confidentially and used or further
disclosed only as Required by Law or for the purpose for which it was disclosed to the person and (b) the person agrees to notify Business Associate in writing of any instances of which it becomes aware in which the confidentiality or security
of the PHI has been breached. Business Associate shall notify Covered Entity at least five (5) days prior to making a disclosure of PHI pursuant to this subsection. 

 

	 	iv.	De-Identification and Data Aggregation. Each Business Associate may not de-identify PHI received or created pursuant to this Agreement unless specifically data de-identification is a service identified in
the Health Net – Vendor Contracts. Should a Business Associate perform data de-identification functions for Health Net, pursuant to the Health Net – Vendor Contracts, such de-identification shall conform to the requirements of 45 C.F.R.
§ 164.514(b). If included in the Health Net – Vendor contracts, a Business Associate may provide data aggregation services relating to the health care operations of Health Net. 

  

					
	Business Associate Agreement		4		Health Net / Cognizant Confidential

 Final 

  

	c.	Security and Privacy Safeguards. Each Business Associate shall use reasonable and appropriate administrative, physical, and technical safeguards designed to prevent improper use or disclosure of PHI, in any form
or media; and, each Business Associate shall comply with the applicable provisions of Subpart C of 45 C.F.R. Part 164 with respect to electronic protected health information (ePHI). 

 

	 	i.	With respect to ePHI, each Business Associate shall implement and comply with (and ensure that its Subcontractors implement and comply with) the applicable administrative safeguards set forth at 45 C.F.R. 164.308, the
physical safeguards set forth at 45 C.F.R. 164.310, the technical safeguards set forth at 45 C.F.R. 164.312, the organization requirements set forth at 45 C.F.R. 164.314, and the policies and procedures set forth at 45 C.F.R. 164.316 to reasonably
and appropriately protect the confidentiality, integrity, and availability of the PHI and ePHI that it accesses, uses, creates, maintain, transmits and/or discloses on behalf of Health Net. 

If a Business Associate is to carry out any part of Health Net’s obligations under the Privacy Rule, the Business Associate and, as
applicable, its Subcontractors must also comply with the Privacy Rule with respect to any such obligations. Business Associates acknowledge that, the foregoing safeguards and requirements shall apply to Business Associates and Business
Associates’ Subcontractors in the same manner that such requirements apply to Health Net, and (b) Business Associates and their Subcontractors may be liable under the civil and criminal enforcement provisions set forth at 42 U.S.C. 1320d-5
and 1320d-6, as amended from time to time, for failure to comply with the safeguards, policies and procedures and requirements and any guidance issued by the Secretary from time to time with respect to such requirements. Business Associates and
their Subcontractors may be liable for violations of any applicable HIPAA Requirement. Each Business Associate shall ensure that, within a reasonable time following the execution of this Agreement, any Subcontractor to whom it discloses PHI agrees
in writing to implement safeguards at least as stringent as those applicable to Business Associate as set forth in this Agreement. 
  

	d.	Reporting of Breaches. Each Business Associate agrees to report to Covered Entity any Breach of Unsecured PHI involving it or its Subcontractor(s) without unreasonable delay and in no case later than two
(2) business days after Discovery of a Breach. Such notice shall include, to the extent known to the Business Associate, the identification of each individual whose Unsecured PHI has been, or is reasonably believed to have been accessed,
acquired, maintained, used or disclosed in connection with such Breach. Notifications must be sent to privacy@healthnet.com. In addition, Business Associate shall provide any additional information reasonably requested by Covered Entity for purposes
of investigating, reporting or, responding to the Breach. 

  

	e.	Reporting of additional Incidents: Each Business Associate and its Subcontractors shall report to Health Net any: (i) loss, destruction, alteration, or other incident in which PHI cannot be accounted for,
(ii) any successful Security Incidents, or (iii) any other acquisition, access, use, or disclosure of PHI not permitted by the Health Net – Vendor Contracts or this Agreement (collectively, an “Incident”). Business Associate
shall notify Health Net of any Incident within two (2) business days of knowledge by Business Associate or Subcontractor of such Incident. 

  

	f.	 Determination of Breach: Each Business Associate shall (i) notify Health Net of any Incident, and (ii) assist Health Net in
performing (or at Health Net’s direction, perform) a risk assessment to determine if there is a low probability that the PHI has been compromised. Health Net shall 

  

					
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 make the ultimate determination as to whether there has been a Breach and if so, whether the
required notifications, including to individuals, the media, as applicable, and the Secretary, will be provided by Covered Entity or Business Associate. To enable Health Net to make a determination whether or not there is a low probability that PHI
has been compromised, Business Associate, and any Subcontractor of Business Associate, shall promptly undertake a risk assessment that addresses the following factors and provide the results of such risk assessment to Health Net: 

 

	 	(i)	The nature and extent of the protected health information involved, including the types of identifiers and the likelihood of re-identification; 

 

	 	(ii)	the unauthorized person who used the protected health information or to whom the disclosure was made; 

  

	 	(iii)	whether the protected health information was actually acquired or viewed; and, 

	 	(iv)	the extent to which the risk to the protected health information has been mitigated. 

 Each
Business Associate shall maintain complete records regarding any Incident or Breach for the period required by 45 C.F.R. § 164.530(j) or such longer period required by state law, and shall make such records available to Covered Entity promptly
upon request, but in no event later than within five (5) business days. Each Business Associate further agrees to mitigate, to the extent practicable, any harmful effect that becomes known to Business Associate of an Incident or Breach. Each
Business Associate shall be responsible for all reasonable Identity-Related Costs incurred in connection with the Incident or Breach involving PHI delivered to, created, maintained, or accessed by Business Associate or a Subcontractor of Business
Associate, including but not limited to, any notifications and mitigation activities taken pursuant to this provision. 
  

	 	g.	Additional Responsibilities in the Event of Incident or Breach. Business Associates shall take prompt steps designed to prevent the recurrence of any Incident or Breach and take any other action pertaining to any
unauthorized access, use and/or disclosure required by applicable federal and state laws and regulations. Business Associates must comply with this provision regardless of any actions taken by Covered Entity. 

 

	 	h.	 Use of Subcontractors. Other than as may be set forth in the Health Net – Vendor Contracts, Business Associates shall not contract with a
Subcontractor without the express prior written consent of Health Net’s Privacy Officer. Upon request, a Business Associate shall provide, in writing, to Health Net’s Privacy Office at Privacy@healthnet.com, a list of those entities that
will fall within the scope of “Subcontractors” as defined in this Agreement, meaning that such entities receive or are expected to receive, access, use, maintain and/or disclose PHI or ePHI that is subject to this Agreement and the Health
Net – Vendor Contract(s). Each Business Associate shall ensure that, consistent with the terms of the Health Net – Vendor Contract(s) with regard to use of Subcontractors, any of its Subcontractors to whom it discloses or provides, or
which have access to, PHI and/or ePHI pursuant to this Agreement or any Health Net – Vendor Contract(s), agree in writing, within a reasonable time following the execution of this Agreement, to

  

					
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 restrictions, conditions and safeguards that are at least as stringent as those that apply
to Business Associate pursuant to this Agreement with respect to any such PHI and/or ePHI. With respect to the obligations of Section II.d. and II.e. hereof, each Business Associate represents that any Subcontractor shall be obligated to notify the
respective Business Associate, who will in turn notify Covered Entity, of any Breach or Incident within two (2) business days in the same manner and according to the same terms as provided herein. 

Availability of Information to Covered Entity. If applicable, within five (5) business days of receipt of a request from Covered
Entity, a Business Associate and, as applicable, its Subcontractor(s) shall make available to Covered Entity such information as Covered Entity may require to fulfill Covered Entity’s obligations to provide access to, and a copy of, PHI
pursuant to the Privacy Rule, including but not limited to 45 C.F.R. § 164.524. If an Individual requests such information directly from a Business Associate or a Business Associate’s Subcontractors, the respective Business Associate must
notify Covered Entity in writing within five (5) business days of any such request. Business Associates shall not give the Individual access to the information unless access is approved by Covered Entity. If the PHI requested is maintained
electronically in one or more Designated Record Sets, Business Associate will be required to produce an electronic copy of PHI if the individual requests it and the form is readily produceable. If PHI is not readily producible in the requested form,
then Business Associate will work with Health Net on an alternate form and format in which to provide the copy of PHI. Covered Entity shall have full discretion to determine whether the Individual shall be given access. If a Business Associate
maintains an Electronic Health Record with PHI, and an individual requests a copy of such information in an electronic format, Business Associate shall provide such information in an electronic format to enable Covered Entity to fulfill its
obligations under the HITECH Act, including but not limited to, 42 U.S.C. § 17935(e). 
  

	 	i.	Amendment of PHI. If applicable, within five (5) business days of receipt of a request from Covered Entity or directly from an Individual or third party, Business Associate and, as applicable, its
Subcontractor(s) shall make Covered Entity’s PHI and/or ePHI available to Covered Entity as it may require to fulfill Covered Entity’s obligations to amend such PHI and/or ePHI pursuant to the Privacy Rule, including but not limited to, 45
C.F.R. § 164.526. Business Associates shall incorporate any amendments to Covered Entity’s PHI and/or ePHI Business Associates maintain. 

  

	 	j.	Accounting of PHI. If applicable, within (5) business days of notice by Covered Entity of a request for an accounting of disclosures of PHI or ePHI, Business Associates and, as applicable, their
Subcontractor(s) shall make available the PHI and/or ePHI to Covered Entity as required for Covered Entity to fulfill its obligations to provide an accounting pursuant to the Privacy Rule, including but not limited to, 45 C.F.R. § 164.528.
Business Associates and their Subcontractor(s) shall implement a documented process that allows for such an accounting. Business Associates shall maintain records sufficient to meet this provision for a period of six years in order to ensure
compliance with the Privacy Rule. 

  

	 	k.	Availability of Books and Records. Business Associates and, as applicable, their Subcontractor(s) shall promptly make its internal practices, books and records relating to the use and disclosure of PHI and ePHI,
accessed, used, disclosed, created or received pursuant to this Agreement and the Health Net – Vendor Contract(s) available to the Secretary of the United States Department of Health and Human Services, for the purpose of determining Covered
Entity’s compliance with the Privacy and Security Rules as set forth in 45 C.F.R. § 160.310. 

  

					
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	 	l.	Record Retention. Subject to section V below, Business Associates and, as applicable, their Subcontractor(s) shall retain all PHI and/or ePHI disclosed to or received from Covered Entity, or created or received
in the course of performing its obligations, at a minimum and subject to the terms of Section V(c) below, until the termination of all Current Contracts and Future Contracts. 

 

	 	m.	Minimum Necessary Amount of PHI. Each Business Associate acknowledges that it shall request from Health Net and so disclose to its affiliates, Subcontractors or other authorized third parties, only (i) the
information contained in a “limited data set,” as such term is defined at 45 C.F.R. § 164.514(e) (2), or, (ii) if needed by a Business Associate or its affiliates, Subcontractors or other authorized third parties, the minimum
necessary data to accomplish the intended purpose of such requests or disclosures. 

  

	 	n.	Data Ownership. Business Associates acknowledge that Covered Entity is the owner of all PHI and/or ePHI that Covered Entity discloses to Business Associates, that Business Associates receive from, or creates,
accesses or obtains or maintains on behalf of or in the name of, Covered Entity. 

  

	 	o.	Indemnification. Each Business Associate shall defend, indemnify and hold harmless Health Net and any of Health Net’s affiliates, directors, officers, employees and agents from and against any claim, cause
of action, liability, damage, reasonable cost or expense (including reasonable attorneys’ fees) arising out of or relating to any Breach. 

  

	 	p.	Limitation of Liability. The parties agree that, notwithstanding anything to the contrary set forth in any Health Net – Vendor Contracts, Vendors’ liability under this Agreement and any other Breach or
Incident related to HIPAA, PHI and any other laws applicable to PHI shall not exceed $225 million (the “BAA Cap”). The parties further agree that, notwithstanding any contrary provision in the Health Net – Vendor Contracts, Business
Associates’ liability under this Agreement and any other Breach or Incident related to HIPAA, PHI and/or any other laws applicable to PHI shall include liability for indirect, incidental, or consequential, exemplary, punitive, or special
damages of any kind or nature whatsoever, up to the BAA Cap. The parties agree that reasonable Identity-Related Costs shall be considered direct damages but will be subject to the BAA Cap. “Identity-Related Costs” means the
following costs that are reasonable and incurred by Health Net relating to a Breach: (i) preparation and mailing or other transmission of notifications and other communications to affected individuals and others, which are required by
applicable law; (ii) establishment of a call center or other communications procedures in response to such Breach as customary in the industry or directed by a regulator (e.g., customer service frequently asked questions, talking points and
training); (iii) costs for credit monitoring services, identity theft insurance, reimbursement for credit freezes, fraud resolution services, identity restoration services, and any similar service which corporate entities which maintain or
store PHI routinely make available to impacted individuals in the event of a Breach; (iv) fees paid to forensic consultants associated with Health Net’s investigation of the event; (v) legal fees and expenses associated with Health
Net’s investigation of and response to such event and defending claims made by parties affected by such Breach or by regulators or other governmental entities relating to such Breach, and costs of settlement or judgment in connection with any
such litigation or arbitration; and (vi) any other costs, expenses or liabilities incurred in connection with such Breach. 

  

					
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	 	q.	Standard Transactions. Unless otherwise agreed by the parties, to the extent Business Associates conduct Standard Transaction(s) on behalf of Health Net, Business Associates shall, without limitation, comply with
the HIPAA Regulations, “Administrative Requirements for Transactions,” 45 C.F.R. § 162.100 et seq., and shall not: (a) Change the definition, data condition or use of a data element or segment in a standard; (b) Add
any data elements or segments to the maximum defined data set; (c) Use any code or data elements that are either marked “not used” in the standard’s implementation specification or are not in the standard’s implementation
specification(s); or (d) Change the meaning or intent of the standard’s implementation specifications. 

  

	 	r.	Notice of Investigation or Lawsuit. Each Business Associate shall notify Health Net immediately upon receipt of notice of an investigation or of a lawsuit filed against the respective Business Associate or any of
its Subcontractors related to or arising from the use or disclosure of PHI or ePHI by the Business Associate pursuant to this Agreement or any of the Health Net - Vendor Contract(s). 

 

	 	s.	State Law Requirements. Business Associates and, as applicable, their Subcontractor(s) shall comply with applicable state law confidentiality, privacy, security, document retention, and breach notification
requirements involving “Personal Information” or “Personally Identifiable Information” (collectively “PII”) as those terms are defined under state law. For purposes of this Agreement, PII shall refer to any data
elements that identify an individual or that could be used to identify an individual, including but not limited to an individual’s first name or initial and last name in combination with one or more of the following data elements: social
security number; driver’s license or State issued identification number; credit or debit card number; medical information (such as an individual’s condition, treatment, or payment information); financial information, such as checking
account or other account number (either in combination with a required security code, access code, or password that would permit access to the account, or alone if the account does not require such an access code); or other identifying information,
such as email addresses and usernames in combination with passwords or security questions, date of birth, mother’s maiden name, digital signature, passport number, fingerprint or other biometric data, an insurance policy number, employment
information, employment history, an employer, student, tribal, or military identification numbers. 

 Notwithstanding any
provision to the contrary, the provisions of this Agreement shall apply equally with respect to PII as they do to PHI; provided, however, that to the extent that state law is more stringent than the HIPAA Requirements or the terms of this Agreement,
Business Associates agree to comply with such applicable State law in addition to the provisions herein. 
  

	 	t.	Regulatory References. A reference in this Agreement to a section in the HIPAA Rules means the section as in effect or as amended. 

 

	III.	COVERED ENTITY’S OBLIGATIONS 

  

	a.	In some circumstances, Health Net has agreed to further limitations on uses and disclosures where Health Net is itself a business associate of a self-funded Group Health Plan (as defined in 45 C.F.R. § 160.103,
each of which is itself a Covered Entity). Where this is the case, Health Net shall notify Business Associates of such additional restrictions, including any limitation(s) in Health Net’s or any applicable Covered Entity’s notice of
privacy practices that are produced in accordance with 45 C.F.R. § 164.520 (as well as any changes to that notice), to the extent that such limitation(s) may affect Business Associates’ use or disclosure of PHI. Business Associates in turn
shall notify any Subcontractors of the additional agreed upon limitations on uses and disclosures of PHI. 

  

					
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	b.	Health Net shall provide Business Associates with any changes in, or revocation of, permission by Individual to use or disclose PHI, to the extent that such changes affect Business Associates’ use or disclosure of
PHI. Business Associates in turn shall notify any Subcontractors of any changes in, or revocation of, permission by Individual to use or disclose PHI. 

  

	c.	Health Net shall notify Business Associates of any restriction to the use or disclosure of PHI that Health Net has agreed to in accordance with 45 C.F.R. 164.522, to the extent that such restriction may affect Business
Associates’ use or disclosure of PHI. Business Associates in turn shall notify any Subcontractors of any restriction to the use or disclosure of PHI that Health Net has agreed to. 

 

	d.	Health Net shall make reasonable efforts to provide Business Associates with a Limited Data Set and, otherwise shall disclose to Business Associates only the minimum amount of PHI reasonably necessary for Business
Associates to accomplish the intended purpose of such disclosure. 

  

	IV.	AUDITS, INSPECTION AND ENFORCEMENT 

 Covered Entity, after providing ten
(10) business days’ written notice, may inspect the facilities, systems, records, policies and procedures relating to the access, use and/or disclosure of PHI or ePHI pursuant to this Agreement for the purpose of determining whether
Business Associates have complied with this Agreement, and Covered Entity may, upon request therefrom, disclose the results of such audit with Covered Entity’s regulators including the U.S. Centers for Medicare & Medicaid Services. Any
audit or inspection by Covered Entity shall be subject to the following limitations: (i) use of any third party auditor that is or acts for a competitor of either Business Associate shall be subject to the applicable Business Associate’s
prior written approval, such approval not to be unreasonably withheld or delayed; and (ii) Covered Entity or any third party auditor conducting any such audit or inspection shall at all times comply with any and all reasonable security and
confidentiality guidelines and other policies of Business Associates with respect to the audit or inspection. 
  

	V.	TERM AND TERMINATION 

  

	a.	Termination for Material Breach. Covered Entity may terminate this Agreement or any or all of the Health Net – Vendor Contract(s) (in whole or in part) immediately if Covered Entity determines that a
Business Associate has materially breached this Agreement or violated any HIPAA Requirement and has failed to cure such material breach or violation within thirty (30) days following Covered Entity’s written notice to Business Associate.
Business Associates acknowledge that any material breach would result in irreparable harm to Covered Entity and that Covered Entity has the right to seek an injunction and other legal and equitable rights and remedies available under the law. A
Business Associate may terminate this Agreement if Business Associate determines that Covered Entity has materially breached its obligations under the HIPAA Requirements. 

  

					
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	b.	Cure. 

  

	 	(i)	If termination of this Agreement or the Health Net – Vendor Contract(s) is not feasible, Covered Entity shall report the problem to the Secretary of U.S. Health and Human Services. 

 

	 	(ii)	As an alternative to the rights set forth in Section V.a. above, Business Associate may choose to provide Covered Entity with written notice of the existence of an alleged material breach of this Agreement, and afford
Covered Entity the opportunity to cure such alleged material breach. 

  

	c.	Effect of Termination. Upon termination or expiration of the Health Net – Vendor Contract or Agreement for any reason, with respect to PHI received from Health Net, or created, maintained, or received by
Business Associates or Business Associates’ Subcontractors on behalf of Covered Entity and upon Covered Entity’s written request, Business Associates shall either return or destroy all PHI received or created pursuant to this Agreement
and/or the Health Net – Vendor Contract that Business Associates or their Subcontractor(s) maintain in any form, and shall retain no copies of such PHI; or if return or destruction is not feasible or contrary to (i) the record retention
requirements of a Health Net—Vendor Contract(s), (ii) the record retention requirements of Business Associates, or (iii) applicable state or federal law, then Business Associates and any Subcontractor of Business Associates shall
continue to extend protections of this Agreement to such information, and limit further use of such PHI to those purposes that make the return or destruction infeasible or that require Business Associates or Business Associates’ Subcontractor
to retain PHI for so long as Business Associates maintain such PHI . If the return or destruction of PHI is delayed pursuant to any of the foregoing reasons, then Business Associates shall notify Health Net in writing when such infeasibility ends
and, upon written direction from Health Net, either return or destroy such PHI promptly upon Health Net’s written request. Business Associates agree that if applicable state or federal law requires the retention of PHI for a specified time
period, Business Associates or Business Associates’ Subcontractor shall in all cases postpone destruction of such PHI until directed to do so by Health Net in writing to ensure compliance with applicable state or federal law. 

Business Associates and their Subcontractor(s) shall continue to maintain reasonable and appropriate administrative, physical, and technical
safeguards designed to prevent improper use or disclosure of PHI, in any form or media, and comply with Subpart C of 45 C.F.R. Part 164 with respect to ePHI retained after termination or expiration for as long as Business Associates and/or their
Subcontractor(s) retain such PHI. Business Associates and their Subcontractor(s) shall not use or disclose the PHI retained after termination or expiration other than for the purposes for which such PHI information was originally disclosed. Each
Business Associate shall return to Health Net or, if directed by Health Net in writing, destroy the PHI retained by each Business Associate when it is no longer needed by the Business Associate for its proper management and administration or to
carry out its legal responsibilities. If applicable, upon written direction of Health Net, each Business Associate will transmit PHI in its possession and/or the possession of its Subcontractors to another business associate of Health Net at
termination. The obligations of each Business Associate under this Section shall survive the termination of this Agreement. 
  

	VI.	NO THIRD PARTY BENEFICIARIES 

 Nothing express or implied in this Agreement is intended
to confer, nor shall anything herein confer, upon any person other than Covered Entity, Business Associates and their respective successors and assigns, any rights, remedies, obligations or liabilities whatsoever. 

  

					
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	VII.	CHANGE IN APPLICABLE LAWS OR REGULATIONS 

 In the event the laws or regulations of the
United States or any State are modified or amended in any material way with respect to this Agreement, this Agreement shall not be terminated but rather, to the extent feasible, shall be promptly amended by the Parties to operate in compliance with
the existing law. The Parties acknowledge that their responsibilities under this Agreement may be affected and governed by the requirements of the HIPAA Requirements that become effective during the term of this Agreement or any renewal thereof,
both Parties agree that, upon the effective date of any such new or revised HIPAA Requirements, this Agreement shall be deemed to incorporate, and impose on the Parties, any obligations applicable to each of them under such new or revised HIPAA
Requirements pursuant to their responsibilities hereunder. To the extent any amendments to this Agreement shall be necessary to effectuate or clarify the obligations of the Parties pursuant to such new or revised HIPAA Requirements, the Parties
hereby agree to negotiate such amendments in good faith, subject to the right of either party to terminate this Agreement and any Health Net—Vendor Contract pursuant to which PHI is provided to Business Associates. 

 

	VIII.	 SURVIVAL 

 The respective rights and obligations of Business Associates under
Section II of this Agreement shall survive the termination of this Agreement. 
  

	IX.	INTERPRETATION 

 Any ambiguity in this Agreement shall be resolved in favor of a meaning
that permits each Party to comply with the HIPAA Requirements. 
  

	X.	ENTIRE AGREEMENT 

 This Agreement – consisting of the signature page, these terms
and conditions constitute the entire agreement between the Parties with respect to its subject matter and merges, integrates and supersedes all prior and contemporaneous agreements, addenda and understandings between the Parties, whether written
(including within any Health Net-Vendor Contract(s)) or oral, concerning its subject matter. 

  

					
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 IN WITNESS WHEREOF, the Parties hereto have duly executed this Agreement as of the date set forth below. 

 

									
	HEALTH NET, INC.				COGNIZANT TECHNOLOGY SOLUTIONS U.S. CORPORATION
					
	By:		  
				By:		  

					
	Print Name:		  
				Print Name:		  

					
	Title:		  
				Title:		  

					
	Date:		  
				Date:		  

				
							COGNIZANT HEALTHCARE SERVICES, L.L.C.
					
							By:		  

					
							Print Name:		  

					
							Title:		  

					
							Date:		  
  

  

  

					
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 BUSINESS ASSOCIATE AGREEMENT 

SCHEDULE “A” 

MASSACHUSETTS STANDARDS FOR THE PROTECTION OF PERSONAL INFORMATION 

Pursuant to this Addendum, Health Net incorporates and Business Associates agree to abide by the applicable Standards for the Protection of
Personal Information of Residents of the Commonwealth of Massachusetts, 201 CMR 17.00. 
 In addition to the requirements set forth in the
Addendum, Business Associates further agree to: (i) Implement and maintain appropriate technical security measures for personal information as required by 201 CMR 17.00; including, but not limited: (a) Encrypting all transmitted records
and files containing personal information that will travel across public networks, and encryption of all data containing personal information to be transmitted wirelessly; and (b) Prohibiting the transfer of personal information to any portable
device unless such transfer has been approved in advance by Health Net; provided further that any such personal information to be transferred to a portable device must be encrypted; and (ii) Implement and maintain a Written Information Security
program as required by 201 CMR 17.00. 
 The Addendum, as amended by this Addendum, shall apply equally to PHI, ePHI and “personal
information.” Personal information means a Massachusetts resident’s first name and last name or first initial and last name in combination with any one or more of the following data elements that relate to such resident: (a) Social
Security number; (b) driver’s license number or state-issued identification card number; or (c) financial account number, or credit or debit card number, with or without any required security code, access code, personal identification
number or password, that would permit access to a resident’s financial account; provided, however, that “Personal information” shall not include information that is lawfully obtained from publicly available information, or from
federal, state or local government records lawfully made available to the general public. 

  

					
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AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #1 (CLAIMS MANAGEMENT SERVICES) 
  

  

					
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 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #1 (CLAIMS MANAGEMENT SERVICES) 

This Statement of Work #1 (Claims Management Services), dated November 21, 2014, but effective as of November 2, 2014
(“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #1 (Claims Management Services) is entered into and shall be governed by the terms of that certain Amended and
Restated Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #1 (Claims Management Services) replaces and supersedes in all respects the
Statement of Work #1 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #1 (Claims Management Services) describes
the Claims Management Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Claims Management Services) to this SOW #1 (Claims Management Services), and sets forth certain terms and conditions
relating to them, including, among other things: 
  

	 	(a)	The scope of the Claims Management Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; (d) The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

	1.2	Structure 

 This SOW #1 (Claims Management Services) is comprised of this cover
document and the following Exhibits: 
  

					
	Table 1: Exhibits to SOW #1 (Claims Management Services)
	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	Exhibit A (Services)	  	Describes the scope of the Claims Management Services.

  

					
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	Table 1: Exhibits to SOW #1 (Claims Management Services)
	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

			
	2	  	 Exhibit A-1 (Solution

Description)
	  	 Describes Supplier’s solution for the provision of the Claims

Management Services and includes as exhibits:
  

•    Exhibit A-1-1 (Approved Service Delivery Centers)

 
 •    Exhibit A-1-2
(Service Delivery Configuration at the
         Completion of Phase 2)

			
	3	  	Exhibit A-3 (Organizational Chart)	  	 Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW

#1 (Claims Management Services).

			
	4	  	Exhibit B-1
(Operational SLAs)	  	Identifies the Operational Service Levels applicable to the Claims Management Services.
			
	5	  	 Exhibit D (Key
 Supplier
Positions)
	  	Identifies the Key Supplier Positions applicable to the Claims Management Services.
			
	6	  	Exhibit H (Subcontractors)	  	Identifies the Subcontractors approved by Health Net to provide certain of the Claims Management Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #1 (Claims Management
Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #1 (Claims Management Services) is
hereby made a part of, and is subject to and governed by, the Agreement. This SOW #1 (Claims Management Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
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 IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #1 (Claims
Management Services) to be signed and delivered by its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

									
	Health Net, Inc.				Cognizant Healthcare Services, LLC
					
	By:		  
				By:		  

					
	Print Name:		  
				Print Name:		  

					
	Title:		  
				Title:		  

					
	Date:		  
				Date:		  

  

  

					
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EXHIBIT A 
 CLAIMS
MANAGEMENT SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	General 

  

	 	(a)	In general terms, the “Claims Management Services” or “Claims Services” are Functions associated with the review, editing, validation and processing of a Claim from
receipt through settlement for all geographies and lines of business requested by Health Net (unless expressly excluded under this Agreement), including the following activities: 

 

	 	(i)	Receipt, assessment, and entry into the Claims processing and imaging platform(s) and system(s) (the “Claims System(s)”) of Claims and Claim-related collateral; 

 

	 	(ii)	Validation and processing of Claims; and 

  

	 	(iii)	Post-payment activities, including adjustments of Claims and recovery of monies. 

  

	 	(b)	The Claims Management Services are more fully described in Section 3, and include the Cross Functional Services described in Section 3 of Schedule A (Cross Functional Services) and the Functions
included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Claims Management Services. For clarity, this includes
Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 of Schedule A (Cross Functional Services). Supplier shall perform the Claims Management Services, except
for those Functions that are expressly identified as retained Health Net responsibilities in Section 2 below. For purposes of clarity, the Party that is assigned responsibility for a Function as per the designations in Section 2 is also
responsible for the Embedded Processes applicable to that Function. 

  

	 	(c)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Claims Management Services to be performed by Supplier include all Functions performed
by or associated with the roles in the Claims Management Organization Chart set forth in Exhibit A-3 (Claims Management Organization Chart), all of which are either being transferred to Supplier or displaced by Supplier roles as a result of
the execution of this Statement of Work. Such Functions will be deemed to be part of the Claims Management Services to be performed by Supplier as if expressly set forth in this Statement of Work. 

 

	 	(d)	In addition to the retained Health Net responsibilities expressly identified in this Exhibit A (Claims Management Services), and in addition to and without limiting Health Net’s rights under the Terms and
Conditions, Health Net may perform quality reviews and audits of Supplier’s performance of the Claims Management Services in accordance with the Terms and Conditions. For the avoidance of doubt, Health Net is not obligated to perform any level
of such quality reviews and activities, except to the extent required by applicable Law. 

  

					
	SOW#1 (Claims) Exhibit A		A-1		Health Net / Cognizant Confidential

	 	(e)	Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is
no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and
evolutions of the Claims Management Services during the term of this Statement of Work.” 

  

	1.2	Definitions 

  

	 	(a)	Certain Terms. 

  

	 	(i)	“Provider Inquiry” means any written provider correspondence (A) resulting in a grievance, or (B) regarding the status or outcome of claims, claims-related transactions, PDRs, or
(C) any other correspondence received that Health Net designates as a Provider Inquiry. Provider Inquiries include Provider Disputes, PDRs and Provider Appeals. 

 

	 	(ii)	“Provider Dispute” or “PDR” or “Provider Appeal” is a written notice from a provider to Health Net that: (a) challenges, appeals or requests
reconsideration of a claim (including a bundled group of similar multiple claims) that has been denied, adjusted or contested; (b) challenges a request for reimbursement for an overpayment of a claim; or (c) seeks resolution of a billing
determination or a contractual dispute. For clarity, in California the nomenclature used for these appeals is Provider Dispute or PDR, and in Oregon and Washington, the nomenclature used is Provider Appeal. References to the term “PDR”
will refer collectively to Provider Disputes and Provider Appeals. 

  

	 	(iii)	“Service Form” or “SF” means the electronic service form that results in a permanent record that is used to document contacts, both internal and external to Health Net.

  

	 	(b)	Capitalized terms not defined in this Section 1.2(a) shall have the meanings given them elsewhere in this Exhibit A or elsewhere in this Agreement, including Schedule W (Glossary). 

 

	2.	RESPONSIBLE PARTY 

 The following table sets forth the responsible party for the Claims
Management Services. The headings have the following meaning: (i) Line of Business is inclusive of Commercial, Medicare, SHP, Arizona AHCCCS, Dual Eligibles, Performance Groups, MHN, Life & Disability; and (ii) Regions are
inclusive of California, Oregon, Washington, Arizona, and North East business. The exclusive Onshore Activities are as follows: Arizona AHCCCS, Performance Groups (UC, Boeing, Verizon, and Southern California Edison (SCE)), Legal, Provider
Reimbursement Specialists, and Vendor Oversight. 

  

					
	SOW#1 (Claims) Exhibit A		A-2		Health Net / Cognizant Confidential

											
	 Process/
Function ID
	  	 Process/Function Name / Description
	  	 Line of Business
(LOB)
	  	 Region
	  	 Resp. Party
Supplier
	  	 HN

	3.1	  	Claims Acquisition	  	All	  	All	  	X	  	
						
	3.2	  	Claims Adjudication	  	All	  	All	  	X	  	
						
	3.3	  	Claim Adjustment & Post Pay Activities	  	All	  	All	  	X	  	
						
	3.4	  	Other Claims Functions	  		  		  		  	
						
	3.4(a)	  	Life and Disability Processing	  	All	  	All	  	X	  	
						
	3.4(b)	  	CMS Incentives	  	All	  	All	  	X	  	
						
	3.4(c)	  	Perform QCare/File Net MediCal Testing	  	SHP	  	California	  	X	  	
						
	3.4(d)	  	Performance Group Processing	  	All	  	California, AZ, MHN	  	X	  	
						
	3.4(e)	  	Reinsurance	  	All	  	All	  	X	  	
						
	3.4(f)	  	Manual Claims Processing	  	All	  	Arizona/North East	  	X	  	
						
	3.4(g)	  	Legal Services Support	  	All	  	All	  	X	  	
						
	3.4(h)	  	Medicare Secondary Payer Requests (MSPs) – currently falls within the PDR unit	  	Medicare	  	All	  	X	  	
						
	3.4(i)	  	Pay and Recover	  	All	  	California	  	X	  	
						
	3.4(j)	  	Accumulator Updates	  	All	  	All	  	X	  	
						
	3.4(k)	  	REPER Processing	  	All	  	All	  	X	  	
						
	3.4(l)	  	Compliance	  	All	  	All	  	X	  	
						
	3.4(m)	  	Financial/Reporting Analytics	  	All	  	All	  	X	  	
						
	3.4(n)	  	Vendor Oversight/Liaison	  	All	  	All	  		  	X
						
	3.4(o)	  	Disaster Recovery	  	All	  	All	  	X	  	
						
	3.4(p)	  	Privacy Incidents/Reporting	  	All	  	All	  	X	  	
						
	3.4(q)	  	Provider Reimbursement Specialists	  	All	  	All	  	X	  	
						
	3.4(r)	  	Shared Risk Discrepancy	  	All	  	California	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-3	  	Health Net / Cognizant Confidential

											
	 Process/
Function ID
	  	 Process/Function Name / Description
	  	 Line of Business
(LOB)
	  	 Region
	  	 Resp. Party
Supplier
	  	 HN

						
	3.4(s)	  	Pre-Pay Audit Functions	  	All	  	All	  	X	  	
						
	3.4(t)	  	Recovery Functions	  	All	  	All	  	X	  	
						
	3.4(u)	  	Desk Top Policy and Procedures	  	All	  	All	  	X	  	
						
	3.4(v)	  	Clerical Functions	  	All	  	All	  	X	  	
						
	3.4(w)	  	Eligibility Guarantee	  	All	  	All	  	X	  	
						
	3.4(x)	  	 TP 2020 Professional Bundled
 Services
	  	All	  	All	  	X	  	
						
	3.4(y)	  	 Claims Development for Medicare
 Non Par and
High Dollar Claims
	  	Medicare	  	All	  	X	  	
						
	3.4(z)	  	 RFP Responses for Nonperformance

Groups
	  	All	  	All	  	X	  	
						
	3.4(aa)	  	Compliance and Regulatory Affairs	  	All	  	All	  	X	  	
						
	3.4(bb)	  	SOX / SARBANES controls	  	All	  	All	  	X	  	
						
	3.4(cc)	  	EDI	  	All (Excludes Life and Disability)	  	All	  	X	  	
						
	3.4(dd)	  	Claims Reporting	  	All	  	All	  	X	  	
						
	3.4(ee)	  	Benefit Testing Team	  	 All (excludes
 MHN)
	  	All	  	X	  	
						
	3.4(ff)	  	Claims Project Team	  	All	  	All	  	X	  	
						
	3.4(gg)	  	Manual Claims Accumulator Team	  	All (Excludes Life and Disability)	  	All	  	X	  	
						
	3.4(hh)	  	Audit Support Services	  	All	  	All	  	X	  	
						
	3.4(ii)	  	Claims Policy Support	  	All	  	All	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-4	  	Health Net / Cognizant Confidential

	3.	CLAIMS MANAGEMENT SERVICES 

  

	3.1	Claims Acquisition 

 Claim acquisition Services are those Functions associated with the
receipt of Claims and Claim-related collateral and information and uploading such documentation and information into the applicable Claims System(s) in preparation for adjudication. Supplier shall perform the Claim acquisition Services, including
those Functions listed in the roles and responsibilities table below, except for those Functions that are expressly identified as retained Health Net responsibilities in the roles and responsibilities table below. 

 

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 1.     Identify and re-route Claims and Claim-related collateral that were not mailed to the proper
address.
	  	X	  	
			
	 2.     Receive hardcopy paper-form Claims and Claim-related collateral, and
perform the following activities:
  

a.      date stamp all pages,

 
 b.     create a scanned
images of all pages,
  

c.     convert the information contained in such documentation to data files (e.g., using OCR
functionality combined with manual data validation and correction), and
  

d.     make available the scanned images and data files for uploading into the applicable
Claims System(s).
	  	X	  	
			
	 3.     Transmit EDI files containing claim information to Health Net for uploading into the applicable Claims
System(s). Examples of EDI files that are received include inbound Claims and Claims-related collateral / inquiries.
	  	X	  	
			
	 4.     Upload the scanned images and data files into the applicable Claims System(s). Assign document control
numbers to each Claim. Manually key, from the Claim images, all Claim information that is not automatically uploaded into the applicable Claims System(s).
	  	X	  	
			
	 5.     For Claim information submitted directly from Providers via a spreadsheet, manually enter such data
directly into, and create the associated Claims in, the applicable Claims System(s). Follow-up with the applicable Provider as needed to obtain missing data or corrected data, including by making telephone calls to Providers. Retain electronic and
hardcopy versions of the spreadsheets. For the avoidance of doubt, this is the pay and recovery process.
	  	X	  	
			
	 6.     Receive, review, analyze and enter data (including manually, where necessary) into the applicable
Claims Systems of prior period Claims history, and deductible and out-of-pocket expenses. For the avoidance of doubt, this is the manual cross-accumulator process.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-5	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 7.      For Claims that are pended because of a failure to identify or
match a Member or Provider:
  

a.     Verify the existence or non-existence of an active Member or an appropriate provider
record for the Claim in question, as applicable;
  

b.     If the provider exists, update the information on the Claim in order for the Claim to
be adjudicated and continue the adjudication process for that Claim;
  

c.     If the provider record does not exist, create an Service Form and provide to Health
Net all necessary information to have the provider record added, and once the provider record is established, update the Claim and continue the adjudication process; and
  

d.     If an active Member does not exist, contest the Claim and return it to the
sender.
	  	X	  	
			
	 8.     Route the Claim or other electronically submitted transaction type (e.g., 270/271) to the appropriate
adjudication / processing workflow.
	  	X	  	

  

	3.2	Claims Adjudication 

 Claims adjudication Services are those Functions associated with
adjudicating Claims, including by processing Claims to completion in accordance with Health Net Policies. Supplier shall perform the Claims adjudication Services, including those Functions listed in the roles and responsibilities table below, except
for those Functions that are expressly identified as retained Health Net responsibilities in the roles and responsibilities table below. 
  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     Validate that the Claim information in the applicable Claims
System(s) is correct, accurate and complete, including by comparing the information contained in the applicable Claims System(s) with the information contained on the Claim, Claim image or supporting documentation. Information to be validated
includes:
  

a.      Member information, including name, date of birth, eligibility, authorization
function, and date of service;
  
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-6	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 b.     Provider information, including tax ID number (with relevant
“suffixes” and/or Provider ID number), assignment of benefits flag, account number, billed amount, referring physician and facility name (if available). For Claims that do not have the servicing provider loaded in the applicable claims
processing system:
  

i.      Route the claim to the applicable team to have the provider record added and
monitor the system for notification that such record has been added; and
  

ii.     Once the provider record is established, update the Claim and continue the
adjudication process for that Claim.
  

c.     Coordination of benefit (“COB”) information, including by making sure all
non-Health Net insurance company information listed on explanations of benefits documentation attached to the Claim match the coordination of benefit information in the system.
  

i.      If Health Net is not the primary insurer for the Claim, validating that all
information regarding the primary insurance that is required for the Claim to be processed is attached to the Claim (e.g., if there is a primary insurance company, that there are Explanations of Benefit from such insurance company). If such
documentation is not attached, requesting such documentation, and
  

ii.     If there is a discrepancy between the COB information provided on the Claim and the
COB information contained in the claims processing system, notify the person/team responsible for maintaining the COB information in the system in order to research and resolve such discrepancy prior to finishing the adjudication of the affected
Claim;
  
 iii.    Supplier
will perform all services in respect to COB investigation including making outbound phone calls to members, providers, facilities, written communications and will update the COB maintenance screens accordingly. All COB inquiries should be completed
within five (5) business days unless the claim in question is facing interest penalties and or going out of compliance. At that point, Supplier must make the appropriate attempts to avoid penalties and going out of compliance by performing
related functions in fewer than five (5) days.
  

d.     Diagnosis information, including the Provider’s diagnosis, and whether or not it
is a Claim for which Health Net has a contract with a Provider (a “Contracted Claim”);
  

e.     Claim information, including billed amount, specific health care plan, detail around
each line item submitted (e.g., if there is both an office visit and a lab test, there should be two separate line items for each); and
	  		  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-7	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 f.      All secondary information that is required for the Claim to be processed is attached to the Claim
(e.g., if there is a secondary insurance a company, that there are Explanations of Benefit from such insurance company).
	  		  	
			
	 2.     Complete missing information using all available resource material.
If the missing information is not available, requesting the missing information via written correspondence or telephone calls, as required by Health Net Policies or Applicable Laws, to Providers and/or Members.

 
 a.     To the extent
such information is obtained, enter such information into the applicable Claims System(s) and request resubmission of the Claim (and if received, scan and upload the revised or additional Claim or Claim-related collateral into the applicable Claims
System(s)).
  

b.     To the extent such information cannot be obtained, deny or contest the claim, as
applicable, in accordance with Health Net Policies, and send the appropriate communications advising the Member or Provider, as applicable, of the missing information.
  

c.     In all cases, log all correspondence in the applicable Claims System(s).
	  	X	  	
			
	 3.      Review and address all system edits.
	  	X	  	
			
	 4.      Validate the following with respect to each Claim:

 
 a.     The eligibility
information associated with a Claim, including whether the Member is a valid Member of a group for the date of service, whether the Provider was eligible to provide service to the Member (e.g., Member/Provider matching, as required by the applicable
Benefit Plan), and whether the Member was eligible to receive services;
  

b.     The Claim was submitted in accordance with the Member’s policy (e.g., service
usage limits, out-of-network restrictions, pre-certification requirements) and/or the Provider’s policy;
  

c.     That coverage is provided for procedures and services listed on a Claim as part of the
Member’s benefits; and
  

d.     All necessary authorizations have been granted and medical determinations have been
made (e.g., whether the service was deemed medically necessary).
  

i.      To the extent that authorizations or medical determinations are missing or do
not align with the information on the Claim, route such Claim to the applicable person/team responsible for reviewing such information.
  

ii.     Upon receiving feedback from the applicable person/team responsible for reviewing
authorizations and making medical determinations, update the information in the applicable Claims System(s).    
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-8	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 5.     Identify and deny Claims submitted more than one time for the same
procedure and/or service (including by running adhoc reports). For potentially duplicate Claims, perform the following:
  

a.     If the later Claim is not a duplicate of the original submission, enable that later
Claim to continue through the process.
  

b.     If the later Claim is identified as a partial or complete duplicate (e.g., if the
original submission was for the same services) of the original submission, review the original submission to determine if the original submission or any portion thereof was correctly contested.

 
 c.     If any portion of
the original submission was incorrectly contested, enable the original Claim to continue through the process by manually reentering the Claim in the applicable Claims System(s) using the original Claim receipt date. Also allow the later Claim to
continue through the process, but ensure that the later Claim (or line items on a Claim) will be denied as a duplicate. After manually processing the corrected services, cancel the contested letter of the originally submitted claim.

 
 d.     If any portion of
the original submission was correctly contested, and the later Claim does not contain the missing information, enable that later Claim to continue through the process and re-contest.

 
 e.     If any portion of
the original submission was correctly contested, and the later Claim contains the missing information, correct those components of the original Claim that were incorrect or missing to enable the original Claim to continue through the process or
re-enter the information including cancelling the original contest (using the date of receipt when the corrected information was provided). Also, allow the later Claim to continue through the process, but ensure that the later Claim (or line items
on a Claim) will be denied as a duplicate.
	  	X	  	
			
	 6.     Identify potentially fraudulent Claims and route them to Health Net for further review. At the
direction of Health Net (including as to whether any such Claim should be approved or contested), continue the Claims adjudication process for such Claims.
	  	X	  	
			
	 7.     Determine the amount of the benefit and calculate the Member’s liability (to the extent the
applicable Claims System does not automatically do so), in each case in accordance with the Member’s benefits, Health Net’s contract with the Provider and Health Net Policies, including by:
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-9	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 a.     In accordance with Health Net Policies, submitting non-Contracted
Claims to the applicable Health Net’s third party pricing vendor to determine possible discount pricing for such Claims (and confirm the same number of Claims submitted are received back), and

 
 i.      Validating
that the same number of Claims submitted to third party pricing vendors are processed and received back, and
  

ii.     To the extent the third party pricing vendor cannot completely price the Claim,
performing the activities described in 7.b below;
  

b.     For (x) Contracted Claims, (y) Claims that go to a third party pricing, but
for which the third party pricing vendor cannot completely price the Claim, and (z) other Claims that do not go to a Health Net third party pricing vendor, manually price the Claim, including by:

 
 i.      researching
pricing (e.g., using appropriate websites (as designated by Health Net) pricing tools and published fee schedules (e.g., for Medi-Cal, Medicare) to obtain the correct price, coordinating and working with Health Net as necessary printing out the
pricing sheets used to perform the manual pricing, and scanning and attaching those pricing documents into the applicable Claims System(s));
  

ii.     applying the coordination of benefit amount, if any;

 
 iii.    calculating, where
necessary, the “usual and customary” amount, including by considering all factors based on the type of plan (e.g., in-network versus out-of-network, emergency services); and

 
 iv.    as applicable,
determining, either manually (e.g., my using on-line Division of Financial Risk (DOFR) tools) or automatically (e.g., by executing the DOFR module linked to the claims processing system), the appropriate risk factor to determine whether a
Participating Provider Group (PPG) is responsible for all or part of the Claim.
  

1.     Except as described in Section 7.b.iv.2, below:

 
 a.     To the extent a
PPG is responsible for all of the Claim, deny such Claim and forward the Claim to the PPG; and
  

b.     To the extent a PPG is responsible for part of the Claim, process and pay that
portion of the Claim for which Health Net is responsible, and perform the activities described in 7.b.iv.1.a, above, with respect to that part of the Claim that is the responsibility of the PPG.

 
 2.     At the specific
direction of Health Net in certain circumstances:
  

a.     Manually over-ride the system and process Claims that are the PPG’s
responsibility, and
	  		  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-10	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 b.     Enter the necessary information into the applicable Claims System(s) so that there is a capitation
deduction made against that PPG.
	  		  	
			
	 8.     Resolve all issues related to a Claim that are identified either by
Supplier’s Quality Audit Services described in Section 3.4(hh), including:
  

a.      Reviewing requests to correct Claims adjudication errors;

 
 b.      Contesting
such requests in accordance with Rebuttal Process described below in Exhibit A-2; and
  

c.      Correcting all errors in the claims processing systems.
	  	X	  	
			
	 9.     Appropriately code each Claim in the applicable Claims System(s) at
all stages during the processing of the Claim, including by using the following coding categories as applicable:
  

a.     Pending the Claim, using the appropriate pending codes (as determined in accordance
with Health Net’s policies and procedures), if other processes or Health Net business units need to investigate any aspect of the Claim. Examples of potential pend (which may differ across the different claims processing system(s)) include
provider update, eligibility, configuration health services (e.g., unlisted codes, missing authorizations), review with team lead or supervisor, high dollar claims exceeding Supplier’s management dollar authority limit.

 
 b.     Contesting the
Claim if additional information or documentation is required from the Employer Group, Member or Provider, including by coding the Claim as contested, adding a detailed description around what is required in order to continue processing the Claim,
and requesting the appropriate notification letter; and
  

c.     Denying Claims that do not meet eligibility requirements, including by coding the
Claim with the appropriate denial code, and adding a detailed description of why the Claim was denied.
	  	X	  	
			
	 10.   Taking appropriate action to resolve (or effectuate the resolution of), using all available resource material,
pended Claims in a timely manner, including by, on a daily basis, monitoring and resolving where possible pended claims and ensuring escalation of any Claims that remain pended for a longer period of time than permitted by Health Net policies and
procedures.
	  	X	  	
			
	 11.   Once Supplier has received additional documentation for Contested Claims or previously processed Claims, then as
applicable, upload the information into the applicable Claims System, attach the image to the appropriate Claim and complete the Claims adjudication process.    
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-11	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 12.   Once adjudicated, if the Claim requires a manual check, returning that Claim to Health Net for manual check
processing.
	  	X	  	
			
	 13.   For Claims processed in the QCare Claims System, balance Health Net’s check register against the reports from
QCare and approve the release of the checks; perform trending analysis over prior months and identify large variances in the dollar amounts. If significant variances are identified, notify the applicable Health Net groups in accordance with Health
Net Policies. For Claims processed in the QCare or MC400 Claims Systems, coordinate regularly with Health Net’s OCOE to ensure that checks are printed and mailed on time (including to account for holidays).
	  	X	  	
			
	 14.   While Claims Adjudication does not have any specific Medicare Part C & D
Star Ratings, Claims Adjudication plays a significant part in the customer experience. Supplier must ensure that the current Star measures are not directly impacted in a negative manner.

 
 Current Star Ratings (which can change quarterly or yearly by CMS)
impacted by Claims Adjudication include:
  
 •
    C22 Customer Service
  
 •
    C24 Overall Rating of Plan
  
 •
    C26 Complaints about the Health Plan
  

•     C27 Beneficiary Access & Performance Problems

 
 •     C28 Member Choosing to Leave the
Plan
  
 •     C29 Improvement

 
 •     C30 Plan Makes Timely Decisions about
Appeals (Member appeals portion)
  
 •
    C31 Reviewing Appeals Decisions (Member appeals portion)
  

•     D02 Appeals Auto-Forward (Applies to Members only)

 
 •     D03 Appeals Upheld (Applies to Members
only)
  
 •     D04 Complaints about the Drug
Plan
  
 •     D05 Beneficiary
Access & Performance Problems
  
 •
    D06 Member Choosing to Leave the Plan
  

•     D07 Improvement
	  	X	  	
			
	 15.   At the request of Health Net, for (a) unique and/or difficult contract administration of provider contracts,
or (b) with respect to processing trends that are identified, which are not meeting service level objectives, the Responsible Party may create specialized units or identify dedicated team members to achieve or remediate service level
objectives.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-12	  	Health Net / Cognizant Confidential

	3.3	Claim Adjustment and Post-Pay Activities 

 Claims adjustment and post-pay Services are
those Functions associated with the adjustment of Claims, the recovery of monies overpaid to Members (if applicable) or Providers, and other post-pay related activities. Supplier shall perform the Claims adjustment and post-pay Services, including
those Functions listed in the roles and responsibilities table below, except for those Functions that are expressly identified as retained Health Net responsibilities in the roles and responsibilities table below. 

 

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     Respond to inquiries from the Contact Center or Health Net to facilitate resolution of Member
grievances and appeals, including by determining whether any errors were made during the Claims adjudication process.
	  	X	  	
			
	 2.     Receive (either directly or via the Contact Center), track, and resolve Provider Claims disputes (e.g.,
regarding allegedly incorrectly processed Claims) and inquiries (e.g., questions regarding reimbursements, billings and payments associated with services they have performed), including as required by Exhibit A-1 to this Exhibit A. This applies to
all Lines of Business, including Medi-Cal (SHP).
	  	X	  	
			
	 3.     There are specific Medicare Part C & D Star Ratings pertaining to Provider Appeals. Supplier must
ensure that these Star items are met in accordance with the Service Levels in Exhibit B-1 (Operational SLA’s).
	  	X	  	
			
	 4.     Supplier to cooperate and coordinate with Health Net review nurses for clinical
determinations.
	  	X	  	
			
	 5.     Respond to inquiries from Health Net regarding adjudicated Claims, including as a result of Health
Net’s post-pay audit activities or other focused auditing, regulatory reviews, legal research, or similar activities.
	  	X	  	
			
	 6.     Perform post-payment review and auditing to identify errors in the Claims adjudication Services,
including as a result of missed or incorrectly applied coordination of benefits, retroactive terminations and/or reinstatements, or otherwise resulting from Supplier error. For the avoidance of doubt, this is in addition to (and not in lieu of) any
post-payment review and auditing performed by Health Net or a Health Net third party recovery vendor pursuant to item #11.
	  	X	  	
			
	 7.     Research and review errors related to Claims that are identified or determined as a result of items 1-
5, above, or otherwise determined by Health Net or Supplier, and determine whether the original Claim determination should be upheld (i.e., no changes needed) or overturned (an adjustment is required), including by following up with the applicable
Provider and/or coordinating with other Supplier and Health Net groups (e.g., Health Net legal, Health Net’s provider network management team). Such research and review shall include:    
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-13	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 a.     performing the relevant Claims adjudication Services to determine
the validity of the Claim (e.g., eligibility determinations, authorizations obtained, covered service determinations, etc.), and
  

b.     coordinating with other teams as needed to determine the validity of the Claim (e.g.,
Medical Management in the case of validating the authorizations).
  

Document, where necessary, such determination in the applicable Claims System(s) and/or other documentation, as required by Health Net
Policies.
	  		  	
			
	 8.     Respond to and resolve Claims-related inquiries (including requests for ad hoc reports) from other
Towers and other Health Net business units.
	  	X	  	
			
	 9.     For incorrectly processed Claims, perform the necessary activities
in the applicable Claims System in order to correct such Claim.
  

a.     If an adjustment is required in order to pay additional monies to a Member or
Provider, enter the adjustment in the applicable Claims System (including entering the appropriate date information based on Health Net Policies) and perform all necessary Claims adjudication Services based on the new, updated or corrected
information.
  

b.     If a receivable is required in order to collect overpaid amounts, create such
receivable in the applicable Claims System(s) and commencing recovery efforts as described in item #10.
	  	X	  	
			
	 10.   Perform a root cause analysis to determine the cause of the problem resulting in an adjustment request and taking
such action as necessary to prevent the problem from reoccurring.
	  	X	  	
			
	 11.   For incorrectly processed Claims that resulted in an overpayment to a Member or
Provider, determine whether any such payment made is recoverable (including in accordance with Laws, Regulators, contracts and Health Net Policies, or otherwise at the direction of Health Net). Overpayments to Members are only recoverable at the
express direction and approval of Health Net. For any such payment that is recoverable, recover such monies in accordance with Laws and Health Net Policies, including as follows:

 
 a.     Where permitted
by Law, Regulators, contracts and Health net Policies or otherwise at the direction of Health Net, automatically deducting such amounts from future payments to the Member or Provider,

 
 b.     Sending
notification letters,
  

c.     As requested by Health Net, coordinating with a Health Net third party collection
agency for them to attempt to recover such amounts, and
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-14	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 d.     Update the applicable Claims System(s) as necessary to
(i) reflect recovery of any such amounts or (ii) in accordance with Health Net Policies or otherwise only to the extent Health Net has approved for amounts not recovered, reflect write-off of any such amounts.

 
 For the avoidance of doubt, this is in addition to (and not in lieu
of) any recovery efforts performed by Health Net or a Health Net third party recovery vendor pursuant to item #11.
	  		  	
			
	 12.   In coordination with a Health Net third party recovery vendor:

 
 a.     Perform
post-payment review and auditing to determine any payments made in error and potential recovery amounts,
  

b.     If an overpayment to a Member or Provider is identified, determine whether any such
payment made is recoverable (including in accordance with Laws and Health Net Policies), and
  

c.     For any such payment that is recoverable, recover such monies in accordance with Laws
and Health Net Policies. Such recover efforts include sending notification letters and/or making phone calls to the applicable Member or Provider. If recovery is obtained, all relevant information and monies to Health Net or Supplier, as
applicable.
	  	X	  	
			
	 13.   Upon notification by Health Net, update the applicable Claims System(s) as necessary to reflect the adjustment
required as determined by item #11 and the recovery of the applicable monies.
	  	X	  	
			
	 14.   Determine if a Claim is eligible for subrogation, and initiate subrogation process and collections in accordance
with regulatory guidelines.
	  	X	  	
			
	 15.   Perform the following finance-related activities associated with Claims
processing:
  

a.     Upon notification by Health Net, post all refunds and credits to applicable Claims
System(s), including by coordinating with other Supplier and Health Net groups to identify the correct Member associated with the refund/credit; update all logs required by Health Net, including Health Net’s finance organization.

 
 b.     Receive and
process check void requests in the applicable Claims System(s).
  

c.     Receive stop payment requests (or otherwise discover the need to issue a stop
payment); complete a check tracer to confirm that the check has not been cashed; record the stop payment in the applicable Claims System; and if applicable from the stop payment request, designate that the check should be re-issued and specify the
appropriate payee for such re-issue.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-15	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 d.     Identify (in accordance with Laws and Health Net Policies)
stale-dated payments to Members or Providers that have not yet been deposited, including by completing a check tracer to confirm that the check has not been cashed; submit, as applicable, a check void request or a check stop payment request to the
Check Void Support or Check Stop Payment Support Processes, respectively; determine whether the check should be re-issued and notify the Check Re-Issue Process accordingly.
  

e.     Designate in the applicable Claims System(s) that a check needs to be re-issued, and
confirm/specify the appropriate payee information for such re-issue.
  

f.      As required by Health Net Policies, monitor Member accounts in order to identify
all the Negative Vendor Records; research and review the Negative Vendor Records to determine the cause of the Negative Vendor Record; and correct Negative Vendor Record in the applicable Claims System(s), including by processing the Negative Vendor
Record in the appropriate order so that such record posts as a positive result. “Negative Vendor Record” means a record in the applicable Claims System(s) that indicates that an account maintains a negative balance.

 
 g.     Review the tax
lien report prepared by Health Net and stop the applicable checks from being mailed to the payee; submit a check void request to the Check Void Support Process for the original check; re-enter the Claim, and include all notes in the applicable
system – to insure all year end reporting is accurate (1099’s).
	  		  	

  

	3.4	Other Claims Functions 

 Other Claims Functions are those additional Functions described
in this Section 3.4 related to the Claims Management Services not already addressed in Sections 3.1 through 3.3. Supplier shall perform the additional Claims Management Services, including those Functions listed in the roles and
responsibilities table below, except for those Functions that are expressly identified as retained Health Net responsibilities in the roles and responsibilities table below. 
  

	 	(a)	Life and Disability Processing and NYHCRA payments 

  

					
	SOW#1 (Claims) Exhibit A	  	A-16	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     In accordance with Health Net Policies, preparing ((including
manually (100% manual – no core adjudication system)), as required) and submitting to Health Net the appropriate written correspondence in the course of performing the Claims Management Services, including:

 
 a.      Life
Insurance Claims. Manually calculate including any applicable interest.
  

b.      Disability Insurance Claims. Manually calculate including any applicable
interest.
  

c.      Monthly NYHCRA payments.
	  	X	  	
			
	 2.     Coordinating with Health Net business units as necessary to perform the Claims Management Services
(e.g., coordinating with Health Net’s medical management group and or legal if a determination is necessary in relationship to cause of death.
	  	X	  	
			
	 3.     Coordinate with beneficiaries in both written and verbal format (must have a dedicated phone number for
contact) for additional information.
	  	X	  	
			
	 4.     Research, update and provide written communications to beneficiaries including but not limited to claim
determination, request for information and any other applicable documents.
	  	X	  	
			
	 5.     Archive (as required by Law, this Agreement, and Health Net’s Policy on records retention)
Claims-related data and stored images of Claims and Claim-related collateral and retrieve such data and images as necessary to perform the Services or otherwise at the request of Health Net.
	  	X	  	
			
	 6.     Maintain daily inventory and report out to HN.
	  	X	  	
			
	 7.     Perform monthly reporting to finance.
	  	X	  	
			
	 8.     Remain compliant as identified by regulators and or HN policy.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-17	  	Health Net / Cognizant Confidential

	 	(b)	CMS Incentives 

  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     In accordance with Health Net Policies, preparing ((including
manually (100% manual – no core adjudication system)), as required) and submitting to Health Net the appropriate written correspondence in the course of performing the Claims Management Services, including:

 
 a.     CMS Incentives
for the Medicare line of business for applicable claims on both ABS and MC400 as identified CMS regulations.
	  	X	  	
			
	 2.     Running of all applicable reports necessary to perform manual calculations.
	  	X	  	
			
	 3.     Perform Calculation Required.
	  	X	  	
			
	 4.     Request related incentive checks through the SAP system.
	  	X	  	
			
	 5.     Bind checks with appropriate back-up documentation and supply to mail services for mailing.
	  	X	  	
			
	 6.     Maintain appropriate back-up as required and defined by retention management.
	  	X	  	
			
	 7.     Perform appropriate reporting to finance.
	  	X	  	

  

	 	(c)	Perform (QCare) MediCal and File Net Testing 

  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     Perform QCare (core adjudication system) and File Net (work flow system) testing and validation of
system enhancements, upgrades, benefits and any other functions necessary to insure accurate adjudication.
	  	X	  	
			
	 2.     Running of all applicable reports necessary to perform testing.
	  	X	  	
			
	 3.     Report out on testing results and provide “Go / No Go” decisions.
	  	X	  	
			
	 4.     Actively participate in BARR/Project creation and necessary meetings to support objective.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-18	  	Health Net / Cognizant Confidential

	 	(d)	Performance Group Processing 

 Performance Groups are employer groups who have performance
penalties assessed based on monthly, quarterly, semi-annual or annual outcomes. Typical penalties from a claims standpoint are related to accuracy (all types), turn-around time, and or adjustment/re-work opportunities. There are Performance Groups
for all respective regions including MHN. A list of performance groups will be attached with their corresponding goals in the P5 Metric Analysis labeled Performance Groups. It should be noted that there are currently 4 specific performance groups
that require all functions related to claims processing be performed onshore. This includes, triage, claims intake, provider disputes, adjustments, recoveries, medical management and any other function required to complete a claim. The 4 groups in
question are as follows: Verizon, Boeing, UC and SCE with UC representing nearly 10% of the entire book of business for CA. This would apply to HNCA, HNOR, HNAZ and MHN. 
  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1.     Process all claims, adjustments, and recovery functions in accordance with established
contracts.
	  	X	  	
			
	 2.     Running of all applicable reports necessary to achieve desired outcomes.
	  	X	  	
			
	 3.     Insure segregation of duties between off-shore and off-shore claims processing to avoid fines,
penalties or loss of group/revenue.
	  	X	  	
			
	 4.     Report out on a monthly basis to various leaders performance outcomes by group.
	  	X	  	
			
	 5.     Respond to and implement corrective action plans as necessary.
	  	X	  	
			
	 6.     Respond and prepare to outside out-side audits and site visits with in-person representation. Typically
2 – 4 audits per year.
	  	X	  	
			
	 7.     Create audit files for outside audit reviews.
	  	X	  	
			
	 8.     Initial response to all RFPs requests from sales and/or Health Net leadership for new and existing
business.
	  	X	  	
			
	 9.     Provide final response on RFP requests after initial assessment performed.
	  		  	X

  

	 	(e)	Reinsurance 

 Reinsurance Services are those Functions to provide Reinsurance claims processing
to approximately 12 – 15 medial groups. In today’s current environment there are system limitations based on the software needed to perform these functions off-shore. The team consists of approximately 13 associates (excluding leadership).

  

					
	SOW#1 (Claims) Exhibit A	  	A-19	  	Health Net / Cognizant Confidential

					
	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 1. In accordance with Health Net Policies, contracts and Provider Policy manually and systematically prepare reinsurance claims to be
processed through ABS.
	  	X	  	
			
	 2. Running of all applicable reports necessary to perform manual calculations.
	  	X	  	
			
	 3. Perform Calculations Required.
	  	X	  	
			
	 4. Enter related claims information into ABS for adjudication.
	  	X	  	
			
	 5. Answer related questions/inquiries through either MACESS Service Forms and or by Phone from PPG and or Finance.
	  	X	  	
			
	 6. Maintain appropriate back-up as required and defined by retention management.
	  	X	  	
			
	 7. Perform appropriate reporting to finance on a monthly basis up to and including accruals for expected reimbursements.
	  	X	  	

  

	 	(f)	Manual Claims Processing for NE and AZ MC400 Related Claims from 1/1/2015 forward (for claims with a received date equal to or greater than 1/1/2015). 

 

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1. Health Net will decommission the MC400 effective 1/1/2015 and will be required to perform manual claims adjudication for AZ and NE
claims.
	  		  	
			
	 a. 100% manual claims adjudication including but not limited to accumulator calculations, contract look-up, archiving, validation,
mailing, collating checks and backers for appropriate regulator, responding to inquiries both in written and verbal format.
	  	X	  	
			
	 2. Running of all applicable reports necessary to perform manual calculations.
	  	X	  	
			
	 3. Perform Calculation Required.
	  	X	  	
			
	 4. Request related incentive claims checks through the SAP system.
	  	X	  	
			
	 5. Bind checks with appropriate back-up documentation and supply to mail services for mailing.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-20	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 6. Maintain appropriate back-up as required and defined by retention management.
	  	X	  	
			
	 7. Perform appropriate reporting to finance.
	  	X	  	
			
	 8. Validating appropriate 1099 calculations.
	  	X	  	

  

	 	(g)	Legal 

  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 1. In accordance with Health Net Policies and Procedures, Supplier will support Health Net Legal Department with the following
(currently a team of 6 individuals and one leader);
	  		  	
			
	 a. Review of legal matters related to claims adjudication. This includes but is not limited to review of spreadsheets, analysis of
underpayments and overpayments, manual calculations of claims and supply the Health Net Legal Team with said documents, spreadsheets and analysis.
	  	X	  	
			
	 b. Production of claims related documents and electronically stored information in the course of discovery and in response to requests
for production, subpoenas or civil investigative demands in all legal proceedings.
	  		  	
			
	 c. Testify in a court of law, depositions and arbitrations and in connection with claims-related matters as well as participation in
mediations and settlement meetings.
	  		  	
			
	 2. Running of all applicable reports necessary to perform manual calculations at the request and direction of Health Net legal
counsel.
	  	X	  	
			
	 3. Respond within the applicable timeframe, which is typically one (1) to two (2) weeks, or defined by either the Health Net
Legal Team or by the timeframes set in the litigation at hand with enough time for Health Net Legal to review.
	  	X	  	
			
	 4. Perform calculations requested by or on behalf of Health Net legal counsel.
	  	X	  	
			
	 5. Trend and analyze claims at the request and direction of Health Net legal counsel. In some instances this could be a random sampling
or a complete analysis of each claim identified.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-21	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 6. Support creation of policy changes as necessary and or system enhancements.
	  	X	  	
			
	 7. Adjust claims as required.
	  	X	  	
			
	 8. Maintain appropriate back-up as required and defined by records and Information Management Policy and Health Net Legal.
	  	X	  	
			
	 9. Perform appropriate reporting to finance for reserve and actuarial purposes.
	  	X	  	
			
	 10. Provide assistance and backup in handling of special claims projects for settlement and evaluation purposes of litigation
risks at the request and direction of Health Net legal counsel. It is agreed and understood that the members of this team will perform tasks at the direction of Health Net legal Department; that any and all communications between Health Net’s
legal Department, it’s in house and outside counsels and the members of this team are considered to be confidential and subject to attorney client privilege, the attorney work product doctrine and common interest Privilege.
	  	X	  	

  

	 	(h)	Medicare Secondary Payor Request Team 

  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 1. In accordance with Health Net Policies and Procedures, and CMS Guidelines, HN must respond to inquiries from either Employer Groups
and or Medicare surrounding claims “possibly” incorrectly paid by Medicare as primary.
	  	X	  	
			
	 a. Intake of request (typically request comes from Medicare hard copy paper).
	  		  	
			
	 b. Date stamp, review, scan and acknowledge.
	  		  	
			
	 2. Perform required research necessary to determine primacy.
	  	X	  	
			
	 3. Respond within the requested/required time frame.
	  	X	  	
			
	 4. Create adjustment in Claims adjudication system for payment.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-22	  	Health Net / Cognizant Confidential

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 5. Adjust claims as required.
	  	X	  	
			
	 6. Maintain appropriate back-up as required and defined by retention management.
	  	X	  	
			
	 7. Update appropriate COB related screens.
	  	X	  	

  

	 	(i)	Pay and Recover 

 Pay and Recover is typically defined as a service provided by a PPG that is HN
risk that Health Net needs to reimburse related services back to the PPG within the contractual agreed upon time frames. (Primarily Sutter) 
  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	HN
	 1. Intake of a pay and recover item typically comes in the form of a spreadsheet through a secured
transmission to Health Net. Health Net has agreed upon contractual agreements to;
  

a. Acknowledge spreadsheets.
  

b. Review and respond to each claim item on the spreadsheet and return spreadsheet with responses.

 
 c. Perform multiple reconciliations with
Sutter on disputed pay and recover items and “new day items.”
  

d. Work in conjunction with the PNAs and Legal Team in arbitrations/litigation specific to “pay and
recover.”
  
 e. Analyze
reconciliations for possible settlements.
	  	X	  	
			
	 2. Create a claim for each line item within ABS even if no payment is due.
	  	X	  	
			
	 3. Respond back with each spreadsheet through the secured website back to Sutter.
	  	X	  	
			
	 4. Insure that any member identified as a “performance group” member for any of the 4 specific performance groups are
performed onshore for any “pay and recover” item.
	  	X	  	
			
	 5. Retain spreadsheets in secure location as required by retention management.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-23	  	Health Net / Cognizant Confidential

	 	(j)	Accumulator Updates 

  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1. Review requests received from multiple sources (contact center, Sales, direct correspondence, etc.,) in respect to incorrect
accumulations.
	  	X	  	
			
	 2. Running of all applicable reports (dump of data from various databases including but not limited to pharmacy, medical, mental
health) necessary to perform manual calculations.
	  	X	  	
			
	 3. Perform calculations requested to validate.
	  	X	  	
			
	 4. Respond back to requestor within thirty (30) days or less of original receipt date.
	  	X	  	
			
	 5. Adjust claims as required.
	  	X	  	
			
	 6. Maintain appropriate back-up as required and defined by retention management.
	  	X	  	

  

	 	(k)	REPER processing 

 A REPER is a claim that needs to be reprocessed, which is typically based on
additional charges being added to an original claim, or additional information coming in to a previously contested claim. 
  

					
	 	  	 Responsible Party

	 Roles and Responsibilities
	  	 Supplier
	  	 HN

	 1. Review and process all REPER related claims within the regulatory time frames and or sooner based on contractual time frames such as
“performance group processing).
	  	X	  	
			
	 2. REPER analysis will also be done on a monthly basis and trends will be shared with senior leadership.
	  	X	  	

  

	 	(l)	Compliance 

  

					
	SOW#1 (Claims) Exhibit A	  	A-24	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Review, update and implement compliance regulations. This will include the following (incorporate
HNCA, HNOR, HNAZ, HNWA, NE, MHN (all):
  

a. In conjunction with HN Corporate Compliance (these individuals) will interpret compliance regulations and
implementing necessary changes.
  
 b. Will
also include the creating and implementation of project briefs through implementation and testing of any systematic changes.
  

c. Training of associates on compliance related changes and or refresher of existing regulations.

 
 d. Participation in on-site HEDIS audit and
follow-up on any items requested during the HEDIS audit.
	  	X	  	
			
	 2. Validation of compliance reporting and metrics as necessary/required.
	  	X	  	
			
	 3. Respond within the requested time frames defined by either the HN Legal

Team or HM Compliance for guidance and interpretation.
	  	X	  	
			
	 4. Final validation of existing regulations to ensure compliance.
	  		  	X

  

	 	(m)	Financial Reporting/Analytics 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Perform various functions to validate and insure appropriate integrity of data and will participate on monthly finance and quarterly
calls.
	  	X	  	
			
	 2. On a daily basis validate that the EIS (Everybody Information System) system is updated, current
and correct.
  
 a. Discrepancies identified
will be reported through the remedy system and key personnel supporting EIS.
  

b. If necessary, participate in creation of BARR/Project to correct data and support testing and
validation.
	  	X	  	
			
	 3. Participate, analyze and provide data to finance/actuary in respect to Day 3 and Day 4 reporting on a monthly and quarterly
basis.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-25	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 4. Maintain and update monthly report card and do analysis on PDRs, REPERS, Denials.
	  	X	  	
			
	 5. Do predictive modeling, analytics and forecasting and partner with Finance and Actuary on a daily, weekly, monthly, quarterly,
semi-annual and annual basis.
	  	X	  	
			
	 6. Approve/Validate Weekly QCare check registers for MediCal claims processing each Monday.
	  	X	  	
			
	 7. Approve/Validate Weekly MC400 check registers and interest reports for MC400 related claims (NE and AZ) as identified for DOS prior
to 1/1/2013.
	  	X	  	
			
	 8. Monthly and Quarterly MTR reporting for Medi-Cal and MHN with supporting back-up.

 
 a. Maintain back-up in a secured
location.
  
 b. Use appropriate tools for
reporting.
	  	X	  	
			
	 9. SOX Controls
  

a. Validate all SOX Controls.
  

b. Run all necessary reports for validation.

 
 c. Participate in SOX Audits.

 
 d. Respond to all SOX inquiries within
established time frames either dictated by policy or auditor request for both pre-pay, and post SOX review.
	  	X	  	
			
	 10. Maintain appropriate back-up as required and defined by retention management.
	  	X	  	
			
	 11. Perform appropriate reporting to finance.
	  	X	  	

  

	 	(n)	Vendor Oversight – List of Vendors to be included in Metric Analysis Document (excel document 

  

					
	SOW#1 (Claims) Exhibit A	  	A-26	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. In accordance with Health Net Policies and Procedures, support vendor oversight of multiple
suppliers of related services for accurate, timely claims adjudication and will insure compliance and appropriate controls as necessary. Functions will include but will not be limited to the following:

 
 a. Validating incoming and outgoing file
transmissions.
  
 b. Working with vendors
via phone, email, and face-to-face on issues and discrepancies.
  

c. Insuring privacy and compliance.
  

d. Invoice validations and reimbursement through the creating of purchase orders and check requests.

 
 e. Insure Compliance.

 
 f.  Work on system modifications/edits.
g. Validate and request work orders.
  

h. Collaborates with Internal Audit on site reviews and other reviews.
	  		  	X

  

	 	(o)	Disaster Recovery 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Disaster Recovery – maintain disaster recovery plan and participate in all required disaster
recovery activities.
  
 a. Applies to all
HN Entities including MHN.
	  	X	  	

  

	 	(p)	Privacy 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Respond to Privacy Incident Inquiries within one (1) to two (2) business days (applies
to all HN entities including MHN).
  

a. Investigate and analyze all privacy incidents brought forward related to claims processing, up to and
including adjustments, reimbursement, recoveries, edi, and paper submission and forwarding.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-27	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 b. Root cause where appropriate.

 
 c. Work with other related vendors and
communicate in writing and via phone where/when necessary.
  

d. Create formal CAPs (Corrective Action Plans).

 
 e. Implement corrective action plans,
project briefs and or minor enhancements.
	  		  	

  

	 	(q)	Provider Reimbursement Specialist 

  

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 1. Provider Reimbursement Specialist – Individual exempt associates assigned specific high
profile accounts to analyze claims data and metrics to perform the following functions;
  

a. Review various payment, denial, PPG liability trends.

 
 b. Act as a point of contact for
providers/facilities to resolve systemic claims issues.
  

c. Meet with individual providers in person and via phone for JOMT meetings.

 
 d. Partner with Provider Network Management
in resolving complex issues.
  

e. Recommend and or initiate policy updates f. Identify process efficiencies.
	  	 	X	  	  	

  

	 	(r)	Shared Risk Discrepancy 

  

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 1. Share Risk Discrepancy Reporting

 
 a. Respond to PPGs/Sales surrounding
discrepancy in respect to risk determination in writing.
	  	 	X	  	  	
			
	 b. Document and log related actions.
	  				  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-28	  	Health Net / Cognizant Confidential

	 	(s)	Pre-Pay Audit Functions 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
			
	 1. Supplier will provide all pre-pay audit functions.
	  	X	  	
			
	 2. Perform pre-payment review and auditing to identify errors in the Claims adjudication Services, including as a result of missed or
incorrectly applied coordination of benefits, retroactive terminations and/or reinstatements, supplier error in claims adjudication, vendor error and all other related errors to insure complete and full compliance.
	  	X	  	
			
	 3. Incorporated into the pre-payment functions until otherwise notified will maintain various inventory levels as identified by Health
Net finance within audit (supplier must remain compliant).
	  	X	  	
			
	 4. Supplier will provide pre-payment monthly metrics and will be required to educate, trend and analyze errors for process
improvement.
	  	X	  	

  

	 	(t)	Recovery Functions 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Supplier would take on the responsibility of all aspects of the recovery process. This includes
but is not limited to;
  
 a. Creating
recovery letters.
	  	X	  	
	  
 b. Validating recovery
letters for accuracy and grammar.
  

c. Manual tracking recovery dollars via an excel spreadsheet.

 
 d. Posting recovery refunds in the core
adjudication systems.
  
 e. Coordinating
with Finance recovery refunds.
	  		  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-29	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 f.  Working with collection agencies.

 
 g. Setting up recoveries in core
adjudication systems.
  
 h. All scanning
and clerical functions related to recoveries.
  

i.  Report to finance recovered dollars.

 
 j.  Work adhoc reports identified by
finance, network, call center associates and or others that identify potential and real recoveries.
  

k. Work with recovery vendors and act as the liaison for related vendors such as:

 
 1.    Rawlings

 
 2.    AIM

 
 3.    CDR

 
 4.    HRI Trover (Trover
Solutions).
  
 5.    Capital
Recovery
  
 6.    GB
Collects
  
 7.    Sovereign
Receivables
  
 8.    HMS

 
 9.    RMS

 
 10. HDI

 
 11. CAQHC
	  		  	
			
	 2. Solicited refunds will be processed within five (5) calendar days.
	  	X	  	
			
	 3. Non-Solicited refunds will be processed within thirty (30) calendar days.
	  		  	
			
	 4. Outbound phone calls as appropriate to recover overpayments.
	  	X	  	
			
	 5. Respond to inbound phone calls are appropriate to handle inquiries.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-30	  	Health Net / Cognizant Confidential

	 	(u)	Desk Top Policy and Procedure Creation, Reviewing and Curriculum Development 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Create, validate and approve (as appropriate) desktop policy and procedures along with curriculum for training.
	  	X	  	
			
	 2. Perform annual review of each desktop policy and procedure and update accordingly for all core adjudication systems and policies and
procedures.
	  	X	  	
			
	 3. Will hold weekly meetings to go over desk to policies and procedures and will be required to do
the following:
  
 a. Coordinate with other
operational departments for review and input to policies and procedures.
  

b. Send out documentation to all “voting members” and validate responses and resolve discrepancies to
responses.
  
 c. Internally disseminate to
claims examiners and leadership policy updates.
  

d. Train and conduct team meetings and insure materials are reviewed and keep supporting documentation of related
review.
	  	X	  	
			
	 4. Validate and update “National Policy” documentation related to claims adjudication and compliance. In addition, will
update related policies as appropriate and seek appropriate approvals where necessary.
	  	X	  	
			
	 5. Support development of claims curriculum and partner with the training department to deliver related curriculum.
	  	X	  	
			
	 6. Ensure that materials, policies and procedures are delivered to appropriate claims teams timely and within all regulatory and
compliance time-frames.
	  	X	  	

  

	 	(v)	Clerical Functions 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Support all related departmental clerical functions required. This includes but is not limited to
(includes all HN entities as well as MHN).
  

a. Review, date stamping, delivery of incoming mail (includes claims, correspondence, legal documents,
miss-routed documents, etc.
  

b. Photocopying and scanning of documents into appropriate workflow systems.

 
 c. Triaging of documents into work flow
systems and or delivering of documents to appropriate personnel.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-31	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 d. Ordering supplies for team members.

 
 e. Maintaining fax, photocopy machines and
reporting outages.
  
 f.  Inventorying
documents received and reporting on a daily, weekly, monthly basis as appropriate.
  

g. Deleting of claims after approval in core adjudication system (x-delete).
	  		  	
			
	 2. QCare manual claims set-up. QCare is uniquely different then ABS and requires manual claims set up for certain adjustment
types.
	  	X	  	

  

	 	(w)	Eligibility Guarantee 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Perform eligibility guarantee calculations and adjudication using the Eligibility Guarantee
Program and ABS and communicate results and or additional payment through ABS and manual notifications.
  

a. Review, date stamping, delivery of incoming mail/claims/spreadsheets. b. Photocopying and scanning of
documents into appropriate workflow systems.
  

c. Enter results into ABS.
  

d. Provide Finance/Actuary with monthly reporting of remaining inventoried claims.
	  	X	  	

  

	 	(x)	TP 2020 Professional Bundled Services 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Perform onshore until Citrix compatibility can be resolved all functions related to transplant
professional services using the TP20/20 system and ABS.
  

a. Review, date stamping, delivery of incoming mail/claims/spreadsheets.

 
 b. Photocopying and scanning of documents
into appropriate workflow systems.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-32	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 c. Enter results into ABS.

 
 d. Provide Finance/Actuary with monthly
reporting of remaining inventoried claims.
	  		  	

  

	 	(y)	Claims Development for Medicare Non Par and High Dollar Claims 

  

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 1. Perform development functions through outbound phone calls.

 
 a. Supplier will do outbound phone call and
development as per regulatory guidelines on Medicare related claims.
  

b. Supplier will do outbound phone call and development on high dollar claims (typically billed amounts greater
than 100,000.00) to obtain necessary information to avoid bouncing of claims between provider/facility and Health Net.
	  	 	X	  	  	

  

	 	(z)	Request For Proposal Responses (for nonperformance groups) 

  

									
	 	  	Responsible Party	 
	 Roles and Responsibilities
	  	Supplier	 	  	HN	 
	 1. Respond to all requests for proposals.

 
 a. Supplier will partner with Sales and
Product teams to supply data surrounding new business.
  

b. Supplier will support Health Net with presentations and demonstrations to potential clients for new and
existing business.
	  	 	X	  	  			
			
	 2. Provide final response on RFP requests after initial assessment performed.
	  				  	 	X	  

  

	 	(aa)	Compliance and Regulatory Affairs 

  

					
	SOW#1 (Claims) Exhibit A	  	A-33	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Designate a minimum of one SME to support compliance review and regulatory affairs. This
individuals tasks include but are not limited to
  

a. Review of All Plan Letters (APLs) from DHCS, Regulatory Notifications from CMS and other regulatory
agencies.
  
 b. Initial interpretation of
letters and documents and communicate findings to Health Net.
  

c. Participate and assist with system design to implement new and or existing legislation.

 
 d. Develop Policies and Procedures.

 
 e. Support and cooperate with Health
Net’s Compliance Oversight Team.
	  	X	  	

  

	 	(bb)	SOX/Sarbanes Controls 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Ensure SOX/Sarbanes controls are in place. a. Interpret and validate controls.

 
 b. Run ad hoc reports for validation.

 
 c. Support and cooperate with HN’s
designated auditors.
	  	X	  	

  

	 	(cc)	Electronic Data Interchange (EDI) 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Perform a daily reconciliation of claims received by the various Clearinghouses (i.e., Emdeon, Capario, MD Online, Group Health
Incorporated (GHI – Medicare Coordination of Benefits Contractor), Data Systems Group (DSG – Qcare hospital claims only) and their successful loading into multiple Claims Adjudication Systems (i.e., ABS, Qcare, Symphony, and MC400). There
are SOX controls relating to these validations.
	  	X	  	
			
	 2. Provide SOX Auditors documentation of the daily electronic claim loads to the various systems as requested. Part of this SOX audit
process includes describing the process used to validate, any changes since the previous audit, and answering any questions from the SOX Auditors on either the process or the documentation.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-34	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 3. Answer the EDI Provider Number (800-977-3568) for various Provider EDI questions. Questions vary from why didn’t the Plan
receive my claims, how to sign-up for electronic remittance, and where is the specific transaction should certain data be submitted.
	  	X	  	
			
	 4. Answer questions from various functional areas (i.e., Provider Network, Provider Reimbursement Specialist, Call Center,
Appeals & Grievances, and Legal) relating to the EDI transactions.
	  	X	  	
			
	 5. Current EDI transactions which are the responsibility of this team includes the 837I, 837P, 835, Claims Electronic Funds Transfer
(EFT), 270/271 Eligibility, and the 276/277 Claim Status. Any additional future EDI transactions that are claims related would also be part of this team’s responsibility such as the finalized ruling on the claims attachment format.
	  	X	  	
			
	 6. Register providers for the electronic remittance (835) and/or the Claims EFT. Part of this process includes validating the
correct account information with the bank as well as data entering information into the ABS/Qcare/Symphony screens.
	  	X	  	
			
	 7. Respond to questions from the Clearinghouses that were either submitted by the Provider or Clearinghouse.
	  	X	  	
			
	 8. For Weekend Releases, the Team will identify 837I and 837P files that need to be held for the Sunday Release Checkout.
	  	X	  	
			
	 9. Administrative Simplification Act has implemented timelines for ICD-10, Operating Rules (i.e., Healthcare Claims and Claim
Attachments), Health Plan ID (HPID), and Compliance Certifications. The ACS requires the Secretary to adopt and regularly update standards, implementation specifications, and operating rules for the information for the purpose of financial and
administrative transactions. As an example, Council for Affordable Quality Healthcare (CAQH) has been selected to implement operating standards (CORE – The Committee on Operating Rules for Information Exchange) for various Claims EDI
transactions (i.e., 835, 837I and 837P). The EDI Team works to implement these operating standards to become CORE certified. This includes understanding the regulations, writing the requirements, working with ITG on the design, EDI testing,
implementation, and providing information to CAQH to become certified.
	  	X	  	
			
	 10. The EDI Team sits on several Workgroup for Electronic Data Interchange (WEDI) committees to steer transaction decisions. Current
committees which they are participating are the 835, Claim Attachments, and HPID. This allows the Team to understand what requirements are needed for the Plan to maintain compliance.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-35	  	Health Net / Cognizant Confidential

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
			
	 11. EDI Team works on multiple projects to determine what their impact is to the EDI transactions. Any projects with EDI impact would
have the Team engaged in writing requirements, working with ITG on the design, EDI testing (which includes creating test scripts), implementation, and post implementation review. Some project examples that have EDI impact are AZ AHCCCS, ICD-10,
Qcare migration, and CalPers.
	  	 	X	  	  	
			
	 12. The EDI Team acts as the liaison between the ITG technical layouts and the Business use of this data. Therefore, members of this
Team have to translate the file layouts and transmissions to how the Claims Team utilizes the data in their adjudication process.
	  	 	X	  	  	

  

	 	(dd)	Claims Reporting 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Pull daily, monthly, quarterly, and annual Claims reports for various Claims Adjudication systems (i.e., ABS, Qcare, and
Macess).
	  	X	  	
			
	 2. Use various tools and databases to extract the claims data (i.e., FOCUS, UDMS files, Kbase, ODW, etc...)
	  	X	  	
			
	 3. Completes ad-hoc Claim report request within three (3) Business days. These requests can come from Claims, Provider Network,
Sales, Medical Management, Legal, and Corporate Executive Management.
	  	X	  	
			
	 4. Claims Reports that ask for multiple years of claims data (typically over three years worth of data) are completed by a negotiated
timeframe. These requests typically come from Provider Network, Compliance, and Legal. For these reports, the Claims Reporting Team creates the queries needed to obtain the specific data requested and then hands off those queries to ITG to
run.
	  	X	  	
			
	 5. Extracts Claims data necessary for various Compliance checks (i.e., CMS Monthly Claims report, AZ AHCCCS Monthly Claims report and
PMRs). Part of the task includes the Claims Reporting Team to take the report results and work with the Claims Operations Team to validate and/or determine why a variance occurred month over month. Typical responses include Membership
declines/increases, New policy implemented, or New Project implemented.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-36	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
			
	 6. Maintains the configuration for the Claims Macess queues. This would include working with the Claims Operations Team to determine
why claims are dropping to another queue than what was expected.
	  	X	  	
			
	 7. There are currently in excess of 300 scheduled reports – daily, weekly, monthly, quarterly, yearly. Other report requirements
include regulator reports such as HEDIS roadmap.
	  	X	  	

  

	 	(ee)	Benefit Testing Team 

  

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Creates claims in the Benefit Testing environment to validate new Benefit plans are appropriately taking co-pays,
deductibles, and accumulating correctly. All benefits having a Member’s responsibility would have a claim created to validate the Benefit plan is working appropriately.
	  	X	  	
			
	 2. Creates claims in the Benefit Testing environment to validate modifications to Benefit plans are appropriately taking
co-pays, deductibles, and accumulating correctly. All benefits having a Member’s responsibility would have a claim created to validate the Benefit plan is working appropriately.
	  	X	  	
			
	 3. Based on set testing percentages provided by Claims and Benefit Configuration Management, Team will randomly select which Benefit
plans are to be tested. Any Benefit plans not selected for testing can be moved directly into production.
	  	X	  	
			
	 4. All testing documents must be maintained for annual SOX audit.
	  	X	  	
			
	 5. Cross-train on the entry of manual claims accumulator to assist when available.
	  	X	  	

  

	 	(ff)	Claims Project Team 

  

					
	SOW#1 (Claims) Exhibit A	  	A-37	  	Health Net / Cognizant Confidential

					
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	  	HN
	 1. Claims expert on multiple Health Net projects to determine what their impact to Claims Operations. Projects with Claims impact would
have a primary and back-up Member assigned. The Team would work with Project Management Office in writing the requirements, working with ITG on the design, review test scenarios from the Claims Testing Team to make sure all appropriate test cases
are identified, implementation, and post implementation review.
	  	X	  	
			
	 2. Creates Project Briefs and Minor Enhancements as needed based on either regulatory or process improvements changes.
	  	X	  	
			
	 3. The Claims Project Team is the link between the technical Claims Adjudication system and the impact to the Claims Operations Team.
Therefore, members of this Team have to understand the systematic process and translate how the Claims Operations Team utilizes the data in their adjudication process.
	  	X	  	
			
	 4. For the implementation of Minor Enhancements, the Claims Project Team would work with the ITG Team on the requirements, solution,
testing, and implementation of the Minor Enhancement.
	  	X	  	
			
	 5. Researches issues from the Claims Operations Team to determine if there are Claims Adjudication issues which require ITG
involvement. If the research determines that a system issue is present, then the Claims Project Team will open a Remedy Ticket.
	  	X	  	
			
	 6. The Claims Project Team would work with ITG on the testing and validation to any code fixes relating to a Remedy Ticket. This Team
would also coordinate with ITG on when the fix is moved to production.
	  	X	  	
			
	 7. Performs audits of the Auto-adjudication (AA) logic and Division of Financial Responsibility (DOFR) to quickly identify any possible
production issues.
	  	X	  	
			
	 8. Triages AA and DOFR concerns from the Claims Operations Team to determine if system issue or training need is occurring.
	  	X	  	
			
	 9. For HN projects, the Claims Project Team works with the Claims Testing Team (currently under ITG) to make sure the Claims scenarios
and test scripts for each project are appropriate. If any questions relating to the testing outcomes develop, the Claims Testing Team reaches out to the Claims Project Team for validation that the results were expected or they will open a defect.
The Claims Project Team does a random audit of completed test scripts and provides their questions or approval as necessary.
	  	X	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-38	  	Health Net / Cognizant Confidential

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 10. Will assist with the Paper Claim Vendor (Xerox) as concerns arise to determine if vendor issue or Claims Adjudication
issue.
	  	 	X	  	  	
			
	 11. Will research PHI concerns from the Privacy Office as needed.
	  	 	X	  	  	
			
	 12. Works with the SOX and Internal Audit Teams to understand the Claims Adjudication systems. As an example, there is a current
SOX control to show the ABS system is identifying possible duplicate claims. One of the Claims Project Team Members coordinates sitting with the SOX Auditors to provide screen shots and answer their questions.
	  	 	X	  	  	
			
	 13. Data entry into the Adjustment Projects Database, which is monitored by the Adjustment Unit and Executive Management.
	  	 	X	  	  	
			
	 14. Works with the Pricing Vendors (i.e., HNS and Multiplan) when possible claim pricing issues are directed to them by either the
Call Center or Provider Network). An example is when a Provider calls HN insisting they don’t have a Multiplan contract. The Claims Project Team would reach out to Multiplan to determine if the Provider’s contract is still active or might
have been retro-actively termed.
	  	 	X	  	  	

 (gg) Manual Accumulator Team 
  

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 1. Manually enters into the ABS Accumulator Screens missing accumulators as directed by the various functional areas.
	  	 	X	  	  	
			
	 2. Requests to input accumulators information manually typically come from the Claims Accumulator Research Team under Supervisor C4d.
This Team would provide documentation on what to manually enter. Accumulator questions and requests can also come from the Call Center, Sales, Brokers, Benefits, Medicare Financial Ops and Systems, and Appeals & Grievances.
	  	 	X	  	  	
			
	 3. Research and adjust claims as appropriate based off the information supplied in the weekly Accumulator override report.
	  	 	X	  	  	
			
	 4. Works on multiple HN projects to determine what their impact to
	  	 	X	  	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-39	  	Health Net / Cognizant Confidential

							
	 	  	Responsible Party
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	     Accumulators might be. Any projects with Accumulator impact would have a member of this Team engaged in creating
requirements, working with ITG on the solution, review test scenarios from the Claims Testing Team to make sure all appropriate test cases are identified, implementation, and post implementation review.
	  				  	
			
	 5. Works closely with the Benefit Configuration Team and the Membership Team to determine member impact when ABS cross-accumulation
flags are not set-up properly.
	  	 	X	  	  	
			
	 6. Works with Pharmacy and MHN when cross-accumulation issues arise to determine the issue and how to resolve.
	  	 	X	  	  	
			
	 7. Cross-trained to be able to assist the Benefit Testing Team when available.
	  	 	X	  	  	

  

	 	(hh)	Audit Support Services 

  

							
	 Roles and Responsibilities
	  	Supplier	 	  	HN
	 “Audit Support Services” means those Functions associated with providing support for Audits of
the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group), including the following:

 
 a. Providing data and reports requested by
the Auditors;
  
 b. Providing subject
matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors;
  

c. Assisting in the development and implementation of corrective action plans in response to Audit findings
identifying weaknesses or deficiencies in the Audited Function; and
  

d. Supporting Health Net communications with Regulators.
	  	 	X	  	  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-40	  	Health Net / Cognizant Confidential

	 	(ii)	Audit Support Services 

  

					
	 Roles and Responsibilities
	  	Supplier	  	HN
	     “Claims Policy Services” means those Functions associated
with development and implementation of “Health Net’s Claims Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies) governing or pertaining to the Claims Management
Services, more specifically, the conduct of Health Net’s Claims Management Services
  

    Below are some examples of selected Claims Policy Development Services Functions, which include
descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only:
	  	X	  	
			
	 (a)  Generally, provide operational subject matter expertise with respect to Health Net
Claims Policies;
  
 (b)  As requested,
participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Claims Policies;

 
 (c)  In response to changes in Laws,
regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or Supplier’s Compliance organization:

 
 (i)     Participate in
Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact;
  

(ii)    Participate in Health Net EPCO regulatory implementation Change Teams;

 
 (iii)  Project manage the operational
implementation and/or affected system changes of legal and regulatory changes that affect Claims Management Services and participate in operational implementation and/or affected system changes of legal and regulatory changes that span multiple
functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and
  

(iv)   Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of
revised or new Health Net Claims Policies and submit them to the relevant Health Net and Supplier stakeholders for review, comment and approval;
	  		  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-41	  	Health Net / Cognizant Confidential

					
	 Roles and Responsibilities
	  	Supplier	  	HN
	 (d)  Prepare updated versions of Health Net Claims Policies to address input provided by
relevant Health Net and Supplier stakeholder groups;
  

(e)  Provide communications and training to Supplier personnel regarding revised and new Health Net Claims
Policies and access to Health Net personnel to such communications and training; and
  

(f)  Implement Heath Net-approved Health Net Claims Policies by Supplier Personnel involved in the
performance of the Claims Management Services.
	  		  	

  

					
	SOW#1 (Claims) Exhibit A	  	A-42	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

PROVIDER INQUIRY PROCESSING SERVICES 
  

	1.	GENERAL 

  

	 	(a)	“Provider Inquiry Processing Services” means all life cycle Functions associated with the handling and processing of Provider Inquiries. Provider Inquiry Processing Services include
(i) those Functions described in this Exhibit A-1, and (ii) the Cross Functional Services, as they apply to the Functions, Equipment, Software, process, or other activities described in this Exhibit A-1. 

 

	 	(b)	Supplier shall provide Provider Inquiry Processing Services for those Provider Inquiries for which Health Net requests that Supplier perform Provider Inquiry Processing Services. 

 

	2.	PROVIDER INQUIRY PROCESSING SERVICES 

 Supplier shall perform the following Provider
Inquiry Processing Services: 
  

	 	(a)	Process Provider Inquiries as follows: 

  

	 	(i)	Research PIs and determine whether an appeal will be upheld, modified or overturned. 

  

	 	(ii)	For any PI that is not deemed a valid appeal and is to be marked as an error, document the reason why the appeal is not valid. 

  

	 	(iii)	Review the SF to ensure all data elements listed are complete and correct, including the following data elements: member ID, provider ID, line of business, received date, closed date, grievance type, provider zip code,
amount in dispute, case outcome, and provider specialty type. If the data elements are not complete or correct, update the information and continue processing the SF in accordance with Section 2(a)(iv). 

 

	 	(iv)	Verify that the PI was received within the correct time period for both participating providers and non-participating providers. If the provider request was timely, Supplier shall continue processing the PI in
accordance with Section 2(a)(v). If the request was not timely, Supplier shall generate an upheld letter indicating that the PI was not timely in accordance with Health Net policies and procedures. 

 

	 	(v)	Determine whether additional information is required to complete the appeal and proceed as follows: 

  

	 	(A)	If additional information is required, Supplier will: 

  

	 	(1)	Generate the necessary correspondence to be sent to the provider; 

  

	 	(2)	Pend the SF; and 

  

	 	(3)	Save all relevant correspondence to the appropriate system. 

  

					
	SOW#1 (CLAIMS) Exhibit A		A-1-1		Health Net / Cognizant Confidential

	 	(B)	If Supplier receives the requested additional information within the required timeframe, Supplier will continue to process the PI in accordance with Section 2(a)(vi). 

 

	 	(C)	If the information is not timely received by Supplier, Supplier will generate a letter to the provider indicating that the Claim has been upheld. 

 

	 	(vi)	Review the PI documentation to determine whether the Claim in the PI has been previously appealed. 

  

	 	(A)	If the Claim has been appealed previously, determine whether the original PI was handled correctly. The Supplier Personnel performing this review function must be a different person than the person who processed the
original Claim being appealed. 

  

	 	(1)	If the original PI was determined to be handled correctly, determine whether additional documentation is included with the current PI. 

 

	 	a.	If additional documents are attached, Supplier should continue processing the PI as provided in Section 2(a)(vii). 

  

	 	b.	If additional documents are not attached, Supplier should generate correspondence to the provider indicating that the Claim will be upheld and should designate the correct grievance type in accordance with Health Net
policies and procedures. 

  

	 	(B)	If (1) the appeal was not originally handled correctly upon initial review; or (2) the Claim was not appealed previously, then Supplier shall proceed with the tasks provided in Section 2(a)(vii).

  

	 	(vii)	Review the documentation and determine if an adjustment is due or if the original determination will be upheld. 

  

	 	(A)	If the Claim is to be overturned, review Claim history to determine if the Claim has since been paid correctly before making an adjustment. 

 

	 	(1)	If the Claim has since been paid correctly, generate the appropriate correspondence, update the SF, and close the SF. 

  

	 	(2)	If the Claim has not been paid correctly, either: 

  

	 	a.	Reprocess the Claim; 

  

	 	b.	Pend Claim for external review by a third party; or 

  

	 	c.	Pend the Claim, update the SF, and keep pended until the Claim reaches remit status. 

  

					
	SOW#1 (Claims) Exhibit A		A-1-2		Health Net / Cognizant Confidential

	 	(viii)	If the PI is upheld, generate the appropriate correspondence (manual process from template) to the provider, file the correspondence in the correct folder, update the SF, and close the SF. 

 

	 	(ix)	Quality audit all correspondence to the provider for accuracy (spelling, name, address, city location) before manually inserting into envelope. 

 

	 	(b)	For PIs that have been processed and are awaiting remit, Supplier shall perform the following: 

  

	 	(i)	Update the SF and validate all data elements in accordance with the Health Net policies and procedures; 

  

	 	(ii)	Track the SF status until it reaches status that is ready for remit; and 

  

	 	(iii)	Once the Claim reaches remit status, enter the appropriate close date on the SF. 

  

	 	(c)	Other Provider Inquiry Processing Services Requirements 

  

	 	(i)	Monitor appropriate mailboxes to receive PI processing requests from the Provider Inquiry Mail workstream and distribute the workload of SFs to be processed. 

 

	 	(ii)	Process any provider appeals forwarded by IMedics in accordance with Health Net policies and procedures, including adjusting any Claims so designated by IMedics and generating all related correspondence to be sent to
IMedics regarding the Claim. 

  

	 	(iii)	Process all PIs in accordance with the timeframes as agreed by the Parties; and 

  

	 	(iv)	Create and provide to Health Net a weekly report of all PI activity and status. 

  

	3.	PROVIDER CORRESPONDENCE SERVICES 

 Supplier shall perform Provider Correspondence
Services. “Provider Correspondence Services” are the Functions associated with the receipt, acknowledgment, routing and tracking of Provider inquiries via mail, including the following activities: 

 

	 	(a)	Scanning and distributing Provider white mail to Supplier; 

  

	 	(b)	Identifying and routing designated (PG) provider mail to the appropriate Tower (onshore); 

  

	 	(c)	Acknowledging to Provider receipt of Provider correspondence; 

  

	 	(d)	Reading Provider white mail, performing triage of the request, and routing correspondence to the correct Tower or Health Net, as appropriate (typically via Service Form); 

 

	 	(e)	Receiving response as appropriate from the appropriate Tower or Health Net; 

  

	 	(f)	Generating outgoing correspondence using Health Net templates and mail to Provider; and 

  

	 	(g)	Placing documents that require additional information in a designated folder and mail to Provider. 

  

					
	SOW#1 (Claims) Exhibit A		A-1-3		Health Net / Cognizant Confidential

	4.	PROVIDER ESCALATION SERVICES 

 Supplier shall perform Provider Escalation Services.
“Provider Escalation Services” are the Functions associated with the receipt and tracking of escalated Provider inquiries and communicating the escalation outcome to the Provider, including the following activities: 

 

	 	(a)	Escalating Provider inquiries based on type of issue presented, age or as required by Law or Health Net Policy; 

  

	 	(b)	Receiving Provider escalation outcome from Health Net and prepare draft communications outlining outcome to Provider; 

  

	 	(c)	Preparing final escalation outcome correspondence to the Provider; 

  

	 	(d)	Executing escalation outcome calls to Providers; 

  

	 	(e)	Sending escalation outcome emails; and 

  

	 	(f)	Responding in the Channel from which the escalation was received unless otherwise requested by the Provider. 

  

	5.	PROVIDER DISPUTE SERVICES 

 Supplier shall perform Provider Dispute Services.
“Provider Dispute Services” are the Functions associated with the receipt, initial inputting, forwarding (as required) and closing (as required) of PDRs (including Provider Inquiries, Re-Routes and Re-Scans) and any other documents,
including the following activities: 
  

	 	(a)	Retrieving, researching, acknowledging, responding and/or routing to the appropriate tower for resolution; 

  

	 	(b)	Receiving, acknowledging and addressing the first submission of a Provider appeal of a claim payment; 

  

	 	(c)	Reviewing and routing to appropriate Health Net entity including MRU, Claims, Provider Network Management and/or Legal for final determination; 

 

	 	(d)	Tracking, addressing, and resolving Provider Disputes (e.g., regarding allegedly incorrectly processed Claims); 

  

	 	(e)	Performing SHP Provider Appeals Services; 

  

	 	(f)	Receiving dispute outcome from Health Net; and 

  

	 	(g)	Generating and distributing determination letter for state health programs. 

 For clarity,
Health Net will retain responsibility for the clinical aspects of all Provider Disputes and Supplier will forward all Provider Disputes involving clinical decision making to Health Net for Health Net’s resolution of the clinical aspect of the
Provider Dispute. 

  

					
	SOW#1 (Claims) Exhibit A		A-1-4		Health Net / Cognizant Confidential

      

 

	6.	PROVIDER INQUIRY MAIL SERVICES 

 Supplier shall perform Provider Inquiry Mail Services.
“Provider Inquiry Mail Services” are the Functions associated with the receipt and initial inputting of Provider Inquiries, including the following activities: 
  

	 	(a)	Providing Provider Inquiry Mail Services for those Provider Inquiries for which Health Net requests that Supplier perform Provider Inquiry Mail Services; 

 

	 	(b)	Drawing the Provider Inquiry submission from the claims imaging system; and 

  

	 	(c)	Researching, acknowledging and responding or routing to the appropriate Tower for resolution within regulatory or Health Net guidelines. 

  

					
	SOW#1 (Claims) Exhibit A		A-1-5		Health Net / Cognizant Confidential

 EXHIBIT A-2 

REBUTTAL PROCESS 
 THE
PROCESS DESCRIBED IN THIS EXHIBIT A-2 SHALL APPLY IN THE EVENT THAT A SUPPLIER PERSONNEL BELIEVES THAT A HEALTH NET AUDITOR INCORRECTLY IDENTIFIED AN ERROR IN ANY OF THE ACTIVITIES PERFORMED BY SUPPLIER (E.G., CLAIM ADJUDICATION, ADJUSTMENT).

  

	1.	FIRST LEVEL REBUTTAL 

 The first level of the rebuttal process involves the following:

  

	 	(a)	The applicable Supplier Personnel is notified of the audit error(s) via an error ticket or other notification means (e.g., excel file). 

 

	 	(b)	If such Supplier Personnel believes that the Health Net audit team incorrectly classified the error, such Supplier Personnel will review the audit error(s) with the applicable Supplier supervisor. 

 

	 	(c)	If such Supplier supervisor is in agreement with the error issued by the Health Net audit team, such Supplier supervisor is responsible for communicating (including, where there is a need for an adjustment, via logging
the request in the applicable system) the result to: 

  

	 	(i)	If the audit was from Health Net’s pre-pay audit team, the Supplier Personnel who performed the activity (e.g., processed the Claim, adjustment). Such Supplier Personnel is then responsible for correcting the error
and re-processing the item (e.g., Claim, adjustment) in accordance with the applicable Service Level(s). 

  

	 	(ii)	If the audit was from Health Net’s post-pay audit team, the applicable Supplier supervisor. Such supervisor will then assign the item to the appropriate Supplier Personnel in order to correct the error and
re-process the item (e.g., Claim, adjustment) in accordance with the applicable Service Level(s). 

  

	 	(d)	If such Supplier supervisor agrees that the error should be rebutted, the Supplier Personnel who performed the activity (e.g., the Claim, adjustment) will complete a “Rebuttal Form”, of a form and format to be
determined by Health Net, attach the necessary documentation to support the rebuttal, and forward it to the applicable Health Net audit supervisor within the applicable timeframes (as set forth in Health Net Policies). 

 

	 	(e)	If multiple errors were noted at a single time (associated with one or more Supplier Personnel), Health Net may require Supplier to consolidate its rebuttals into a single form and resubmit them to the applicable Health
Net audit supervisor in a single response. 

  

	 	(f)	The Health Net audit supervisor and, if applicable based on Health Net Policies, the Health Net claims supervisor will review the error finding to determine if the audit error is based on established claims processing
guidelines. 

  

	 	(g)	If the Health Net audit supervisor and, if applicable based on Health Net policies and procedures, the Health Net claims supervisor: 

  

					
	SOW#1 (Claims) Exhibit A		A-2-1		Health Net / Cognizant Confidential

	 	(i)	Accepts the rebuttal, then the errors are removed from the applicable Supplier Personnel’s records. 

  

	 	(ii)	Does not accept the rebuttal (i.e., continues to believe there is an error), then the error is upheld and this decision along with the appropriate documentation is sent back to the applicable Supplier supervisor. The
Supplier supervisor is responsible for communicating the result as described in Section 1(c)(i) and (ii), above. 

  

	2.	SECOND LEVEL REBUTTAL 

 The second level of the rebuttal process involves the following:

  

	 	(a)	If the Supplier Personnel and the applicable Supplier supervisor continue to disagree with the error identified by Health Net, the rebuttal will be forwarded to the Supplier Director of the Claims Operation for review
and determination. 

  

	 	(b)	The Supplier Director of Claims Operation will review the rebuttal along with the Supplier Claims Trainer and the Supplier Claims service manager. 

 

	 	(i)	If the Supplier Director of Claims Operation, Supplier Claims Trainer, and Supplier Claims service manager are in agreement with the error, such decision will be forwarded to the appropriate Supplier supervisor. The
Supplier supervisor is responsible for communicating the result as described in Section 1(c)(i) and (ii), above. 

  

	 	(ii)	If all the members of the Supplier Claims service team are in agreement that a second level rebuttal is necessary, the Rebuttal Form and the supporting documentation shall be forwarded to the Health Net Claims Audit
Director (Manager) for review. 

  

	 	(A)	If the Health Net Claims Audit Director (Manager) and, if applicable based on Health Net Policies, the Health Net claims director, overturn the error, the error is removed from the applicable Supplier Personnel’s
record. 

  

	 	(B)	If the Health Net Claims Audit Director (Manager) and, if applicable based on Health Net Policies, the Health Net claims director, upholds the error, such decision is final and the supplier Claims service team shall be
notified electronically as described in Section 1(c)(i) and (ii) above. 

  

					
	SOW#1 (Claims) Exhibit A		A-2-2		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

CLAIMS 
 SOLUTION
DESCRIPTION 

  

					
	SOW#6 (Claims) Exhibit A-1		A-1-i		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

CLAIMS SOLUTION DESCRIPTION 

TABLE OF CONTENTS 
  

											
	1.		 	INTRODUCTION		 	3	  
			
	2.		 	DEFINITIONS AND INTERPRETATION		 	3	  
				
			 	    2.1	  		Defined Terms		 	3	  
			
	3.		 	SOLUTION OVERVIEW		 	3	  
				
			 	    3.1	  		High-level Service Delivery Architecture and Configuration		 	3	  
				
			 	    3.2	  		Service Delivery Model		 	4	  
				
			 	    3.3	  		Business-Process-as-a-Service		 	4	  
			
	4.		 	CHANGES TO SUPPLIER’S SOLUTION		 	5	  
			
	5.		 	SCOPE OF SERVICES		 	6	  
			
	6.		 	OPERATING MODEL		 	6	  
				
			 	    6.1	  		Resource Mix		 	6	  
				
			 	    6.2	  		Location		 	9	  
				
			 	    6.3	  		Operating Hours		 	11	  
				
			 	    6.4	  		Operations		 	13	  
				
			 	    6.5	  		Resource Profile		 	14	  
				
			 	    6.6	  		Voice Solution		 	16	  
				
			 	    6.7	  		IT Systems		 	17	  
				
			 	    6.8	  		Third Party Tools and Services		 	17	  
				
			 	    6.9	  		Regulatory On-shore Requirements		 	18	  
				
			 	    6.10	  		Service Performance Management		 	18	  
			
	7.		 	KEY ASSUMPTIONS		 	18	  

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-ii		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

CLAIMS SOLUTION 
  

	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work # 1
(Claims Management) Services (“Statement of Work”). Whereas Exhibit A (Claims Management Services) describes which Functions Supplier is responsible for performing under this Statement of Work, this Exhibit A-1
(Claims Solution Description) describes the means by which and the manner in which Supplier will perform those Functions. This document contains an overview of Supplier’s service delivery architecture, a depiction of which
is – displayed on a global map containing the geographic configuration (and delivery architecture of Supplier’s Solution (as it will exist at the completion of Phase 2, identifying all Service Delivery Centers of Supplier (and its
Affiliates and other Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how they will be interconnected to each other and to Health Net’s IT Environment.
It also provides additional descriptive information about each of the principal components of Supplier’s Solution. 
 This Exhibit A-1
(Claims Solution Description) includes the following attachments, which are incorporated herein by reference 
 Exhibit A-1.1 Approved
Service Delivery Centers 
 Exhibit A-1.2 Service Delivery Configuration at the Completion of Phase 2 

 

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings set forth below unless otherwise specifically defined in the body of this document. Additionally any capitalized term used but not defined in this Exhibit A-1 (Claims Solution Description) will have the meaning indicated in
Schedule W (Glossary). 
  

			
	 Defined Term
	  	 Meaning

	 “Solution”
	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work.

  

	3.	SOLUTION OVERVIEW 

  

	3.1	High-level Service Delivery Architecture and Configuration 

 This section provides an
overview of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service Delivery Centers) provides additional information about each of the Service
Delivery Centers Supplier will use to provide the Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if
operations at any primary Service Delivery Center are disrupted or disabled. 

  

					
	SOW#6 (Claims) Exhibit A-1	  	A-1.1-3	  	Health Net / Cognizant Confidential

 Final 
  

  
 

 
 Figure 1 

Note: Dates represent effective end date of each transition wave. 

The above diagram illustrates the overall solution at the Point of Departure and how it evolves into the Point of Arrival. Initially all the
Health Net resources will be rebadged and work out of the current Health Net US locations in Rancho Cordova and Woodland Hills. The Transition is planned to occur over in 3 waves as depicted in the diagram with some of the work gradually moving to
the offshore locations of Chennai and Hyderabad in India. The onshore/offshore ratio at the Point of Arrival and the Point of Departure is illustrated above. 
  

	3.2	Service Delivery Model 

 This section provides an overview of the commercial delivery
model Supplier will utilize to provide the Services under this Statement of Work. Exhibit H (Claims Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform the Services under this Statement of Work. 

 

	3.3	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work
will be provided under a ‘Business- Process-as-a-Service’ delivery model - i.e., as a fully integrated vertical service which Supplier is responsible for providing all the associated resource / service layers (facilities, IT
infrastructure, tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’ (e.g., fully processed
claims). Supplier will be responsible for performing the Claims Management Services set forth in Exhibit A (Claims Management Services). 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-4		Health Net / Cognizant Confidential

 Final 
  

	4.	CHANGES TO SUPPLIER’S SOLUTION 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Claims Solution Description). That said, Supplier is charged with responsibility for the adequacy of its
Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Claims Solution Description), should prove inadequate at any point during the Statement of Work Term for Supplier to perform and deliver the
Services in accordance with the obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in
accordance with such obligations. All such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such
changes at its own cost and expense except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. SOLUTION DESCRIPTION 

Supplier’s solution is built on the following foundational aspects: 

 

	 	•	 	Quality Focus– Supplier’s primary focus is to maintain seamless continuity of services while ensuring regulatory and contractual compliance requirements. For all processes migrated Offshore, the focus
will be on ensuring adherence to compliance and quality. 

  

	 	•	 	Support ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides an Personnel to Supervisor and QA ratio Onshore and Offshore as described in Section 7.4 of this
exhibit 

  

	 	•	 	Continuous Improvement—Supplier will appoint dedicated Six Sigma resources during the different stages of the project, to identify sustainable improvement opportunities. The typical ratio will be 1 Six Sigma
resource for every 150 Supplier Personnel FTEs. 

 Knowledge Retention: 

 

	 	•	 	Domain Experts – Supplier will invest in staff (existing and hired) with previous healthcare experience for key support functions including Operations, Transition, Training, Quality and Compliance.

  

	 	•	 	Health Net Training Academy –, Supplier’s dedicated Health Net Training Academy will be tasked with the mandate of building a Knowledge repository during Phase 2. During phase 3, the Training Academy
will be involved in maintaining a Knowledge repository, updating Training Academy, process documentation, providing training to new hire supplier personnel and providing higher level training to experienced resources for Claims Operations. Supplier
will periodically conduct training to keep supplier personnel up-to date on regulatory, process and system changes. Supplier will provide ongoing/refresher training as per the updates received from Health Net and will conduct assessments to ensure
that there are no knowledge gaps. Refresher training will be conducted based on Quality audit scores for Supplier Personnel 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-5		Health Net / Cognizant Confidential

 Final 
  

 Solution Location: 

 

	 	•	 	Supplier will deliver Claims Management Services from Service Delivery Centers in the US and India. Exhibit A-1.1 (Approved Service Delivery Centers) describes the On-shore, near-shore and Offshore Service
Delivery Centers that Supplier will use to deliver the Claims Management Services. 

  

	5.	SCOPE OF SERVICES 

 In addition to the Claim Management Services described in Exhibit A
(Claim Management Services) and for clarity includes the following: 
  

	 	1.	Supplier will research, respond, track and report privacy related incidents 

  

	 	2.	Supplier will also train and educate the team on HIPAA Privacy and Security 

  

	 	3.	Supplier’s Claims operations team will provide necessary information to sales team 

  

	 	4.	For RFP support, Supplier Claims operations team will provide opinion and operational data points 

  

	 	5.	Supplier will provide necessary operational information for new vendor on-boarding and existing vendor renewals. Health Net will be responsible for vendor negotiations and contract execution. 

 

	 	6.	Supplier Personnel for Claims Management Services will be dedicated only to Claims operations. 

  

	6.	OPERATING MODEL 

 The operating model for Claims operations defines the service delivery
blue print and key aspects of service delivery. The operating model also describes how the Claims Management Services will be delivered for each functional process area in a scalable global environment 

 

	6.1	Resource Mix 

 Supplier will leverage its global operating model to delive the Claim
Management Services. 
 Supplier has considered the following criteria to define its Onshore/Offshore strategy - 

 

	 	•	 	Regulatory requirements 

  

	 	•	 	Availability of skills at Offshore locations 

  

	 	•	 	Health Net Offshore restrictions 

  

	 	•	 	Consideration for work load to resource ratio 

  

	 	•	 	HR constraints (i.e. PTO, illness, injury, etc.) 

 Processes requiring voice support will be
delivered out of US and Philippines. Roles identified to move offshore (Supervisors/coordinators/sr. coordinators) will continue to be responsible for current tasks and activities being performed onshore. 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-6		Health Net / Cognizant Confidential

 Final 

 The Onshore/Offshore resource mix for Claims Management Services listed below in Table 1.

  

							
	 Sub function
	  	 Estimated End State

	  	 Onshore %
	  	 Offshore %
	  	 Location

	 Claims Management
 Team

 
 (VP, Executive Assistant and Senior Systems Analysts)
	  	100%	  	0%	  	W,R
				
	Claims Sub Tower A	  		  		  	
				
	Claims Pre Pay Audit	  	15%	  	85%	  	W,R,Ch,H,Co
				
	 Claims Compliance and
 SOX Control
	  	25%	  	75%	  	W,R,Ch,H
				
	Policies & Procedure	  	20%	  	80%	  	W,R,Ch,H
				
	Legal / Adjustments	  	25%	  	75%	  	W,R,Ch,H
				
	 Claims Recovery and
 COB
	  	25%	  	75%	  	W,R,Ch,H,Co
				
	Claims Sub Tower B	  		  		  	
				
	 Cal MediConnect (Duals)
 and Medicare
Advantage
	  	25%	  	75%	  	W,R,Ch,H
				
	Medi-Cal (Primarily Provider Disputes and Testing), Clerical and Life Insurance and Disability Claims	  	25%	  	75%	  	W,R,Ch,H
				
	 Reinsurance and Member
 Fallout
	  	25%	  	75%	  	W,R,Ch,H
				
	PDRs (From Call Center)	  	100%	  	0%	  	R
				
	Claims Sub Tower C	  		  		  	
				
	MHN Claims	  	20%	  	80%	  	W,R,Ch,H

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-7	  	Health Net / Cognizant Confidential

 Final 

							
	 Sub function
	  	 Estimated End State

	  	 Onshore %
	  	 Offshore %
	  	 Location

	AZ AHCCCS	  	100%	  	0%	  	PH
				
	Pay and Recover	  	15%	  	85%	  	W,R,Ch,H
				
	Provider Disputes	  	25%	  	75%	  	W,R,Ch,H
				
	 Provider Reimbursement
 Specialist
	  	25%	  	75%	  	W,R,Ch,H
				
	Performance Group	  	100%	  	0%	  	W,R
				
	Accumulator Research	  	25%	  	75%	  	W,R,Ch,H
				
	Claims Sub Tower D	  		  		  	
				
	 Electronic Data
 Interchange
	  	25%	  	75%	  	W,R,Ch,H
				
	Claims Projects	  	25%	  	75%	  	W,R,Ch,H
				
	Claims Reporting	  	15%	  	85%	  	W,R,Ch,H,Co
				
	Benefit Testing	  	100%	  	0%	  	W,R,Ch,H,Co
				
	 Manual Accumulator
 Entry
	  	20%	  	80%	  	W,R,Ch,H
				
	Paper Vendor	  	25%	  	75%	  	W,R,Ch,H

 Table 1 
  

			
	 Legend

	Locations	  	Code
		
	Woodland Hills (US)	  	W
		
	Rancho Cordova (US)	  	R
		
	Tempe (US)	  	Te
		
	San Rafael (US)	  	S

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-8	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Legend
	  	 
	Telecommuting (US)	  	T
	Manila (Philippines)	  	M
	Cebu (Philippines)	  	Cb
	Phoenix (US)	  	P

 Key Note 
  

	 	•	 	*The above percentages are approximate estimates at this point. 

  

	 	•	 	The above plan will be finalized during the Process Assessment Phase as described in the Transition Manual, with agreement between Health Net and Supplier. 

 

	 	•	 	The estimated end state is expected by March 2017 

  

	 	•	 	As shared in Section 6 above only those roles mandated by Health Net or where skills are not available offshore would be onshore. 

 

	 	•	 	As shown in the Table 1, while a process can span across 4 locations there will be no role within a process which will span across more than 2 locations 

 

	 	•	 	Support for the Commercial and Medicare processes (as currently provided under the existing agreement between Supplier and Health Net) from Supplier’s delivery centers in Hyderabad and Coimbatore, India. Changes to
the current Solution will be documented through the Change Management process 

  

	 	6.2	Location 

 Supplier will deliver the Claims Management Services from the US and India.
Onshore services for the initial 2 years following the contract effective date will be provided from Health Net facilities at Woodland Hills and Rancho Cordova. For AZ AHCCCS, current resource will be relocated to Supplier Phoenix, AZ delivery
center. For those not willing to relocate, Supplier will hire experienced staff in either Rancho Cordova or Woodland Hills and train them to ensure compliance, knowledge transfer and production ramp up before releasing existing staff. 

 

	 	•	 	Health Net mandated onshore staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

	 	•	 	Regulatory limitations 

  

	 	•	 	Business continuity 

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-9	  	Health Net / Cognizant Confidential

 Final 
  

					
	 	  	 Delivery Location

	 Sub Function
	  	 US
	    	 Philippines

	Claims Management Team	  	US	    	
	(VP, Executive Assistant and Senior Systems Analysts)	  		    	
			
	Claims Sub Tower- A	  		    	
			
	 Claims Pre Pay Audit
	  	US	    	 Hyderabad,

Chennai, Coimbatore

			
	 Claims Compliance and SOX Control
	  	US	    	 Hyderabad,

Chennai

			
	 Policies & Procedure
	  	US	    	 Hyderabad,

Chennai

			
	 Legal / Adjustments
	  	US	    	 Hyderabad,

Chennai

			
	Claims Sub Tower- B	  		    	
			
	 Cal MediConnect (Duals) and Medicare Advantage
	  	US	    	 Hyderabad,

Chennai

			
	 Medi-Cal (Primarily Provider Disputes and Testing),

Clerical and Life Insurance and Disability Claims
	  	US	    	 Hyderabad,

Chennai

			
	 Reinsurance and Member Fallout
	  	US	    	Hyderabad, Chennai
	 PDRs (From Call Center)
	  	US	    	
			
	Claims Sub Tower- C	  		    	
			
	 MHN Claims
	  	US	    	 Hyderabad,

Chennai

			
	 AZ AHCCCS
	  	US	    	
			
	 Pay and Recover
	  	US	    	 Hyderabad,

Chennai

			
	 Provider Disputes
	  	US	    	 Hyderabad,

Chennai

			
	 Provider Reimbursement Specialists
	  	US	    	 Hyderabad,

Chennai

			
	 Performance Group
	  	US	    	
			
	 Accumulator Research
	  	US	    	 Hyderabad,

Chennai

			
	Claims Sub Tower- D	  	US	    	 Hyderabad,

Chennai

			
	 Electronic Data Interchange
	  	US	    	 Hyderabad,

Chennai

			
	 Claims Projects
	  	US	    	 Hyderabad,

Chennai

			
	 Claims Reporting
	  	US	    	 Hyderabad,

Chennai,

		  		    	Coimbatore

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-10	  	Health Net / Cognizant Confidential

 Final 

					
	 	  	 Delivery Location

	 Sub Function
	  	 US
	    	 Philippines

			
	 Benefit Testing
	  	US	    	
			
	 Manual Accumulator Entry
	  	US	    	Hyderabad, Chennai
			
	 Paper Vendor
	  	US	    	 Hyderabad,

Chennai

 Table 2 

During Phase 2, Supplier will keep Health Net rebadged FTEs at its current location. Post Phase 2, Supplier will evaluate the operating model
and will have the right to relocate resources to its other onsite US locations including Woodland Hills and Phoenix. 
 The below diagram
illustrates how teams across locations in US & India will interact on an ongoing basis to ensure effective planning, monitoring and tracking of Claims processes, activities and requirements. Following are the key activities: 

 

	 	1.	Forecasting – identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	2.	Capacity Planning- ensure staffing in place can manage the forecasted volumes 

  

	 	3.	Monitor Productivity- An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	4.	Reallocation based on productivity – An ongoing exercise to track and shift work, based on the transaction and volumes, within teams and individuals to ensure desired productivity 

 

	 	5.	Monitor Quality and SLAs—An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

The organization structure has been functionally designed in a manner that facilitates effective operations across locations. This model
ensures that workflow is effective in real time facilitating tactical monitoring. 
  

	6.3	Operating Hours 

 Supplier will at minimum replicate the operating hours currently
adhered to by Health Net’s Claims organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Claims Management Services will regularly require Supplier Personnel to perform
additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Claims Management Services. 

Supplier will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet
regulatory requirements, Compliance and Service 

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-11	  	Health Net / Cognizant Confidential

 Final 
  

 Level metrics and other requirements of the Agreement. Supplier’s work during such
extended hours of operations is within the scope of the Claims Management Services. 
 Within the regular Hours of Operations listed below,
Supplier will have staff work according to defined shift schedules. However, Supplier will make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. 
 The operating hours for the Claims
Management Services are given below. 
  

			
	 Sub function
	  	 Hours of Operations

(PST)

	 Claims Sub Tower- A
	  	
		
	 Claims Pre Pay Audit
	  	08:00 am to 17:00 pm
		
	 Claims Compliance and SOX Control
	  	08:00 am to 17:00 pm
		
	 Policies & Procedure
	  	08:00 am to 17:00 pm
		
	 Legal / Adjustments
	  	08:00 am to 17:00 pm
		
	 Claims Recovery and COB
	  	08:00 am to 17:00 pm
		
	 Claims Sub Tower- B
	  	
		
	 Cal MediConnect (Duals) and Medicare Advantage
	  	08:00 am to 17:00 pm
		
	 Medi-Cal, Clerical and Life Insurance and Disability Claims
	  	08:00 am to 17:00 pm
		
	 Reinsurance and Member Fallout
	  	08:00 am to 17:00 pm
		
	 PDRs (From Call Center)
	  	08:00 am to 17:00 pm
		
	 Claims Sub Tower- C
	  	
		
	 MHN Claims
	  	08:00 am to 17:00 pm
		
	 AZ AHCCCS
	  	08:00 am to 17:00 pm
		
	 Pay and Recover
	  	08:00 am to 17:00 pm
		
	 Provider Disputes
	  	08:00 am to 17:00 pm
		
	 Provider Reimbursement Specialists
	  	08:00 am to 17:00 pm
		
	 Performance Group
	  	08:00 am to 17:00 pm
		
	 Accumulator Research
	  	08:00 am to 17:00 pm
		
	 Claims Sub Tower- D
	  	
		
	 Electronic Data Interchange
	  	08:00 am to 17:00 pm
		
	 Claims Projects
	  	08:00 am to 17:00 pm
		
	 Claims Reporting
	  	08:00 am to 17:00 pm
		
	 Benefit Testing
	  	08:00 am to 17:00 pm
		
	 Manual Accumulator Entry
	  	08:00 am to 17:00 pm
		
	 Paper Vendor
	  	08:00 am to 17:00 pm

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-12	  	Health Net / Cognizant Confidential

 Final 
  

 Table 3 
  

	6.4	Operations 

 Supplier approach managing operations, is as follows 

 

	 	•	 	Operations Focus: Team huddles, floor walks, daily performance reviews, daily supplier personnel communication plan and customer calibration sessions. 

 

	 	•	 	Performance Management Measure and manage supplier personnel performance through data and service dashboards 

  

	 	•	 	Span of Control: Supplier will provide for the following span of control: 

  

	 	•	 	Operations Lead/1:500 

  

	 	•	 	Manager 1:50 

  

	 	•	 	Supervisor 1:15 

  

	 	•	 	Quality Auditor 1:15 

  

	 	•	 	Trainer 1:20 (during training) 

  

	 	•	 	Team Lead 1:15 

  

	 	•	 	Six Sigma & Process Excellence 1:150 

  

	 	•	 	Health Net Training Academy: Supplier will establish a dedicated Health Net Training academy for management of training content and delivery of training programs. The Claims management function of the training
academy will maintain a “Knowledge Management Portal” for management and easy access to training content, desktop procedures and P&Ps. The Health Net Training Academy will work closely with the Training operations and facilitate
necessary training. Training material will be continuously updated based on the System updates and process updates. 

  

	 	•	 	Team Huddle: Supplier’s team leads will conduct daily team meetings for individual processes to share any critical updates, provide feedback and communicate lessons learned, and plan for the day.

  

	 	•	 	Quality: Supplier will implement Health Net mandated specific quality and compliance programs in its delivery model for managing and achieving Service Levels. Supplier will analyse audit findings to determine
root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings, prevalent trends in errors, root causes and preventive actions will be discussed and implemented. 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-13		Health Net / Cognizant Confidential

 Final 

	 	•	 	Continuous Improvement: Supplier will have a dedicated Process Excellence (PEX) team consisting of Six Sigma resources for Health Net Claims functions to optimize performance and handoffs in Health Net Claims
processes while improving standardization. 

  

	 	•	 	Rewards and Recognition: Supplier will recognize the efforts of its best performers using stack ranking and will reward them through a structured reward and recognition program that aligns with quality and
productivity objectives. The Rewards and Recognition will be applicable for both Onshore and Offshore teams. The specific criteria for the awards will be decided by the Operations Leads depending on the specific behavior and/or results to be
achieved 

  

	6.5	Resource Profile 

 Supplier has a very well defined methodology for recruitment and
selection of candidates at offshore locations. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper qualifications
and experience in order to ensure a “best-fit” for Health Net. 
 The table below is an illustration of indicative requirements for
Offshore staffing and the minimum qualifications that must be met to be selected for the Claims operations. 
  

			
	 Claims Examiner

	 Qualification & Experience
	  	 Selection Process

	 •    Graduates with 1-2 years with Healthcare claims experience

 
 •    Good written and
verbal communication skills.
  

•    Knowledge of healthcare basics

 
 •    Familiar with
claims processing applications
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Written test of
Claims basics
  

•    Domain / Operations Interview

 
 •    Technical interview
on Claims adjudication concepts
  

•    Education and Professional

 Table 4 
  

			
	Claims Adjuster
	 Qualification & Experience
	  	 Selection Process

	 •    Graduates with 3-4 years with Healthcare claims experience

 
 •    Good written and
verbal communication skills.
  

•    Knowledge of healthcare basics

 
 •    Familiar with one
or more claims processing applications
  

•    Familiar with claims for multiple LOBs
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Written test of
Claims basics
  

•    Domain / Operations Interview

 
 •    Technical interview
on Claims adjudication and recovery concepts
  

•    Education and Professional Background Check

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-14	  	Health Net / Cognizant Confidential

 Final 
  

 Table 5 
  

			
	 Claims Recovery Examiner

	 Qualification & Experience
	  	 Selection Process

	 •    Graduates with 2-3 years with Healthcare claims and/or Coding
experience
  
 •    Good
written and verbal communication skills
  

•    Good analytical skills

 
 •    Knowledge of
healthcare basics
  

•    Familiar with one or more claims processing applications

 
 •    Familiar with
claims for multiple LOBs
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Written test of
Claims basics
  

•    Domain / Operations Interview

 
 •    Technical interview
on Claims adjudication and recovery concepts
  

•    Education and Professional Background Check

 Table 6 
  

			
	 Supervisor

	 Qualification & Experience
	  	 Selection Process

	 •    Graduate with 4 to 5 years’ experience in Healthcare Industry
specifically in respective in-scope process
  

•    2 years of Supervisory experience leading teams of at least 30-40 team members

 
 •    Leadership and
Communication skills
	  	 •    HR Interview for Cultural fitment

 
 •    Communication
Skills Screening
  

•    Domain/ Operations Interview

 
 •    Education and
Professional Background Check

 Table 7 
  

			
	 Auditors

	 Qualification & Experience
	  	 Selection Process

	 •    Graduates with 3-5 years’ experience in Healthcare process
auditors
  
 •    Six
Sigma/Lean exposure of at least 2 years
	  	 •    HR Interview for Cultural fitment

 
 •    Communication
Skills Screening
  

•    Domain/ Operations Interview

 
 •    Education and
Professional Background Check

 Table 8 
  

			
	 Team Manager

	 Qualification & Experience
	  	 Selection Process

	 •    Graduate/Post Graduate with 5+ years’ experience in Healthcare
Claims / Enrollment / Credentialing/ Benefits configuration/ Provider Calls/ Provider Data Management Process
  

•    Excellent Communication and Leadership skills

 
 •    3-4 years’
experience leading large teams
	  	 •    HR Interview-screening for roles and responsibility

 
 •    Technical
Interview
  

•    Operations Interview

 
 •    HR/ Operations
Leadership screening for leadership ability and cultural fit
  

•    Education and Professional Background Check

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-15	  	Health Net / Cognizant Confidential

 Final 
  

 Table 9 
  

			
	 Delivery Manager

	 Qualification & Experience
	  	 Selection Process

	 •    MBA with 8-10 years of experience

 
 •    Excellent
Communication and Leadership skills
  

•    7-9 years of overall BPO experience with at least 6 years leading a process in a
BPO.
	  	 •    Initial screening of profiles by recruitment team

 
 •    Interview with
Business Leader/ HR Manager
  

•    Technical/ Communication ability Interview

 
 •    Screening for
leadership ability and cultural fit
  

•    Salary Negotiation

 
 •    Education and
Professional Background Check

 Table 10 
  

	6.6	Voice Solution 

 Health Net expects Supplier to deliver voice assisted member and
provider interactions from both Onshore in the US and the Philippines. All Supplier Personnel will be skilled to handle Member and provider interactions. 
  

	
	Indicative Processes
	1-800-EDI team
	Claims Recovery
	Pay & Recover
	Claims Compliance
	Claims Projects
	Provider Disputes, Provider Reimbursement Specialists
	Recovery, COB
	Member Fallout
	1-800 number for Life insurance – 5 to 10 calls per week (part of MediCal tower)

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-16	  	Health Net / Cognizant Confidential

 Final 
  

 Table 11 
  

	6.7	IT Systems 

 The following systems will be used by Supplier for delivery of Claims
Management Services. 
  

	
	 Claims Applications / Platforms

	ABS
	MACESS
	Qcare
	FileNet
	MHN – Symphony
	SIR (MHN) imaging system.
	Viant/ Multiplan and other pricing vendor tools
	DRG Grouper
	Lotus Notes - all databases including Policy and Procedure Database
	TP 20/20 and Reinsurance/Eligibility Guarantee
	Unity
	GENELCO

 Table 12 
  

	6.8	Third Party Tools and Services 

 Supplier will use the following Tools and Services. The
contractual relationship for all Supplier Managed Third Parties will continue to remain with Health Net. Supplier will be responsible to manage day to day operational liaison. 

 

					
	 Third Party Tools/Service
	  	 Tool/Service Provider
	  	Contract Ownership
	Scanning/Imaging Services	  	Xerox/ACS	  	Claims
			
	Storage and Archival Services	  	MACESS / Filenet / MHN	  	Health Net
		  	Imaging System	  	
			
	Language Translation	  	Marketing Translation Services	  	Claims
			
	Clearing House	  	Emdeon, Capario, MD Online,	  	Claims
		  	GHI, DSG, WebMD	  	
			
	DRG Grouper	  	3M	  	Health Net
			
	Pricing	  	Burgess	  	Configuration
			
	Pricing	  	Viant	  	Configuration
			
	Pricing	  	Multi Plan (Funnel pricing)	  	PNM
			
	Data transfer to CMS for reimbursement	  	Ingenix	  	Claims
			
	Subrogation Services	  	Rawlings	  	Claims
			
	Recovery Services	  	Rawlings	  	Claims
		  	AIM	  	
		  	CDR	  	
		  	HRI Trover (Trover Solutions).	  	
		  	Capital Recovery	  	

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-17	  	Health Net / Cognizant Confidential

 Final 
  

					
			GB Collects		
		Souverign Receivables		
		HMS		
		RMS		
		HDI		
		CAQHC		
	 EDI Tools
  

Code Sets
  

Pricing
  

Pricing
  

Pricing
		 Edifecs
  

Optum
  

iHealth
  

FirstHealth
  

FirstChoice - Oregon, Washington
		 Health Net IT 
 Claims

 
 Medical Management

 
 PNM
  

PNM

 Table 13 

Table 14 
  

	6.9	Regulatory On-shore Requirements 

 Section 7 sets forth the Claims Management
Services roles that Supplier is required to retain Onshore. Supplier will at all times provide the Claims Management Services in accordance with Schedule Y (Offshore Prohibitions and Requirements) 

 

	6.10	Service Performance Management 

 Supplier will provide and implement the quality
assurance procedures that are necessary to perform the Claims Management Services in accordance with the Service Levels, reporting formats and frequency 

Approach 
  

	 	•	 	Supplier will use a statistically valid sample size will be for auditing 

 Tools 

Supplier will use quality analysis using tools including: 
  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

	7.	KEY ASSUMPTIONS 

  

	 	1.	Any work request received directly at Health Net in non-digital format will be batched and sent by Supplier to the scanning/imaging service provider for conversion into digital format. However for regulatory
requirements Onshore Supplier Personnel will scan the documents in the United States 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-18		Health Net / Cognizant Confidential

 Final 
  

	 	2.	The Onshore/Offshore mix will be validated during detailed Transition Planning as set forth in the Transition Manual. 

  

	 	3.	Cognizant will deploy resources that are proficient in English for providing the Services, however, member communications will be in their preferred languages 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-19		Health Net / Cognizant Confidential

 EXHIBIT A-1.1 

APPROVED SERVICE DELIVERY CENTERS 
 The
Service Delivery Centers at (or from) which Supplier is authorized to perform the Services under this Statement of Work are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform
certain aspects of the Services, their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.1 (Approved Service Delivery Centers). 

Supplier will provide sufficient coverage for the Claims Management Services by leveraging its global delivery network. A list of holidays across delivery
locations will be mutually agreed with Health Net to ensure that there is no impact on operations. 
 Onshore Service Delivery Centers 

 

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours of
Operation	  	Functions /
Services	  	Languages
Supported	  	Key
Platform /
Systems	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in
Service	  	Multi-
client
Site
(Y/N)?
	 Rancho
 Cordova
	  	 Office
 Building
	  	Refer
to
section
7.3	  	Claims
 Management
	  	English	  	Refer
 to 7.7
IT
Systems
	  	Woodland
 Hills
	  	Refer to
section 7.3	  		  		  	
											
	 Woodland
 Hills
	  	 Office
 Building
	  	Refer
to
section
7.3	  	Claims
 Management
	  	English	  	Refer
 to 7.7
IT
Systems
	  	Rancho
 Cordova
	  	Refer
to
section 7.3	  		  		  	

  

					
	SOW#6 (Claims) Exhibit A-1	  	A-1.2-1	  	Health Net / Cognizant Confidential

 Final 
  

 Near-shore Service Delivery Centers 

Supplier will not use any near-shore Delivery Centers to perform the Claims Management Services. 

Offshore Service Delivery Centers 
  

																					
	 Primary

Location
	 	 Type of

Facility
	 	Hours of
Operation	 	 Functions /

Services
	 	Languages
Supported	 	Key
Platform /
Systems	 	 Back-up / Fail-over
Location
	 	Facility
Operator	 	Facility
Owner	 	Date
Placed
in
Service	 	Multi-
client
Site
(Y/
N)?
	 India Hyderabad Cognizant Technology Solutions, Raheja Mindspace, Building No.20,

7thFloor, Madhapur, -500081
	 	 Office
 Building
	 	Refer
to
section
7.3	 	 Claims
 Management
	 	English	 	Refer
 to 7.7
IT
Systems
	 	 DLF Cognizant
 Technology

Solutions, DLF Cybercity
 Plot.No:

129,130,13
 1 & 132

APHB Colony, Gachibowli
 – 500019

 
 Intercity

India - Chennai -
 CRC, Cognizant Technology Solutions,
India
	 	Cognizant	 	Third
 Party
	 	2007	 	Y

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-2	  	Health Net / Cognizant Confidential

 Final 

  

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours
of
Operation	  	Functions /
Services	  	Languages
Supported	  	Key
Platform /
Systems	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in
Service	  	Multi-
client
Site
(Y/N)?
		  		  		  		  		  		  	Pvt Ltd,
 Block B,

CARR
Tower,
 Ramanujan

IT
 City,
Taramani,

Rajiv
 Gandhi

Salai
 (OMR)
	  		  		  		  	
											
	 India - Chennai -
 CRC, Cognizant Technology
Solutions, India
 Pvt Ltd, Block B,
 CARR Tower,

Ramanujan
 IT

City, Taramani,
	  	 Office
 Building
	  	Refer
to
section
7.3	  	Claims
 Management
	  	English	  	Refer
 to 7.7
IT
Systems
	  	Intra-city
 India -
Chennai -

ASV
Suntech
 park ,
Cognizant
Technology

Solutions,
Pvt.
 Ltd., ASV
Suntech

Park,
 Old

Mahabalip
	  	Cognizant	  	Third
 Party
	  	2012	  	Y

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-3	  	Health Net / Cognizant Confidential

 Final 

  

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours
of
Operation	  	Functions /
Services	  	Languages
Supported	  	Key
Platform /
Systems	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in
Service	  	Multi-
client
Site
(Y/N)?
	 Rajiv
 Gandhi

 
 Salai

(OMR)
	  		  		  		  		  		  	uram
 Road,
Chennai
  

Intercity
India
Hyderabad
Cognizant

Technology
Solutions,
Raheja
Mindspace,
Building
No.20,

7thFloor,
Madhapur,
 - 500081
	  		  		  		  	

 Table 17 

Supplier will mutually agree on the list of holidays and ensure sufficient coverage by leveraging the global delivery networkto ensure no impact on
operations. 

  

					
	SOW#1 (Claims) Exhibit A-1	  	A-1-4	  	Health Net / Cognizant Confidential

 Final 

 EXHIBIT A-1.2 

SERVICE DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 

Set out below is a description of Supplier’s ‘To-Be’ Solution for the Claims Management Services as it will be configured at the completion of
Phase 2. The tactical To Be solution will be mutually defined during the Transition below is an illustrative technology environment for claims operations 
  

 
  

	*	Lotus notes above includes associated databases 

  

					
	SOW#1 (Claims) Exhibit A-1		A-1-5		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

CLAIMS ORGANIZATION CHART 

  

					
	SOW#1 (Claims) Exhibit A-3		 		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

CLAIMS ORGANIZATION CHART 
 This Exhibit
A-3 (Claims Organization Chart) contains organization charts showing, at a specific recent point in time prior to the Effective Date, the positions (including both filled and currently open positions) that represent the Health Net
organizational unit(s) whose Functions are being outsourced to Supplier under this Statement of Work. This document is included as part of this Statement of Work as a supplemental means of depicting the Functions that comprise the Claims Management
Services for which Supplier is assuming responsibility from Health Net under this Statement of Work. It is not included for the purpose of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s Charges for
the Claims Management Services. Any changes in the organization charts between the Agreement’s Effective Date and the BPaaS Services Commencement Date shall not be interpreted to represent a change in the scope of the Claims Management Services
in the absence of Health Net specifically adding or removing Functions from Exhibit A (Claims Management Services) of this Statement of Work. 

  

					
	SOW#1 (Claims) Exhibit A-3		 		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

CLAIMS MANAGEMENT ORGANIZATION CHART 
  

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-2		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-3		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-4		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-5		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#1 (Claims) Exhibit A-3		A-3-6		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT B-1 

CLAIMS SERVICE LEVEL METRICS 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

	1	  	 Manual Cross-Accumulator
 Turnaround
Time
	  	 [% TBD (Baseline Consideration)] of

Cross-Accumulator Update Submissions shall have a Cross-Accumulator Turnaround Time of less than or equal to twenty (20) Business Days (Base Line
Consideration)
  
 This Service Level shall be calculated in accordance with the
following formula:
  
 (# Completed Cross-Accumulator Update Submission – # Late
Completed Cross- Accumulator Update Submission) / # Completed Cross-Accumulator Update Submission x 100%
  

Where:
  

“Cross-Accumulator Update Submission” means a submission by a Member requiring manual updates to a Member’s accumulator
information in the applicable Claims System(s).
  
 “# Completed
Cross-Accumulator Update Submissions” means the number of Cross- Accumulator Update Submissions for which Cognizant has performed all required Services necessary to update the required information in all of the applicable Claims
System(s).
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

									
		  		  	 “# Late Completed Cross-Accumulator

Update Submissions” means the number of Completed Cross-Accumulator Update Submission s for which the Cross- Accumulator Turnaround Time is
greater than twenty (20) Business Days (Base Line Consideration).
  

“Cross Accumulator Turnaround Time” means, for each Cross-Accumulator Update Submission, the elapsed time (in twenty (20) Business
Days) (Base Line Consideration) between (i) the date on which the Cross-Accumulator Update Submission is made available to Supplier (including via a Service Form, email, or a specific queue in the applicable Claims System(s)) and (ii)
the date when the applicable Cross-Accumulator Entry is considered a Completed Cross- Accumulator Entry.
	  		  		  		  		  		  	
									
	2	  	 Manual Cross-Accumulator
 Accuracy
	  	 The percentage of Cross-Accumulator
 Update
Submissions that are processed without any errors shall be greater than or equal to [% TBD (Baseline Consideration)]
  

This Service Level shall be calculated in accordance with the following formula:
  

[(Total # of audited Cross-Accumulator Update Submissions – # of audited Cross- Accumulator Update Submissions with 1 or more errors) / Total # of audited
Cross- Accumulator Update Submissions] x 100%
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	Y
									
	3	  	 Accumulator Inquiry
 Response Time
	  	[% (Base Line Consideration)] of Accumulator Inquiries shall have an Accumulator Inquiry Response Time of less than or equal to thirty (30) calendar days.	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

		  		  	 This Service Level shall be calculated in accordance with the following formula:

 
 (# Completed Accumulator Inquiries – # Late Completed Accumulator Inquiries) / #
Completed Accumulator Inquiries x 100%
  
 Where:

 
 “Accumulator Inquiry” means an inquiry from a Member requesting
information regarding the amount of their accumulator totals.
  
 “#
Completed Accumulator Inquiries” means the number of Accumulator Inquiries for which Supplier has provided all of the requested information and satisfied the Member’s inquiry.

 
 “# Late Completed Accumulator

Inquiries” means the number of Completed Accumulator Inquiries for which the Accumulator Inquiry Response Time is greater than forty-five
(45) calendar days.
  
 “Accumulator Inquiry Response Time” means,
for each Accumulator Inquiry, the elapsed time (in calendar days) between (i) the date on which the Contact Center submitted the Service Form describing the Accumulator Inquiry, and (ii) the date when the applicable Cross-Accumulator Entry is
considered a Completed Cross-Accumulator Entry.
	  		  		  		  		  		  	

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-3	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

	4	  	 Capitation Deduct
 Turnaround Time
	  	 [% (Base line consideration)] of all Capitation Deduction Requests shall have a Capitation Deduction Request Turnaround Time of less
than or equal to ten (10) calendar Days.
  
 This Service Level shall be calculated in
accordance with the following formula:
  
 (# Completed Capitation Deduction Requests
– # Late Completed Capitation Deduction Requests) / # Completed Capitation Deduction Requests x 100%
  

Where:
  

“Capitation Deduction Request” means a request from Health Net for a capitation deduction for a particular PPG or capitated
hospital.
  
 “# Completed Capitation Deduction Request”
means the number of Capitation Deduction Requests for which Cognizant has performed all required Services necessary to pay the applicable Claim and enter the necessary information into the applicable Claims System(s) so that the payment is deducted
from the subsequent capitation payment to the applicable PPG or capitated hospital.
  

“# Late Completed Capitation Deduction Request” means the number of Completed Capitation Deduction Requests for which the Capitation
Deduction Requests Turnaround Time is greater than five (5) Business Days (Base Line Consideration).
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

		  		  	“Capitation Deduction Request Turnaround Time” means, for each Capitation Deduction Request, the elapsed time (in Business Days) between (i) the date on which the Capitation Deduction Request is first
submitted to Supplier and (ii) the date when the applicable Capitation Deduction Request is considered a Completed Capitation Deduction Request and processed within the core adjudication system.	  		  		  		  		  		  	
									
	5	  	 Balanced Checks (QCare)
 Turnaround
Time
	  	Each week, the Check Register Report will be balanced against all of the checks that are approved for printing for the same period covered by the applicable Check Register Report and such checks will be approved for release (as
evidenced by an email to Health Net’s fulfillment center) by 9:30am PT on the same day that the Check Register Report is prepared and provided to Supplier.	  	Monthly	  	TBD	  	N	  	TBD	  	A	  	N
									
	6	  	 Recovery Notification Letter

Submission
	  	 [% TBD (Baseline Consideration)]of all

Recovery Notification Letters shall be prepared for mailing and submitted to Health Net’s fulfillment center within the following timeframes:

 
 •    ABS =
Automatically produced on Day 1, Day 45, Day 90
  

•    QCare = Manually produced on Day 1 and Day 30. [To be base lined.]

 
 •    MC400 =
Automatically produced on Day 1, and each subsequent RA contains recover language if there is an outstanding balance.]
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

		  		  	 •    Symphony = Manually produced weekly for first notification, and monthly for ongoing recovery efforts.
[To be baselined.]
	  		  		  		  		  		  	
									
	7	  	 Coordination of Benefits
 Turnaround
Time
	  	 [% TBD (Baseline Consideration)] of all

COB Notification shall have a COB Turnaround Time of less than or equal to five (5) Business Days.

 
 This Service Level shall be calculated in accordance with the following formula:

 
 (# Completed COB Notifications – # Late Completed COB Notifications) / # Completed
COB Notifications x 100%
  
 Where:

 
 “COB Notification” means a notification that the coordination of
benefits information for a particular Member needs to be updated.
  
 “#
Completed COB Notifications” means the number of COB Notifications for which Supplier has performed all required Services necessary to research and determine the appropriate coordination of benefit and make the necessary
updates to the applicable Claims System(s).
  
 “# Late Completed COB
Notifications” means the number of Completed COB Notifications for which the COB Turnaround Time is greater than five (5) Business Days.
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

		  		  	 “COB Turnaround Time” means, for each

COB Notification, the elapsed time (in Business Days) between (i) the earlier of (a) date on which the COB Notification is first submitted to Supplier
(including from a person performing Claims Adjudication services, the Contact Center Tower or the Membership Tower), or (b) Supplier otherwise becomes aware that such an update is necessary (provided that in the case of (b), Supplier has the
authority to perform such activity in the absence of Health Net request or prior-approval), and (ii) the date when the applicable COB Notification is considered a Completed COB Notification.
	  		  		  		  		  		  	
									
	8	  	 Coordination of Benefits
 Accuracy
	  	 The percentage of COB Notifications that
 are
processed without any errors shall be greater than or equal to [% TBD (Baseline Consideration)]
  

This Service Level shall be calculated in accordance with the following formula:
  

[(Total # of audited Cross-Accumulator Update Submissions – # of audited Cross- Accumulator Update Submissions with one (1) or more errors) / Total # of
audited Cross-Accumulator Update Submissions] x 100%
	  	Monthly	  	TBD	  	N	  	TBD	  	C	  	Y
									
	9	  	 Benefit Testing Turnaround
 Time
	  	 [% TBD (Baseline Consideration)] of all

Benefit Testing Requests shall have a Benefit Testing Request Turnaround Time of less than or equal to the earlier of (i) three (3) Business Days (Base
Line Consideration), or (ii) the effective date of the applicable benefit plan.
	  	Monthly	  	TBD	  	Y	  	TBD	  	C	  	N

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-7	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 #
	  	 Category
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement

		  		  	 This Service Level shall be calculated in accordance with the following formula:

 
 (# Completed Benefit Testing Requests – # Late Completed Benefit Testing Requests) /
# Completed Benefit Testing Requests x 100%
  
 Where:

 
 “Benefit Testing Request” means a request from Health Net to do
Claims processing testing for a new or modified benefit plan.
  
 “#
Completed Benefit Testing Request” means the number of Benefit Testing Requests for which Cognizant has performed all required Services necessary to test the applicable benefit plan in accordance with Section 3.4(ee) of
Exhibit A (Claims Management Services).
  
 “# Late Completed Benefit
Testing Request” means the number of Completed Benefit Testing Requests for which the Benefit Testing Requests Turnaround Time is greater than the earlier of (i) three (3) Business Days, or (ii) the effective date of the applicable
benefit plan.
  
 “Benefit Testing Request Turnaround Time” means,
for each Benefit Testing Request, the elapsed time (in Business Days) between (i) the date on which the Benefit Testing Request is first submitted to Supplier and (ii) the date when the applicable Benefit Testing Request is considered a Completed
Benefit Testing Request.
	  		  		  		  		  		  	

  

					
	SOW#1 (Claims) Exhibit B-1	  	B-1-8	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT B-2 

FINANCIAL SUPPORT REQUESTS 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
	  1	 	 Refund Posting – For All Adjudication

Systems (QCare/ABS/Symphony)
	  	 Baseline Consideration of refund checks shall be completed and posted within the applicable Claims System(s) no later than the earlier of (a)
seven (7) Business Days from the date on which Supplier first receives the applicable refund request, or (b) provided that Supplier first receives the applicable refund request no later than three (3) Business Days prior to the end of the calendar
month, the end of the calendar month.
  
 For clarity, refund requests include requests
related to actual checks paid to Health Net as well as for funds collected by vendors.
	 		 	[TBD]	 	C	 	Y	 	N
								
	  2	 	 Returned Check Re-mails – For All

Adjudication Systems
 (QCare/ABS/Symphony)
	  	 “Check Re-mail” means a check that Health Net issued to a provider or member but was returned to Health Net by the
post office due to an incorrect or incomplete address.
  
 [% Baseline
Consideration] of all Check Re-mails will be completed no later than five (5) Business Days after the date on which Health Net notifies Supplier of such Check Re-mail; and
  

[% Base line consideration] of all Check Re-mails will be completed no later than the earlier of (a) seven (7) Business Days after the date on which
Health Net notifies Supplier of such Check Re-mail; or (b) provided that Health Net notifies Supplier of such Check Re-mail no later than three (3) Business Days prior to the end of the
	 		 	[TBD]	 	C	 	N	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-1	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	calendar month, the end of the calendar month. For purposes of this Service Level, a “completed” Check Re-mail is one for which Supplier has provided all necessary information back to Health Net for Health Net to be able
to successfully re-mail the applicable check.	 		 		 		 		 	
								
	3	 	 Negative Vendor Records – For All

Adjudication Systems
 (QCare/ABS/Symphony)
	  	 [% TBD (Baseline Consideration)] of all Negative Vendor Records will be researched, resolved and cleared no later than three ( 3)
Business Days after the first date on which the payee record became a Negative Vendor Record.
  

100% of all Negative Vendor Records will be researched, resolved and cleared within five (5) Business Days after the first date on which the payee record
became a Negative Vendor Record.
  
 “Negative Vendor Records”
has the meaning given in Section 3.3 # 15(f) in Exhibit A (Claims Management Services).
	 		 	[TBD]	 	C	 	Y	 	N
								
	4	 	 Check Stop Payments/Stale Dated
 Checks/Reissues
– For All Adjudication Systems (QCare/ABS/Symphony)
	  	[% TBD (Baseline Consideration)] of stop payments, stale dated checks, and related reissue requests shall be completed no later than five (5) Business Days after the date on which the need for such stop payment is first
logged in the applicable system.	 		 	[TBD]	 	C	 	N	 	N
								
	5	 	 Voids/Reissues – For All Adjudication

Systems (QCare/ABS/Symphony)
	  	 [% TBD (Baseline Consideration)] of voids and related reissue requests shall be completed no later than five (5) Business Days after
the date on which the need for such void/reissue is first logged in the applicable system; and
  

[% TBD (Baseline Consideration)] of voids and related reissue requests shall be completed no later than seven (7) Business Days after the date on which
the need for such void/reissue is first logged in the applicable system.
	 		 	[TBD]	 	C	 	N	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-2	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
	6	 	 Financial Accuracy (Must meet for
 each of the
specified categories)
	  	 The percentage of the total dollar amount of Completed Claims and Adjusted Claims Transactions that were processed accurately shall be
greater than or equal to the percentage shown below for each category.
  
 This Service
Level shall be calculated in accordance with the following formula:
  
 Total $
Processed – Absolute $ Error
 Total $ Processed x 100%
  

Where:
  

“Total $ Processed” means the sum, across all Completed Claims and Adjusted Claims that are Audited Transactions, of the amount
actually paid for such Completed Claims and Adjusted Claims that are Audited Transaction. For the avoidance
 of doubt, “denied” Claims are
included in this calculation as a $0.
  
 “Absolute $ Error” means
the sum of the absolute value of the Financial Errors in each of the Completed Claims and Adjusted Claims that are Audited Transactions.
  

1.      California: >= 98.08%

2.      MediCal (California): >= 99.00%

3.      Cal Medi-Connect Dual Eligibles (Calif.): >= - Baseline Consideration

4.      Oregon: >= 99.35% Arizona: >= 99.21

5.      AZ AHCCCS: >= Baseline Consideration.

6.      MHN: >=% 98.48% as per data provided
	 	Monthly	 	Health
Net
Post
 PayAudit
Database.
	 	A
 except
for:
  

Cal
Medi-
Connect
  

Dual
Eligib
les
=
 C

 
 AZ
AHC
CCS

= B
	 	Y	 	Y

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-3	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 *  Baselining will be considered for AHCCCS & Cal Medi-Connect Dual Eligibles.
	 		 		 		 		 	
								
	7	 	 Payment Accuracy (Must meet for
 each of the
specified categories)
	  	 The percentage of Completed Claims and Adjusted Claims Transactions that are processed without any Financial Errors shall be greater than or
equal to the percentage shown below for each category %.
  
 This Service Level shall be
calculated in accordance with the following formula:
  
 [(Total # of Completed Claims and
Adjusted Claims that are Audited Transactions - # of Completed Claims and Adjusted Claims that are Audited Transactions with 1 or more Financial Errors) / Total # of Completed Claims and Adjusted Claims that are Audited Transactions] x 100%

 
 1.      California:
>= 96.99%
 2.      MediCal (California): >= 97.8%

3.      Cal Medi-Connect Dual Eligibles (Calif.): >= Baseline consideration

4.      Oregon: >= 98.86%

5.      Arizona: >=% 98.5%

6.      AZ AHCCCS: >=* Baseline Consideration

7.      MHN: >=98.00%

 
 *  Baselining will be considered for
AHCCCS & Cal Medi-Connect Dual Eligibles.
	 	Monthly	 	Health Net Post Pay
 Audit
Database.
	 	A
 except
for:
  

Cal
Medi-
Connect

Dual
Eligib
les
=
 C

 
 AZ
AHC
CCS

=
B
	 	Y	 	Y
								
	8	 	Procedural Accuracy (Must meet for each of the specified categories)	  	 The percentage of Transactions that are processed without any Procedural Errors shall be greater than or equal to the percentage shown below
for each category %.
  
 This Service Level shall be calculated in accordance with the
following formula:
	 	Monthly	 	Health
Net
Post
 PayAudit
Database.
	 	A
 except
for:

Cal
Medi-
Connect
	 	Y	 	Y

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-4	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 [(Total # of Audited Transactions – # of Audited Transactions with one (1) or more Procedural Errors) / Total # of Audited Transactions]
x 100%
  

1.      California: >= 96.05%

2.      MediCal (California): >= 97.00%

3.      Cal Medi-Connect Dual Eligibles (Calif.): >= % Baseline Consideration

4.      Oregon: >= % 98.5%

5.      Arizona: >=98.25%

6.      AZ AHCCCS: >=* Baseline Consideration

7.      MHN: >=98.25% - Agree

 
 *  Baselining will be considered for
AHCCCS & Cal Medi-Connect Dual Eligibles.
	 		 		 	Dual
Eligib
les
=
 C 

AZ
AHC
CCS
=
B
	 		 	
								
	9	 	Adjudication Turnaround Time (must meet for each of the specified categories)	  	 New Day Claims will be processed at greater than or equal to the rate shown for each category below:

 
 **unless otherwise called out for a different
metric such as ((Community Based Adult Services (CBAS) as outlined below))
  
 #
Completed Claims - #Late Claims Adjudicated
 # Completed Claims x 100%
  

1.      California EDI (Professional and Institutional) Claims in thirty (30) calendar
days (including MediCal): Baseline Consideration
 2.      California Paper
(Professional and Institutional) Claims in thirty (30) calendar days (including MediCal): Baseline Consideration

3.      Oregon EDI (Professional and Institutional) Claims in thirty (30) calendar days:
Baseline Consideration
	 	Monthly	 	Core Adjudication
 Systems
	 	A
 except
for:
  

AZ
AHC
CCS
 =
B

 
 Cal
Medi-
Connect

Dual
Eligib
les
=
 B

 
 CBAS

=
C
	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-5	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 4.      Oregon Paper (Professional and Institutional) Claims in thirty
(30) calendar days: Baseline Consideration
 5.      Arizona All Claims (includes AZ
AHCCCS) in fourteen (14) calendar days: Baseline Consideration
 6.      Arizona All
Claims (includes AZ AHCCCS) in thirty (30) calendar days: 98.5%
 7.      AZ AHCCCS:
*
 8.      Cal Medi-Connect Dual Eligibles (Calif.): *

9.      Community Based Adult Service (CBAS – Calif.) Claims [Check Date –
Received Date] within ten (10) days: Baseline Consideration
 10.    All states Medicare
Non-Contracted Clean Claims within thirty (30) calendar days: Baseline Consideration

11.    All states Medicare all other (Non-Contracted Unclean & Contracted) Claims within sixty
(60) calendar days: Baseline Consideration
  
 * Baseline to be determined.
	 		 		 	Medic
 are

(both)
 =
B
	 		 	
								
	10	 	 California, Oregon, California
 MediCal along
with Arizona and
 AZHCCCS Adjudication
	  	Team will maintain a month end inventory established by Finance/Actuary in respect to billed charges plus or minus 5% for all commercial and Medicare lines of business within each region and specific to AZHCCCS and California
MediCal.	 	Monthly	 	Measurement using

EIS as the
reporting tool
or ABS
related inventories.
For MediCal,
the 
measurement
tool will
be QCARE
data until
such time the
information
is housed in a
repository.
	 	A	 	Y	 	N
								
	11	 	 California Provider Dispute Turn
 Around
Time
	  	Team will maintain a month end inventory of 2,000 claims/adjustments plus or minus 10% for PDR Clinical Determinations and 6,000 claims/adjustments plus or minus 10% for non-Clinical PDR adjustments.	 	Monthly	 	Monthly
 Measurement
using EIS as the
reporting tool.
	 	A	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-6	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
	12	 	California and Oregon Adjustment Turnaround Time	  	- [% TBD (Baseline Consideration)] of all other adjustment requests related to California and Oregon PPO Claims shall have a California and Oregon Adjustment Turnaround Time of thirty (30) Calendar Days and [% TBD
(Baseline Consideration)] of such adjustment requests shall have an Escalation Turnaround Time of one (1) Business Day; and - [% TBD (Baseline Consideration)] of all other adjustment requests related to California and Oregon HMO Claims
shall have a California and Oregon Adjustment Turnaround Time of thirty (30) Calendar Days and [% TBD (Baseline Consideration)]of such adjustment requests shall have an Escalation Turnaround Time of one (1) Business Day. This Service Level
shall be calculated in accordance with the following formula: # California and Oregon Adjusted Claims – # Late California and Oregon Claims Adjusted # Adjusted Claims x 100% “#Late California and Oregon Claims Adjusted”
means the number of California and Oregon Adjusted Claims for where the Adjustment Turnaround Time is greater than the maximum number of days, as set forth above.	 	Monthly	 	Monthly
–
Manual
Calculation
and
using
MACESS	 	C	 	Y	 	N
								
	13	 	Arizona Adjustment Turnaround Time	  	 The Arizona Adjustment Turnaround Time shall be greater than or equal to the following:

 
 - 90% of Arizona Adjustment Requests shall have an Arizona Adjustment Turnaround of
fifteen (15) calendar days; and
	 	Monthly	 	Manual
 andMACESS
	 	A	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-7	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 - 98.4% of Arizona Adjustment Requests shall have an Arizona Adjustment Turnaround of twenty (20) calendar days.

 
 This Service Level shall be calculated in accordance with the following formula:

 
 # Arizona Adjusted Claims – # Late Arizona Claims Adjusted

# Arizona Adjusted Claims x 100%
  

Where:
  

“# Late Arizona Claims Adjusted” means the number of Arizona Adjusted Claims for which the Arizona Adjustment Turnaround Time is
greater than the maximum number of days, as set forth above.
  
 “Arizona
Adjustment Turnaround Time” means the elapsed time (in calendar days) between (i) the moment Supplier receives an adjustment request, and (ii) the moment that the applicable Claim is considered an Arizona Adjusted Claim.
	 		 		 		 		 	
								
	14	 	 Arizona Provider Inquiry Mail –
 Service
Form Creation Turnaround
 Time
	  	 100% of all PI Mail SF Created shall have a PI Mail SF Turnaround Time of two (2) Business Days.

 
 This Service Level shall be calculated in accordance with the following formula:

 
 # PI Mail SFs Created – # Late Service Forms Created

# Service Forms Created x 100%
	 		 		 	A	 	N	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-8	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 Where:
  

“# Late Service Forms Created” means the number of PI Mail SFs Created for which the Service Form Turnaround Time is greater than two
(2) Business Days.
  
 “Service Form Turnaround Time” means the
elapsed time in Business Days between (i) the moment that the request for the creation of the PI Mail SF Created becomes available to Supplier (e.g., is accessible to Supplier via the designated system), and (ii) the moment that the creation of such
PI Mail SF Created is deemed complete by Health Net.
	 		 		 		 		 	
								
	15	 	 Arizona – Provider Inquiry Processing

Turnaround Time
	  	 The PI Turnaround Time shall be greater than or equal to the following:

 
 - [% TBD (Baseline Consideration)] of Pis shall have a PI Turnaround Time within
fifteen (15) calendar days;
  
 - [% TBD (Baseline Consideration)] shall have a PI
Turnaround Time within thirty (30) calendar days
  
 This Service Level shall be
calculated in accordance with the following formula:
  
 # Completed Pis – # Late
Completed Pis
 # Completed Pis x 100%
  

Where:
  

“# Late Completed Pis” means the number of Completed Pis for which the PI Processing Turnaround Time is greater than the maximum number
of days, as set forth above.
	 		 		 	C	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-9	  	Health Net / Cognizant Confidential

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	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	 “PI Turnaround Time” means the elapsed time (in calendar days) between (i) the moment that a PI is available for PI
Mail SF Created processing, and (ii) the moment that such PI is considered a
 PI Processed.
	 		 		 		 		 	
								
	16	 	All Entities (Mail Services)	  	[% TBD (Baseline Consideration)]All Mail for all entities will be opened, reviewed, date stamped and delivered to appropriate departments, associates, others within twenty-four (24) hours of receipt (Receipt to CTS to be in a
mutually agreed format and placed in specific location/queue.).	 		 	Manual
Process	 	C	 	N	 	N
								
	17	 	All Returned Mail	  	[% TBD (Baseline Consideration)]Returned mail related to incorrect address for correspondence, checks, recovery letters and any other documents generated in the normal course of business surrounding claims
adjudication/processing will be processed within ten (10) business days. (Receipt to CTS to be in a mutually agreed format and placed in specific location/queue.).	 		 	Manual
Process	 	C	 	N	 	N
								
	18	 	MHN NDP Letters	  	[% TBD (Baseline Consideration)]Process all Notice of Denials Baseline Consideration of the time within one (1) business day and Baseline Consideration of the time within two (2) business days of generation from the NDP
database.	 	Daily
 toMonthly
	 		 	C	 	N	 	N
								
	19	 	 PDR – Commercial/Medicare (from
 Call
Center) TAT
	  	[% TBD (Baseline Consideration)]Receive, triage and route PDRs to Claims within six (6) business days.	 	Daily
 toMonthly
	 		 	C	 	Y	 	N
								
	20	 	PDR – SHP (from Call Center) TAT	  	(% Baseline consideration) Receive, triage and route PDRs to Claims within fifteen (15) business days.	 	Daily
 toMonthly
	 		 	C	 	Y	 	N
								
	21	 	Medicare Out of Network Provider Appeals	  	Greater than 85% of all appeals decisions will be made within sixty (60) calendar days.	 	Monthly	 	TBD	 	B	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-10	  	Health Net / Cognizant Confidential

 Final 
  

															
	#	 	 Category
	  	 Description
	 	Measurement
Period	 	Measurement Tool	 	Code	 	Critical
(Y/N)	 	Continuous
Improve
		 		  	Measures the rate of cases auto-forwarded to the Independent Review Entity (IRE) (Medicare Part C) because decision timeframes for coverage determinations/redeterminations were exceeded by the plan. Appeals /other dept that
impacts/delays coverage determination/redetermination from being processed timely impacts measure, (e.g., miss- routes in mailroom).	 		 		 		 		 	
								
	22	 	Medicare Out of Network Provider Appeals	  	 Greater than 87% of all appeals will be fair.
  

Fair is defined as HN has made the appropriate determination with the appropriate supporting documentation no less than 87% of the time.

 
 Measures % cases overturned by Independent Review Entity (IRE) (Medicare Part C).

 
 Improperly prepped cases and/or weak rationale to support uphold impacts measure.
	 	Monthly	 	TBD	 	B	 	Y	 	N
								
	23	 	Medicare Out of Network Provider Disputes	  	 Greater than 95% of all disputes will be processed within thirty (30) calendar days.

 
 Measures the responses to disputes about payment amounts on previously paid
claims.
	 	Monthly	 	TBD	 	B	 	Y	 	N

  

					
	SOW#1 (Claims) Exhibit B-2	  	B-2-11	  	Health Net / Cognizant Confidential

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EXHIBIT D 
 KEY SUPPLIER
PERSONNEL 
 Subject to Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions
filled by the individuals listed in the table below. 
  

			
	 Key Supplier Position
	  	 Initially Approved Individual

	Director Claims	  	TBD
	Director Claims	  	TBD
	Claims Examiner Lead-Ops	  	TBD
	Dir Configuration & Claims	  	TBD
	Business Analyst, Sr	  	TBD
	Mgr Claims	  	TBD
	Business Systems Analyst, Sr	  	TBD
	Director Claims	  	TBD
	Business Systems Analyst, Sr	  	TBD
	Mgr Claims	  	TBD
	Mgr Claims	  	TBD
	Mgr Vendor Management	  	TBD
	Business Systems Analyst, Sr	  	TBD

  

					
	SOW#1 (Claims Management) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

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EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms and
Conditions, this Exhibit H (Subcontractors) identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth below.

  

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	 ***
	  		  	

  

					
	SOW#1 (Claims) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

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AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #2 (MEMBERSHIP AND CONFIGURATION SERVICES) 

  

					
	SOW #2 (M + C)		 		Health Net / Cognizant Confidential

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AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #2 (MEMBERSHIP AND CONFIGURATION SERVICES) 

This Statement of Work #2 (Membership and Configuration Services), dated November 21, 2014, but effective as of November 2,
2014 (“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #2 (Membership and Configuration Services) is entered into and shall be governed by the terms of that certain Amended
and Restated Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #2 (Membership and Configuration Services) replaces and supersedes in all
respects the Statement of Work #2 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #2 (Membership and Configuration
Services) describes the Membership and Configuration Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Membership and Configuration Services) to this SOW #2 (Membership and Configuration
Services), and sets forth certain terms and conditions relating to them, including, among other things: 
  

	 	(a)	The scope of the Membership and Configuration Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; 

  

	 	(d)	The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

	1.2	Structure 

 This SOW #2 (Membership and Configuration Services) is comprised of
this cover document and the following Exhibits: 
  

					
	 Table 1: Exhibits to SOW
#2 (Membership and Configuration Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	Exhibit A (Services)	  	Describes the scope of the Membership and Configuration Services.

  

					
	SOW #2 (M + C)	  	1	  	Health Net / Cognizant Confidential

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	 Table 1: Exhibits to SOW
#2 (Membership and Configuration Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	2	  	 Exhibit A-1 (Solution

Description)
	  	 Describes Supplier’s solution for the provision of the Membership and Configuration Services and includes as exhibits:

 
 •    Exhibit A-1-1
(Approved Service Delivery Centers)
  

•    Exhibit A-1-2 (Service Delivery Configuration at the Completion of Phase
2)

			
	3	  	Exhibit A-3 (Organizational Chart)	  	Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW #2 (Membership and Configuration Services).
			
	4	  	Exhibit B-1 (Operational SLAs)	  	Identifies the Operational Service Levels applicable to the Membership and Configuration Services.
			
	5	  	 Exhibit D (Key
 Supplier
Positions)
	  	Identifies the Key Supplier Positions applicable to the Membership and Configuration Services.
			
	6	  	Exhibit H (Subcontractors)	  	Identifies the Subcontractors approved by Health Net to provide certain of the Membership and Configuration Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #2 (Membership and
Configuration Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #2 (Membership and Configuration
Services) is hereby made a part of, and is subject to and governed by, the Agreement. This SOW #2 (Membership and Configuration Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW #2 (M + C)	  	2	  	Health Net / Cognizant Confidential

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IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #2 (Membership and Configuration Services) to be signed and
delivered by its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

							
	Health Net, Inc.		Cognizant Healthcare Services, LLC
				
	By:		  
		By:		  

				
	Print Name:		  
		Print Name:		  

				
	Title:		  
		Title:		  

				
	Date:		  
		Date:		  

  

					
	SOW #2 (M + C)		 		Health Net / Cognizant Confidential

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 EXHIBIT A 

MEMBERSHIP AND CONFIGURATION SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	General. 

  

	 	(a)	The “Membership Services” means the Functions associated with the provision of Group Setup Services, Group Maintenance, Renewal & Termination Services, Enrollment Services, Accounts
Receivable Services, Financial Reporting Services, Finance Operations Services, Broker Commissions Services, Sales Incentives Services, Cash Unit Services, Collections Services, Reporting Services, Miscellaneous Membership Services, Audit Support
Services, and Medicare OEV Outbound Calls Services and other membership-related services for all geographies and lines of business requested by Health Net (unless expressly excluded under this Statement of Work). 

 

	 	(b)	The “Configuration Services” means the Functions associated with the provision of Configuration, Provider data management, and Capitation Functions for all geographies and lines of business
requested by Health Net (unless expressly excluded under this Agreement) and include the following activities: 

  

	 	(i)	Load and configure new Products and new Provider contracts in core systems; 

  

	 	(ii)	Perform on-boarding and maintenance of Physician Provider Group (PPG) and Provider demographic information; and 

  

	 	(iii)	Perform Capitation payment calculation and reconciliation. 

  

	 	(c)	The Membership Services and Configuration Services are more fully described in Sections 3 and 5, and include the Cross Functional Services described in Section 3 of Schedule A (Cross Functional Services) and
the Functions included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Membership Services and Configuration Services. For
clarity, this includes Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 (Managed Third Party Contract Services) of Schedule A (Cross Functional
Services). Supplier shall perform the Membership Services and Configuration Services, except for those Functions that are expressly identified as retained Health Net responsibilities in Sections 2 and 4 below. For purposes of clarity, the Party
that is assigned responsibility for a Function as per the designations in Sections 2 and 4 is also responsible for the Embedded Processes applicable to that Function. 

 

	 	(d)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Membership Services and Configuration Services to be performed by Supplier include all
Functions performed by or associated with the roles in the Membership Accounting and Eligibility Organization Chart set forth in Exhibit A-3 (Membership and Configuration Organization Charts), all of which are either being transferred to
Supplier or displaced by Supplier roles as a result of the execution of this Statement of Work. Such Functions will be deemed to be part of the Membership Services and Configuration Services to be performed by Supplier as if expressly set forth in
this Statement of Work. 

  

					
	SOW#2 (M + C) Exhibit A		A-1		Health Net / Cognizant Confidential

 Final 
  

	 	(e)	As part of the Membership and Configuration Services, Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health
Net confirms in writing that such operational report is no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing
reports as may be necessary to reflect changes to and evolutions of the Membership and Configuration Services during the term of this Statement of Work. 

  

	 	(f)	In addition to the Health Net responsibilities expressly identified in Sections 2 and 4 below, and in addition to and without limiting Health Net’s rights under Section 18 (Audits and Records) of the
Terms and Conditions, Health Net may perform quality reviews and audits of Supplier’s performance of the Membership and Configuration Services in accordance with the Terms and Conditions. For the avoidance of doubt, Health Net is not obligated
to perform any level of such quality reviews and audits, except to the extent required by applicable Law. 

  

	1.2	Definitions. 

  

	 	(a)	The following terms have the meaning set forth as follows: 

  

	 	(i)	“Behavioral Health IPAs” means Behavioral Health Independent Practitioners Associations. 

  

	 	(ii)	“Beneficiary” means a person who has health care insurance through the Health Net plan for Medicare programs. 

 

	 	(iii)	“Best Available Evidence” or “BAE” means the policy created in 2006 by CMS to address situations where the CMS systems do not reflect a Beneficiary’s correct
low-income subsidy (LIS) status at a particular point in time and as a result, the most up-to-date and accurate subsidy information has not been communicated to the Medicare plan. This BAE policy requires sponsors to establish the appropriate
cost-sharing for low-income Beneficiaries when presented with evidence as defined by CMS that the Beneficiary’s information is not accurate. 

  

	 	(iv)	“Broker” means an agent who sells for a principal on a commission basis. 

  

	 	(v)	“Business Hours” means hours during the normal operating hours for the Function and location in question, which are set forth in Schedule A-1 (Solution Description) of this
Statement of Work (specifically, in Section 3.1.5.3 for the Membership Services and in Section 3.2.4.3 for the Configuration Services). 

  

	 	(vi)	“Callidus” means a Broker commission and Sales Incentive Compensation System. 

  

	 	(vii)	“CMS” means the Centers for Medicare and Medicaid Services. 

  

					
	SOW#2 (M + C) Exhibit A		A-2		Health Net / Cognizant Confidential

 Final 
  

	 	(viii)	“CMS Guidance” means CMS’s published regulations and guidance documentation, including all published policy manuals, chapters and exhibits. 

 

	 	(ix)	“Commission Statements” means a statement explaining the owed or commissions. 

  

	 	(x)	“Election Period” means the time when an eligible person may choose to join or leave the Medicare plan. There are three types of Election Periods for individuals during which the individual may
join and leave Medicare health plans: (i) Annual Election Period (AEP), (ii) Initial Coverage Election Period (ICEP), and (iii) Special Election Period (SEP). 

 

	 	(xi)	“Groups” has the meaning provided in Schedule W (Glossary). 

  

	 	(xii)	“Enrollment Application” means hard copy or electronic enrollment applications or transactions. 

  

	 	(xiii)	“Health Net Policies” has the meaning provided in the Terms and Conditions. 

  

	 	(xiv)	“ID Card” means identity card identifying the Member by name and containing other health plan related data. 

  

	 	(xv)	“LEP Reconsideration Process” the process for reevaluating a Member disputed additional charge that was billed to an enrollee who appeared to not maintain creditable prescription drug coverage
for a continuous period of 63 days or longer at any time following his/her initial enrollment period for the Medicare prescription drug benefit. See CMS’s Reconsideration Procedures Manual. 

 

	 	(xvi)	“MARx Part A/B Eligibility” means Member eligibility for Medicare Part A and Part B. 

  

	 	(xvii)	“Member” has the meaning provided in Schedule W (Glossary). 

  

	 	(xviii)	“Membership and Configuration Services” means the Membership Services and the Configuration Services. 

  

	 	(xix)	“Out of Area” means a designation for Members outside the service area who elected a plan while they were living in the service area. 

 

	 	(xx)	“PCP Assignment” means assignment of PCP to a Member using unique criteria specific for the Member’s health plan. If a Member in a managed care plan does not select a Primary Care Physician
(PCP) before enrollment, a PCP Assignment occurs. 

  

	 	(xxi)	“Pended Enrollments” means those Enrollment Applications where the applicant-Member has omitted material information, except that in the context of SHP, Pended Enrollment means a Member benefit
that is suspended until the Member requalifies. 

  

	 	(xxii)	“Power of Attorney” means a written document in which one person or entity (the principal) appoints another person or entity to act as an agent on the principal’s behalf, thus conferring
authority on the agent to perform certain acts or functions on behalf of the principal. 

  

					
	SOW#2 (M + C) Exhibit A		A-3		Health Net / Cognizant Confidential

 Final 
  

	 	(xxiii)	“Print and Mail Services” means the Health Net department that is provides printing and mailing services (i.e., Customer Distributed Services (CDS) as of the Effective Date). 

 

	 	(xxiv)	“Ten-Day Demand Letter” means a standardized letter to prompt a debtor into paying the amount that is past due on an invoice. 

 

	 	(b)	The following acronyms have the meaning set forth as follows: 

  

			
	ABD		Automated Bank Draft
		
	ABS		Automated Business System
		
	ACH		Automated Clearing House
		
	AEVS		Automated Eligibility Verification System
		
	AHCCCS		Arizona Health Care Cost Containment System
		
	APTC		Advanced Premium Tax Credit,
		
	AR		Accounts Receivable
		
	ASO		Administrative Services Only
		
	BAE		Best Available Evidence
		
	BARR		Business Area Requirements
		
	BHA		Behavioral Health IPA
		
	CHIPA		Children’s Health Insurance Program
		
	COB		Coordination of Benefits
		
	CPT		Current Procedural Terminology
		
	CSR		Customer Service Repetitive
		
	ESRD		End Stage Renal Disease
		
	FFS		Fee-For-Service
		
	GSA		Group Service Agreement
		
	HCPC		Heath Care Common Procedure Codes
		
	HEDIS		Healthcare Effectiveness Data and Information Set
		
	HICN		Health Insurance Claim Number
		
	IBNR		Incurred But Not Reported
		
	ICD-9 /10		International Classification of Diseases
		
	IEP		Initial Enrollment Period
		
	IPA		Independent Practitioners Associations
		
	IRE		Independent Review Entity

  

					
	SOW#2 (M + C) Exhibit A		A-4		Health Net / Cognizant Confidential

 Final 
  

			
	ITG	  	Information Technology Group
		
	LEP	  	Late Enrollment Penalty
		
	LIS	  	Low Income Subsidy
		
	MARx	  	Medicare Advantage Prescription Drug system
		
	MHN	  	MHN Inc. and its subsidiaries
		
	NCF	  	Network Change Form
		
	OAEVS	  	Online Automated Eligibility Verification System
		
	PBP	  	Plan Benefit Package
		
	PCP	  	Primary Care Physician
		
	PDE	  	Prescription Drug Event
		
	PHI	  	Protected Health Information
		
	PIF	  	Provider Information Form
		
	RBRVS	  	Resource-Based Relative Value Scale
		
	SEP	  	Special Enrollment Period
		
	SF	  	Service Form
		
	SWP	  	Sales Web Portal
		
	TATs	  	Turn Around Time
		
	TRR	  	Transaction Reply Report

  

	 	(c)	Capitalized terms not defined herein shall have the meanings given them elsewhere in this Statement of Work, or in the Agreement. 

  

	2.	MEMBERSHIP SERVICES – ROLES AND RESPONSIBILITIES 

 The following table sets forth
the respective roles and responsibilities of Supplier and Health Net for the Membership Services, as well as identifying the Health Net lines of business and regions for which each listed component of the Membership Services is applicable. Supplier
shall perform the Membership Services, including those Functions listed and described in Section 3 below, except for those Functions (if any) that are expressly identified herein as retained Health Net responsibilities. 

 

											
	 Process /
Function
ID
	  	 Process/Function Name / Description
	  	Lines of
Bsns (LOB)	  	Resp. Party
	  	  	  	Region	  	Supplier	  	Health
Net
	MS1	  	Group Services	  		  		  		  	
						
	MS1.1	  	Group Setup Services	  	All	  	All	  	X	  	
						
	MS1.2	  	Group Maintenance, Renewal & Termination Services	  	All	  	All	  	X	  	

  

					
	SOW#2 (M + C) Exhibit A	  	A-5	  	Health Net / Cognizant Confidential

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	 Process /
Function
ID
	  	 Process/Function Name / Description
	  	Lines of
Bsns (LOB)	  	Resp. Party
	  	  	  	Region	  	Supplier	  	Health
Net
	MS2	  	Enrollment Services	  	All	  	All	  	X	  	
						
	MS2.1	  	Commercial Enrollment Services	  	Commercial	  	All	  	X	  	
						
	MS2.2	  	MHN Enrollment Services	  	MHN	  	All	  	X	  	
						
	MS2.3	  	State Health Program Enrollment Services	  	SHP	  	All	  	X	  	
						
	MS2.4	  	Medicare Enrollment Services	  	Medicare	  	All	  	X	  	
						
	MS2.5	  	Duals Demonstration Enrollment Services	  	Medicare	  	CA	  	X	  	
						
	MS3	  	Accounts Receivable Services	  	All	  	All	  	X	  	
						
	MS3.1	  	Commercial Accounts Receivable Services	  	Commercial	  	All	  	X	  	
						
	MS3.2	  	MHN Accounts Receivable Services	  	MHN	  	All	  		  	
						
	MS3.3	  	State Health Program Accounts Receivable Services	  	SHP	  	All	  	X	  	
						
	MS3.4	  	Medicare Accounts Receivable Services	  	Medicare	  	All	  	X	  	
						
	MS3.5	  	Duals Demonstration Accounts Receivable Services	  	Medicare	  	All	  	X	  	
						
	MS4	  	Finance Operations Services	  		  		  		  	
						
	MS4.1	  	Financial Reporting Services	  	All	  	All	  	X	  	
						
	MS4.2	  	MHN Finance Operations Services	  	MHN	  	All	  	X	  	
						
	MS5	  	Broker Commissions Services	  	All	  	All	  	X	  	
						
	MS6	  	Sales Incentives Services	  	All	  	All	  	X	  	
						
	MS7	  	Cash Unit Services	  	All	  	All	  	X	  	
						
	MS8	  	Collections Services	  	All	  	All	  	X	  	
						
	MS9	  	Reporting Services	  	All	  	All	  	X	  	
						
	MS10	  	Miscellaneous Membership Services	  	All	  	All	  	X	  	
						
	MS11	  	Medicare OEV Outbound Calls Services	  	All	  	All	  	X	  	
						
	MS12	  	Audit Support Services	  	All	  	All	  	X	  	
						
	MS13	  	Membership Policy Services	  	All	  	All	  	X	  	

  

					
	SOW#2 (M + C) Exhibit A	  	A-6	  	Health Net / Cognizant Confidential

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	3.	MEMBERSHIP SERVICES – FUNCTIONAL DECOMPOSITION 

  

	3.1	Membership Services, Generally. 

 Except as set forth in Section 2, the Membership
Services, which are described generally in Section 1.1(a), support all lines of business across Health Net and MHN. The principal Functions comprising the Membership Services are set forth in the remainder of this Section 3. 

 

	3.2	MS1: Group Services. 

  

	 	(a)	MS1.1: Group Setup Services. 

 “Group Setup Services” means those
Functions associated with the receipt, uploading, testing and maintenance of the setup of Group information and Member information within each Group into the applicable system(s). 

Below are some examples of selected Group Setup Services Functions, some of which include descriptions of the manner in which such Functions
are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	Interact via phone with Health Net and external parties (including Brokers, Groups, and third party administrators) to understand Group requirements and gather and complete the applicable data. 

 

	 	(ii)	Communicate the account structure back to Sales team. 

  

	 	(iii)	Enter applicable Group setup data into the applicable system, including the applicable system data elements (approximately 5-7). 

  

	 	(iv)	Configure accurate billing information for Groups in the current billing system, including entering rates, populations, billing and payer information in the applicable system for each account. 

 

	 	(v)	Enter Enrollment Applications and create discrepancy report. 

  

	 	(vi)	Interact via phone with Health Net and external parties (including Brokers, Groups, underwriting, and third party administrators) to resolve any discrepancies. 

 

	 	(vii)	Enter final GSN into the applicable system. 

  

	 	(viii)	Check on status of the group setup and discrepancy report, and perform any outstanding items and resolve any outstanding issues. 

  

	 	(ix)	Perform 100% internal quality assurance of enrollment application, enrollment information, Group set up documents and GSA. 

  

	 	(x)	Validate if the discrepancy is over 30% and if so, prepare appropriate letter addressed to the applicable Groups. 

  

	 	(xi)	Release Group discrepancy letters to Print and Mail Services. 

  

	 	(xii)	Obtain corrected Group setup information as required. 

  

					
	SOW#2 (M + C) Exhibit A		A-7		Health Net / Cognizant Confidential

 Final 
  

	 	(xiii)	Correct any outstanding errors in the applicable system. 

  

	 	(xiv)	Activate the Group, including creating the enrollment files and ID Cards. 

  

	 	(xv)	Generate ID Cards, GUI hold, audit ID Cards. 

  

	 	(xvi)	Release ID Cards to Print and Mail Services. 

  

	 	(xvii)	Complete the initial billing process for first bill. 

  

	 	(xviii)	Enter skeleton data system into the applicable system (approximately 5-7 data elements). 

  

	 	(xix)	Enter enrollment information into the applicable system. 

  

	 	(xx)	Obtain from Health Net Underwriting team any missing or incorrect data from Health Net and external parties (including Brokers, Groups, and third party administrators) and input corrections into the applicable system.

  

	 	(xxi)	Compare GSA to final GSN, load Group into the applicable system and resolve any issues, including through gathering additional data from Health Net and external parties (including Brokers, Groups, and third party
administrators). 

  

	 	(xxii)	Implement the billing process in the applicable system and create initial bill. 

  

	 	(xxiii)	Credit the binder check to the initial bill in the applicable system. 

  

	 	(xxiv)	Reverse initial bill in the applicable system. 

  

	 	(xxv)	Create the cover letter and welcome kit with billing information. 

  

	 	(xxvi)	Release cover letter and welcome kit with billing information to Print and Mail Services. 

  

	 	(xxvii)	Validate Group’s first month payment against bill. 

  

	 	(xxviii)	Update the applicable systems and databases as necessary. 

  

	 	(b)	MS1.2: Group Maintenance, Renewal & Termination Services. 

 “Group
Maintenance, Renewals & Termination Services” means those Functions associated with maintaining, renewing, and terminating Group information and Member information within each Group, including updating the applicable systems
and databases as necessary. 
 Below are some examples of selected Group Maintenance, Renewals & Termination Services Functions,
some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	Process assumptive renewal (based on existing plans) 45-60 days in advance of renewal deadline. 

  

					
	SOW#2 (M + C) Exhibit A		A-8		Health Net / Cognizant Confidential

 Final 
  

	 	(ii)	If GSN is not complete, contact Health Net and external parties (including Brokers, Groups, and third party administrators) to complete all information accurately. 

 

	 	(iii)	Print GSN (to an image) from SWP and reconcile number of GSNs 

  

	 	(iv)	Prioritize renewals to be processed by bill date. 

  

	 	(v)	Notify Health Net and external parties (including Brokers, Groups, and third party administrators). 

  

	 	(vi)	Capturing any plan changes, including those identified by Health Net. 

  

	 	(vii)	Coordinate the Member transfer from old to new product (e.g., cancel Member, move to new Group, cancel old suffixes). 

  

	 	(viii)	Upon transferring members from old to new group numbers, coordinate with Broker Commissions team to update Broker linkages timely to enable appropriate transactions to be generated on ABS extract to Callidus.

  

	 	(ix)	Coordinate with Accounts Receivable to move any and all applicable premiums that need to be moved to the new suffix, and do so timely to avoid impact to the Broker (commissions). 

 

	 	(x)	Coordinate with Billing team to verify that bills accurately reflect the changes in a timely manner. 

  

	 	(xi)	Generate new ID Card if change in plan or change billing if there is a rate change. 

  

	 	(xii)	Send renewal request to Supplier. 

  

	 	(xiii)	Process renewal (auto update in the applicable system for new suffixes or map suffixes, update in the applicable system) including contacting and coordinating with Health Net and external parties (including Brokers,
Groups, and third party administrators) to process the renewal. 

  

	 	(xiv)	Send a spreadsheet to the Enrollment Services team. 

  

	 	(xv)	Coordinate with Accounts Receivable to move any and all applicable premiums that need to be moved to the new suffix, and do so timely to avoid impact to the Member (causing double drafts to Members) or Broker
(commissions). 

  

	3.3	MS2: Enrollment Services. 

  

	 	(a)	Enrollment Services, Generally. 

 “Enrollment Services” means those
Functions associated with the receipt, uploading, and processing (manually or electronic) of Enrollment Applications and eligibility (managed and unmanaged), testing, and maintenance of enrollment information in the applicable system(s), including
initial enrollments, renewals, modifications, terminations, disenrollment, and reenrollment services, research for inquiries, enrollment reconciliation, troubleshooting, system error resolution, any quality checks that may be required. 

  

					
	SOW#2 (M + C) Exhibit A		A-9		Health Net / Cognizant Confidential

 Final 
  

Below are some examples of selected Enrollment Services Functions, some of which include descriptions of the manner in which such Functions
are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	Update the applicable systems and databases as necessary. 

  

	 	(ii)	Create ID Cards and Member materials. 

  

	 	(iii)	Release ID Cards and Member material to Print and Mail Services. 

  

	 	(iv)	Review requests received for completeness and accuracy. 

  

	 	(v)	Validate the Member eligibility for transaction. 

  

	 	(vi)	Comply with all regulatory, legislative or contractual mandates for all lines of business. 

  

	 	(vii)	Receive any necessary approvals. 

  

	 	(viii)	Contact Health Net and external parties (including Brokers, Groups, and third party administrators) as applicable. 

  

	 	(ix)	Perform Member correspondence Functions, including CMS mandated correspondence, and release printed correspondence to Print and Mail Services. 

 

	 	(x)	Validate and process Power of Attorney/PHI requests. 

  

	 	(xi)	Record error research. Conduct and document on the Member record all research, perform all Member contact and make any necessary changes to a Member’s record. 

 

	 	(xii)	Address discrepancies. Conduct and document on the Member record all research, perform Member contact and will make any necessary changes to a Member’s records for discrepancies, including enrollment effective date
discrepancies, LIS, PBP and others (e.g., TRR rejects). 

  

	 	(xiii)	Perform disenrollments (both voluntary and involuntary) and reenrollments. 

  

	 	(b)	MS2.1: Commercial Enrollment Services. 

 “Commercial Enrollment
Services” means Enrollment Services associated with Commercial Members. 
 Below are some examples of selected Commercial
Enrollment Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	EDI file management and Member electronic file set up, which includes the following Functions: 

  

					
	SOW#2 (M + C) Exhibit A		A-10		Health Net / Cognizant Confidential

 Final 
  

	 	(A)	Perform daily functions for processing enrollment, payment and any other Member electronic files interfaces; 

  

	 	(B)	Reconcile Member enrollment; 

  

	 	(C)	Work with Members to set up, test and implement new electronic files; and 

  

	 	(D)	Update systems and files for any other changes. 

  

	 	(ii)	iBilling customer service support, which includes the following Functions: 

  

	 	(A)	Intake and resolve all internal and external Member inquiries, including password setups, resets; 

  

	 	(B)	Identify and report any iBilling systems issues to iBilling system management team; and 

  

	 	(C)	Coordinate with Health Net Sales team, enrollment and billing staff as necessary on iBilling Member issues. 

  

	 	(iii)	Receive paper Enrollment Applications via Fax, lock box and USPS Mail. 

  

	 	(iv)	Route Enrollment Applications to the applicable system. 

  

	 	(v)	Receive Enrollment Applications (for all markets) via the applicable system. 

  

	 	(vi)	Receive, review and process all emails related to Enrollment Applications. 

  

	 	(vii)	Prioritize and process all Enrollment Applications (including urgent and all non-critical). 

  

	 	(viii)	Route Enrollment Applications to the applicable system. 

  

	 	(ix)	Process any urgent Enrollment Applications that require pharmacy overrides, and make required contact. 

  

	 	(x)	Make phone calls or obtain overrides related to Enrollment Applications as required. 

  

	 	(xi)	Process all Enrollment Applications from all channels, including data entry. 

  

	 	(xii)	Create discrepancy report, follow up to resolve discrepancy via written contact or via phone calls with Health Net and external parties (including Brokers, Groups, and third party administrators), and resolve such
discrepancy. 

  

	 	(xiii)	Contacts Group via phone, obtains required information and pass it on via the applicable system. 

  

	 	(xiv)	Activate, update or amend Member in the applicable system. 

  

	 	(xv)	Close Enrollment Applications in the applicable system, as appropriate. 

  

					
	SOW#2 (M + C) Exhibit A		A-11		Health Net / Cognizant Confidential

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	 	(xvi)	Notify Members of the denied Enrollment Applications. 

  

	 	(xvii)	Verify approved Enrollment Applications in IST against all critical fields and enable the ‘Verification’ status. 

  

	 	(xviii)	Verify the Enrollment Applications in the applicable system through quality assurance. 

  

	 	(xix)	Download approved Enrollment Applications to the applicable system. 

  

	 	(xx)	Process all binder payments received. 

  

	 	(xxi)	Prepare and release Member acceptance letter and contract documents to Print and Mail Services. 

  

	 	(xxii)	Track and Audit enrollment for dependents reaching the maximum age. 

  

	 	(xxiii)	COB notifications, as described in Section 3.3(e)(vi). 

  

	 	(xxiv)	ID card services, as described in Section 3.3(e)(vii). 

  

	 	(xxv)	Member maintenance services, as described in Section 3.3(e)(viii). 

  

	 	(xxvi)	Resolve Pended Enrollments. 

  

	 	(xxvii)	Application rejects, as described in Section 3.3(e)(xi). 

  

	 	(xxviii)	PDE reconciliation, as applicable. 

  

	 	(c)	MS2.2: MHN Enrollment Services. 

 “MHN Enrollment Services” means
Enrollment Services associated with MHN Members. As of the Effective Date, the applicable system for MHN Members is Symphony. 
 Below are
some examples of selected MHN Enrollment Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	Perform the accurate processing and maintenance of eligibility data into the applicable system including: 

  

	 	(A)	Upload electronic eligibility data into Symphony via automated processes. Manually work eligibility queues (which validate various data) and stage the data. Use staged data (and validated data) to update the eligibility
data in the Member and affiliate translation files. 

  

	 	(B)	Manually enter and validate eligibility data where automated update is not feasible, including verifying Member data in third party systems (ABS, CSI, and QCARE as of the Effective Date). 

  

					
	SOW#2 (M + C) Exhibit A		A-12		Health Net / Cognizant Confidential

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	 	(C)	Meet accuracy and timeliness standards – standards measured by internal audits performed on samples monthly by Eligibility Coordinator audits. 

 

	 	(D)	Work queue related to eligibility verification requests (typically these are sent by intake and referral teams). 

  

	 	(E)	Work queue for claims pended for lack of Member identification (AR27). 

  

	 	(F)	Work cross-data accumulation (CDA) queues where record is pended for lack of Member identification. 

  

	 	(G)	Implement new or modified client eligibility files (834v5010 and other proprietary formats) 

  

	 	(H)	Implement new or modified cross-data accumulation (CDA) queues with Account Management and EDI teams. 

  

	 	(I)	Implement system enhancements and process improvements related to eligibility, including requirements gathering, BARR review, testing, validation and check out (i.e., validation in production before the work week begins
that no system functionality has been adversely affected) for process improvements/changes/projects/implementations/system changes that would maintain or improve MHN membership activities. 

 

	 	(J)	Prepare internal audits (TATs and accuracy related) and metrics. 

  

	 	(ii)	Provide information to medical carriers as necessary, and confirm that information is successfully passed through. 

  

	 	(d)	MS2.3: State Health Program Enrollment Services. 

 “State Health Program Enrollment
Services” means Enrollment Services associated with State Health Program Members: 
 Below are some examples of selected State
Health Program Enrollment Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	Update Enrollment Applications electronically including new enrollments and changes. 

  

	 	(ii)	Work on monthly error report to determine if a transaction needs to be entered and the system updated. If the system needs to be updated, determine if the required information from the State system (e.g., AEVS, AHCCCS)
is available, and update and close the transaction as necessary. 

  

	 	(iii)	Document closure of the Enrollment Application on the error report. 

  

	 	(iv)	Work on daily system report to determine if both medical and dental transactions need to be updated. If the system needs to be updated, determine if the required information from the State system (e.g., AEVS, AHCCCS) is
available, and update and close the transaction as necessary. 

  

					
	SOW#2 (M + C) Exhibit A		A-13		Health Net / Cognizant Confidential

 Final 
  

	 	(v)	ID card services, as described in Section 3.3(e)(vii). 

  

	 	(e)	MS2.4: Medicare Enrollment Services. 

 “Medicare Enrollment Services”
means Enrollment Services associated with Medicare Members. 
 Below are some examples of selected Medicare Enrollment Services Functions,
some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	General. Perform maintenance and daily research/review of the following: 

  

	 	(A)	TRR fallout workbasket; 

  

	 	(B)	New enrollments; 

  

	 	(C)	Disenrollments; 

  

	 	(D)	Reinstatements/re-enrollments; 

  

	 	(E)	Plan changes/PBP changes; 

  

	 	(F)	Power of attorney/PHI; 

  

	 	(G)	Enrollment correspondence; 

  

	 	(H)	Enrollment exceptions and issues, including pre-edit and others; 

  

	 	(I)	Member record maintenance; 

  

	 	(J)	Billing services including Member set up; 

  

	 	(K)	Posting cash / billing adjustments 

  

	 	(L)	Accounts receivable processing; 

  

	 	(M)	Work and resolve all work baskets(to be defined- those associated with processing of disenrollments, new enrollment, and select plan/PBP changes); 

 

	 	(N)	COB; and 

  

	 	(O)	BAE. 

  

	 	(ii)	Member outreach for various type of information verification. 

  

	 	(iii)	Pre-Enrollment Services. 

  

					
	SOW#2 (M + C) Exhibit A		A-14		Health Net / Cognizant Confidential

 Final 
  

	 	(A)	Perform the following pre-enrollment Services: 

  

	 	(1)	Identify the transaction type (e.g., SEP, IEP, disenrollment, or change). 

  

	 	(2)	Determine the Election Period for each Member. 

  

	 	(3)	Verify Member eligibility. 

  

	 	(4)	Identify the election source and display the method of receipt of the Enrollment Application (Internet, CMS online, paper). 

  

	 	(5)	Determine LEP (Late Enrollment Penalty) for Members, including: 

  

	 	a.	Process Late Enrollment Penalty correspondence and requests pertaining to the reconsideration process; and 

  

	 	b.	Process each Member’s attestation of creditable coverage. 

  

	 	i.	Review the enrollment period data received from the Member, and make the creditable coverage determination and forward to Health Net all CMS-required correspondence. 

 

	 	ii.	Submit any necessary changes/corrections to the number of uncovered months to CMS. 

  

	 	iii.	Process response upon the receipt of TRR and within the timeframe mandated by CMS Guidance. 

  

	 	(6)	Perform LEP Reconsideration Process. 

  

	 	(7)	Process all documentation requests from the IRE (e.g., Maximus) regarding LEP reconsideration requests. 

  

	 	a.	Gather the relevant documentation and create a case file. 

  

	 	b.	Respond to requests within the timeframe set forth in the CMS Guidance or fourteen (14) days, whichever time period is shorter. 

 

	 	(8)	Set up, attach and maintain Broker/GA information to the Member records as required, (Health Net may have as many as (three) 3 layers of Broker/GA classification (i.e. FMO, general agent, and Broker)).

  

	 	(9)	Prior to receiving final confirmation of enrollment of a Member from CMS, prepare a confirmation for the Member of their enrollment in the plan so that the Member may access their benefits. 

  

					
	SOW#2 (M + C) Exhibit A		A-15		Health Net / Cognizant Confidential

 Final 
  

	 	(B)	Provide access to the Services to new enrollees upon: 

  

	 	(1)	the process date of the enrollee’s application; or 

  

	 	(2)	the qualifying effective date of the enrollee’s membership, whichever is later. 

  

	 	(C)	Generate a welcome letter to new enrollees. 

  

	 	(D)	Verify and document the Member’s MARx Part A/B Eligibility. 

  

	 	(E)	Review all Medicare applications for possible gaps in coverage. Perform outreach to sales and or Member as necessary. 

  

	 	(F)	Add Member level system notes as needed for audit purposes. 

  

	 	(iv)	CMS Transmissions/Reply Functions. 

  

	 	(A)	Submit all required data extracts to CMS; 

  

	 	(B)	Perform all CMS file processing for files received from CMS (i.e., TRRs, MMR, etc); 

  

	 	(C)	Submit all necessary 4Rx (CMS Pharmacy Report) data to CMS; 

  

	 	(D)	Perform reporting of the data submissions, including the status of those submissions; and 

  

	 	(E)	Prepare all related correspondence as required by CMS. 

  

	 	(v)	Member Correspondence Services. 

  

	 	(A)	Perform Member correspondence, including: 

  

	 	(1)	Out of Area-related correspondence Functions, including instances when Supplier receives information from either CMS or the United States Postal Service (“USPS”) that a Member no longer resides
in the service area; 

  

	 	(2)	Plan Benefit Package (“PBP”) changes related correspondence Functions; 

  

	 	(3)	LIS (Low Income Subsidy) correspondence Functions; 

  

	 	(4)	HICN correspondence Functions, including accepting HICN changes from CMS; 

  

	 	(5)	Enrollment application acknowledgement letter; 

  

					
	SOW#2 (M + C) Exhibit A		A-16		Health Net / Cognizant Confidential

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	 	(6)	Disenrollment request acknowledgement letter; and 

  

	 	(7)	PCP Assignment letter. 

  

	 	(B)	Adhere to and use CMS and Health Net and RPC approved templates, guidance, time tables as required by CMS Guidance or as required by Health Net. 

 

	 	(C)	Maintain CMS compliant templates in letter system. 

  

	 	(D)	Generate both automated and manual letter files. 

  

	 	(1)	All the letter files that are configured in the applicable system will be generated in an automated fashion. 

  

	 	(2)	Generate manual letter files as triggered by the special requests made by the Members. 

  

	 	(E)	Provide archive and retrieval capability and services for correspondence related to the Services (including all legacy correspondence converted by Supplier). 

 

	 	(F)	Process all correspondence received related to Enrollment Applications, processing or status. Conduct all research and necessary Member contact, and make any necessary changes to a Member’s record related to the
received enrollment correspondence. 

  

	 	(vi)	COB Notifications. Perform COB notification related Functions, including: 

  

	 	(A)	Prepare and release to Print and Mail Services COB notification letters. 

  

	 	(B)	If a response to the COB notification letter is not received from the Member, do not contact the Member further regarding COB. 

  

	 	(1)	Anytime information is received concerning an addition or revision to an existing other coverage information, submit the new or revised information to the applicable party within 30 days of receipt. 

 

	 	(2)	Track all COB responses and actions in the applicable system. 

  

	 	(3)	Reach out directly to Members, other health plans or employer groups to correct inaccurate data. 

  

	 	(vii)	ID Card Services. Perform ID Card related Functions, including: 

  

	 	(A)	Maintain and utilize appropriate ID Card templates (e.g., individual vs. Group); 

  

	 	(B)	Store ID Card history and archive electronic version of cards; 

  

					
	SOW#2 (M + C) Exhibit A		A-17		Health Net / Cognizant Confidential

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	 	(C)	Meet all government regulations surrounding ID Cards, including card file generation; 

  

	 	(D)	Generate ID Card files in accordance with Health Net specifications; 

  

	 	(E)	Produce reports documenting ID Card file submission metrics; 

  

	 	(F)	Generate replacement ID Card files for Members within required timeframes; 

  

	 	(G)	Release ID Cards to Print and Mail Services. 

  

	 	(viii)	Member Maintenance Services. Perform Member maintenance related Functions, including: 

  

	 	(A)	Perform Out of Area tracking and processing in accordance with CMS guidelines. 

  

	 	(B)	Perform enrollment requests for PBP (Plan Benefit Package) changes. 

  

	 	(C)	Perform Member maintenance services related to LIS (Low Income Subsidy). 

  

	 	(D)	Process all Member maintenance requests. 

  

	 	(E)	Validate that data fields are correctly input and maintained (e.g., HICN (Health Insurance Claim Number)). 

  

	 	(F)	Utilize the Best Available Evidence (BAE) as provided by the Member. 

  

	 	(ix)	Application Processing Failures. 

 Using the Workflow ticket system, resolve all pre-edit
(multiples, singleton and pending pre-edit) workbaskets. An “Application Processing Failure” occurs when an Enrollment Application is rejected by CMS. Upon the occurrence of an Application Processing Failure and upon receipt
of the rejected Enrollment Application from CMS, conduct all research, perform Member contact and track expiration dates in order to resolve the Application Processing Failure. 

 

	 	(x)	Resolve Pended Enrollments. 

  

	 	(xi)	Application Rejects. Resolve all enrollment rejects in accordance with the CMS Guidance and Health Net requirements. 

  

	 	(xii)	TRR Processing. 

  

	 	(A)	Using the workflow ticket system and enrollment systems, resolve all records that fail some point of validation within the TRR engine. 

 

	 	(B)	Research and resubmit all failed records in accordance with CMS Guidance. 

  

					
	SOW#2 (M + C) Exhibit A		A-18		Health Net / Cognizant Confidential

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	 	(xiii)	PDE (Prescription Drug Event) Reconciliation. 

  

	 	(A)	Using various data sources, conduct and document on the Member record all research, perform Member contact and make any necessary changes to a Member’s PDE record (for enrollment and eligibility rejects only).

  

	 	(B)	Resolve any eligibility issue that results in the rejection of a PDE record submitted to CMS with in the CMS mandated timeframes. 

  

	 	(xiv)	Health Net Plan vs Medicare Reconciliation Services. Research, work discrepancies identified by the eligibility reconciliation process, provide written confirmation that reconciliation occurred, and provide related
information requested by Health Net. 

  

	 	(A)	Update reconciliation logic as required to accommodate CMS software changes; and 

  

	 	(B)	Provide guidance to the Member services team on discrepancy resolution process, work with the Application Development team as required to analyze automated discrepancy fixes, research causes of reconciliation
discrepancies, and review discrepancy trends: 

  

	 	(f)	MS2.5: Duals Demonstration Enrollment Services. 

 “Duals Demonstration Member
Enrollment Services” means Enrollment Services associated with Duals Members. 
 Below are some examples of selected Duals
Demonstration Member Enrollment Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	General. 

 Perform maintenance and daily research/review of the following: 

 

	 	(A)	TRR fallout workbasket; 

  

	 	(B)	New Enrollments 

  

	 	(C)	Disenrollments; 

  

	 	(D)	Reinstatements/re-enrollments; 

  

	 	(E)	Plan changes/PBP changes; 

  

	 	(F)	Power of attorney/PHI; 

  

	 	(G)	Enrollment correspondence; 

  

	 	(H)	Enrollment exceptions and issues, including pre-edit and others; 

  

					
	SOW#2 (M + C) Exhibit A		A-19		Health Net / Cognizant Confidential

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	 	(I)	Member record maintenance; 

  

	 	(J)	Work and resolve all work baskets(to be defined- those associated with processing of disenrollments, new enrollment, and select plan/PBP changes); 

 

	 	(K)	COB; and 

  

	 	(L)	BAE. 

  

	 	(ii)	Member outreach for various type of information verification. 

  

	 	(iii)	Generate a welcome letter to new voluntary enrollee. 

  

	 	(iv)	Add Member level system notes as needed for audit purposes. 

  

	 	(v)	CMS Transmissions/Reply Functions. 

 Submit all required data extracts to CMS including: 

 

	 	(1)	Perform all CMS file processing for files received from CMS (i.e., TRRs, MMR, etc); 

  

	 	(2)	Submit all necessary 4Rx (CMS Pharmacy Report) data to CMS; 

  

	 	(3)	Perform reporting of the data submissions, including the status of those submissions; and 

  

	 	(4)	Prepare all related correspondence as required by CMS. 

  

	 	(vi)	Member correspondence services, as described in 3.3(e)(v) (but only those correspondences applicable to Duals Members). 

  

	 	(vii)	COB notification, as described in Section 3.3(e)(vi). 

  

	 	(viii)	ID Card services, as described in Section 3.3(e)(vii). 

  

	 	(ix)	Member maintenance services, as described in Section 3.3(e)(viii). 

  

	 	(x)	Application Processing Failures, as described in Section 3.3(e)(ix). 

  

	 	(xi)	TRR processing, as described in Section 3.3(e)(xii). 

  

	 	(xii)	PDE reconciliation, as described in Section 3.3(e)(xiii). 

  

	 	(xiii)	Health Net Plan vs Medicare reconciliation services, as described in Section 3.3(e)(xiv). 

  

	3.4	MS3: Accounts Receivable Services. 

  

	 	(a)	Accounts Receivable Services, Generally. 

  

					
	SOW#2 (M + C) Exhibit A		A-20		Health Net / Cognizant Confidential

 Final 

“Accounts Receivable Services” means those Functions associated with performing daily and monthly financial
reconciliation, including balancing and cash applications, performing eligibility reconciliation with the relevant government payer entity, working all system or database fall out and error reports, and performing accounts receivable Functions,
including, e.g., generating and distributing invoices to payers, applying payments, research related to inquiries, troubleshooting, system error resolution and any quality checks that may be required. 

At Health Net’s discretion, Health Net may require that Health Net review and approve certain accounts receivable transactions prior to
Supplier completing such transactions. 
 Below are some examples of selected Accounts Receivable Services Functions, some of which include
descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	Update the applicable systems and databases as necessary. 

  

	 	(ii)	Comply with all regulatory, legislative or contractual mandates for all lines of business. 

  

	 	(iii)	Receive any necessary approvals. 

  

	 	(iv)	Deposit all monies collected for or on behalf of Health Net daily into the applicable Health Net bank account. 

  

	 	(b)	MS3.1: Commercial Accounts Receivable Services. 

 “Commercial Accounts Receivable
Services” means Accounts Receivable Services associated with Commercial Members. 
 Below are some examples of selected
Commercial Accounts Receivable Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	Create invoices. 

  

	 	(ii)	Complete quality check of all invoice files. 

  

	 	(iii)	Release invoices to Print and Mail Services. 

  

	 	(iv)	Upload the image files of the check and the supporting documents into the applicable system. Generate Unapplied Cash Report for all unapplied checks. 

 

	 	(v)	Validate that supporting documentation is included, and follow up as necessary. Reconcile at an individual Member level – billed versus paid in the applicable system. 

 

	 	(vi)	Allocate premium in the applicable system. 

  

	 	(vii)	Review and accordingly close auto-posted cases in the applicable system. 

  

	 	(viii)	Verify that all items in Unapplied Cash Report are designated ‘Complete’. 

  

					
	SOW#2 (M + C) Exhibit A		A-21		Health Net / Cognizant Confidential

 Final 
  

	 	(ix)	Upload the approved discrepancy report along with the approval and the cover letter to the applicable system. 

  

	 	(x)	Provide the discrepancy report along with cover letter to the respective payer. 

  

	 	(xi)	Handle any calls/follow-up from payers/responsible party in connection with the discrepancy. 

  

	 	(xii)	Resolve with the payer whether to pay or dispute as per the discrepancy report. Based on the outcome, update status and upload all supporting information. 

 

	 	(xiii)	Update and present the reports required for the monthly accounts receivable meetings. Based on report, decide on next step/actions. 

  

	 	(xiv)	For a refund request, perform a reconciliation to assess whether it is a valid refund request. Once refund is identified, complete a refund form and initiate approval process. 

 

	 	(xv)	Sign-off on refund requests, or obtain Health Net approval of refund requests, as applicable, and make manual adjustments as required. Run a re-bill upon request by Health Net or Member. 

 

	 	(c)	MS3.2: MHN Accounts Receivable Services. 

 “MHN Accounts Receivable
Services” means Accounts Receivable Services associated with MHN Members. 
 Below are some examples of selected MHN Accounts
Receivable Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	Handle non-affiliate group client billing – affiliate activity is processed via intercompany transfers by Health Net corporate finance. 

 

	 	(ii)	Perform premium, administrative services (ASO) and fee-for-service (FFS) billing and related AR functions. Billing/AR is on SAP AR module which is fully integrated with Health Net’s general ledger.

  

	 	(iii)	Process all related cash receipts and cash application, including: 

  

	 	(A)	Premium and ASO fees billings based on per employee per month rates. 

  

	 	(B)	ASO claims reimbursement billing. 

  

	 	(1)	Perform periodic (weekly, bi-weekly, monthly, etc.) billing based on claims detail per reporting out of the MHN Data Warehouse. 

  

	 	(2)	Upload invoices (with claims in aggregate) into the applicable system (SAP AR as of the Effective Date). 

  

					
	SOW#2 (M + C) Exhibit A		A-22		Health Net / Cognizant Confidential

 Final 
  

	 	(3)	On a monthly basis, aggregate ASO claims from Symphony, interface into the general ledger, and track the ASO claims detail (tracked in a separate Access database as of the Effective Date). 

 

	 	(4)	Reconcile claims detail, SAP AR and SAP G/L monthly and send to the Corporate Finance department. 

  

	 	(C)	Aggregate FFS or ad hoc client services billing (as of the Effective Date, aggregated from two systems - Salesforce and a Data Warehouse report on Unity FFS transactional data); ‘scrub’ data to verify fields
are complete, validate data for appropriate and accurate content after reviewing with MHN Client Services and Training departments. Once scrubbed, put into the correct format, upload invoices to the applicable system (e.g., SAP AR) and feed back
into Salesforce. 

  

	 	(iv)	Prepare, review and analyze AR aging, identify trends for collection purposes, and use reports to identify retro-active changes. 

  

	 	(v)	Work collaboratively with MHN Account Management, configuration teams, Sales teams and Client Services/ Training departments. 

  

	 	(vi)	Post cash daily as per bank statements and accompanying detail to SAP AR. Log and track received cash within appropriate turn-around-times. Coordinate with Health Net to confirm that they have complete information (i.e.
about deposits in transit, etc.) for bank reconciliations and required entries. 

  

	 	(vii)	Coordinate collections with MHN Sales / Account Management teams. 

  

	 	(viii)	Prepare Schedule As (Form 5500). 

  

	 	(ix)	Maintain standards (days sales and timely invoicing). 

  

	 	(d)	MS3.3: State Health Program Accounts Receivable Services. 

 “State Health Program
Accounts Receivable Services” means Accounts Receivable Services associated with State Health Program Members. 
  

	 	(e)	MS3.4: Medicare Accounts Receivable Services. 

 “Medicare Accounts Receivable
Services” means Accounts Receivable Services associated with Medicare Member. 
 Below are some examples of selected Medicare
Accounts Receivable Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(i)	Premium Billing. Perform premium billing services functions, including: 

  

	 	(A)	Generate and distribute invoices/files; 

  

	 	(B)	Maintain the capability and functions related to perform “split billing”; 

  

					
	SOW#2 (M + C) Exhibit A		A-23		Health Net / Cognizant Confidential

 Final 
  

	 	(C)	Perform invoicing for both payer in a format to be designated by the payer; 

  

	 	(D)	Perform Functions related to SSA (Social Security Administration) premium withholds, including reconciliations, discrepancy reporting, processing any change in SSA status, and any associated status correspondence; and

  

	 	(E)	Support ABD/ACH (Automated Clearing House) Functions. 

  

	 	(ii)	Process payments. 

  

	 	(iii)	Perform Accounts Receivable (AR) functions, including: 

  

	 	(A)	Apply and reconcile cash payments. 

  

	 	(B)	Perform manual adjustments, including (1) write-offs, subject to Health Net’s approval; and (2) non-revenue impacting payer payment information. 

 

	 	(C)	Support transaction types as specified by Health Net. 

  

	 	(D)	Process refunds with appropriate approvals. 

  

	 	(E)	Delinquency processing Functions, including Member correspondence, bad debt write off, and disenrollment, each with appropriate approvals. 

 

	 	(F)	Provide aging and financial reports, including a list of standard or previously created reports. 

  

	 	(iv)	Perform billing reconciliations, including: 

  

	 	(A)	Conduct billing reconciliations for all billing files and document all research. 

  

	 	(B)	Make changes to correct identified discrepancies. 

  

	 	(f)	MS3.5: Duals Demonstration Accounts Receivable Services. 

 “Duals Demonstration
Accounts Receivable Services” means Accounts Receivable Services associated with Duals Members. 
  

	3.5	MS4: Finance Operations Services. 

  

	 	(a)	MS4.1: Financial Reporting Services. 

 “Financial Reporting Services”
means those Functions that involve the gathering of data for and development of financial statements, assets and liabilities, revenue and revenue projections, the performance of financial analysis and financial reconciliations, and the payment of
outside vendors. 
  

	 	(b)	MS4.2: MHN Finance Operations Services. 

  

					
	SOW#2 (M + C) Exhibit A		A-24		Health Net / Cognizant Confidential

 Final 

“MHN Finance Operations Services” means those Functions that sit in between MHN operations and financial reporting.

 Below are some examples of selected MHN Finance Operations Services Functions, some of which include descriptions of the manner in which
such Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(i)	Sub-ledger accounting for MHN revenue, healthcare, and membership. 

  

	 	(ii)	Act as finance liaison on MHN operations to various external departments (e.g., Tax, Actuarial, Statutory, Divisional Accounting, Treasury, Health Net Accounts Payable, and Internal Audit); coordinate the complete check
cycle for Symphony claims. 

  

	 	(iii)	Report on healthcare operations, where the reporting is not strictly financial in nature. 

  

	 	(iv)	Run daily checkwrite for applicable system (e.g., Symphony) claims checks. Coordinate and monitor all related activities with Health Net Divisional Accounting and claims such as: 

 

	 	(A)	Workflow and accounting related to system (e.g., Symphony) claims void checks; stop payments, stale dated checks, and escheatment. Perform management reporting to monitor that the processes are followed and finalized in
a timely manner. 

  

	 	(B)	Implement system enhancements and process improvements related to checkwrite function, including requirements gathering, BARR review, testing, validation and check out (i.e., validation in production before the work
week begins that no system functionality has been adversely affected). 

  

	 	(C)	Validate 1099 raw files for reasonableness. 

  

	 	(D)	Process tax levies and garnishments. As of the Effective Date, MHN cannot pay levies/ garnishments directly from Symphony because the system doesn’t allow splitting the payment. The manual process involves voiding
the Symphony check and issuing a pair of checks out of SAP AP to split the payment. 

  

	 	(v)	Handle all MHN cash receipts (mostly AR payments and provider refunds) and deposit to the bank if payer didn’t send directly to the lockboxes. 

 

	 	(vi)	Copy provider refund checks and their backups and send to claims department to process the credits in the claims system. Once reconciled to their related claims credits in the system, deposit provider refunds. Track and
document via a detail claims refund database. 

  

	 	(vii)	Prepare monthly summarized sub-capitation documentation to pay the Behavioral Health IPAs (CHIPA and BHA) on behalf of Health Net California. There is a fair amount of trouble-shooting and analysis due to old
programming that is very sensitive to plan code changes and other set-up issues. Calculate Member counts and prepare reporting to test and validate the amounts. 

  

					
	SOW#2 (M + C) Exhibit A		A-25		Health Net / Cognizant Confidential

 Final 
  

	 	(viii)	Run Policy and Procedure department to update P&Ps, desktops, and workflows for MHN Customer Service departments (Eligibility, Finance Operations, Claims, Configuration) and confirm these are compliant with
regulations and legislation. 

  

	 	(ix)	Prepare sub-ledger financial support and trouble-shooting for a variety of accounts (by line of business, where indicated) including those related to: 

 

	 	(A)	ASO claims detail reconciliation to aggregate claims on SAP G/L and AR. 

  

	 	(B)	Calculates MHN Broker commissions and accruals (based on premiums cash receipts). 

  

	 	(C)	Claims expense, IBNR and payables in coordination with Health Net actuary. This includes claims interfaced to affiliate general ledgers; as well as MHN entities. 

 

	 	(D)	Revenue and accounts receivables (including AR aging and bad debt write-offs). 

  

	 	(E)	Financial subscribers/ membership (also used for client reporting). 

  

	 	(F)	Complete various management analyses and troubleshooting on an ad-hoc basis as issues arise. For example, troubleshoot issues w/ APTC eligibility extracts having incomplete data by running queries and looking for
certain patterns. 

  

	 	(G)	Review and trouble-shoot eligibility translation matrices (which map ABS eligibility data (and their claims) to Symphony) to verify affiliate Members and healthcare costs are classified correctly for general ledger
purposes. 

  

	 	(H)	Prepare cash receipts reports used for MHN Broker commissions and sales incentive compensation calculations. Also prepare cash to revenue reconciliation as required by financial auditors. 

 

	 	(I)	Create, monitor and maintain, internal controls over all MHN financial operations and MHN eligibility to confirm accuracy and completeness. Comply with deadlines for month-end close, and mid-month reconciliations.
Provide detail back-up for financial audits related to these accounts, when requested. 

  

	 	(x)	Regulatory, audit, financial reporting and internal controls support. Subject to final review and approval by Health Net. 

  

	 	(A)	Prepare and reviews board of director financial statements quarterly for Knox-Keene regulated entity (7007 Managed Health Network). 

  

					
	SOW#2 (M + C) Exhibit A		A-26		Health Net / Cognizant Confidential

 Final 
  

	 	(B)	Audit support and detail back up for auditor PBC requests (Ernst & Young, Deloitte & Touche, state auditors, etc.) 

 

	 	(C)	Prepare and review information for state licensures in states, many of which require views of Members, claims, or revenue by state compiled from reporting from the data warehouse and SAP systems. 

 

	 	(D)	Perform and review system access controls, in addition to basic management review of staff assigned to roles; provide finance oversight including reviewing roles for segregation of duties. 

 

	 	(E)	Prepare and assist with quarterly and annual regulatory filings and audit support for the Department of Managed Health Care (DMHC) – Schedule G & H and Medical Loss Ratio calculations. 

 

	 	(F)	Prepare reports used for state tax apportionment – revenue and/or claims by state for MHN Services which operates in multiple states. Other documentation as requested by Health Net Tax department.

  

	 	(G)	Work with Health Net planning and budgeting teams to finalize budgets and research variances and allocation methodologies. 

  

	 	(H)	Complete other reporting and analysis in compliance w/ various regulatory agencies. 

  

	3.6	MS5: Broker Commissions Services. 

 “Broker Commission
Services” means those Functions associated with the receipt and input into the applicable system of information relating to Broker commissions, verifying Broker files are accurate, sending and receiving files in a timely manner,
producing commission statements, working with vendors to calculate Broker commissions correctly, facilitating payment, preventing duplicate payments, and any other Functions necessary to process Broker commissions accurately and timely. 

Below are some examples of selected Broker Commission Services Functions, some of which include descriptions of the manner in which such
Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(a)	Generate and manage timely Broker commission payments. 

  

	 	(b)	Review, address and respond to commissions-related inquiries and special ad hoc reporting that may be required. 

  

	 	(c)	Generate commission statements. 

  

	 	(d)	Maintain Broker contracting data, including implementing changes identified by Health Net. 

  

	 	(e)	Review annual guidance that may drive changes to commission types, structure and frequency. Implement the changes timely to avoid disruption to commissions for Brokers. 

  

					
	SOW#2 (M + C) Exhibit A		A-27		Health Net / Cognizant Confidential

 Final 
  

	 	(f)	Oversee vendor software that performs the Broker commission calculations and tracks the Broker information, and act as the business customer for any system enhancements to the vendor software. 

 

	 	(g)	Input and maintain in the applicable system the Broker information (including administrative information, and group assignments), sales, and Broker commission and incentive structures, agreements, Commissions rates, and
payments. 

  

	 	(h)	Respond to, research, follow up, contact, etc. inquiries received from Brokers and from Health Net. 

  

	 	(i)	Generate Broker commissions files. 

  

	 	(j)	Generate special handles/manual adjustment payments. 

  

	 	(k)	Complete various projects related to Broker commissions. 

  

	 	(l)	Obtain information required to determine Broker commissions earned and due, apply Broker commission and incentive structures, and determine payments due. 

 

	 	(m)	Maintain payment terms in the applicable system, cause payments to be generated and update and maintain payment history. 

  

	 	(n)	Aggregate, track and report Broker commissions across states and business segments. 

  

	 	(o)	Reconcile Broker commissions paid to sub-ledgers. 

  

	 	(p)	Address inquiries on Broker/Sales payments. 

  

	 	(q)	Perform Broker commission audits and analysis 

  

	 	(r)	Generate, validate, distribute and file daily, weekly, and monthly reports. 

  

	 	(s)	Provide financial data requested by Health Net. 

  

	 	(t)	Provide Month-end financial data to Accounts Payable and review monthly-allocated dues and open items in Health Net’s financial system. 

 

	 	(u)	Prepare the Bonus Payment Files for Brokers per Health Net sales requests. 

  

	 	(v)	Perform the collections for Broker commissions. 

  

	 	(w)	Complete the monthly ERISA 5500 (Schedule A) reporting. 

  

	 	(x)	Complete the annual AB2589 reporting. 

  

	3.7	MS6: Sales Incentives Services. 

 “Sales Incentives
Services” means those Functions associated with identifying persons that receive sales incentives, calculating payments, facilitating payment of sales incentives, tracking, reporting, and auditing sales incentives, responding to
inquiries, implementing changes to sales incentives, generating and providing reports, and responding to ad hoc requests. 

  

					
	SOW#2 (M + C) Exhibit A		A-28		Health Net / Cognizant Confidential

 Final 

Below are some examples of selected Sales Incentives Services Functions, some of which include descriptions of the manner in which such
Functions are currently performed by Health Net. The examples are illustrative only. 
  

	 	(a)	Generate and manage timely Sales Incentive payments according to contractual obligations. 

  

	 	(b)	Obtain approvals for payments and adjustments. 

  

	 	(c)	Review, address and respond to incentive related inquiries and special ad hoc reporting. 

  

	 	(d)	Review annual amendments and/or new compensation plans in order to determine which (if any) components have changed or are new. 

  

	 	(e)	Implement changes so new component (or updates) can be calculated. 

  

	 	(f)	Develop the new reporting necessary in order to identify correct membership activity driving payment. 

  

	 	(g)	Calculate accruals for financial reporting. 

  

	 	(h)	Complete required manual processing. 

  

	 	(i)	Provide files to payroll for payment. 

  

	3.8	MS7: Cash Unit Services. 

 “Cash Unit Services” means those
Functions associated with the receipt, reconciliation, processing, and management of premium payments, deposit of paper payments, reclassification of non-premium payments, and other cash unit Functions. 

Below are some examples of selected Cash Unit Services Functions, some of which include descriptions of the manner in which such Functions are
currently performed by Health Net. The examples are illustrative only. 
  

	 	(a)	Balance reports and process lockbox payments daily. 

  

	 	(b)	Intake all paper payments and deposit all paper payments into appropriate Health Net bank account. 

  

	 	(c)	Identify, process, and balance all premium payment wire transfers. Reclassify all non-premium receipts and prepare a manual adjustment to remove the item from the applicable system. 

 

	 	(d)	Process all check by Fax items. 

  

	 	(e)	Process all credit card remittance transactions. 

  

	3.9	MS8: Collections Services. 

 “Collections Services” means
those Functions associated with the collections process, including identifying delinquent payers, researching errors, producing demand and termination letters, cancelling coverage, forwarding balances due to outside collection agencies, and
completing associated write offs. 

  

					
	SOW#2 (M + C) Exhibit A		A-29		Health Net / Cognizant Confidential

 Final 

Below are some examples of selected Collections Services Functions, some of which include descriptions of the manner in which such Functions
are currently performed by Health Net. The examples are illustrative only. 
  

	 	(a)	Identify delinquent Group and Member payments. 

  

	 	(b)	Utilize collection database to track and manage delinquent Group and Member payments. Collection database for Groups and Individuals. 

 

	 	(c)	Research each account to determine if a payment has been made, and update account information as necessary. 

  

	 	(d)	Send delinquency letter (i.e., “Risk of Termination” letter) reports to the applicable parties. 

  

	 	(e)	Cancel Group or Member coverage in accordance with Health Net Policies. 

  

	 	(f)	Distribute Ten-Day Demand Letters, prior to groups being referred to outside third party collection agency. 

  

	 	(g)	Perform additional reconciliation/audit procedures as required to support Ten-Day Demand Letters. 

  

	 	(h)	Forward balances due to outside collection agency the following month and write off balances the same month, each with appropriate approval. 

 

	3.10	MS9: Reporting Services. 

 “Reporting Services” means those
Functions that involve development of tools, programming and business support to the Customer Service areas. 
 Below are some examples of
selected Reporting Services Functions, some of which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only. 

 

	 	(a)	Provide daily, weekly & monthly reports to the many different business teams (e.g: pended enrollments, new group data for broker commissions, monthly commission reports, dual coverage, unapplied cash, etc.).

  

	 	(b)	Provide adhoc reporting for available data stored in data repositories (e.g. ODW, MR, KBASE, TRR, etc) 

  

	 	(c)	Provide reconciliation reports as requested by Health Net. 

  

	 	(d)	Aggregate documentation for error correction activities into an annual report for Medical Management (e.g., HEDIS reporting). 

  

	 	(e)	Report application reject rates. 

  

					
	SOW#2 (M + C) Exhibit A		A-30		Health Net / Cognizant Confidential

 Final 
  

	 	(f)	Function as subject matter experts for back end repositories (ODW, MR, TRR, KBASE, etc.). 

  

	 	(g)	Provide requirements for data repositories in projects so that information flows appropriately. 

  

	 	(h)	Develop complex Access Databases, web tools and business tools that support Customer Services (eg enrollment, AR, Group Database, Provider, Claims, etc.). 

 

	 	(i)	Develop new and maintain existing Robotech/Technobot jobs. 

  

	 	(j)	Process Robotech/Technobot requests. 

  

	 	(k)	Provide analytical results to the business regarding Robotech/Technobot jobs that have been run along with detailed information around the fall out. 

 

	 	(l)	Automate letters and other customer facing documents as needed (e.g. manual bill generation) outside of the core systems. 

  

	 	(m)	Develop and maintain tools outside source system to improve accuracy or efficiency. 

  

	 	(n)	Provide the reports set forth in Exhibit G (Operational Reports). 

  

	3.11	MS10: Miscellaneous Membership Services. 

 “Miscellaneous Membership
Services” means those additional Functions described in this Section 3.9 related to the Membership Services not already addressed in Sections 3.1 through 3.10, including: 

 

	 	(a)	Review and approve Member materials sent out by other teams. 

  

	 	(b)	Perform activities related to all components of system enhancements such as: requirements gathering, document review, gap analysis, writing UAT test scripts and test execution. 

 

	 	(c)	Implementation of new and revised processes and membership activities as it relates to the introduction of a new and revised product, operational processes, and regulations. 

 

	 	(d)	Requirements gathering, BARR review, testing, validation and check out (i.e., validation in production before the work week begins that no system functionality has been adversely affected) for system changes that impact
Membership Services. 

  

	 	(e)	Testing and implementation of CMS changes and other regulatory changes. 

  

	 	(i)	Supply SME knowledge support for requirements gathering. 

  

	 	(ii)	Review and approve requirements documents. 

  

	 	(iii)	Review and endorse design documentation. 

  

	 	(iv)	Review and endorse system testing. 

  

					
	SOW#2 (M + C) Exhibit A		A-31		Health Net / Cognizant Confidential

 Final 
  

	 	(v)	Review and endorse test plan. 

  

	 	(vi)	Review and endorse gap analysis. 

  

	 	(vii)	Write tests scripts. 

  

	 	(viii)	Execute test scripts. 

  

	 	(ix)	Document testing deficiencies. 

  

	 	(x)	Supply testing status reports. 

  

	 	(xi)	Record/report defects and track until resolution. 

  

	 	(xii)	Implementation of CMS changes and other regulatory changes. 

  

	 	(f)	Perform all Services in a manner compliant with CMS call letters, CMS Guidance, and other policies and regulations. 

  

	 	(g)	Perform correspondence Functions related to the Membership Services in accordance with Health Net Policies. 

  

	 	(h)	At Health Net’s request, support Health Net’s testing activities related to Membership Services, including user acceptance testing (e.g., support for Health Net’s testing in connection with a system
release). 

  

	 	(i)	Collateral Design. 

  

	 	(i)	Implement and maintain the design of the Group’s and Members collateral, including: 

  

	 	(A)	Member ID Cards (e.g., layout, colors) which are consistent with the Product’s regulatory and brand standards and in accordance with Health Net Policies; 

 

	 	(B)	Bill designs and re-designs provided by Health Net; 

  

	 	(C)	Broker commission statements; and 

  

	 	(D)	Sales Incentive statements. 

  

	 	(ii)	Unless otherwise directed by Health Net, define and design membership letter templates for all lines of business (e.g. layout, colors), which are consistent with the regulatory and brand standards. 

 

	 	(j)	Archive (as required by Law and this Agreement) stored images of membership collateral and membership-related collateral and retrieve such images as necessary to perform the Services or otherwise at the request of
Health Net and in accordance with Health Net Policy and this Agreement. 

  

					
	SOW#2 (M + C) Exhibit A		A-32		Health Net / Cognizant Confidential

 Final 
  

	3.12	MS11: Medicare OEV Outbound Calls Services. 

 “Medicare OEV Outbound Calls
Services” are the Functions associated with providing technology, letter mailing fulfillment, and Contact Center Services to support the CMS Required Outbound Enrollment Verification (“OEV”) program, including
the following activities: 
  

	 	(a)	Providing the services and activities hereunder regarding the Medicare Advantage plan products issued by Health Net in accordance with CMS regulations; 

 

	 	(b)	Verifying that new Medicare Advantage plan (“MA”) applicants and Prescription Drug plan (“Part D”) applicants (“Enrolled Members”) understand the
Medicare Plan that they have applied for and to answer and address any concerns that such Enrolled Members may have (“Activities”) Using the CMS approved script, attempting to contact Enrolled Member(s) to make the OEV;

  

	 	(c)	Upon second unsuccessful call attempt, mailing the CMS-approved Verification Letter (“Verification Letter”), provided by Health Net; regarding new applications for a Medicare Plan. Mailing out an
OEV letter per CMS regulations; 

  

	 	(d)	Sending all letters using CMS approved templates in English, Spanish and Chinese; 

  

	 	(e)	Validating that the logic to calculate cancellation dates is accurate for both phone scripts and letter; 

  

	 	(f)	Using CSRs to make calls to and having the conversations set forth herein with Enrolled Members; 

  

	 	(g)	Documenting all enrollment verification activities including when each call was made to an Enrolled Member and the outcome of the call (disposition); and 

 

	 	(h)	Establishing an instance of Supplier’s proprietary or commercially standard system/ CRM platform for use by Supplier employees to assist in the completion of the efforts mentioned herein. 

 

	3.13	MS12: Audit Support Services. 

 “Audit Support Services” means
those Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group),
including the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with Regulators. 

  

					
	SOW#2 (M + C) Exhibit A		A-33		Health Net / Cognizant Confidential

 Final 
  

	3.14	MS13: Membership Policy Services. 

 “Membership Policy Services”
means those Functions associated with the development and implementation of “Health Net Membership Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies) governing or pertaining to
the Membership Services and, more specifically, the conduct of Health Net’s Membership Services. 
 Below are some examples of selected
Membership Policy Development Services Functions, which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only: 

 

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Membership Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Membership Policies; 

 

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

 

	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Membership Services and participate in operational implementation and/or affected system changes
of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net Membership Policies and submit them to the relevant Health Net and Supplier stakeholders for review,
comment and approval; 

  

	 	(d)	Prepare updated versions of Health Net Membership Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Membership Policies and access to Health Net personnel to such communication and training; and 

 

	 	(f)	Implement Health Net approved Health Net Membership Policies by Supplier Personnel involved in the performance of the Membership Services. 

  

					
	SOW#2 (M + C) Exhibit A		A-34		Health Net / Cognizant Confidential

 Final 
  

	4.	CONFIGURATION SERVICES—ROLES AND RESPONSIBILITIES 

 The following table sets forth
the respective roles and responsibilities of Supplier and Health Net for the Configuration Services, as well as identifying the Health Net lines of business and regions for which each listed component of the Configuration Services is applicable.
Supplier shall perform the Configuration Services, including those Functions listed and described in Section 5 below, except for those Functions (if any) that are expressly identified herein as retained Health Net responsibilities. 

 

											
	 Process /
Function ID
	  	 Process/Function Name / Description
	  	Lines of
Bsns
(LOB)	  	Region	  	Resp. Party
	  	  	  	  	Supplier	  	Health
Net
	CS1	  	Health Net Configuration Services	  		  		  		  	
	 CS1.1
	  	 Benefits Configuration Services
	  	All	  	All	  	X	  	
	 CS1.2
	  	 Pricing Configuration Services - Health Net
	  	All	  	All	  	X	  	
	CS2	  	Provider Configuration Services	  	All	  	All	  	X	  	
	CS3	  	Division of Financial Risk (DOFR) Configuration Services - Health Net	  	All	  	All	  	X	  	
	CS4	  	MHN Configuration Services	  	All	  	All	  	X	  	
	CS5	  	Provider Data Management Services - Health Net	  	All	  	All	  	X	  	
	CS6	  	Capitation Services - Health Net	  	All	  	All	  	X	  	
	CS7	  	Audit Support Services	  	All	  	All	  	X	  	
	CS8	  	Configuration Policy Services	  	All	  	All	  	X	  	

  

	5.	CONFIGURATION SERVICES - FUNCTIONAL DECOMPOSITION 

  

	5.1	Configuration Services, Generally. 

 “Configuration Services”,
which are described generally in Section 1.1(b), support all lines of business (e.g. Commercial, Medicare, and Medicaid and Duals) across Health Net and MHN. The principal Functions comprising the Configuration Services are set forth in the
remainder of this Section 5. 
  

	5.2	CS1: Health Net Configuration Services. 

  

	 	(a)	CS1.1: Benefits Configuration Services. 

 “Benefits Configuration
Services” are the Functions associated with benefits configuration, including the following activities: 
  

	 	(i)	Maintain databases and provide quality and timeliness reporting for date when Configuration team initially received the benefits information, validated it, returned it to Health Net for any clarifications, received
clarifications and completed benefits system configuration, Summary of Benefits and Coverage (SBC) or Summary of Benefits processes. 

  

					
	SOW#2 (M + C) Exhibit A	  	A-35	  	Health Net / Cognizant Confidential

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	 	(ii)	Receive new and updated data from Health Net (Product grids); 

  

	 	(iii)	Setup and configure Health Net benefits information in the applicable systems, including to enable the following: 

  

	 	(A)	Claims adjudication; 

  

	 	(B)	Display benefits information on ID Cards, Web, etc.; and 

  

	 	(C)	Use of benefits information by surround systems and process partners in capitation, medical management, membership, finance, claims, etc. 

 

	 	(iv)	Review the benefits for completeness. For benefits that require clarification and/or additional information, research and obtain such clarification and/or information, and upon obtaining the missing data, complete the
entry of the benefit data into the applicable system. 

  

	 	(v)	For clean benefit information requiring no clarification and/or additional information, enter the complete benefit information into the applicable system. 

 

	 	(vi)	Coordinate with Claims to test Benefit Plans to simulate proper processing and outcomes of different claim payment scenarios. Make any corrections and changes required as demonstrated from the test results and obtain
final claims sign off. 

  

	 	(vii)	Finalize benefits load into applicable production systems. 

  

	 	(viii)	Maintain Benefit Plan accumulators. 

  

	 	(ix)	Create and maintain the “Prior Authorization List”. 

  

	 	(x)	Maintain understanding of benefits requirements on the web sites of CMS, other applicable regulatory agencies and industry vendors, and participate in Health Net and other regulatory activities. 

 

	 	(xi)	Research, correct systems information and respond timely to benefits issues from internal and external audiences. 

  

	 	(xii)	Create, quality monitor, translate and publish Summary of Benefits Coverage (SBC) and Schedule of Benefits (SOB) for quoting benefits to Members, providers and other internal and external audiences for:

  

	 	(A)	New products; and 

  

	 	(B)	Existing products, monthly renewals or other updates as required by CMS. 

  

					
	SOW#2 (M + C) Exhibit A		A-36		Health Net / Cognizant Confidential

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	 	(b)	CS1.2:Pricing Configuration Services—Health Net 

 “Pricing Configuration
Services” are the Functions associated with pricing configuration, including the following activities: 
  

	 	(i)	Load and configure all professional fee schedules to support government and commercial pricing arrangements, which includes checking the applicable government website for updates to fee schedules (i.e. RBRVS).

  

	 	(ii)	Configure and maintain the Provider fee schedule. 

  

	 	(iii)	Update all industry standard professional fee schedules (RBRVS, Medi-Cal, AWP) in Health Net systems, as well as confirm that Burgess tools are updated timely and accurately to support government and commercial pricing
arrangements. 

  

	 	(iv)	Monitor web sites of CMS and other applicable regulatory agencies and industry vendors (e.g., Optum), and Medi-Cal for updates to industry pricing methodologies (RBRVS, Medi-Cal allowable, etc), industry standard coding
updates, (e.g. CPT, HCPCs, ICD-9) daily, weekly, quarterly, or annually depending on the frequency of update releases. 

  

	 	(v)	Perform system updates, either through direct table updates or via a Service Request sent to ITG within 3 Business Days of update posting or notification. 

 

	 	(vi)	Test updates and releases prior to moving them to the live production environment. 

  

	 	(vii)	Notify affected Health Net departments of updates and releases—e.g., by posting them to Health Net’s intranet. 

  

	5.3	CS2: Provider Configuration Services. 

 “Provider Configuration
Services” are the Functions associated with provider configuration, including the following activities: 
  

	 	(a)	Conduct pre-signature review on any non-standard contracts and coordinate resolution of any issues with Network Management and Claims. 

 

	 	(b)	Maintain databases and provide quality and timeliness reporting for date when Configuration team initially received the information, validated it, returned it to Health Net for any clarifications, received
clarifications and completed system configuration. 

  

	 	(c)	Based on provider contract data provided by Health Net, receive, configure, load and validate new and amended Provider rates and Division of Financial Risk (DOFR) for Professional Direct Network, PPG, Institutional
Inpatient/Outpatient and Ancillary contracts in the system. 

  

	 	(i)	Review the contract for completeness. For contracts that require clarification and/or additional information, research and obtain such clarification and/or information, and upon obtaining the missing data, complete the
entry of the contract data into the applicable system. 

  

	 	(ii)	For clean contracts requiring no clarification and/or additional information, enter the complete contract into the applicable system. 

  

					
	SOW#2 (M + C) Exhibit A		A-37		Health Net / Cognizant Confidential

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	 	(iii)	Maintain existing provider contract data files to support SOX (Sarbanes Oxley) audits. 

  

	 	(iv)	After Finance approval of Viant load, activate contract configured in Health Net system to send claims batch files to Viant for pricing of Inpatient and Outpatient par and non-par claims per Viant rules.

  

	 	(v)	Create provider fee keys per contractual agreements that can be utilized in the configuration of automated physician claims (CMS 1500) pricing. (Fee key cascading logic). 

 

	5.4	CS3: DOFR Configuration Services – Health Net. 

 “DOFR Configuration
Services” are the Functions associated with DOFR configuration, including the following activities: 
  

	 	(a)	Configure and load all DOFR contract risk arrangements for PPGs and Dual Risk facilities into the various Health Net systems for claims adjudication. 

 

	 	(b)	Receive the PPG contract and log the contract into the applicable system, including logging the date on which Supplier received the contract, and track all contracts in the database through the process to completion.

  

	 	(c)	Assign contract to a Configuration Analyst and log it into the department’s internal Inventory Access Database. 

  

	 	(d)	Review the contract for completeness. For contracts that require clarification and/or additional information, research and obtain such clarification and/or information, and upon obtaining the missing data, complete the
entry of the contract data into the applicable system. 

  

	 	(e)	For clean contracts requiring no clarification and/or additional information, enter the complete contract into the applicable system. 

 

	 	(f)	Maintain and update all applicable contract data in applicable Health Net systems. 

  

	 	(g)	Perform audits in accordance with Health Net Policies. Correct discrepancies and enter all data into the applicable system. 

  

	5.5	CS4: MHN Configuration Services. 

 “MHN Configuration
Services” are the Functions associated with MHN configuration, including the following activities: 
  

	 	(a)	MHN’s portfolio includes multiple products and states. Provide accurate business design and implementation of business rules into the applicable system to support client benefits and enable accurate claims
adjudication. For Affiliate accounts, implement and maintain configuration grids that outline business rules for each of the Affiliates. Regularly review rules with the Affiliates to enable accuracy, consistency and specialization where required.
Maintain these grids for Commercial and Medicare accounts as well. 

  

					
	SOW#2 (M + C) Exhibit A		A-38		Health Net / Cognizant Confidential

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	 	(b)	Perform benefit design analysis to validate benefits against state and federal regulations, as well as current Health Net internal business rules. For Commercial accounts, act as a gatekeeper for the Managed Care
Benefit record in applicable system. Validate all new and renewing benefit designs with changes in compliance with all Laws. 

  

	 	(c)	Accurately install Commercial and Affiliate matrices. These matrices are “crosswalks” that convert client specific data values into MHN Net data values. This facilitates an accurate benefit
translation and update into the on-line system. Process Affiliate matrices weekly and process Commercial matrices as needed or as otherwise directed by Health Net. 

 

	 	(d)	Contribute subject matter expertise to support the accurate development of business requirements and appropriate system enhancements and modifications. Actively participate in projects for Health Net business areas,
including Claims, Clinical Operations, Customer Service, Finance, and Membership Accounting. 

  

	 	(e)	Maintains multiple Configuration tables, including those related to various coding sets, benefit categories, maintenance, and financial indicators. Update and maintain Configuration items and tables, including the Cross
Data Accumulation table, the Parity table, Procedure Codes, Benefit Category rules, and Diagnosis Code File. 

  

	 	(f)	Administer the Business Solutions Request Database. This database is used by operational departments within MHN & Health Net Affiliates to track operational issues and projects that require resolution. Closely
track compliance of all requests in the database and follow up on all outstanding requests to facilitate meeting Service Level Agreement and other requirements. 

  

	 	(g)	Load account and benefit information in the Client and Benefit Repositories in the applicable system for all Affiliate and Commercial accounts. 

 

	5.6	CS5: Provider Data Management Services – Health Net. 

 “Provider Data
Management Services” are the Functions associated with provider data management, including the following activities: 
  

	 	(a)	Receive and maintain PPG and Provider demographic information in systems of record (including for Professional, Institutional and Ancillary Providers, as well as participating and non-participating Providers). Link
pricing to Provider Tax ID number. Input and maintain Provider suffixing. 

  

	 	(b)	Receive and input Provider accreditation and affiliation information and artifacts from multiple sources (including third party agencies). 

 

	 	(c)	Receive and process debarment information provided by Credentialing to reflect timely and accurate provider licensing status in systems. 

 

	 	(d)	Identify missing PPG and Provider data (internally or through requests from other departments). Unless otherwise directed by Health Net, contact the Provider and obtain any missing information. Update additional
information in the applicable systems of record. 

  

					
	SOW#2 (M + C) Exhibit A		A-39		Health Net / Cognizant Confidential

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	 	(e)	Provide a concierge level of service to certain Providers (as identified by Health Net in its sole discretion, which list of Providers may be modified by Health Net from time to time during the Term). Such service shall
NOT include making in-person visits. 

  

	 	(f)	Support requests from Health Net and other Supplier functional areas, including: Claims, Provider Services, Provider Network Management, Credentialing, Medicare Management, Finance, Tax, and Appeals and Grievances
regarding Provider Data Management related information and assistance. 

  

	 	(g)	Receive requests to add / update Provider data via various media, including SFs, Profiles, Fee Schedules, NCFs, PIFs, 1099s, W-9s, Projects, miscellaneous mail and returned mail. 

 

	 	(h)	Provide accurate and timely data entry of contracted and non-contracted provider data for all applicable geographies. 

  

	 	(i)	Assign Configuration-related tasks to the applicable Managed Third Parties, including Profiles, Fee Schedules, NCF’s, Projects, and auto-suffix claims for all contracted and non-contracted Provider data. Provide
training and support as needed. 

  

	 	(j)	Research Provider information on Claims that are not auto-matched in the applicable system. Manually research and resolve any claim suffixing issues via claim review of all claims in the auto-suffix queue.

  

	 	(k)	Validate the contents of debarred, sanctioned and suspended provider list. 

  

	 	(l)	Flag all (contracted and non-contracted) debarred, sanctioned or suspended providers. 

  

	5.7	CS6: Capitation Services—Health Net. 

 “Capitation Services”
are the Functions associated with Capitation, including the following activities: 
  

	 	(a)	Load New/Amended Capitated Provider/Vendor Contract Information into the applicable systems, including the date the contract was received for the applicable geographies; 

 

	 	(b)	Load and maintain Capitation benefit relativity rates for medical plans and ancillary riders; perform DOFR maintenance to process Capitation deductions. 

 

	 	(c)	Load Benefit Base Rate Table/Remit Rule/Age Sex Table for monthly capitation calculation. 

  

	 	(d)	Review the contract for completeness. For contracts that require clarification and/or additional information, research and obtain such clarification and/or information from internal and external partners and, upon
obtaining the missing data, complete the entry of the contract data into the applicable system. 

  

	 	(e)	For clean contracts requiring no clarification and/or additional information, enter the complete contract into the applicable system. 

 

	 	(f)	Input the data into the applicable system for payment calculation and generation. 

  

					
	SOW#2 (M + C) Exhibit A		A-40		Health Net / Cognizant Confidential

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	 	(g)	Generate on a monthly basis Provider Remittance/Audit Sheet/Check request documents and support requests from Health Net and other supplier functional areas, including but not limited to: Claims, Provider Services,
Provider Network Management, Credentialing, Medicare Management, Finance and Tax. 

  

	 	(h)	Obtain necessary approvals for check requests. 

  

	 	(i)	Generate Capitation payment files based on PPG contract arrangement (Medicare, Medicaid, Duals and HMO) and other ancillary provider contracts as applicable. 

 

	 	(j)	Upload the Provider/Vendor Group payment files to the applicable system. 

  

	 	(k)	Reconcile payments with past dues and determine final payments. 

  

	 	(l)	Perform analysis and validation prior to making the final files available to Health Net. 

  

	 	(m)	Submit payment proposal/ check register to Accounts Payable. Submission timing differs for paper checks and electronic payments. 

  

	 	(n)	Reconcile paper checks and provide checks to the Health Net mail room. 

  

	 	(o)	Set up and maintain payee information (e.g., name, address, and tax ID) and routing information (e.g., routing number, account number, etc. for electronic payments) for payment submissions. 

 

	 	(p)	Conduct internal monthly capitation payment audits (pre-remittance), including the following: 

  

	 	(i)	Generate and perform audit of Cap Remittance Summary/Audit Sheets. 

  

	 	(ii)	Verify that Cap dollars, along with adjustments if applicable, are accounted for. 

  

	 	(iii)	If error is found, make the appropriate adjustment(s) and resubmit for additional audit. 

  

	 	(iv)	Forward to Health Net for final approval and payment generation. 

  

	 	(q)	Conduct internal daily / weekly provider contract audits. 

  

	 	(r)	Request check tracers and process check reissues as needed in the applicable system. 

  

	 	(s)	Provide a concierge level of service to certain Providers (as identified by Health Net in its sole discretion, which list of Providers may be modified by Health Net from time to time during the Term). Such service shall
NOT include making in-person visits. Provide such concierge service (at the frequency and schedule specified by Health Net) to such Providers in order to educate the applicable Provider regarding the Capitation Services. 

 

	 	(t)	Generate the following Provider/Hospital Capitation reports: 

  

	 	(i)	Remittance Detail – capitation paid per Member. 

  

	 	(ii)	Eligibility – active eligible Members. 

  

					
	SOW#2 (M + C) Exhibit A		A-41		Health Net / Cognizant Confidential

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	 	(iii)	Activity – Member changes (i.e. adds/cancels etc.). 

  

	 	(iv)	Eligibility Summary by Group Name – Member count by Group. 

  

	 	(v)	CMS MMR, CMS HCC Risk, SB 260 Reconciliation. 

  

	 	(u)	Set up PGP keys for WEB transmission with Providers/Hospitals. Perform testing to validate all data elements are correct and regulatory requirements are met. 

 

	 	(v)	Conduct meetings with Providers/Hospitals to field questions on capitation calculations at the Member level. 

  

	5.8	CS7: Audit Support Services. 

 “Audit Support Services” means
those Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group),
including the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with Regulators. 

  

	5.9	CS8: Configuration Policy Services. 

 “Configuration Policy
Services” means those Functions associated with the development and implementation of “Health Net Configuration Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies)
governing or pertaining to the Configuration Services and, more specifically, the conduct of Health Net’s Configuration Services. 

Below are some examples of selected Configuration Policy Development Services Functions, which include descriptions of the manner in which such
Functions are currently performed by Health Net. The examples are illustrative only: 
  

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Configuration Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Configuration Policies;

  

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

  

					
	SOW#2 (M + C) Exhibit A		A-42		Health Net / Cognizant Confidential

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	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Configuration Services and participate in operational implementation and/or affected system
changes of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Prepare initial drafts of revised or new Health Net Configuration Policies and submit them to the relevant Health Net and Supplier stakeholders for review, comment and approval; 

 

	 	(d)	Based on the aforementioned meetings and guidance from the EPCO, prepare updated versions of Health Net Configuration Policies to address input provided by relevant Health Net and Supplier stakeholder groups;

  

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Configuration Policies and access to Health Net personnel to such communications and training; and 

 

	 	(f)	Implement Health Net approved Health Net Configuration Policies by Supplier Personnel involved in the performance of the Configuration Services. 

  

					
	SOW#2 (M + C) Exhibit A		A-43		Health Net / Cognizant Confidential

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EXHIBIT A-1 
 MEMBERSHIP
AND CONFIGURATION 
 SOLUTION DESCRIPTION 

  

					
	SOW#2 (M+C) Exhibit A-1		 		Health Net / Cognizant Confidential

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EXHIBIT A-1 
 MEMBERSHIP
AND CONFIGURATION SOLUTION DESCRIPTION 
 TABLE OF CONTENTS 

 

									
	 1.
		INTRODUCTION		 	1	  
			
	 2.
		DEFINITIONS AND INTERPRETATION		 	1	  
				
			2.1		Defined Terms		 	1	  
			
	 3.
		MEMBERSHIP SOLUTION OVERVIEW		 	1	  
				
			3.2		Changes to Supplier’s Solution		 	3	  
				
			3.3		Solution Description		 	3	  
				
			3.4		Operating Model		 	4	  
			
	 4.
		CONFIGURATION SERVICES SOLUTION		 	16	  
				
			4.1		Solution Overview		 	16	  
				
			4.2		Changes to Supplier’s Solution		 	17	  
				
			4.3		Solution Description		 	17	  
				
			4.4		Operating Model		 	18	  

  

					
	SOW#2 (M+C) Exhibit A-1		A-1-i		Health Net / Cognizant Confidential

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	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work #5 –
Membership and Configuration (this “Statement of Work”). Whereas Exhibit A (Membership and Configuration Services) describes the Functions which Supplier is responsible for performing under this Statement of Work. This
Exhibit A-1 (Membership and Configuration Solution Description) describes the means by which and the manner in which Supplier will perform those Functions. This document includes an overview of Supplier’s service delivery
architecture –including a depiction on a global map of the geographic configuration and delivery architecture of Supplier’s Solution (as it will exist at the completion of Phase 2). This geographical depiction also identifies all Service
Delivery Centers of Supplier (and its Affiliates and other Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how they will be interconnected to each other and
to Health Net’s IT Environment. It then provides additional descriptive information about each of the principal components of Supplier’s Solution. 

This Exhibit A-1 (Membership and Configuration Solution Description) includes the following attachments, which are incorporated herein
by reference: 
 Exhibit A-1.1 Approved Service Delivery Centers 

Exhibit A-1.2 Service Delivery Configuration at the Completion of Phase 2 

 

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings set forth below unless otherwise specifically defined in the body of this document. Additionally any capitalized term used but not defined in this Exhibit A-1 (Membership and Configuration Solution Description) will have the meaning
indicated in Schedule W (Glossary). 
  

			
	 Defined Term
	  	 Meaning

		
	“Solution”	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work.

  

	3.	MEMBERSHIP SOLUTION OVERVIEW 

  

	 	(a)	High-level Service Delivery Architecture and Configuration 

 This section provides an overview
of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service Delivery Centers) provides additional information about each of the Service Delivery
Centers Supplier will use to provide the Membership Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if
operations at any primary Service Delivery Center are disrupted or disabled. 

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-1	  	Health Net / Cognizant Confidential

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Figure 1 
  

 
 The above diagram illustrates Supplier solution and Onshore Offshore ratio from the beginning of phase 2 to
the end of phase 2. Initially all the Health Net resources will be rebadged and work out of the current Health Net US locations in Rancho Cordova, Woodland Hills and San Rafael. The Transition is planned to occur over 3 waves as depicted in Figure
1, with some of the work gradually moving to the Offshore locations of Chennai and Bangalore in India and Manila and Cebu in the Philippines. The overall target Onshore/ Offshore ratios at the initial state and the final state (Phase 3) are
illustrated above. 
  

	 	(b)	Service Delivery Model 

 This section provides an overview of the commercial delivery model
Supplier will utilize in providing the Membership Services under this Statement of Work. As described in Exhibit H (Membership and Configuration Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform the
Services under this Statement of Work. 
  

	 	(c)	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work will be
provided under a ‘Business-Process-as-a-Service’ delivery model—i.e., as a fully integrated vertical service in which Supplier is responsible for providing all the associated resource / service layers (facilities, IT infrastructure,
tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’ (e.g., fully processed enrollment). 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-2		Health Net / Cognizant Confidential

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	3.2	Changes to Supplier’s Solution 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Membership and Configuration Solution Description). That said, Supplier is charged with responsibility
for the adequacy of its Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Membership and Configuration Solution Description), should prove inadequate at any point during the Statement of Work
Term for Supplier to perform and deliver the Services in accordance with the obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to
perform and deliver the Services in accordance with such obligations. All such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however,
that Supplier is responsible for making such changes at its own cost and expense except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 

 

	3.3	Solution Description 

 Supplier’s Solution is built on the following foundational
aspects: 
 Delivery Solution: 
  

	 	•	 	Quality Focus – Supplier’s primary focus is to maintain continuity of services while ensuring regulatory and contractual compliance. For all processes migrated Offshore, the objective will be to adhere
to compliance requirements and get the quality right. 

  

	 	•	 	Support ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides personnel to Supervisor and QA ratio Offshore as described in Section 3.4(d) of this Exhibit A
(Membership and Configuration Services). 

  

	 	•	 	Continuous Improvement—Supplier will appoint dedicated Six Sigma resources during the Term to identify sustainable improvement opportunities. The typical ratio is around 1 Six Sigma resource for every 150
FTEs. 

 Knowledge Retention: 
  

	 	•	 	Domain Experts – Supplier will deploy staff (existing and hired) with previous Healthcare experience for key functions, including Operations, Transition, Training, Quality and Compliance. 

 

	 	•	 	Health Net Training Academy – During Phase 2 and Phase 3, Supplier’s dedicated Health Net Training Academy will be tasked with the mandate of building/maintaining a Knowledge repository, updating
Training and process documentation, providing training to new hire Supplier Personnel and providing higher level training to experienced resources for Membership Operations 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-3		Health Net / Cognizant Confidential

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	3.4	Operating Model 

 The operating model for Membership Services describes the service
delivery blue-print and key aspects of service delivery. The operating model also describes how the in-scope Services will be delivered for each functional process area in a scalable global delivery environment. 

 

	 	(a)	Resource Mix 

 The initial Onshore/Offshore resource mix and target ratio for Phase 3 for
Membership operations is listed in the following table. 
 Supplier has considered the following criteria to define its Onshore/ Offshore
strategy - 
  

	 	•	 	Regulatory requirements 

  

	 	•	 	Non-availability of skill at Offshore 

  

	 	•	 	Health Net mandated Offshore restricted function 

 Processes requiring voice support will be
delivered out of US and Philippines. 
 Table 1 
  

											
	 	  	Resource Mix Estimate
	 Sub function
	  	Final State - Phase 3
	 	  	Onshore
%	 	 	Offshore
%	 	 	Delivery
Location
	 Duals Demonstration Enrollment Services
	  	 	100.00	% 	 	 	0.00	% 	 	W,R
	 (a) Employer Group Setup Services
	  	 	25.00	% 	 	 	75.00	% 	 	W,R,Ch,B
	 (a) Medicare Enrollment Services
	  	 	40.00	% 	 	 	60.00	% 	 	W,R,Ch,B
	 Commercial Enrollment Services
	  	 	10.00	% 	 	 	90.00	% 	 	W,R,Ch,B
	 Medicare Accounts Receivable Services
	  	 	25.00	% 	 	 	75.00	% 	 	W,R,Ch,B
	 Commercial Accounts Receivable Services
	  	 	10.00	% 	 	 	90.00	% 	 	W,R,Ch,B
	 Broker Commission Services
	  	 	10.00	% 	 	 	90.00	% 	 	W,R,M,Ce
	 Compliance Oversight
	  	 	100.00	% 	 	 	0.00	% 	 	W,R
	 Membership Financial Forecasting / Budgeting
	  	 	100.00	% 	 	 	0.00	% 	 	W,R
	 Membership Financial Reporting
	  	 	50.00	% 	 	 	50.00	% 	 	W,R,Ch,B
	 Membership Special Projects
	  	 	100.00	% 	 	 	0.00	% 	 	W,R
	 Membership Support
	  	 	25.00	% 	 	 	75.00	% 	 	W,R,Ch,B
	 MHN Billing and AR
	  	 	33.00	% 	 	 	67.00	% 	 	SR,Ch,B

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-4	  	Health Net / Cognizant Confidential

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	 MHN Eligibility processing
	  	 	25.00	% 	 	 	75.00	% 	 	SR,Ch,B
	 MHN Finance Operations
	  	 	25.00	% 	 	 	75.00	% 	 	SR,Ch,B
	 MHN Membership Services
	  	 	100.00	% 	 	 	0.00	% 	 	SR,Ch,B
	 Sales Incentives
	  	 	25.00	% 	 	 	75.00	% 	 	W,R,M,Ce
	 Other Membership Services
	  	 	100.00	% 	 	 	0.00	% 	 	W,R

  

			
	
Legend

	 Location
	  	Code
	 Woodland Hills (US)
	  	W
	 Rancho Cordova (US)
	  	R
	 San Rafael (US)
	  	SR
	 Chennai (India)
	  	Ch
	 Bangalore (India)
	  	B
	 Manila (Philippines)
	  	M
	 Cebu (Philippines)
	  	Cb

  

	 	•	 	The above percentages are approximate estimates at this point. 

  

	 	•	 	The estimated Final State ratios are expected to be reached by March 2017. This may change based on the final agreed Transition plan. 

 

	 	•	 	Roles that Health Net mandates to remain Onshore and roles for which the required skills are not readily available at Supplier’s Offshore locations will remain Onshore. 

 

	 	•	 	As shown in Table 1, while a process can span across up to 4 locations, there will be no role within a process that will span across more than 2 locations. 

 

	 	(b)	Service Locations 

 To achieve Health Net’s objectives of improvement in services delivery,
faster speed to market, focus on growth and significant reduction in cost, Supplier will leverage its global operating model. Supplier will deliver the in-scope services from US, India and Philippines locations. The delivery location strategy has
been planned taking into consideration the following criteria. 
  

	 	•	 	Health Net mandated Onshore staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

	 	•	 	Regulatory limitations 

  

	 	•	 	Business Continuity 

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-5	  	Health Net / Cognizant Confidential

 Final 
  

Functional processes subject to regulatory location restrictions will be performed from US locations. The processes requiring voice-assisted
stakeholder interaction will be performed from Philippines and US locations. Supplier will also adhere to the requirements of the Agreement, including those set forth in Schedule E (Employee Transfer) of the Agreement, relating to the work
locations of Affected Employees who become Supplier Personnel. 
 As per Health Net’s requirements, the Supplier Personnel performing
the following Membership Services Functions must be retained in Onshore locations: 
  

	 	•	 	AZ AHCCCS Line of Business 

  

	 	•	 	Performance Groups 

  

	 	•	 	Auditors interfacing with Compliance Group 

  

	 	•	 	Power of Attorney/PHI 

  

	 	•	 	Legal and Compliance Liaison 

  

	 	•	 	All triage functions 

  

	 	•	 	Scanning and batching of work requests received in non-digital format for transmission to the third party scanning/imaging service provider for conversion into digital format. 

Table 2 
  

					
	 	  	Delivery Location
	 Sub function
	  	Onshore	  	Offshore
	 Membership Management Team (VP) 
	  	US	  	
	 Commercial Line of Business
	  	US	  	Bangalore, Chennai
	 Medicare Line of Business
	  	US	  	Bangalore, Chennai
	 The Duals Demonstration (Cal MediConnect also known as CMC) Line of Business
	  	US	  	
	 MHN Membership Services
	  	US	  	Bangalore, Chennai
	 Broker Commission Services
	  	US	  	Manila, Cebu
	 Miscellaneous Membership Services
	  	US	  	Bangalore, Chennai,
Manila, Cebu

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-6	  	Health Net / Cognizant Confidential

 Final 
  

The teams across locations in the US, India and Philippines will interact on an ongoing basis to enable effective planning, monitoring and
tracking of processes, activities and requirements. Following are the key activities: 
  

	 	•	 	Forecasting – identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	•	 	Capacity Planning- verify staffing in place to manage the forecasted volumes 

  

	 	•	 	Monitor Productivity- An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	•	 	Reallocation based on productivity – Process wherein the transaction and volumes are shifted within teams and individuals to achieve desired productivity 

 

	 	•	 	Monitor Quality and Service Levels—An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

The organization structure has been functionally designed to facilitate effective operations across locations. 

This model will enable the workflow to be effective in real time, facilitating tactical monitoring. 

 

	 	(c)	Operating Hours 

 Supplier will at minimum replicate the operating hours currently adhered to by
Health Net’s Membership organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Membership Services will regularly require Supplier Personnel to perform
additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Membership Services. Examples include the following areas and time periods: 

 

	 	•	 	Expanded operational hours to accommodate the increased time zone difference between Arizona (Mountain Standard Time year-round) and West Coast US locations (Pacific Time) during the portion of the year when West Coast
US locations change from Daylight Savings Time to Standard Time. 

  

	 	•	 	During any kind of regulatory or financial audits as necessary to meet assigned deadlines. 

  

	 	•	 	During periods of Open Enrollment and Annual Election Period. 

 Supplier will extend its hours
of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such
extended hours of operations is within the scope of the Membership Services. 
 Within the regular Hours of Operations listed in Table 3
below, Supplier will have staff work according to defined shift schedules. However, Supplier will make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to
meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-7		Health Net / Cognizant Confidential

 Final 
  

Table 3 
  

					
	 Sub function
	  	Hours of Operations
(Pacific Time)	 
	 Commercial Line of Business
	  			
	 Supervisor – Group Setup
	  	 	08:00 am to 17:00 pm	  
	 Employer Group Setup Services
	  	 	08:00 am to 17:00 pm	  
	 Director – Commercial Membership
	  	 	08:00 am to 17:00 pm	  
	 Manager – Enrollment
	  	 	08:00 am to 17:00 pm	  
	 Supervisor – Enrollment
	  	 	08:00 am to 17:00 pm	  
	 Commercial Enrollment Services
	  	 	08:00 am to 17:00 pm	  
	 Manager – AR/Billing
	  	 	08:00 am to 17:00 pm	  
	 Supervisor – AR/Billing
	  	 	08:00 am to 17:00 pm	  
	 Commercial Accounts Receivable Services
	  	 	08:00 am to 17:00 pm	  
	 Medicare Line of Business
	  			
	 Director – Government Programs, Compliance Oversight
	  	 	08:00 am to 17:00 pm	  
	 Manager – Enrollment, Member Project Support
	  	 	08:00 am to 17:00 pm	  
	 Supervisor – Enrollment, Data/Systems, Project/System
	  	 	08:00 am to 17:00 pm	  
	 Membership Project Support
	  	 	08:00 am to 17:00 pm	  
	 Manager – AR/Billing
	  	 	08:00 am to 17:00 pm	  
	 Supervisor – AR/Billing
	  	 	08:00 am to 17:00 pm	  
	 Medicare Enrollment Services
	  	 	08:00 am to 17:00 pm	  
	 Medicare Accounts Receivable Services
	  	 	08:00 am to 17:00 pm	  
	 The Duals Demonstration (Cal MediConnect also known as CMC) Line of Business
	  			
	 Duals Demonstration Enrollment Services
	  	 	08:00 am to 17:00 pm	  
	 MHN Membership Services
	  	 	08:00 am to 17:00 pm	  
	 MHN Membership Services – Oversight
	  	 	08:00 am to 17:00 pm	  
	 MHN Eligibility processing
	  	 	08:00 am to 17:00 pm	  
	 MHN Billing and AR
	  	 	08:00 am to 17:00 pm	  
	 MHN Finance Operations
	  	 	08:00 am to 17:00 pm	  

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-8	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Broker Commission Services
				
	 Broker Commission Services – Oversight
		 	08:00 am to 17:00 pm	  
	 Broker Commission Services – Medicare
		 	08:00 am to 17:00 pm	  
	 Broker Commission Services – Commercial
		 	08:00 am to 17:00 pm	  
	 Sales Incentives
		 	08:00 am to 17:00 pm	  
	 Miscellaneous Membership Services
				
	 Compliance Oversight
		 	08:00 am to 17:00 pm	  
	 Membership Financial Reporting
		 	08:00 am to 17:00 pm	  
	 Membership Financial Forecasting / Budgeting
		 	08:00 am to 17:00 pm	  
	 Membership Special Projects
		 	08:00 am to 17:00 pm	  
	 Executive Admin
		 	08:00 am to 17:00 pm	  
	 Tech Team Reporting
		 	08:00 am to 17:00 pm	  

  

	 	(d)	Operations 

 Supplier’s approach to managing Membership operations is as follows: 

 

	 	•	 	Operational Focus: 

 Team huddles, floor walks, daily performance reviews, daily
Supplier Personnel communication plan and customer calibration sessions. 
  

	 	•	 	Performance Management: 

 Measure and manage Supplier Personnel performance through data
and service dashboards 
  

	 	•	 	Span of Control: 

 Supplier will provide for the following span of control (applicable
during Phase 3 - i.e., after Transition has been completed): 
  

	 	•	 	Operations Lead 1: £500 

  

	 	•	 	Manager 1: £50 

  

	 	•	 	Supervisor 1: £15 

  

	 	•	 	Quality Auditor 1: £15 

  

	 	•	 	Trainer 1: £20 (during training following completion of Transition)—Proposed training ratio of 1: £20 is based on typical
classroom training. However for specific processes this ratio could be lower. 

  

	 	•	 	Six Sigma and Process Excellence 1: £150 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-9		Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Health Net Training Academy: 

 Supplier will establish a dedicated Health Net Training
academy for the management of training content and the delivery of training programs. Supplier will establish a Knowledge Management Portal for management and easy access to Training Content, desktop procedures and P&Ps. Academy will work
closely with the Training Tower and facilitate necessary training during Phase 2 and Phase 3. Based on the System updates and Process updates, the training materials will be constantly updated. 

 

	 	•	 	Team Huddle: 

 Supplier’s Team Leads will conduct daily team meetings for
individual processes to share any critical updates, feedback and communication on learnings, and plan for the day. 
  

	 	•	 	Quality: 

 Supplier will implement Health Net mandated specific quality/compliance
programs in its delivery model for managing and achieving service levels. Supplier will analyse audit findings to determine root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings, prevalent
trends in errors, root causes and preventive actions will be discussed and implemented. 
  

	 	•	 	Continuous Improvement: 

 Supplier will have a dedicated Process Excellence (PEX) team
consisting of Six Sigma resources for Health Net Membership functions to enhance performance and handoffs in Health Net Membership’s processes while improving standardization and the “To-Be operating model”. 

 

	 	•	 	Rewards and Recognition 

 Supplier will recognize the efforts of its best performers
using stack ranking and will reward them through a structured reward and recognition program that aligns with quality and productivity objectives. The Rewards and Recognition will be applicable for both Onshore and Offshore teams. The specific
criteria for the awards will be decided by the Operations Leads depending on the specific behavior and/or results to be achieved. 
  

	 	(e)	Resource Profile 

 Supplier has a very well defined methodology for the recruitment and
selection of candidates. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper qualifications and experience in
order to achieve a “best-fit” for Health Net. 
 Tables 4-9 below set forth indicative requirements for Offshore staffing and the
minimum qualifications required to be selected for Membership operations. 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-10		Health Net / Cognizant Confidential

 Final 

Table 4 
  

			
	 Enrollment and Billing Representatives

 

	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2
years of Healthcare
experience
	  	 •    Aptitude Test

 
 •    HR
Interview

		
	 •    Skills in membership /
financial reconciliation
process
	  	 •    Written test of Enrollment and Billing basics

 
 •    Domain / Operations
Interview
  

•    Technical interview on Financial terms and Healthcare AR concepts

		
	 •    Excellent written and
verbal communication
skills

 
	  	 •    Education and Professional Background Check

	 •    Knowledge of healthcare basics

 
	  	
	 •    Familiar with financial processing applications
	  	

 Table 5 
  

			
	 Enrollment and Billing Senior Representatives

	 Qualification & Experience
	  	 Selection Process

		
	• Graduates with 2-3 years of Healthcare experience	  	 •    Aptitude Test

 
 •    HR
Interview

		
	• Skills in membership / financial reconciliation process	  	 •    Written test of Enrollment and Billing basics

		
	• Excellent written and verbal communication skills.	  	 •    Domain / Operations Interview

 
 •    Technical interview
on Financial terms and Healthcare AR concepts

		
	• Knowledge of healthcare basics	  	
		  	 •    Education and Professional Background Check

		
	• Familiar with one or more Financial applications	  	
		
	• Familiar with Enrollment and Billing for multiple LOBs	  	

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-11	  	Health Net / Cognizant Confidential

 Final 

Table 6 
  

			
	Supervisor	  	
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduate with 4 to 5 years’ experience in Healthcare Industry specifically in respective in-scope
process
	  	 •    HR Interview for Cultural fitment

 
 •    Communication
Skills Screening

		
	 •    2 years of Supervisory experience leading teams of at least 30-40 team members
	  	 •    Domain/ Operations Interview

 
 •    Education and
Professional Background Check

	 •    Leadership and Communication skills
	  	

 Table 7 
  

			
	 Auditors
  

	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 3-5 years’ experience in Healthcare process auditors
	  	 •    HR Interview for Cultural fitment

 
 •    Communication
Skills Screening
  

	 •    Six Sigma/Lean exposure of at least 2 years
	  	 •    Domain/ Operations Interview

		
		  	 •    Education and Professional Background Check

 Table 8 
  

			
	 Team Manager

 

	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduate/Post Graduate with 5+ years’ experience in one of the following Healthcare processes.
Healthcare Claims / Enrollment / Account Receivables / Appeals and Grievances / Credentialing/ Benefits configuration/ Provider Calls/ Provider Data Management Process.
	  	 •    HR Interview-screening for roles and responsibility

 
 •    Technical
Interview
  

•    Operations Interview

 
 •    HR/ Operations
Leadership screening for leadership ability and cultural fit
  

		  	 •    Education and Professional Background Check.

	 •    Excellent Communication and Leadership skills

 
	  	
	 •    3-4 years’ experience leading large teams
	  	

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-12	  	Health Net / Cognizant Confidential

 Final 

Table 9 
  

			
	Delivery Manager
		
	Qualification & Experience	  	Selection Process
		
	 •    MBA with 8-10 years of experience
	  	 •    Initial screening of profiles by recruitment team

		
	 •    Excellent Communication and Leadership skills
	  	 •    Interview with Business Leader/ HR Manager

		
	 •    7-9 years of overall BPO experience with at least 6 years leading a process in a BPO.
	  	 •    Technical/ Communication ability Interview

 
 •    Screening for
leadership ability and cultural fit
  

•    Salary Negotiation

 
 •    Education and
Professional Background Check

  

	 	(f)	Voice Solution 

 Per Health Net requirements, Supplier will deliver voice-assisted member,
employer group, financial institutions and provider interactions from Onshore US or Philippines locations. 
 Table 10 

Indicative Processes 
 Enrollment– Member and Group
calls 
 Billing and Reconciliation – Member, Group, Provider calls 

Coordination with internal functions like Medical Management, Claims, Benefit Configuration, Compliance, Legal, Finance, Contact Center 

Coordination with carve out service providers 
 Broker Services

 Coordination with external Entities as described in SOW 
  

	 	(g)	IT Systems 

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-13	  	Health Net / Cognizant Confidential

 Final 
  

The following systems/systems from vendors will be used by Supplier for delivery of Membership Services. SOW #4 (IT Services)
documents should be referenced for complete information. 
 Table 11 

 

	
	Enrollment and Billing Applications / Platforms
	
	Genelco
	
	ABS
	
	MACESS
	
	Symphony
	
	SAP
	
	Salesforce
	
	Showcase (Data Warehouse Query Tool)/Opus
	
	CSI (Will be replaced by PEGA)
	
	Monarch
	
	Check deposit software
	
	CMS MARX
	
	Callidus
	
	FindApps
	
	MC400
	
	OMNI
	
	QCare/HNCS
	
	Data warehouses (Kbase, ODW)
	
	PL SQL Tool to query ODW, Kbase
	
	AHCCCS (for Arizona Medicaid)
	
	Salsa, AMES, EDI Translator (Upstream/surround systems which may require some ad hoc touch points on case to case basis)
	
	AEVS (External data sources to validate member eligibility)

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-14		Health Net / Cognizant Confidential

 Final 
  

	 	(h)	Third Party Tools and Services 

 Supplier will use the following third party tools and services
in providing the Membership Services. 
 Table 12 
  

			
	Third Party	  	 Tool/Service Provider

	 Tools/Service
	  	 
		
	Scanning/Imaging	  	Ricoh
	Services	  	
		
	Image Storage and	  	Health Net IT
	Archival Services	  	
		
	Vendor system used to process Broker	  	
	Commissions for both	  	Callidus
	Medicare and Commercial	  	
	Lines of business.	  	
		
	Source system for	  	
	Enrollment, Billing and	  	
	Broker Commissions.	  	Genelco
	Only Life Product is on	  	
	Genelco.	  	
		
	Short term temporary	  	Kelly Services
	staffing	  	

  

	 	(i)	Service Performance Management 

 Supplier will provide and implement quality assurance
procedures for the Membership Services that are reasonably necessary to satisfy the requirements of the Agreement, including Service Levels, reporting format and frequency. 

Approach 
  

	 	•	 	Initially during Transition (Phase 2), a higher frequency of audits will be performed, and any feedback on errors will be communicated to the processors on a daily basis. 

 

	 	•	 	Once it has been confirmed through quality assurance that the processors are meeting the all requirements of the Agreement for their respective Functions, the audit frequency will be gradually reduced while keeping the
quality levels constant. 

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-15	  	Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Post Transition (during Phase 3), a statistically valid sample size will be employed for quality assurance auditing. 

Tools 
  

	 	•	 	Quality analysis will be performed using tools such as the following: 

  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

	4.	CONFIGURATION SERVICES SOLUTION 

  

	4.1	Solution Overview 

  

	 	(a)	High-level Service Delivery Architecture and Configuration 

 This section provides an overview
of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service Delivery Centers) provides additional information about each of the Service Delivery
Centers Supplier will use to provide the Configuration Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if
operations at any primary Service Delivery Center are disrupted or disabled. 
 Figure 2 

 
 

 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-16		Health Net / Cognizant Confidential

 Final 

Note: Dates represent currently planned end date of each Transition wave. Timelines will need to be updated based on actual Transition timeline
when finalized. 
 The above diagram illustrates Supplier solution and Onshore Offshore ratio from the beginning of phase 2 to the end of
phase 2. Initially, all the Health Net resources will be rebadged and will continue to work out of the current US locations in Rancho Cordova and Woodland Hills. The Transition will happen in 3 waves as depicted in Figure 2, with some of the work
gradually moving to the Offshore locations of Chennai and Bangalore in India. The overall target Onshore/ Offshore ratios at the initial state and the final state (Phase 3) are illustrated above. 

 

	 	(b)	Service Delivery Model 

 This section provides an overview of the commercial delivery model
Supplier will utilize in providing the Configuration Services under this Statement of Work. As described in Exhibit H (Membership and Configuration Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform
the Services under this Statement of Work. 
  

	 	(c)	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work will be
provided under a ‘Business-Process-as-a-Service’ delivery model—i.e., as a fully integrated vertical service in which Supplier is responsible for providing all the associated resource / service layers (facilities, IT infrastructure,
tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’ (e.g., fully processed claims). 

 

	4.2	Changes to Supplier’s Solution 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Membership and Configuration Solution Description). That said, Supplier is charged with responsibility
for the adequacy of its Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Membership and Configuration Solution Description), should prove inadequate at any point during the Statement of Work
Term for Supplier to perform and deliver the Services in accordance with the obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to
perform and deliver the Services in accordance with such obligations. All such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that
Supplier is responsible for making such changes at its own cost and expense except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 

 

	4.3	Solution Description 

 Supplier’s Solution is built on the following foundational
aspects: 
 Delivery Solution 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-17		Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Quality Focus – Supplier’s primary focus will be to maintain continuity of services, while ensuring regulatory and contractual compliance. For all processes migrated Offshore, the focus will be to
adhere to compliance requirements and get the quality right. 

  

	 	•	 	Support Ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides a personnel to supervisor and QA ratio Onshore and Offshore as described in Section 4.4(d) of this
exhibit. 

  

	 	•	 	Continuous Improvement—Supplier will appoint dedicated Six Sigma resources during the Term to identify sustainable improvement opportunities. The typical ratio will be 1 

Six Sigma resource for every 150 FTEs. 

Knowledge Retention: 
  

	 	•	 	Domain Experts – Supplier will deploy staff (existing and hired) with Healthcare experience for key support functions including Operations, Transition, Training, Quality and Compliance. 

 

	 	•	 	Health Net Training Academy – During Phase 3, Supplier’s dedicated Health Net Training Academy will be tasked with the mandate of building/maintaining a Knowledge repository, update Training and process
documentation, and provide training to new hire Supplier Personnel and higher level training to experienced resources for Configuration Operations. Why would there be a reference to Phase 2? Remove reference. 

 

	4.4	Operating Model 

 The operating model for Configuration Services describes the service
delivery blue-print and key aspects of service delivery. The operating model also describes how the in-scope services will be delivered for each functional process area in a scalable global delivery environment. 

 

	 	(a)	Resource Mix 

 The initial Onshore/Offshore resource mix and target ratio for Phase 3 for
Configuration operations is listed in the following table. 
 Supplier has considered the following criteria to define its Onshore/ Offshore
strategy - 
  

	 	•	 	Regulatory requirements 

  

	 	•	 	Non-availability of skill at Offshore 

  

	 	•	 	Health Net mandated Offshore restricted function 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-18		Health Net / Cognizant Confidential

 Final 

Table 17 
  

											
	 	  	Resource Mix Estimate
	 Sub function
	  	Final State – Phase 3
	 	  	Onshore	 	 	Offshore	 	 	Delivery
	 	  	%	 	 	%	 	 	Location
	 Configuration Management Team (VP)
	  	 	100	% 	 	 	0	% 	 	W,R
	 Director – Configuration
	  	 	100	% 	 	 	0	% 	 	W,R
	 Benefit Configuration MHN
	  	 	25	% 	 	 	75	% 	 	W,R,C,B
	 Benefit Configuration SOB SBC
	  	 	20	% 	 	 	80	% 	 	W,R,C,B
	 Benefit Configuration Production
	  	 	20	% 	 	 	80	% 	 	W,R,C,B
	 Pricing, Contract, DOFR, Fee Schedule,
	  	 	15	% 	 	 	85	% 	 	W,R,C,B
	 Vendor management, Projects, P&P, Training
	  	 	100	% 	 	 	0	% 	 	W,R
	 Director – Cashiering/Capitation
	  	 	100	% 	 	 	0	% 	 	W,R
	 Capitation
	  	 	47	% 	 	 	53	% 	 	W,R,C,B
	 Provider Data Management Commercial, Medicare and Medi- Cal and Prison
	  	 	15	% 	 	 	85	% 	 	W,R,C,B
	 Auto Suffixing
	  	 	42	% 	 	 	58	% 	 	W,R,C,B
	 PDM AZ and AHCCCS
	  	 	100	  	 	 	0	  	 	W,R,C,B

  

			
	 Legend

	 Woodland Hills (US)
	  	W
	 Rancho Cordova (US)
	  	R
	 Chennai (India)
	  	C
	 Bangalore (India)
	  	B
	 Telecommute
	  	T

  

	 	•	 	The above percentages are approximate estimates at this point 

  

	 	•	 	The estimated end state is expected by March 2017. This may change based on the final agreed Transition plan. 

  

	 	•	 	Roles that Health Net mandates to remain Onshore and roles for which the required skills are not readily available at Supplier’s Offshore locations will remain Onshore. 

 

	 	•	 	As shown in Table 17, while a process can span across up to 4 locations, there will be no role within a process that will span across more than 2 locations. 

 

	 	(b)	Service Locations 

 To achieve Health Net’s objectives of improvement in services delivery,
faster speed to market, focus on growth and significant reduction in cost, Supplier will leverage its global operating model. Supplier will deliver the in-scope services from US and India locations. The delivery location has been planned taking into
consideration the following criteria: 

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-19	  	Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Health Net mandated Onshore staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

	 	•	 	Regulatory limitations 

  

	 	•	 	Business continuity 

 Functional processes subject to regulatory location restrictions will be
performed from US locations. The processes requiring voice-assisted stakeholder interaction will be performed from Philippines and US locations. Supplier will also adhere to the requirements of the Agreement, including those set forth in Schedule E
(Employee Transfer) of the Agreement, relating to the work locations of Affected Employees who become Supplier Personnel. During Phase 2, Supplier intends to keep Health Net transferred employees at their current locations. 

As per Health Net’s requirements, the Supplier Personnel performing the following Configuration Services Functions must be retained in
Onshore locations: 
  

	 	•	 	Performance Group 

  

	 	•	 	AZ AHCCCS (includes all AZ Provider Data Management) 

  

	 	•	 	Auditors interfacing with Compliance Group 

  

	 	•	 	Legal and Compliance Liaison 

 Table 18 

 

					
	 Sub Function
	  	 Delivery Location

	 	  	 US
	  	 India

			
	Configuration Management Team (VP)	  	Rancho	  	
			
	Director – Configuration	  	Rancho, Woodland Hills	  	
			
	 Benefit Configuration MHN
	  	Rancho, Woodland Hills	  	Chennai, Bangalore
			
	 Benefit Configuration SOB SBC
	  	Rancho, Woodland Hills	  	Chennai, Bangalore
			
	 Benefit Configuration Production
	  	Rancho, Woodland Hills	  	Chennai, Bangalore
			
	 Pricing, Contract, DOFR, Fee Schedule,
	  	Rancho, Woodland Hills	  	

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-20	  	Health Net / Cognizant Confidential

 Final 

					
	 Vendor management, Projects, P&P, Training
		Rancho, Woodland Hills		Chennai, Bangalore
			
	Director – Capitation/Cashiering		Rancho, Woodland Hills		
			
	 Capitation PDM
		Rancho, Woodland Hills		Chennai, Bangalore
			
	 Provider Data Management Medi-Cal
		Rancho, Woodland Hills		Chennai, Bangalore
			
	 Provider Data Management Commercial,

AZ AHCCCS, Auto Suffixing
		Rancho, Woodland Hills		Chennai, Bangalore
			
	 PDM production
		Rancho, Woodland Hills		Chennai, Bangalore
			
	 PDM – HOV Outsourced
				Chennai

 Teams across locations in US and India, will typically interact on an ongoing basis to enable effective
planning, monitoring and tracking of Configuration processes, activities and requirements 
  

	 	1.	Forecasting – identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	2.	Capacity Planning- verify staffing in place to manage the forecasted volumes 

  

	 	3.	Monitor Productivity- An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	4.	Reallocation based on productivity – Process wherein the transaction and volumes are shifted within teams and individuals to achieve desired productivity 

 

	 	5.	Monitor Quality and Service Levels—An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

The organization structure has been functionally designed to facilitate effective operations across locations. 

This model will enable the workflow to be effective in real time, facilitating tactical monitoring. 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-21		Health Net / Cognizant Confidential

 Final 
  

 

	 	(c)	Operating Hours 

 Supplier will at minimum replicate the operating hours currently adhered to by
Health Net’s Configuration organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Configuration Services will regularly require Supplier Personnel to perform
additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Configuration Services. Examples include the following areas and time periods: 

 

	 	•	 	Pricing Fee Schedules - Oct and Nov 

  

	 	•	 	Pricing Code Updates - Jan and Feb 

  

	 	•	 	Pricing Contracts - Dec, Jan and Feb 

  

	 	•	 	Provider Data Management - Nov, Dec and Jan 

  

	 	•	 	Capitation - Nov, Dec, Jan and Feb 

  

	 	•	 	Benefit Config - Health Net - Nov, Dec, Jan and Feb 

  

	 	•	 	Benefit Config - MHN - Nov, Dec, Jan and Feb 

 Supplier will extend its hours of operations (for
example, through overtime, weekend and holiday work) from time to time as needed to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of
operations is within the scope of the Configuration Services. 
 Within the regular Hours of Operations listed in Table 19 below, Supplier
will have staff work according to defined shift schedules. However, Supplier will have the right to evaluate operational requirements and if feasible permit Supplier staff to work flexible shift start times subject to it not jeopardizing
Supplier’s ability to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. 

Table 19 
  

					
	 Sub function
	  	Hours of Operations
(Pacific Time)	 
	 Configuration Management Team (VP)
	  			
		
	 Director – Configuration
	  			
		
	 Benefit Configuration MHN
	  	 	08:00 am to 17:00 pm	  
		
	 Benefit Configuration SOB SBC
	  	 	08:00 am to 17:00 pm	  
		
	 Benefit Configuration Production
	  	 	08:00 am to 17:00 pm	  

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-22	  	Health Net / Cognizant Confidential

 Final 

			
		
	 Pricing, Contract, DOFR, Fee Schedule,
		08:00 am to 17:00 pm
		
	 Vendor management, Projects, P&P, Training
		08:00 am to 17:00 pm
		
	 Director – Capitation/Cashiering
		
		
	 Capitation PDM
		08:00 am to 17:00 pm
		
	 Provider Data Management Medi-Cal
		08:00 am to 17:00 pm
		
	 Provider Data Management Commercial, AZ AHCCCS, Auto Suffixing
		08:00 am to 17:00 pm
		
	 PDM production
		08:00 am to 17:00 pm

  

	 	(d)	Operations 

 Supplier’s approach to managing Configuration operations is as follows 

 

	 	•	 	Operational Focus: 

 Team leaders and supervisors take part in team huddles, floor
walks, daily performance reviews, daily Supplier Personnel communication plan and customer calibration sessions 
  

	 	•	 	Performance Management: 

 Measure and manage Supplier Personnel performance through data
and service dashboards 
  

	 	•	 	Span of Control: 

 Supplier will provide for the following span of control (applicable
during Phase 3 - i.e., after Transition has been completed): 
  

	 	•	 	Operations Lead 1:<500 

  

	 	•	 	Manager 1: £50 

  

	 	•	 	Supervisor 1: £15 

  

	 	•	 	Quality Auditor 1: £15 

  

	 	•	 	Trainer 1: £20 (during training following completion of Transition). Proposed training ratio of 1: £20 is based on typical
classroom training. However for specific processes this ratio could be lower. 

  

	 	•	 	Team Leader 1: £15 

  

	 	•	 	Six Sigma & Process Excellence 1: £150 

  

	 	•	 	Health Net Training Academy: 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-23		Health Net / Cognizant Confidential

 Final 

Supplier will establish a dedicated Health Net Training academy to manage content and delivery of training programs. Supplier will establish a
Knowledge Management Portal for management organization, easy access to Configuration management content, desktop procedure and P&Ps. Academy will work closely with the training team to facilitate necessary training during Phase 2 and Phase 3.
Based on system updates and process updates, the training material will be constantly updated. 
  

	 	•	 	Team Huddle: 

 Supplier’s Team Leads will conduct daily team meetings for
individual processes to share any critical updates, feedback and communication on learnings, and plan for the day. 
  

	 	•	 	Quality: 

 Supplier will implement Health Net mandated specific quality/compliance
programs in its delivery model for managing and achieving service levels. Supplier will analyse audit findings to determine root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings, prevalent
trends in errors, root causes and preventive actions will be discussed and implemented. 
  

	 	•	 	Continuous Improvement: 

 Supplier will have a dedicated Process Excellence (PEX) team
consisting of Six Sigma resources for Health Net Configuration functions to enhance performance and handoffs in Health Net Configuration’s processes while improving standardization and the “To-Be operating model”. 

 

	 	•	 	Rewards and Recognition 

 Supplier will recognize the efforts of its best performers
using stack ranking and will reward them through a structured reward and recognition program that aligns with quality and productivity objectives. The Rewards and Recognition will be applicable for both Onshore and Offshore teams. The specific
criteria for the awards will be decided by the Operations Leads depending on the specific behavior and/or results to be achieved. 
  

	 	(e)	Resource Profile 

 Supplier has a very well defined methodology for recruitment and selection of
candidates. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper qualifications and experience in order to achieve
a “best-fit” for Health Net. 
 Tables 20-28 below set forth indicative requirements for Offshore staffing and the minimum
qualifications required to be selected for Configuration operations. 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-24		Health Net / Cognizant Confidential

 Final 

Table 20 
  

			
	Benefits Coder/Tester
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2 years with Healthcare experience

 
 •    Configurations and
benefits coding skills
  

•    Good written and verbal communication skills

 
 •    Knowledge of
healthcare products and services
  

•    Familiar with Configurations processing applications

 
 •    Critical Thinking
Ability
  

•    Knowledge of Federal and State regulations

 
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Written test of
Benefits Coding and Testing basics
  

•    Domain / Operations Interview

 
 •    Technical interview
on Configurations, Claims and Benefit Coding concepts
  

•    Educational and Professional Background Check

 Table 21 
  

			
	Contract & Fee Schedule Loading
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2 years with Healthcare Experience

 
 •    Contract
Configurations skills
  

•    Good written and verbal communication skills

 
 •    Knowledge of
provider contracts
  

•    Knowledge of healthcare products and services

 
 •    Knowledge of claims
reimbursement methods
  

•    Critical Thinking Ability

 
 •    Knowledge of
Federal and State regulations
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Domain / Operations
Interview
  

•    Technical interview on Provider
Contracting, Reimbursement and Claims concepts

 
 •    Educational and
Professional Background Check

 Table 22 
  

			
	Provider Data Management
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2 years with Healthcare experience

 
 •    Provider Data
Management skills
  

•    Good written and verbal communication
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Written test of
Provider
  
 •    Domain
/ Operations Interview

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-25	  	Health Net / Cognizant Confidential

 Final 
  

			
		
	 skills
  

•    Knowledge of provider types and provider data management

 
 •    Critical Thinking
Ability
  

•    Knowledge of Federal and State regulations
	  	 •    Technical interview on Provider Data Management Concepts

 
 •    Educational and
Professional Background Check

 Table 23 
  

			
	Auto Suffixing
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2 years with Healthcare experience

 
 •    Claims/Provider
data Management skills
  

•    Good written and verbal communication skills.

 
 •    Knowledge of
provider types, data management and capitation payments
  

•    Critical Thinking Ability

 
 •    Knowledge of
Federal and State regulations
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Technical interview
on Provider types data management
  

•    Domain / Operations Interview

 
 •    Educational and
Professional Background Check

 Table 24 
  

			
	Capitation
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 1-2 years with Healthcare experience

 

•    Accounting/Capitation skills

 
 •    Good written and
verbal communication skills.
  

•    Knowledge of debits/credits, general ledger, journal entries and expense
reclassifications
  

•    Critical Thinking Ability

 
 •    Knowledge of
Federal and State regulations
	  	 •    Aptitude Test

 
 •    HR Interview

 
 •    Technical interview
on Accounting concepts
  

•    Domain / Operations Interview

 
 •    Educational and
Professional Background Check

 Table 25 
  

			
	Supervisor
	 Qualification & Experience
	  	 Selection Process

	 •    Graduate with 4 to 5 years’ experience in
	  	 •    HR Interview for Cultural fitment

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-26	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Healthcare Industry specifically in

respective in-scope process
	  	 •    Technical Interview

 
 •    Communication
Skills Screening

		
	 •    Knowledge of healthcare products, and one of the process area—benefits configuration or provider
data management or provider contract configuration
	  	 •    Domain/ Operations Interview

 
 •    Educational and
Professional Background Check

		
	 •    2 years of Supervisory experience leading teams of at least 15-20 team members
	  	
		
	 •    Leadership and Communication skills
	  	
		
	 •    Critical Thinking Ability
	  	
		
	 •    Knowledge of Federal and State regulations
	  	

 Table 26 
  

			
	Auditors
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduates with 3-5 years’ experience in Healthcare process
auditors
  

•    Knowledge of healthcare products, and one of the process area—benefits
configuration or provider data management or provider contract configuration
  

•    Six Sigma/Lean exposure of at least 2 years

 
 •    Leadership and
Communication skills
  

•    Critical Thinking Ability

 
 •    Knowledge of
Federal and State regulations
	  	 •    HR Interview for Cultural fitment

 
 •    Technical
Interview
  

•    Communication Skills Screening

 
 •    Domain/ Operations
Interview
  

•    Educational and Professional Background Check

 

 Table 27 
  

			
	Team Manager
	 Qualification & Experience
	  	 Selection Process

		
	 •    Graduate/Post Graduate with 5+ years’ experience in Healthcare
processes
  

•    Knowledge of healthcare products, and one of the process area—benefits
configuration or provider data management or provider contract configuration
  

•    Excellent Communication and
	  	 •    Initial screening of profiles by recruitment team

 
 •    Screening for
leadership ability and cultural fit
  

•    Technical/Communication ability Interview

 
 •    Interview with
Business Leader
  

•    Interview with HR Manager

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-27	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Leadership skills
	  	 •    Educational and Professional Background Check

		
	 •    3 to 4 years’ experience of leading large teams
	  	

 Table 28 
  

			
	Delivery Manager
	 Qualification & Experience
	  	 Selection Process

	 •    MBA with 8-10 years of experience

 
 •    Excellent
Communication and Leadership skills
  

•    7-9 years of overall BPO experience with at least 6 years leading a process in a
BPO.
	  	 •    Initial screening of profiles by recruitment team

 
 •    Screening for
leadership ability and cultural fit
  

•    Technical/Communication ability Interview

 
 •    Interview with
Business Leader
  

•    Interview with HR Manager

 
 •    Educational and
Professional Background Check

  

	 	(f)	Voice Solution 

 Per Health Net requirements, Supplier will deliver voice-assisted provider
interactions from Onshore US locations. 
 Table 29 
  

	
	Indicative Processes
	
	Provider Data Management, Capitation and Auto Suffixing – Provider Outreach

  

	 	(g)	IT Systems 

 The following systems/systems from vendors will be used by Supplier for delivery of
Configuration Services. SOW #4 (IT Services) documents should be referenced for complete information. 
 Table 30 

 

	
	Configuration Applications/Platforms
	
	ABS Dev and Prod
	
	Qcare/UPS 2
	
	Viant

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-28	  	Health Net / Cognizant Confidential

 Final 
  

 

	
	FileNet
	
	Burgess
	
	Symphony
	
	DRG Grouper – Not sure what this is
	
	Alfresco
	
	BRCC
	
	PSA Archive
	
	Inventory Management Databases
	
	HEALTH NET CAP
	
	SAP
	
	NDS
	
	Framemaker
	
	PEGA – DOFR
	
	Macess
	
	Ingenix

  

	(h)	Third Party Tools and Services 

 Supplier will use the following third party tools and services
in providing the Configuration Services. 
 Table 31 
  

			
	 Third Party Tools/Service
	 	 Tool/Service Provider

		
	HOV	 	Outsourced Partner
		
	Viant	 	Claims Re-pricing
		
	Marketing Translation Services	 	Translation Services
		
	Burgess	 	Claims Pricing Software

  

					
	SOW#2 (M + C) Exhibit A-1	  	A-1-29	  	Health Net / Cognizant Confidential

 Final 
  

	 	(i)	Service Performance Management 

 Supplier will provide and implement the quality assurance
procedures that are reasonably necessary for the services in scope and as per mutually agreed Service Levels, reporting format and frequency 

Approach 
  

	 	•	 	Initially during Transition (Phase 2), a higher frequency of audits will be performed, and any feedback on errors will be communicated to the processors on a daily basis. 

 

	 	•	 	Once it has been confirmed through quality assurance that the processors are meeting the all requirements of the Agreement for their respective Functions, the audit frequency will be gradually reduced while keeping the
quality levels constant. 

  

	 	•	 	Post Transition (during Phase 3), a statistically valid sample size will be employed for quality assurance auditing. 

Tools 
  

	 	•	 	Quality analysis will be performed using tools such as the following: 

  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

					
	SOW#2 (M + C) Exhibit A-1		A-1-30		Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-1.1 
 APPROVED
SERVICE DELIVERY CENTERS 
  

	1.	MEMBERSHIP SERVICES 

 The Service Delivery Centers at (or from) which Supplier is
authorized to perform the Membership Services under this Statement of Work are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform certain aspects of the Membership Services,
their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.1. 
 Onshore Service Delivery
Centers (Health Net facilities) 
 Table 1 
  

									
	 Primary

Location
	  	Type of
Facility	  	Functions /
Services	  	Languages
Supported	  	Back-up /
Fail-over
Location
					
	 Rancho
	  	Office
 Building
	  	Membership
 Management
	  	English	  	Woodland
 Hills

					
	 Woodland

Hills
	  	Office
 Building
	  	Membership
 Management
	  	English	  	Rancho

 Offshore Service Delivery Centers 

Table 2 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	Functions /
Services	  	Languages
Supported	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed in
Service	  	Multi-
client Site
(Y/N)?
	 Cognizant Technology Solutions, Carr Tower, Ramanujan IT SEZ,

Taramani, Rajiv Gandhi Salai,
	  	 Office
 Building
	  	Membership
 Management
	  	English	  	Cognizant
 TechnologySolutions,
SEZ - 2

Manyata
Embassy
	  	Supplier	  	Third
 Party
	  	2012	  	Y

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	Functions /
Services	  	Languages
Supported	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed in
Service	  	Multi-
client Site
(Y/N)?
									
	Taramani, Chennai 600113	  		  		  		  	Business Park,
 Bangalore- 560045
	  		  		  		  	
									
	 Cognizant Technology Solutions, SEZ - 2 Manyata Embassy Business Park,

Bangalore- 560045
	  	 Office
 Building
	  	Membership
 Management
	  	English	  	Cognizant
Technology
Solutions,
Carr
Tower,
Ramanujan
IT SEZ,
Taramani,
Rajiv
Gandhi
Salai,
Taramani,
Chennai
600113	  	Supplier	  	Third
 Party
	  	F2 –
 2008
 F3-

2013
 G4 –

2012
	  	Y
									
	 Philippines - Manila Taguig - Square Building,

Cognizant Technology Solutions Philippines Inc.
 ,One World Square
Building, Unit A, Mckinley Hill, Fort Bonifacio, Taguig City, Philippines -
 1634
	  	 Office
 Building
	  	Membership
 Management
	  	English	  	Philippines—Cebu
 11 & 12 /
F Sky
Rise 4

Tower, B
 lock 2,
Lot 4,
Cebu IT
Park,

Cebu
City,
Philippines
 6000
	  	Third
 Party
	  	Third
 Party
	  	2013	  	Y
									
	Philippines -	  	Office	  	Membership	  	English	  	Philippines—Manila	  	Third	  	Third	  	2013	  	Y

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	Functions /
Services	  	Languages
Supported	  	Back-up /
Fail-over
Location	  	Facility
Operator	  	Facility
Owner	  	Date
Placed in
Service	  	Multi-
client Site
(Y/N)?
									
	 Cebu
 11 & 12 / F Sky Rise 4

Tower, B
 lock 2, Lot 4, Cebu IT Park, Cebu City, Philippines
6000
	  	Building	  	Management	  		  	Taguig -
 SquareBuilding,
Cognizant
Technology
Solutions
Philippines
Inc.

,One
World
Square
Building,
Unit A,
Mckinley
Hill, Fort
Bonifacio,
Taguig
City,
Philippines
-

1634
	  	Party	  	Party	  		  	

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-3	  	Health Net / Cognizant Confidential

 Final 
  

	2.	CONFIGURATION SERVICES 

 The Service Delivery Centers at (or from) which Supplier is
authorized to perform the Configuration Services under this Statement of Work are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform certain aspects of the Configuration
Services, their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.3. 
 Onshore Service Delivery Centers
(Health Net facilities) 
 Table 3 
  

									
	 Primary

Location
	  	 Type of

Facility
	  	Functions /
Services	  	Languages
Supported	  	Back-up /
Fail-over
Location
	Rancho	  	 Office
 Building
	  	Configuration
 Services
	  	English	  	Woodland
 Hills

					
	 Woodland
 Hills
	  	 Office
 Building
	  	Configuration
 Services
	  	English	  	Rancho
 Cordova

 Offshore Service Delivery Centers 

Table 4 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Back-up / Fail-over

Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date
Placed
in
Service
	  	 Multi-
client
Site
(Y/N)?

	 India - Chennai - CRC, Cognizant Technology
Solutions India

Pvt Ltd, Block B,
	  	Leased	  	 Configuration
 Services
	  	English	  	 Intra-city

India - Chennai - ASV Suntech park , Cognizant

Technology
	  	Supplier	  	 Third
 Party
	  	2012	  	Y

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Back-up / Fail-over

Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date
Placed
in
Service
	  	 Multi-
client
Site
(Y/N)?

	 CARR Tower, Ramanujan IT
City, Taramani, Rajiv Gandhi
Salai (OMR), Chennai – 600

113.
	  		  		  		  	 Solutions Pvt. Ltd., ASV Suntech Park, Old Mahabalipuram

Road, Chennai
  

Intercity
India
Hyderabad
 Cognizant Technology
Solutions, Raheja Mindspace, Building No.20,
 7thFloor, Madhapur,

- 500081
	  		  		  		  	
									
	 India - Bangalore

- MBP, Cognizant Technology
Solutions India Private Limited, Outer Ring Road Rachenahalli

Village,
	  	Leased	  	 Configuration
 Services
	  	English	  	 India - Bangalore

- Bagmane
 Tech

Park, Cognizant Technology Solutions India Private Limited,

65/2 Adjacent To
	  	Supplier	  	 Third
 Party
	  	2008	  	Y

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Primary

Location
	  	 Type of

Facility
	  	 Functions
/ Services
	  	 Languages

Supported
	  	 Back-up / Fail-over

Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date
Placed
in
Service
	  	 Multi-
client
Site
(Y/N)?

	Nagavaraha,
Bangalore -560045	  		  		  		  	 LRDE
Byrasandra C.V.Ramanagar Post, Bangalore

– 5600 013
  

Inter City
 India - Chennai - CRC, Cognizant
Technology Solutions India
Pvt Ltd, Block B, CARR Tower, Ramanujan IT
City, Taramani,
Rajiv Gandhi
Salai (OMR), Chennai – 600

113.
	  		  		  		  	

  

					
	SOW#2 (M + C) Exhibit A-1.1	  	A-1-1-6	  	Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-1.2 
 SERVICE
DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 
  

	1.	MEMBERSHIP SERVICES 

 Set out in Figure 3 below is a description of Supplier’s ‘To-Be’
Solution for the Membership Services as it will be configured at the completion of Phase 2. The tactical To Be solution will be refined during the Transition (Phase 2); however, below is an illustrative delivery configuration for Membership
operations. 
 Figure 3 
  

 

  

					
	SOW#2 (M + C) Exhibit A-1.2		A-1-2-7		Health Net / Cognizant Confidential

 Final 
  

	2.	CONFIGURATION SERVICES 

 Set out in Figure 4 below is a description of Supplier’s
‘To-Be’ Solution for the Configuration Services as it will be configured at the completion of Phase 2. The tactical To Be solution will be refined during the Transition (Phase 2); however, below is an illustrative delivery configuration
for Configuration operations. 
 Figure 4 
  

 

  

					
	SOW#2 (M + C) Exhibit A-1.2		A-1-2-8		Health Net / Cognizant Confidential

 Final 

EXHIBIT A-3 
 MEMBERSHIP
AND CONFIGURATION ORGANIZATION CHART 

  

					
	SOW#2 (M + C) Exhibit A-3		 		Health Net / Cognizant Confidential

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EXHIBIT A-3 
 MEMBERSHIP
AND CONFIGURATION ORGANIZATION CHART 
 This Exhibit A-3 (Membership and Configuration Organization Chart) contains organization charts showing,
at a specific recent point in time prior to the Effective Date, the positions (including both filled and currently open positions) that represent the Health Net organizational unit(s) whose Functions are being outsourced to Supplier under this
Statement of Work. This document is included as part of this Statement of Work as a supplemental means of depicting the Functions that comprise the Membership and Configuration Services for which Supplier is assuming responsibility from Health Net
under this Statement of Work. It is not included for the purpose of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s Charges for the Membership and Configuration Services. Any changes in the
organization charts between the Agreement’s Effective Date and the BPaaS Services Commencement Date shall not be interpreted to represent a change in the scope of the Membership and Configuration Services in the absence of Health Net
specifically adding or removing Functions from Exhibit A (Membership and Configuration Services) of this Statement of Work. 
  

	1.	MEMBERSHIP 

  

					
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	2.	CONFIGURATION 

  
 

 

  

					
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EXHIBIT B-1 
 SERVICE
LEVEL METRICS - MEMBERSHIP AND CONFIGURATION 
  

	1.	DEFINITIONS 

 The following capitalized terms will have the meanings given them below:

 “Completed” means that Supplier has performed all applicable Services with respect to the item to which the
Service Level pertains, and in compliance with applicable Health Net Policies and procedures. 
  

	2.	OPERATIONAL SERVICE LEVELS 

 All Service Levels are subject to the Service Level
Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement and the Exhibits thereto. 
  

	2.1	Membership Services (MS). 

  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  	Multiple Lines of Business	  		  		  		  		  		 	
	MS-1	  	 Enrollment -
 EA Processing Timeliness -
(Commercial
 & Medicare Lines of Business)
	  	 This Service Level measures the timeliness of Enrollment Application (“EAs”) processing and shall be calculated in
accordance with the following formula:
  
 [(# Completed EAs – #
Late
 Completed EAs) ÷ # Completed

EAs]
 x 100%

 
 Where:

 
 “# Late Completed EAs” means
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Commercial System: ABS

 
 Medicare System: AMES
	  	 > [Baseline]% within

established targets for each of Commercial and Medicare.
  

Established targets:
  

Commercial:
  

•       Med Sup:7 Business Days

 

•       COB/PDP:2 Business Days

 

•       Major Accounts:4 Business Days

 

•       CA Mid-Market:4 Business Days
	  	Y	  	8	  	B	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  		  	 the number of Completed EAs, by category, for which the Enrollment Application Turnaround Time is greater than the maximum number of days set
forth in the Service Level column for this Service Level.
  
 “Enrollment
Application Turnaround Time” means the elapsed time (in Business Days) between (i) the moment that an EA is available to Supplier for EA processing, and (ii) the moment that such EA is considered a Completed EA.
	  		  		  	 •       AZ Group:4 Business Days

 

•       OR Group:3 Business Days

 

•       Other:5 Business Days

 
 Medicare:
  

•       3 Business Days.
  

MHN and SHP: Not applicable.
	  		  		  		 	
										
	MS-2	  	 Enrollment –
 EA Processing Accuracy -
(Commercial
 & Medicare
 Lines of

Business)
	  	 This Service Level measures the accuracy of the Completed EAs and shall be calculated at the program level for Commercial, State Health
Programs (SHP) and Medicare in accordance with the following formula:
  

[(# Completed EAs – # Inaccurate

Completed EAs) ÷ #
 Completed
EAs]
 x 100%
  

Where:
  

“# Inaccurate Completed EAs”

means the number of processed
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Commercial System: ABS

 
 Medicare System: ABS

 
 SHP Arizona System:
	  	> [Baseline]% for each of Commercial, Medicare, and SHP.	  	Y	  	4	  	B	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
										
		  		  	 Enrollment Applications that are
 identified
through the QA process as having one or more Critical Accuracy errors. Critical
 Accuracy is determined by errors in fields reviewed and agreed upon by the
business to be member impacting (i.e. name, address, SSN#, provider, etc.). Initially reported errors that are rescinded by the QA team may be excluded from the calculation.
	  		  	 ABS
  

SHP California System: Q Care until April 2015, then ABS
	  		  		  		  		 	
										
	MS-3	  	Invoicing – Invoice File Timeliness (All Lines of Business)	  	 This Service Level measures the timeliness of invoice file production, which shall be calculated in accordance with the following
formula:
  
 [(Total # Invoice Files – # Late

Invoice Files) ÷
 Total #
Invoice Files]
 x 100%
  

Where:
  

“# Late Invoice Files” means the number of Invoice Files Supplier provides to Health Net that are not provided within the Parties’
defined pre-established billing schedule for a particular line of business.
	  	Monthly	  	 Manual calculation based on extracted data from:
  

Commercial System: ABS
  

Medicare System: ABS
  

MHN System: SAP
	  	[Baseline]% for each of Commercial, Medicare, SHP, and MHN.	  	Y	  	8	  	B	 	Y
										
	MS-4	  	Invoicing – Invoice File Accuracy (Commercial	  	 This Service Level measures the
 accuracy of
invoice files delivered to Health Net and shall be calculated in accordance with
	  	Monthly	  	 Manual
 calculation based on extracted
	  	> [Baseline]% for each of Commercial and Medicare	  	Y	  	5	  	C	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  	& Medicare Lines of Business)	  	 the following formula:
  

[(Total # Invoice Files – #

Inaccurate Invoice Files) ÷

Total # Invoice Files]
 x 100%

 
 Where:

 
 “# Inaccurate Invoice Files” means the number of Invoice Files
that are generated and mailed with one or more errors.
  
	  		  	 data from:
  

Commercial System: ABS
  

Medicare System: ABS
	  		  		  		  		 	
	MS-5	  	Accounts Receivable – Payment Application Timeliness (Commercial, Medicare & MHN Lines of Business)	  	 This Service Level measures the
 percentage of
payment applications and adjustments, and shall be calculated in accordance with the following formula:
  

[(Total # Payment Applications –

# Late Payment Applications) ÷

Total # Payment Applications]
 x
100%
  
 Where:

 
 “# Late Payment Applications” means the number of Payment
Applications, by category, for which the Payment Application Turnaround Time is greater than the maximum number of days, as set forth in the Service Level column for this Service Level.
	  	Monthly	  	 Manual calculation based on extracted data from:
  

Commercial System: ABS
  

Medicare: System: ABS
  

MHN System: SAP
	  	 > [Baseline]% within the established targets for each of Commercial, Medicare, and MHN.

 
 Established targets:

 
 Commercial:

Oregon: 4 Business Days

Other: 7 Business Days
  

Medicare: 7 Business

Days
  

MHN: 3 Business Days or by the 1st or 15th calendar day of the month, whichever is sooner.
	  	Y	  	4	  	B	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  		  	 “Payment Application Turnaround Time” means the

elapsed time (in Business Days) between (i) the moment that a payment or adjustment is available to Supplier for processing, and (ii) the moment that such
payment or adjustment has been processed.
  
	  		  		  		  		  		  		 	
	MS-6	  	 Accounts Receivable – Payment Applications Accuracy (Commercial & Medicare Lines of

Business)
	  	 This Service Level measures the financial accuracy of Payment Applications and shall be calculated in accordance with the following
formula:
  
 [(Total # Payment Applications –

# Inaccurate Payment
 Applications)
÷ Total # of
 Payment Applications]

x 100%
  

Where:
  

“# Inaccurate Payment Applications” means the number of Payment Applications that are identified through Quality Auditing to have been
processed with one or more errors.
  
	  	Monthly	  	 Manual calculation based on extracted data from:
  

ABS
	  	 > 98% for each of Commercial and Medicare
  

Not applicable to MHN or
 SHP.
	  	Y	  	3	  	A	 	Y
	MS-7	  	Broker Commissions - Broker Commission Timeliness - (All Lines of Business)	  	This Service Level measures the percentage of finalized Broker Commissions (BC) payment files which are released for upload to SAP (to create check files) and to the OCOE (to create statements & collate & mail with check/EFT
files) in accordance with contractual and regulatory agreements.	  	 Monthly

or Weekly (for Medicare FastPay)
	  	 Manual
 process
	  	 100% for each of group extract, IFP extract, and Medicare extract.
  

Cut-off dates by category:
  

•       Group 
extract:8th calendar day of the month
	  	Y	  	6	  	A	 	N

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
										
		  		  	 [(Total #Final BC Payment Files

– # Late Final BC Payment Files)

÷ Total # Final BC Payment

Files]
 x 100%

 
 Where:

 
 “Broker Contracts” are contractual agreements between applicable
Brokers and Health Net that include the applicable amounts of Broker Commissions and the applicable deadlines by which Health Net must pay the applicable Broker.
  

“Late” means the number of ABS Extract Files or Final Broker Commissions Payment that are received or released past the applicable
cut-off date in the Service Level column.
  
	  		  		  	 •       IFP extract:16th calendar day of the month
  

•       Medicare extract:By the scheduled release dates (weekly and
monthly) according to the monthly calendar.
	  		  		  		 	
	MS-8	  	 Broker Commissions
 - Broker Commission Accuracy
- (Commercial & Medicare Lines of Business)
	  	 This Service Level measures the
 accuracy of
Broker Commission Files (BC Files) provided by Supplier to Health Net and shall be calculated in accordance with the following formula:
  

[(Total # BC Files – # Inaccurate BC Files) ÷ Total # BC Files] x 100%
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Source: Monthly Audits
	  	 > 98% for each of Commercial and Medicare.
  

Not applicable to MHN or
 SHP.
	  	Y	  	4	  	 A

(Commercial)
  

B (Medicare)
	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
										
		  		  	 Where:
  

“# Inaccurate BC Files” means the number of Broker Commissions Files that are processed with at least one error.

 
	  		  	 performed
 on Callidus/ ABS systems

 
 Tool: Health Net Auditing Database

 
	  		  		  		  		 	
		  	Commercial Line of Business Only	  		  		  		  		  		 	
										
	MS-9	  	 ID Cards –
 ID Card File Timeliness -
(Commercial Only)
	  	 This Service Level measures the timeliness of ID Card File (ID CF) production (both initial and replacement) and shall be calculated in
accordance with the following formula:
  
 [(# Completed ID CF – #
Late
 Completed ID CF) ÷ # Completed

ID CF]
 x 100%

 
 Where:

 
 “# Late Completed ID Card Files” means the number of ID Card Files
created for which the ID Card File Turnaround Time is greater than the maximum number of days, as set forth in the Service Level column for this Service Level.
  

“ID Card File Turnaround Time” means the elapsed time (in Business Days) between (i) the
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 ABS
	  	 > [Baseline]%
  

IEX: 2 Business Days
 Other: 5 Business Days
	  	TBD	  	7	  	C	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  		  	 moment that an ID Card request is available to Supplier for ID Card processing, and (ii) the moment that Supplier provides such ID Card File
to Health Net.
  
	  		  		  		  		  		  		 	
	MS-10	  	 Accounts Receivable – Over 90
 Days Due
(Commercial Only)
	  	 This Service Level measures the
 percentage of
Accounts Receivable (in dollars) (AR$) that have been outstanding for more than 90 days and shall be calculated in accordance with the following formula:
  

[AR$ Outstanding for Longer
 than 90
Days ÷ Total
 AR$ Commercial]

x 100%
  

Where:
  

“AR$ Outstanding for Longer than 90 Days” means amounts due to Health Net that have not been paid for a period exceeding 90 days, which
90 day time period commences on the Account payment due date and ends on the date that Accounts are to be reconciled.
  

“Total AR$ Commercial” means the total amount billed minus current amount due (0days)

 
	  	Monthly	  	 Manual calculation based on extracted data from:

ABS
	  	> [Baseline]%	  	Y	  	4	  	B	 	Y
	MS-11	  	Accounts	  	This Service Level measures the	  	Monthly	  	Manual	  	> [Baseline]% of all	  	Y	  	2	  	C	 	Y

  

					
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	 SL #
	  	 Category
	  	 Description
	  	 Measure-

ment
 Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	 	 Continuous

Improvement
(Y/N)

		  	MEMBERSHIP SERVICES	  		  		  		  		  		 	
		  	Receivable –Days in Accounts Receivable - (Commercial Only)	  	 number of days Accounts are in Accounts Receivable and shall be calculated in accordance with the following formula (amounts in dollars):

 
 [Ending Accounts Receivable

Balance x the # of days in month]

÷ Total Revenue = Days in

Accounts Receivable
  

The “Ending Accounts Receivable Balance” is determined through a calculation “Total Due” + Prepaid or “Unearned”
amount.
  
 This formula provides the actual receivable balance for that month ending
without the future payments incorrectly reducing it. Amounts tied to any RMC codes that are not Commercial Exchanges (i.e. Dental, PDP, Medicare RMC codes) should not be included.

 
 The “Total Revenue” is currently provided on the ABS generated
report called ARSMB226 (amounts tied to any RMC codes that are not Commercial Exchanges (i.e. Dental, PDP, Medicare RMC codes) should not be included).
  
	  		  	 calculation
 based on extracted data from:

 
 System: ABS
  

Reports: Flash Report
	  	 Accounts shall be in Accounts Receivable for less than or equal to the following number of Business Days:

 
 Commercial:

 

•       CA:5 Business Days

 

•       OR/WA:3 Business Days

 

•       AZ:5 Business Days

 
 Not applicable to Cobra and

IFP.
	  		  		  		 	
	MS-12	  	Accounts	  	This Service Level measures the	  	Quarterly	  	Manual	  	<= 25 days	  	Y	  	TBD	  	A	 	N

  

					
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	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 	Receivable –
Days Sales Outstanding -
(MHN Only)	 	 Days Sales Outstanding (DSO)
 ratio of MHN
Accounts and shall be calculated in accordance with the following formula (amounts
 in dollars):

 
 DSO ratio = accounts receivable

÷ average sales per day; calculated on a year to date basis every quarter end.
	 		 	 calculation
 based on extracted
data from:
  
 AR & Sales data in SAP AR
	 		 		 		 		 	
										
	MS-13	 	 Accounts
 Receivable
–
Dollars
Collected - (Commercial
Off
 Exchange
Only)
	 	 This Service Level measures the percentage of money, by category, identified through the account reconciliation audit (Audit) process as owed
to Health Net that is actually collected by Health Net and shall be calculated in accordance with the following formula:
  

[Total Audit $ Collected ÷ Total

Audit $ Identified]
 x 100%

 
 Where:

 
 “Audit $ Identified” means amounts identified from reconciliation
discrepancies as amounts owed to Health Net.
  
 “Total Audit $
Collected” means the total dollar value of amounts
	 	Annual	 	 Manual
 calculation based on extracted
data from:
  
 ABS
	 	 > the following for each category below:
  

•  Mid –90%
  

•  Large – 45%
  

•  Oregon –75%
  

Not applicable to other Commercial lines of business.
	 	Y	 	2	 	A	 	Y

  

					
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	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 		 	 collected during the Measurement Period in respect of Audit $ Identified.

 
 “Total Audit $ Identified” means the total dollar value of Audit $
Identified during the Measurement Period.
	 		 		 		 		 		 		 	
										
	MS-14	 	 Accounts
 Receivable – Reconciliation
Percentage - (Commercial Only)
	 	 This Service Level measures the percentage of Health Net Accounts for which Supplier performs Reconciliation Services each month and shall be
calculated in accordance with the following formula:
  
 [Total #
Reconciled Accounts ÷ Total # Accounts]
 x 100%
  

Where
  

“Total # Reconciled Accounts” means the total number of Accounts for which Supplier performed Reconciliation Services during a
Measurement Period. For Reconciliation Services to be considered performed, Supplier must obtain both a receipt of payment and supporting documentation within Measurement Period.
	 	Monthly	 	 Manual
 calculation based on extracted data
from:
  
 ABS
	 	 > the following for each category below:
  

•  SBG and Mid: [Baseline]%

 

•  Large: [Baseline]%

 
 Not applicable to Cobra and

IFP.
	 	Y	 	2	 	B	 	Y
										
	MS-15	 	 Employer
 Group
	 	This Service Level measures the timeliness of New Employer	 	Monthly	 	 Manual
 calculation
	 	 > 98% within 10 Business

Days
	 		 	8	 	A	 	Y

  

					
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	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 	Activations & Renewals– Employer Group Activation and Renewal Timeliness - (Commercial Only)	 	 Groups Activations and Renewals, which shall be calculated in accordance with the following formula:

 
 [(# Employer Group A&R – # Late Employer Group A&R) ÷ #
Employer Group A&R]
 x 100%
  

Where:
  

“# Late Employer Group A&R” means the number of New Employer Group Activations and Renewals for which the Employer Group
Activations and Renewals Turnaround Time is greater than the maximum number of days, as set forth in the Service Level column for this Service Level.
  

“Employer Group Activations and Renewals Turnaround Time” means the elapsed time (in Business Days) between (i) the moment that a
complete Employer Group Activation or Renewal is available to Supplier for processing, and (ii) the moment that such Employer Group Activation and Renewal is considered Completed.
	 		 	 based on
 extracted data from:

 
 SALSA
	 		 		 		 		 	
										
	MS-16	 	 Employer
 Group

Activations
	 	This Service Level measures the accuracy of Employer Group Activations and Renewals and	 	Monthly	 	Manual calculation based on	 	> 98%	 		 	4	 	A	 	Y

  

					
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	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES	 	
		 	 & Renewals
 – Employer Group Activation
and Renewal Accuracy -(Commercial Only)
	 	 shall be calculated in accordance with the following formula:
  

[(Total # Employer Group A&R–

# Inaccurate Employer Group A&R) ÷ Total # of Employer Group A&R]

x 100%
  

Where:
  

“# Inaccurate Employer Group A&R” means the number of Employer Group Activations and Renewals that are processed with at least one
error.
	 		 	 extracted data from:
  

ABS
	 		 		 		 		 	
			
		 	Medicare and Cal Medi-Connect Only	 	
										
	MS-17	 	 Inquiry
 Response Timeliness - (ACA-
Regulatory, Legal, Appeals & Grievances)
	 	 This service level measures the timeliness of responses to ACA inquiries from A&G or any regulatory/compliance area (such as DOI, ADOI,
DMHC, Legal, etc), which shall be calculated in accordance with the following formula:
  

[(Total # Inquiry Responses—# Late Inquiry Responses ) ÷ Total

# Inquiry Responses]
 x 100%

 
 Where:

 
 “# Late Inquiry Responses”

means the number of responses to
	 	Monthly	 	 Manual
 calculation based on extracted data
from:
  
 Regulatory Response Tracking Database
	 	 > [Baseline]% of all ACA inquiries received shall be Completed within the specified timeframes –

 
 •  Regulatory: 24 hours

 
 •  All other: 72 hours
	 	Y	 	5	 	C	 	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-13	  	Health Net / Cognizant Confidential

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	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 		 	 ACA inquiries that are not
 Completed within the
specified timeframes.
	 		 		 		 		 		 		 	
										
	MS-18	 	Suspense Item Resolution Timeliness	 	 This service level measures the timeliness of resolution of items in suspense, which shall be calculated in accordance with the following
formula.
  
 [(Total # Suspense items—# Late Suspense items) ÷
Total # Suspense items]
 x 100%
  

Where:
  

“# Late Suspense items” means the number of Identifiable & Accurate Suspense Items that are not Completed within the specified
timeframe in the Service Level column.
  
 “Identifiable & Accurate
Suspense Items” means an item that falls into suspense which can be identified as belonging to a member enrolled in the ABS system after all possible methods of research have been exhausted.
	 	Monthly	 	 Manual
 calculation based on extracted data
from:
  
 ABS
	 	 •  > [Baseline]% within 2

Business Days;
  

•  > [Baseline]% within 5

Business Days; and
  

•  > [Baseline]% within 30 calendar days
	 	Y	 	5	 	C	 	Y
										
		 	MHN	 		 		 		 		 		 		 		 	
										
	MS-19	 	Eligibility File Accuracy (MHN Only)	 	This Service Level measures the accuracy of eligibility file updates and shall be calculated in accordance with the following	 	Monthly	 	 Manual
 calculation based on extracted
	 	> 98%	 	Y	 	2	 	A	 	N

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-14	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 		 	 formula:
  

[(Total # Sampled EF Updates – # Inaccurate EF Updates) ÷ Total # Sampled EF Updates]

x 100%
  

Where:
  

“# Inaccurate EF Updates” means the number of sampled eligibility file updates completed by Supplier that contain one or more
errors.
  
 Compliance with this Service Level shall be measured by sampling at least 10%
of group file updates and is based on an internal audit tool.
	 		 	 data from:
  

MHN Elig Audit Tool (Excel)
	 		 		 		 		 	
										
	MS-20	 	 Eligibility
 File Update and Error Correction
Timeliness –
	 	 This Service Level measures the timeliness of Member Eligibility File (EF) error corrections and updates, and shall be calculated in
accordance with the following formula:
  
 [(Total # EF Updates – #
Late EF Updates) ÷ Total # EF Updates] x 100%
  
 Where:

 
 “# Late EF Updates” means the number of Eligibility File updates
for which the Eligibility File
	 	Monthly	 	 Manual
 calculation based on extracted data
from:
  
 MHN Eligibility Metrics

 
 CA SHP Eligibiligy System: Q-Care for

data E-mails to start and
	 	 > 98% for each of the following categories of file:
  

MHN:
  

•    Activity or change files: within 5 Business Days

 
 •    Full eligibility
files: within 10 Business Days
  
 CA SHP:

 
 •    Activity or daily
change files: within 3 Business Days
	 	Y	 	2	 	 A (for
 MHN and CA
SHP)
  
 B (for AZ SHP)
	 	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-15	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	 	 Category
	 	 Description
	 	 Measure-

ment
 Period
	 	 Measure-

ment Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement
(Y/N)

		 	MEMBERSHIP SERVICES
		 		 	 Update Turnaround Time is greater than the maximum number of Business Days, as set forth in the Service Level column for this Service
Level.
  
 “Eligibility File Update Turnaround Time” means the
elapsed time between (i) the moment that an Eligibility File is received and (ii) the moment that the Eligibility File is updated in the applicable system.
	 		 	 end process
  

AZ SHP Eligibility System: ABS
	 	 •    Full eligibility files: within 5 Business Days

 
 AZ SHP:
  

•    Within 24 hours
	 		 		 		 	

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-16	  	Health Net / Cognizant Confidential

 Final 
  

 

	2.2	Configuration Services (CS) 

  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	CONFIGURATION SERVICES	  	
	CS-1	  	 Configuration
 – Benefit Configuration
Timeliness (MHN and Health Plans only)
	  	 This Service Level measures the

timeliness of configuration of Benefits, by category, and shall be calculated in accordance with the following formula:

 
 [(Total # Benefits Configs – # Late

        Benefits Configs) ÷

Total # Benefits Configs] x 100%
  

Where:
  

“# Late Benefits Configs” means the number of Benefits configurations for which the Benefit Configs Turnaround Time is greater than the
maximum number of Business Days, as set forth in the Service Level column for this Service Level.
  

“Benefits Configs Turnaround Time” means the elapsed time (in Business Days) between (i) the moment that a Benefit to be configured
becomes available to Supplier for processing, and (ii) the moment that such Benefit has been configured in the applicable system.
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Department Inventory Database

 
	  	 The percentage of Benefits,
 by
category that is configured within the specified Benefits Configs Turnaround Time, shall be greater than or equal to the following percentages:
  

Health Plans:
  

•       CA/OR/WA: 98% within £ 30
Business Days
 •       AZ: 98% within
£ 15 Business Days
  
 MHN:

 

•       98% within £ 1 Business
Day
 •       98% within £ 5
Business Days
 •       98% within
£ 10 Business Days

•       99% within £ 30 Business
Days
	  	Y	  	 [TBD –
 4% of Configuration
points]
	  	A	  	Y
										
	CS-2	  	Configuration	  	This Service Level measures the	  	Monthly	  	Manual	  	3 99% of all Benefits	  	Y	  	[TBD –	  	A	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-17	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  	– Benefit Configuration Accuracy - (MHN and Health Plans Only)	  	 accuracy of Benefits
 configurations
and shall be calculated in accordance with the following formula:
  

[(Total # Bens Configs – # Inaccurate Bens Configs) ÷ Total # of Benefits Configs] x 100%

 
 Where:
  

“# Inaccurate Bens Configs” means the number of Benefits configurations containing one or more errors.
	  		  	 calculation
 based on extracted data
from:
  
 Health Net Auditing Database
	  	 configurations shall be
 Completed
without any errors.
	  		  	 12% of

Configuration points]
	  		  	
										
	CS-3	  	 Configuration
 – Pricing Configuration
Timeliness - (Health Plan Only)
	  	 This Service Level measures the

timeliness of configuration of pricing, by category, and shall be calculated in accordance with the following formula:

 
 [(Total # Pricing Configs – # Late

                    Pricing Configs)
÷ Total # Pricing Configs] x 100%
  
 Where:

 
 “# Late Pricing Configs” means the number of Pricing
configurations for which the Pricing Configs Turnaround Time is greater than the maximum number of Business Days, as set
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Department Inventory Database
	  	 The percentage of Pricing,
 by category, that is
configured within the specified Pricing Configs Turnaround Time, shall be greater than or equal to the following:
  

•       CA/OR/WA: 99% within £ 15
Business Days
  

•       AZ: 99% within £ 7
Business Days
	  	Y	  	 [TBD –

4% of Configuration points]
	  	A	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-18	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  		  	 forth in the Service Level column

for this Service Level.
  

“Pricing Configs Turnaround Time” means the elapsed time (in Business Days) between (i) the moment that pricing to be
configured is made available to Supplier for processing, and (ii) the moment that such pricing has been configured in the applicable system.
	  		  		  		  		  		  		  	
										
	CS-4	  	 Configuration
 – Pricing Configuration
Accuracy - (Health Plans only)
	  	 This Service Level measures the
 accuracy of
Pricing configurations and shall be calculated in accordance with the following formula:
  

[(Total # Pricing Configs – # Inaccurate Pricing Configs) ÷ Total # Pricing Configs]

x 100%
  

Where:
  

“# Inaccurate Pricing Configs” means the number of Pricing configurations containing one or more errors.
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Health Net Auditing Database
	  	 3 99% of Pricing

configurations shall be Completed without any errors.
	  	Y	  	 [TBD –

12% of Configuration points]
	  	A	  	Y
										
	CS-5	  	 Configuration
 – PPG Configuration
Turnaround Time -
	  	 This Service Level measures the
 timeliness of
configuration of PPGs and shall be calculated in accordance with the following formula:
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
	  	 3 99% of PPGs shall be

configured within a PPG Configs Turnaround time of no greater than 30 Business Days.
	  	Y	  	 [TBD –

4% of Configuration points]
	  	A	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-19	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
	(Health Plans Only)	  		  	 [(Total # PPG Configs – # Late

PPG Configs) ÷ Total # PPG Configs] x 100%

 
 Where:

 
 “# Late PPG Configs” means the number of PPG configurations for
which the PPG Configs Turnaround Time is greater than the maximum number of
 Business Days, as set forth in the Service Level column for this Service
Level.
  
 “PPG Configs Turnaround Time” means the elapsed time
(in Business Days) between (i) the moment that a PPG to be configured is available to Supplier for processing, and (ii) the moment that such PPG has been configured in the applicable system.
	  		  	Department Inventory Database	  		  		  		  		  	
										
	CS-6	  	 Configuration
 – PPG Accuracy - (Health
Plans Only)
	  	 This Service Level measures the
 accuracy of PGG
configurations and shall be calculated in accordance with the following formula:
  

[(Total # PPG Configs – # Inaccurate PPG Configs) ÷ Total # of PPG Configurations] x 100%
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Health Net Auditing Database
	  	 3 99% of PPG

configurations shall be Completed without any errors.
	  	Y	  	 [TBD –

12% of Configuration points]
	  	A	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-20	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  		  	  
 Where:

 
 “# Inaccurate PPG Configs” means the number of PPG
configurations containing one or more errors.
	  		  		  		  		  		  		  	
										
	CS-7	  	 Configuration
 – Provider Demographic
Timeliness - (Health Plans Only)
	  	 This Service Level measures the
 timeliness of
configuration of Provider demographic data and shall be calculated in accordance with the following formula:
  

[(Total # Provider Configs – # Late

Provider Configs) ÷
 Total #
Provider Configurations]
 x 100%
  

Where:
  

“# Late Provider Configs” means the number of Provider configurationss for which the Provider Configs Turnaround Time is
greater than the
 maximum number of Business Days, as set forth in the Service Level column for this Service Level.

 
 “Provider Configs Turnaround Time” means the
elapsed time (in Business Days) between (i) the moment that Provider
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Department Inventory Database
	  	 3 99% of Provider

demographic data shall be configured within a Provider Configs Turnaround time of no greater than 20 Business Days.
	  	Y	  	 [TBD –

4% of Configuration points]
	  	B	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-21	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  		  	 demographic data to be
 configured is available
to Supplier for processing, and (ii) the moment that such Provider demographic data has been configured in the applicable system.
	  		  		  		  		  		  		  	
										
	CS-8	  	 Configuration
 – Provider Demographic
Accuracy - (Health Plans Only)
	  	 This Service Level measures the
 accuracy of
Provider demographic data configurations and shall be calculated in accordance with the following formula:
  

[(Total # Provider Configs – # Inacc

Provider Configs) ÷
 Total #
Provider Configurations]
 x 100%
  

Where:
  

“# Inacc Provider Configs” means the number of Provider demographic data configurations containing one or more errors.
	  	Monthly	  	 Manual
 calculation

based on extracted data from:
  

Health Net Auditing Database
	  	 3 98.5% of Provider

demographic data configurations shall be Completed without any errors.
	  	Y	  	 [TBD –

12% of Configuration points]
	  	A	  	Y
										
	CS-9	  	 Capitation –
 Capitation Payment Processing
and Handoff Timeliness - (All Lines of Business)
	  	 This Service Level measures the
 timeliness of
the Capitation Payments File processing and handoff to Health Net Accounts Payable and processing and handoff of paper checks to the Health Net mail room in relation to the applicable Capitation Contract’s deadline and shall be calculated in
accordance with the following formulas:
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Department Inventory Database
	  	 (a) 100% of Capitation
 Payment
Files shall be processed and provided to Health Net Accounts Payable before 2 pm 1
 Business Day prior to the Capitation Payment deadline set forth in the
applicable Capitation Contract.
	  	Y	  	 [TBD –

18% of Configuration points]
	  	A	  	N

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-22	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL
#
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment
Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  		  	 (a) [(Total # Capitation Payment Files – # Late Capitation Payment Files) ÷

Total # Capitation Payment Files]
 x
100%
  
 and

 
 (b) [(Total # Capitation Paper Checks – # Late Capitation Paper
Checks) ÷
 Total # Capitation Paper Checks]

x 100%
  

Where:
  

“Capitation Contracts” are contractual agreements between Providers and Health Net that include the amounts of Capitation payments and
the deadlines by which Health Net must pay the applicable Capitation payments.
  
 “#
Late Capitation Payment Files” means the number of Capitation Payment Files that are provided by Supplier to Health Net in a time period that exceeds the time period provided in the Service Level column for this Service Level.

 
	  		  		  	 (b) 100% of Capitation
 paper
checks shall be processed and provided to the Health Net mail room by
 4 pm 1 Business Day prior to Capitation payment deadline set forth in the applicable
Capitation Contract.
	  		  		  		  	

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-23	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 SL #
	  	 Category
	  	 Description
	  	 Measure-
ment

Period
	  	 Measure-

ment Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improvement
(Y/N)

	 CONFIGURATION SERVICES
	  	
		  		  	 “# Late Capitation Paper Checks” means the number of

Capitation paper checks that are provided by Supplier to Health Net in a time period that exceeds the time period provided in the Service Level column for this
Service Level.
	  		  		  		  		  		  		  	
										
	CS-10	  	 Capitation –
 Capitation File Processing
Accuracy - (All Lines of Business)
	  	 This Service Level measures the
 accuracy of
Capitation Payment File processing and shall be calculated in accordance with the following formula:
  

[(Total # Capitation Payment Files –

# Inacc Capitation Payment Files) ÷ Total # Capitation Payment Files]

x 100%
  

Where:
  

“# Inacc Capitation Payment Files” means the number of processed Capitation Payment Files containing one or more errors.
	  	Monthly	  	 Manual
 calculation based on extracted data
from:
  
 Health Net Auditing Database
	  	 399% of Capitation

Payment Files shall be processed without any errors.
	  	Y	  	 [TBD –

18% of Configuration points]
	  	A	  	Y

  

					
	SOW#2 (M + C) Exhibit B-1	  	B-1-24	  	Health Net / Cognizant Confidential

 Final 
  

EXHIBIT D 
 KEY SUPPLIER
PERSONNEL 
 Subject to Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions
filled by the individuals listed in the table below. 
  

			
	Key Supplier Position	  	Initially Approved Individual
	Director Membership Accounting	  	TBD
	Director Membership Accounting	  	TBD
	Director Membership Accounting*	  	TBD
	Director Capitation/Provider Data Management	  	TBD
	Director Configuration	  	TBD
	Business Systems Analyst	  	TBD

  

	*	May be able to remove as key personnel once migration of Symphony to ABS occurs if all goes according to plan 

  

					
	SOW#2 (M + C) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

 Final 
  

 
 EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms and
Conditions, this Exhibit H (Subcontractors) identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth below.

  

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	***	  		  	

  

					
	SOW#2 (M + C) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

 Final 
  

AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #3 (CONTACT CENTER SERVICES) 

  

					
	SOW #3 (Contact Center)		 		Health Net / Cognizant Confidential

 Final 
  

AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #3 (CONTACT CENTER SERVICES) 

This Statement of Work #3 (Contact Center Services), dated November 21, 2014, but effective as of November 2, 2014
(“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #3 (Contact Center Services) is entered into and shall be governed by the terms of that certain Amended and
Restated Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #3 (Contact Center Services) replaces and supersedes in all respects the
Statement of Work #3 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #3 (Contact Center Services) describes
the Contact Center Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Contact Center Services) to this SOW #3 (Contact Center Services), and sets forth certain terms and conditions relating to
them, including, among other things: 
  

	 	(a)	The scope of the Contact Center Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; 

  

	 	(d)	The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

					
	SOW #3 (Contact Center)		1		Health Net / Cognizant Confidential

 Final 
  

 

	1.2	Structure 

 This SOW #3 (Contact Center Services) is comprised of this cover
document and the following Exhibits: 
  

					
	Table 1: Exhibits to SOW #3 (Contact Center Services)
			
	 Item #
		Exhibit		Purpose of Exhibit
			
	1		Exhibit A (Services)		Describes the scope of the Contact Center Services.
			
	 2
		 Exhibit A-1 (Solution

Description)
		 Describes Supplier’s solution for the provision of the Contact Center

Services and includes as exhibits:
  

•        Exhibit A-1-1 (Approved Service Delivery Centers)

 

•        Exhibit A-1-2 (Service Delivery Configuration at the
Completion of Phase 2)

			
	 3
		 Exhibit A-3

(Organizational Chart)
		Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW #3 (Contact Center Services).
			
	 4
		 Exhibit B-1
 (Operational SLAs)
		 Identifies the Operational Service Levels applicable to the Contact

Center Services.

			
	 5
		 Exhibit D (Key
 Supplier
Positions)
		 Identifies the Key Supplier Positions applicable to the Contact Center

Services.

			
	 6
		 Exhibit H
 (Subcontractors)
		Identifies the Subcontractors approved by Health Net to provide certain of the Contact Center Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #3 (Contact Center
Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #3 (Contact Center Services) is hereby
made a part of, and is subject to and governed by, the Agreement. This SOW #3 (Contact Center Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW #3 (Contact Center)		2		Health Net / Cognizant Confidential

 Final 
  

IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #3 (Contact Center Services) to be signed and delivered by
its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

					
	Health Net, Inc.				Cognizant Healthcare Services, LLC
			
	By:                                     
                                         
                      		                    		By:                                     
                                         
                     
			
	Print
Name:                                        
                                         
   				Print
Name:                                        
                                         
  
			
	Title:                                     
                                         
                   				Title:                                    
                                         
                   
			
	Date:                                     
                                         
                   				Date:                                     
                                         
                  

  

					
	SOW #3 (Contact Center)		 		Health Net / Cognizant Confidential

 Final 

EXHIBIT A 
 CONTACT CENTER
SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	General 

  

	 	(a)	In the most general terms, the “Contact Center Services” are the Functions associated with the intake, routing, and tracking of inquiries and requests received from Members, Providers, Brokers,
Employer Groups and Sales through all Channels for all Regions and Lines of Business requested by Health Net. 

  

	 	(b)	The Contact Center Services are more fully described in this Exhibit A (Contact Center Services), and include the Cross Functional Services described in Section 3 of Schedule A (Cross Functional
Services) and the Functions included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Contact Center Services. For
clarity, this includes Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 of Schedule A (Cross Functional Services). Supplier shall perform the
Contact Center Services, except for those Functions that are expressly identified as retained Health Net responsibilities in Section 2 below. For purposes of clarity, the Party that is assigned responsibility for a Function as per the
designations in Section 2 is also responsible for the Embedded Processes applicable to that Function. 

  

	 	(c)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Contact Center Services to be performed by Supplier include all Functions performed by
or associated with the roles in the Contact Center Organization Chart set forth in Exhibit A-3 (Contact Center Organization Chart), all of which are either being transferred to Supplier or displaced by Supplier roles as a result of the
execution of this Statement of Work. Such Functions will be deemed to be part of the Contact Center Services to be performed by Supplier as if expressly set forth in this Statement of Work. 

 

	 	(d)	In addition to the retained Health Net responsibilities expressly identified in this Exhibit A (Contact Center Services), and in addition to and without limiting Health Net’s rights under the Terms and Conditions,
Health Net reserves the right to perform quality reviews and audits of Supplier’s performance of the Contact Center Services when and to the extent it desires in its sole discretion. For the avoidance of doubt, Health Net is not obligated to
perform any level of such quality reviews and activities, except to the extent required by applicable Law. 

  

	 	(e)	Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is
no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and
evolutions of the Contact Center Services during the term of this Statement of Work. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-1		Health Net / Cognizant Confidential

 Final 
  

	1.2	Definitions 

  

	 	(a)	Certain Terms 

  

	 	(i)	“Communications” means phone calls, chats, emails, texts, SMS, etc. 

  

	 	(ii)	“Contact Centers” means department that manages all inbound and outbound communication channels for Health Net 

 

	 	(iii)	“EOC” or “Evidence of Code” means a brief explanation within a Health Net processed claim as to why a certain action was taken on the claim. 

 

	 	(iv)	“OMNI Interaction” means call inquiry type in the specific system of record that the Contact Centers utilizes (e.g., View Member Auth, View Provider Auth, Add Dependent, etc.).

  

	 	(v)	“OMNI Service Object” means documentation within the specific system of record that the Contact Centers utilizes of the interaction with the caller. 

 

	 	(vi)	“Overturn” means an SHP Provider Appeal that has been reviewed and determined to be in favor of the provider. 

 

	 	(vii)	“Partial Overturn” means an SHP Provider Appeal that involves multiple claim lines, and after review, at least one (but not all) of the claim lines has been determined to be in favor of the
provider. 

  

	 	(viii)	“Provider Dispute” or “PDR” or “Provider Appeal” is a written notice, other than an SHP Provider Appeal, from a provider to Health Net that:
(a) challenges, appeals or requests reconsideration of a claim (including a bundled group of similar multiple claims) that has been denied, adjusted or contested; (b) challenges a request for reimbursement for an overpayment of a claim; or
(c) seeks resolution of a billing determination or a contractual dispute. For clarity, in some of Health Net’s geographies the nomenclature used for such appeals are Provider Dispute or PDR, and in other geographies, the nomenclature used is
Provider Appeal. References to the term “PDR” will refer collectively to Provider Disputes and Provider Appeals. 

  

	 	(ix)	“Provider Inquiry” or “PI” means a request from a provider or from Health Net regarding the status or outcome of claims, claims-related transactions, PDRs, or any other
correspondence received that Health Net designates as a Provider Inquiry. 

  

	 	(x)	“Service Form” or “SF” means the electronic service form that results in a permanent record that is used to document contacts, both internal and external to Health Net.

  

	 	(xi)	“SHP Determination” means the final outcome and decision of an SHP Provider Appeal, after review of the SHP Provider Appeal, which informs the appealing provider if it has been determined to be
in favor of the provider or in favor of the health plan. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-2		Health Net / Cognizant Confidential

 Final 
  

	 	(xii)	“SHP Provider Appeal” means a written notice to Health Net submitted by a provider challenging, appealing or requesting reconsideration of a claim that has been denied, adjusted or contested or
seeking resolution of a billing determination or other contract dispute or disputing a request for reimbursement of an overpayment of a claim, in each case for a state health plan. 

 

	 	(xiii)	“SHP Provider Appeals Services” means processing provider appeals for the SHP line of business. 

  

	 	(xiv)	“Upheld” means an SHP Provider Appeal that has been reviewed and determined to be in favor of the Health Plan. References to Uphelds shall also include the “upheld” portion of Partial
Overturns. 

  

	 	(b)	Capitalized terms not defined in this Exhibit A (Contact Center Services) shall have the meanings given them in
 Schedule W (Glossary) or elsewhere in this Agreement. 

 

	2.	RESPONSIBLE PARTY 

 The following table sets forth the responsible party for the Contact
Center Services. 
  

											
	 Process /
Function
ID
	  	 Process/Function Name / Description
	  	 	  	Resp. Party
	  	  	 Line of

Business
 (LOB)
	  	 Region
	  	 Supplier
	  	 Health

Net

	CC0	  	Contact Center Services, Generally	  		  		  		  	
						
	 CC0.1
	  	Infrastructure Services	  	All	  	All	  	X	  	
						
	 CC0.2
	  	Communication Intake Services	  	All	  	All	  	X	  	
						
	 CC0.3
	  	Customer Service Representatives Services	  	All	  	All	  	X	  	
						
	 CC0.4
	  	Knowledge Base Services	  	All	  	All	  	X	  	
						
	 CC0.5
	  	Contact Center Quality Assurance Services	  	All	  	All	  	X	  	
						
	 CC0.6
	  	Workforce Management Services	  	All	  	All	  	X	  	
						
	 CC0.7
	  	Project Support Services	  	All	  	All	  	X	  	
						
	 CC0.8
	  	Policies and Procedures, Workflows and Desktops Services	  	All	  	All	  	X	  	
						
	 CC0.9
	  	Administrative Payments Services	  	 Commercial

and SHP
	  	All	  	X	  	
						
	 CC0.10
	  	Escalation Support Services	  	All	  	All	  	X	  	
						
	 CC0.11
	  	Email Inquiries Services	  	All	  	All	  	X	  	
						
	 CC0.12
	  	Silverlink Calls Services	  	 Commercial

and SHP
	  	All	  	X	  	
						
	 CC0.13
	  	Documentation and Tracking	  	All	  	All	  	X	  	
						
	 CC0.14
	  	Post Call Surveys	  	All	  	All	  	X	  	
						
	 CC0.15
	  	Audit Support Services	  	All	  	All	  	X	  	
						
	 CC0.16
	  	Health Net Policy Support Services	  	All	  	All	  	X	  	
						
	 CC1
	  	Medicare Contact Centers	  		  		  		  	
						
	 CC1.1
	  	Medicare Resolution Team - Oral Grievances – Resolution Team Services	  	Medicare	  	All	  	X	  	
						
	 CC1.2
	  	Contact Center, Executive Office Support – Resolution Team Services	  	Medicare	  	All	  	X	  	
						
	 CC1.3
	  	Sales Desk Support – Resolution Team Services	  	Medicare	  	All	  	X	  	

  

					
	SOW#3 (Contact Center) Exhibit A	  	A-3	  	Health Net / Cognizant Confidential

 Final 
  

											
	 Process /
Function ID
	  	 Process/Function Name / Description
	  	 	  	Resp. Party
	  	  	 Line of

Business
 (LOB)
	  	 Region
	  	 Supplier
	  	 Health

Net

						
	 CC1.4
	  	TTY Inbound Call Support – Resolution Team Services	  	All	  	All	  	X	  	
						
	 CC1.5
	  	Prior Authorization Calls	  	All	  	All	  	X	  	
						
	 CC2
	  	MHN Contact Centers	  		  		  		  	
						
	 CC2.1
	  	Outbound Call Support Services	  	MHN	  	All	  	X	  	
						
	 CC2.2
	  	Claims Box Support Services	  	MHN	  	All	  	X	  	
						
	 CC2.3
	  	Exempt and Formal Grievances Process Services	  	MHN	  	All	  	X	  	
						
	 CC3
	  	State Health Programs and Cal Medi Connect Contact Centers	  		  		  		  	
						
	 CC3.1
	  	15 Day Letter	  	SHP	  	All	  	X	  	
						
	 CC3.2
	  	Pre-Natal Forms Services	  	SHP	  	All	  	X	  	
						
	 CC3.3
	  	Transition of Care Form Services	  	SHP	  	All	  	X	  	
						
	 CC3.4
	  	Disenrollment Services	  	SHP	  	All	  	X	  	
						
	 CC3.5
	  	Noncompliant Members Services	  	SHP	  	All	  	X	  	
						
	 CC3.6
	  	Reimbursements Services	  	SHP	  	All	  	X	  	
						
	 CC3.7
	  	Mail Return Services	  	SHP	  	All	  	X	  	
						
	 CC3.8
	  	PCP Transfers Requiring Overrides Services	  	SHP	  	All	  	X	  	
						
	 CC3.9
	  	Exempt Grievances Services	  	SHP	  	All	  	X	  	
						
	 CC3.10
	  	Grievance and Appeals Intake Services	  	SHP	  	AZ	  		  	X
						
	 CC3.11
	  	Inquiries	  	SHP	  	All	  	X	  	
						
	 CC3.12
	  	Member Warnings	  	SHP	  	All	  	X	  	
						
	 CC4
	  	Commercial Contact Centers	  		  		  		  	
						
	 CC4.1
	  	Exempt Grievances Services	  	Commercial	  	All	  	X	  	
						
	 CC4.2
	  	Letter Requests Services	  	Commercial	  	All	  	X	  	
						
	 CC4.3
	  	Technical Support Services (TST) Services	  	Commercial	  	All	  	X	  	
						
	 CC4.4
	  	Account Services Unit Services	  	Commercial	  	All	  	X	  	
						
	 CC4.5
	  	Centralized Unit Services	  	Commercial	  	All	  	X	  	
						
	 CC4.6
	  	Provider Email Services	  	Commercial	  	All	  	X	  	
						
	 CC4.7
	  	Provider Registrations Services	  	Commercial	  	All	  	X	  	
						
	 CC4.8
	  	Member Emails Services	  	Commercial	  	All	  	X	  	
						
	 CC4.9
	  	IFP Emails and Faxes Services	  	Commercial	  	All	  	X	  	
						
	 CC4.10
	  	Medical Services Costs Estimates (Member and Provider Services)	  	Commercial	  	All	  	X	  	
						
	 CC4.11
	  	Provider Transfer Unit Services	  	All	  	All	  	X	  	
						
	 CC4.12
	  	Chat Services	  	Commercial	  	All	  	X	  	
						
	 CC4.13
	  	Real Time Adjustments (RTA) Services	  	Commercial	  	All	  	X	  	
						
	 CC4.14
	  	Inquiries	  	Commercial	  	 AZ, OR,

WA
	  	X	  	
						
	 CC4.15
	  	Member Warnings	  	Commercial	  	 AZ, OR,

WA
	  	X	  	
						
	 CC4.5 and
	  	Prior Authorization Calls	  	Commercial and	  	All	  	X	  	
	 CC7.16
	  		  	Medicare	  		  		  	
						
	 CC7.17
	  	DMHC After Hours Calls Intake	  	 Commercial

HMO and
 POS
	  	CA	  	X	  	

  

					
	SOW#3 (Contact Center) Exhibit A	  	A-4	  	Health Net / Cognizant Confidential

 Final 
  

 

	3.	CONTACT CENTER SERVICES, GENERALLY 

 Supplier will provide the Contact Center Services
described in this Exhibit A (Contact Center Services). Supplier will document and track all Contact Center processes in the appropriate system of record and adhere to all Health Net, regulatory, compliance and business standards applicable to
all Products, Regions and Line of Business. Except as specifically noted, the Services set forth in this Section 3 apply to all Lines of Business, Regions, and Geographies. 

 

	3.1	Infrastructure Services 

 “Infrastructure Services” means
providing and supporting all infrastructure, technology and software required to be able to operate the Contact Centers and support the Contact Center Services, and aligns with all PHI, HIPAA, PCI and Compliance requirements including: 

 

	 	(a)	Operating Contact Centers that are open and completely functional during all required open hours of operations; 

  

	 	(b)	Providing voicemail boxes for all LOBs that require after hours voice mail coverage. 

  

	3.2	Communication Intake Services 

 “Communication Intake Services”
are the Functions associated with performing intake for all service requests or inquiries from all available Channels, including the following activities: 
  

	 	(a)	Addressing all Member, Provider, Broker Sales and Employer Group inquiries including, benefits, claims, eligibility, material requests, multiple claims, check tracers, W9, evidence of check, out of pocket member
requests, and network including simple and complex calls and Web inquiries; 

  

	 	(b)	If required, making outbound calls on behalf of Members to facilitate issue resolution giving a “concierge”-like experience; 

 

	 	(c)	Properly identifying all Member, Provider, Broker, or Employer Group Representative Communications; 

  

	 	(d)	Providing the opening greeting for all calls in the required threshold languages; 

  

	 	(e)	Every communication, as appropriate, will be HIPAA verified; 

  

	 	(f)	Documenting Communications in the appropriate system of record; 

  

					
	SOW#3 (Contact Center) Exhibit A		A-5		Health Net / Cognizant Confidential

 Final 
  

 

	 	(g)	Based on the type of inquiry or request or other information captured on intake, identifying the appropriate destination (e.g., Membership, Claims, etc.) for service inquiries and requests including routing to an
outside contact center (e.g., Nurse Line, Pharmacy Service Center, etc.); 

  

	 	(h)	Coordinating translation of Communications and correspondence; 

  

	 	(i)	Escalating inquiries based on type of issue presented or as required by Law or Health Net Policy; 

  

	 	(j)	Monitoring all open service objects (also known as intents or Service forms); (k) Escalating open service objects as needed for prompt resolution based upon the turnaround times in the policies and procedures; and

  

	 	(l)	Accepting payments and protecting all payment transactions in compliance with current PCI security requirements. 

  

	3.3	Customer Service Representatives (“CSRs”) Services 

“Customer Service Representatives Services” are the Functions associated with staffing the Contact Center with CSRs
that satisfy the following requirements: 
  

	 	(a)	Every bilingual CSR will be language certified; (for Spanish) Language Services Company will be used for other languages beyond English and Spanish) 

 

	 	(b)	Every CSR will complete all Health Net required LMS regulatory training; 

  

	 	(c)	Every CSR will adhere to all compliance and regulatory requirements outlined in the training documents; 

  

	 	(d)	Every CSR (as well as other dedicated Supplier Personnel) providing Contact Center Services will undergo a background check and complete a pre-employment screening; 

 

	 	(e)	Every CSR will complete medical terminology training and all other training as required by Health Net; and 

  

	 	(f)	Sending out periodic Communications to the CSRs informing them of changes in plans or policies; 

  

	 	(g)	Ensuring that periodic Communications are read and understood, and archiving all Communications, with all distribution data. 

  

	3.4	Knowledge Base Services 

 “Knowledge Base Services” are the
Functions associated with managing and maintaining the Knowledge Base (KB) system and content according to Health Net policies and procedures. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-6		Health Net / Cognizant Confidential

 Final 
  

 

	3.5	Contact Center Quality Assurance Services 

 “Contact Center Quality Assurance
Services” are the Functions associated with recording and storing all calls for quality assurance purposes and providing Health Net with the ability to listen live to active calls and listening of recorded calls. 

 

	3.6	Workforce Management Services 

 “Workforce Management Services”
are the Functions associated with providing all necessary resources to forecast call volumes and staff the Contact Center to meet all key metrics including scheduling all PTO, team meetings, coaching time, and similar workforce management
responsibilities to fall within a shrinkage utilized in the staffing run to meet all key metrics. 
  

	3.7	Project Support Services 

 “Project Support Services” are the
Functions associated with participating in departmental and enterprise-wide projects and provide project support to ensure deliverables are implemented on schedule and adhere to all project, business, compliance, and regulatory requirements. 

 

	3.8	Policies and Procedures (P&Ps), Workflows and Desktops Services 

“Policies and Procedures (P&Ps), Workflows and Desktops Services” are the Functions associated with maintaining the
accuracy and completeness of existing P&Ps, workflows and desktops for all in scope Contact Center Services, including the following activities: 
  

	 	(a)	Ensuring that documents are align to any process changes that may occur; 

  

	 	(b)	Ensuring that related P&Ps, workflows, and desktops align to one another; 

  

	 	(c)	Creating new P&Ps, workflows, and desktops for every new process developed; 

  

	 	(d)	Ensure all P&Ps, workflows, and desktops are in accordance with regulatory, compliance and business requirements; and 

  

	 	(e)	Following the P&P review timelines requirements as specified by Health Net policies. 

  

	3.9	Administrative Payments Services 

 “Administrative Payments
Services” are the Functions associated with performing administrative payments in accordance with the regulatory, SOX requirements and Health Net policies and procedures, including the following activities: 

 

	 	(a)	Monitoring and trending administrative payments to identify areas of opportunity; and 

  

	 	(b)	Coaching and retraining associates as necessary to drive down administrative payment volumes. 

  

	3.10	Escalation Support Services 

 “Escalation Support Services” are
the Functions associated with establishing a process to support escalated Communications and issues including complex billing, eligibility, claim, authorization escalation requests, regulatory requests, etc., including the following activities: 

  

					
	SOW#3 (Contact Center) Exhibit A		A-7		Health Net / Cognizant Confidential

 Final 
  

	 	(a)	As necessary, establishing a team of highly skilled associates to handle, track, and respond; 

  

	 	(b)	Ensure all escalations are resolved; 

  

	 	(c)	Documenting inquiries in the appropriate system of record; and 

  

	 	(d)	Performing trend issues, inquiries, etc. 

  

	3.11	Email Inquiries Services 

 “Email Inquiries Services” are the
Functions associated with providing a designated team to respond and resolve email inquiries and issues within the prescribed and required timeframes. 
  

	3.12	Silverlink Calls Services 

 “Silverlink Calls Services” are the
Functions associated with welcoming new members to Health Net and explaining the plan and offer assistance and educating new members on various processes. 
  

	3.13	Documentation and Tracking Services 

 “Documentation and Tracking
Services” are the Functions associated with ensuring that all Communications are appropriately documented in the applicable systems of record. 
  

	3.14	Post Call Surveys 

 “Post Call Surveys” means conducting and
managing post call surveys for members and providers on a quarterly basis or more frequently as dictated by business and/or stakeholder needs. Post Call Survey Services include analyzing and trending the data and providing the results to Health Net
following each survey and upon request. The Post Call Survey shall include the following questions: 
  

	 	(a)	“How many times have you contacted Health Net regarding your request or issue?” 

  

	 	(b)	“Was your request or issue resolved with this call?” (yes, no, or too soon to tell) 

  

	 	(c)	“On a scale of 1 to 4, where 1 means “very low effort” and 4 means “very high effort”, how much effort did you personally have to put forth to handle your request or issue? 

 

	 	(d)	“On a scale of 1 to 4, where 1 means “never” and 4 means “always”, rate how Health Net’s customer service staff over the last 6 months treated you with courtesy and respect?

  

	 	(e)	“On a scale of 1 to 4, where 1 means “never” and 4 means “always”, please rate how often Health Net’s customer service over the last 6 months, including this call, gave you the information
or help you needed? 

  

	 	(f)	“Are you satisfied with the service provided by the associate who assisted you today?” 

On an annual basis, the Supplier shall evaluate the effectiveness of the Post Call Survey and align to industry best practices. Supplier shall
submit any changes to Health Net for approval. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-8		Health Net / Cognizant Confidential

 Final 
  

	3.15	Audit Support Services 

 “Audit Support Services” means those
Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group), including
the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with Regulators. 

  

	3.16	Health Net Policy Support 

 “Contact Center Policy Services”
means those Functions associated with the development and implementation of “Health Net Contact Center Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies) governing or pertaining
to the Contact Center Services, more specifically, the conduct of Health Net’s Contact Center Services. 
 Below are some examples of
selected Contact Center Policy Development Services Functions, which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only: 

 

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Contact Center Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Contact Center Policies;

  

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

 

	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Contact Center Services and participate in operational implementation and/or affected system
changes of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

  

					
	SOW#3 (Contact Center) Exhibit A		A-9		Health Net / Cognizant Confidential

 Final 
  

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net Contact Center Policies and submit them to the relevant Health Net and Supplier stakeholders for
review, comment and approval; 

  

	 	(d)	Prepare updated versions of Health Net Contact Center Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Contact Center Policies and access to Health Net personnel to such communications and training; and 

 

	 	(f)	Implement Heath Net-approved Health Net Contact Center Policies by Supplier Personnel involved in the performance of the Contact Center Services. 

 

	4.	MEDICARE CONTACT CENTERS 

  

	4.1	Medicare Resolution Team - Oral grievances – Resolution Team Services 

“Oral Grievances – Resolution Team Services” are the Functions associated with providing a designated team to
manage, track, and monitor the oral grievance process, including the following activities: 
  

	 	(a)	Tracking and documenting oral grievances in the appropriate system of record; 

  

	 	(b)	Identifying trends, preventable issues and outlier opportunities and informing Health Net points of contacts of trends, including increases in oral grievances volumes; 

 

	 	(c)	Partnering with other departments as necessary to identify root cause of issues identified as a trend or as preventable and of an increased number of oral grievances; 

 

	 	(d)	Collaborating with Appeals & Grievances for oversight and reporting purposes; and 

  

	 	(e)	Implementing a monitoring and reconciliation process to ensure that oral grievances are worked timely, accurately, and completed in accordance with Health Net, regulatory, compliance and business standards.

  

	4.2	Contact Center, Escalation Support–Resolution Team Services 

 “Contact
Center, Escalation Support – Resolution Team Services” are the Functions associated with providing a designated team to support Contact Center with inbound escalated member inquiries, including the following activities: 

 

	 	(a)	Ensuring all escalations are resolved timely; 

  

	 	(b)	Documenting inquiries in the appropriate system of record; 

  

	 	(c)	Supporting and responding to both live and email escalated calls; and 

  

	 	(d)	Processing fulfillment request i.e. marketing materials, ANOC, EOC, etc. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-10		Health Net / Cognizant Confidential

 Final 
  

	4.3	Sales Desk Support–Resolution Team Services 

 “Sales Desk Support –
Resolution Team Services” are the Functions associated with providing a designated team to support CA Sales team with inbound potential enrollee inquiries calls, including the following activities: 

 

	 	(a)	Supporting and responding to both live and email inquiries (e.g. PCP availability, plan/benefits questions, Formulary questions, etc.); and 

 

	 	(b)	Documenting inquiries in the appropriate system of record. 

  

	4.4	TTY Inbound Call Support–Resolution Team Services 

 “TTY Inbound Call
Support – Resolution Team Services” are the Functions associated with providing a designated team to support TTY inbound customer support services during all hours of operations, including the following activities: 

 

	 	(a)	Performing back-office coordination and follow up necessary to fully respond to the members’ inbound inquiry for Health Net’s California, Arizona and Oregon members under its Medicare product line;

  

	 	(b)	Documenting inquiries in the appropriate system of record; 

  

	 	(c)	TTY is one of the CMS Star key measures, closely monitoring performance and oversee daily results ensure accuracy of calls and call handling; 

 

	 	(d)	Producing a daily report that outline all TTY activity and performance results; and 

  

	 	(e)	Transitioning TTY Inbound Call Support to the State Relay (711) program. This transition should begin in Q1 of 2015, however Supplier will maintain the current TTY process as long as it is required.

  

	4.5	Prior Authorization Calls 

 “Prior Authorization Calls” are the
Functions associated with supporting customer support services for prior authorization calls during all hours of operations, including the following activities: 
  

	 	(a)	Authorization Status – CSI, OMNI or ABS 

  

	 	(b)	Checking CPT Codes to see if Authorization Required 

  

	 	(c)	Benefits 

  

	 	(d)	Verify COB and Eligibility 

  

	 	(e)	Claims 

  

					
	SOW#3 (Contact Center) Exhibit A		A-11		Health Net / Cognizant Confidential

 Final 
  

 

	5.	MENTAL HEALTH NETWORK (MHN) CONTACT CENTERS 

  

	5.1	Outbound Call Support Services 

 “Outbound Call Support Services”
are the Functions associated with providing a designated team to support all out bound calls/follow up for the MHN Contact Center, including the following activities: 
  

	 	(a)	Responding to inquiries, including: Provider appointment notification, Eligibility verification to members, Exempt Grievance follow up calls, Provider Availability Check for member referrals, and Language Interpretation
appointments; 

  

	 	(b)	Documenting inquiries in the appropriate system of record; and 

  

	 	(c)	Producing reporting that includes outbound aged calls and back log. 

  

	5.2	Claims Box Support Services 

 “Claims Box Support Services” are
the Functions associated with providing a designated team to support the review of claims submissions and upload to ACS for the MHN Contact Center, including the following activities: 

 

	 	(a)	Submitting BSRs as needed for new claims submissions; 

  

	 	(b)	Documenting inquiries in the appropriate system of record; 

  

	 	(c)	Contacting providers regarding any issues with claim forms; and 

  

	 	(d)	Producing reporting that includes claims inventory and back log. 

  

	5.3	Exempt and Formal Grievances Process Services 

 “Exempt and Formal Grievances
Process Services” are the Functions associated with following the California Department of Managed Health Care requirements contained in Knox-Keene Health Care Service Plan Act of 1975, Section 1368(a)(4)(B) in regard to handling
and resolution of exempt grievances received by the MHN Representatives, including the following activities: 
  

	 	(a)	Per 28 CCR 1300.68 (d)(8), responding to grievances as required; 

  

	 	(b)	Facilitating biweekly calibration sessions for customer service and clinical leadership including preparing the cases that are discussed; 

 

	 	(c)	Preparing monthly reports (exempt/formal grievances, number of grievances submitted by CSR, learning tools report); 

  

	 	(d)	Preparing quarterly report for Quality Committee; 

  

	 	(e)	Providing a designated team to manage, track, and monitor the exempt grievance process; 

  

	 	(f)	Tracking and documenting exempt grievances in the appropriate system of record; 

  

	 	(g)	Identifying trends, preventable issues and outlier opportunities and inform Health Net points of contacts of trends, including increases in oral grievances volumes; 

  

					
	SOW#3 (Contact Center) Exhibit A		A-12		Health Net / Cognizant Confidential

 Final 
  

 

	 	(h)	Partnering with other departments as necessary to identify root cause of issues identified as a trend or as preventable and of an increased number of exempt grievances; 

 

	 	(i)	Collaborating with Appeals & Grievances for oversight and reporting purposes; and 

  

	 	(j)	Implementing a monitoring and reconciliation process to ensure that exempt grievances are worked timely, accurately, and completely in accordance with Health Net, regulatory, compliance and business standards.

  

	6.	STATE HEALTH PROGRAMS (SHP) CA, AZ AND CAL MEDI CONNECT (CMC) CONTACT CENTERS 

  

	6.1	15 day Letter Services 

 “15 Day Letter Services” are the
Functions associated with processing Pay demand letters sent to Providers for unpaid claims to ensure appropriate assumptions of financial responsibilities, including the following activities: 

 

	 	(a)	Determining the appropriate financial responsibility; 

  

	 	(b)	Creating and sending the 15 day letter (pay/demand letter); 

  

	 	(c)	Performing appropriate follow-up actions as necessary; and 

  

	 	(d)	Documenting in the appropriate system of record. 

  

	6.2	Pre Natal Forms Services 

 “Pre Natal Forms Services” are the
Functions associated with routing pre natal forms to the care management team to ensure information is accurate and also to ensure PCP/PPG/OBGYN /hospital are linked within the same network including performing all necessary work to ensure form is
complete, accurate, linked and triaged to the Care Management Team. 
  

	6.3	Transition of Care Services 

 “Transition of Care Services” are
the Functions associated with ensuring members’ care is not interrupted due to change in network, incomplete information, etc., including the following activities: 
  

	 	(a)	Validating request and add any missing information to form; 

  

	 	(b)	Linking PCP/ PPG change via appropriate system of record; 

  

	 	(c)	If unable to link the request, triaging to the utilization management for further handling; and 

  

	 	(d)	For TOC/COC for SPD members, triaging to the Public program coordinator for handling track and log accordingly. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-13		Health Net / Cognizant Confidential

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	6.4	Disenrollment Services 

 “Disenrollment Services” are the
Functions associated with processing requests made by the PNM (provider network mgmt.), compliance, med management, Utilization mgmt. or PPC to dis-enroll a Member based on criteria provided by the regulators, including the following activities:

  

	 	(a)	Researching, retrieving and communicating with HCO (Health care options, a supplier contracted by the state); and 

  

	 	(b)	Tracking and logging accordingly. 

  

	6.5	Noncompliant Members Services 

 “Noncompliant Members
Services” are the Functions associated with processing Providers’ requests to remove members from their practice due to non-compliant behavior, including the following activities: 

 

	 	(a)	Researching, retrieving and communicating via letter with appropriate parties; 

  

	 	(b)	Assisting members in finding a new Provider; and 

  

	 	(c)	Coordinating TOC/COC if applicable. 

  

	6.6	Reimbursements Services 

 “Reimbursements Services” are the
Functions associated with processing reimbursement for members who may have paid for services and/or medicine by mistake, including the following activities: 
  

	 	(a)	After check is processed and sent, logging and filing the case; and 

  

	 	(b)	Tracking and logging accordingly. 

  

	6.7	Mail Return Services 

 “Mail Return Services” are the Functions
associated with sending all returned member mail to SHP customer service team, including the following activities: 
  

	 	(a)	Looking up Member information in system and flagging accordingly so more mail does not go out until a new address is added in the system; 

 

	 	(b)	For returned ID cards, process sending of a copy of the ID card to privacy office; and 

  

	 	(c)	Tracking and logging accordingly. 

  

	6.8	PCP Transfers Requiring Overrides Services 

 “PCP Transfers Requiring
Overrides Services” are the Functions associated with processing PCP/PPG transfers that require override access, including the following activities: 
  

	 	(a)	Researching the case to consider to the appropriate override access and reaching out to PNM (Provider Network Management) whenever needed; 

  

					
	SOW#3 (Contact Center) Exhibit A		A-14		Health Net / Cognizant Confidential

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	 	(b)	Processing PCP transfer in the appropriate system of record (e.g. HNCS/ABS); 

  

	 	(c)	Responding back to requestor with outcome; and 

  

	 	(d)	Tracking and logging accordingly. 

  

	6.9	Exempt Grievances Services 

 “Exempt Grievance Services” are the
Functions associated with an oral expression of dissatisfaction excluding coverage disputes that are resolved within 1 business day. Where the plan is unable to distinguish between a grievance and an inquiry, it shall be considered a grievance.
Supplier will perform the following Exempt Grievances activities including: 
  

	 	(a)	Taking appropriate actions to resolve member grievances to the member’s satisfaction; 

  

	 	(b)	Documenting all actions taken in the appropriate system of record; 

  

	 	(c)	Resolving exempt grievances within the prescribed or required timeframes; and 

  

	 	(d)	Routing to Appeals and Grievances as appropriate in adherence to Health Net policies and procedures and compliance requirements; and 

 

	 	(e)	Collaborating with Appeals and Grievances for oversight and reporting purposes. 

  

	6.10	Grievance and Appeals Intake Services 

 “Grievance and Appeals Intake
Services” are the Functions associated with processing all Provider Disputes for AHCCCS to remain compliant, including the following activities: 
  

	 	(a)	Processing all AHCCCS disputes; 

  

	 	(b)	Processing Medical Management Overturns; and 

  

	 	(c)	Processing all uphold letters. 

  

	6.11	Inquiries 

 “Inquiries” are the Functions associated with
responding to all written inquiries within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

 

	 	(a)	Member outreach; 

  

	 	(b)	Complete investigation; 

  

	 	(c)	Real time case file updates; 

  

	 	(d)	Sending required correspondence; 

  

	 	(e)	Address all resolve all actionable items; and 

  

	 	(f)	Case closure. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-15		Health Net / Cognizant Confidential

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	6.12	Member Warnings Services 

 “Member Warnings Services” are the
Functions associated with completing all member warning cases within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

 

	 	(a)	Member and/or Provider outreach; 

  

	 	(b)	Assign warning level; 

  

	 	(c)	Process based on assigned level; 

  

	 	(d)	Complete investigation; 

  

	 	(e)	Real time case file updates; and 

  

	 	(f)	Sending required correspondence. 

  

	7.	COMMERCIAL CONTACT CENTERS 

  

	7.1	Exempt Grievances Services 

 “Exempt Grievance Services” are the
Functions associated with processing oral expressions of dissatisfaction excluding coverage disputes that are resolved within 1 business day, including the following activities: 

 

	 	(a)	Where the plan is unable to distinguish between a grievance and an inquiry, designating it as a grievance; 

  

	 	(b)	Providing training to identify, document, track and trend provider grievances by grievance type; 

  

	 	(c)	Managing all Functions associated with Exempt Grievances as defined in Health Net policies and procedures; and 

  

	 	(d)	Collaborating with Appeals and Grievances for oversight and reporting purposes. 

  

	7.2	Letter Requests Services 

 “Letter Requests Services” are the
Functions associated with creating and responding to correspondence requests based on the nature of the request including sending cease and desist letters to Providers, benefit and eligibility confirmation, requests for remittance advice and
explanation of coverage. 
  

	7.3	Technical Support Services (TST) 

 “Technical Support Services”
are the Functions associated with providing technical web support to internal and external Health Net customers, including the following activities: 
  

	 	(a)	Researching or validating the issue and creating a remedy or incident ticket; 

  

	 	(b)	Tracking through resolution and escalate, where appropriate; and 

  

	 	(c)	Once ITG resolves the incident ticket, testing, validating and confirming the issue is resolved and following up with the Health Net customer to confirm resolution. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-16		Health Net / Cognizant Confidential

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	7.4	Account Services Unit Services 

 “Account Services Unit Services”
are the Functions associated with providing a designated team to support Broker, Employer and Sales inquiries received via multiple Channels including processing member requests for alternate mailing addresses that are not reflected in the
appropriate system (e.g. ABS) due to sensitive information in accordance with Health Net policies and procedures. 
  

	7.5	Centralized Unit Services 

 “Centralized Unit Services” are the
Functions associated with fulfilling Member translation requests for written vital documents and oral (face to face) interpreter services at Provider offices or facility locations in accordance with SB853 and Health Net policies and procedures. 

 

	7.6	Provider Email Services 

 “Provider Email Services” are the
Functions associated with responding to all Provider email inquiries received including Provider demographic and fee schedule/rate requests, including but not limited to the following activities: 

 

	 	(a)	As appropriate, routing emails to the appropriate Tower for resolution; and 

  

	 	(b)	Tracking email inquiries to ensure turnaround times. 

  

	7.7	Provider Registrations Services 

 “Provider Registrations
Services” are the Functions associated with responding to and as appropriate processing all Provider registration requests in accordance with Health Net policies and procedures 

 

	7.8	Member Email Services 

 “Member Email Services” are the Functions
associated with responding to all Member emails in accordance with required turnaround times and routing to the appropriate Tower for resolution, including the following activities: 

 

	 	(a)	Tracking inquiries routed to ensure turnaround times are achieved; and 

  

	 	(b)	Following-up with Members regarding status and/or resolution. 

  

	7.9	IFP Emails and Faxes Services 

 “IFP Emails and Faxes Services”
are the Functions associated with responding to ACA on/off exchange member requests within the required turnaround times and route to the appropriate Tower for resolution including tracking inquiries to ensure turnaround times are achieved. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-17		Health Net / Cognizant Confidential

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	7.10	Medical Services Costs Estimates Services 

 “Medical Services Cost Estimates
Services” are the Functions associated with responding to and processing Member requests for cost estimates of certain medical services as required by the regulators. 

 

	7.11	Provider Transfer Unit 

 “Provider Transfer Unit” are the
Functions associated with processing Commercial, Medicare and State Health Programs Provider transitions (aka rollouts) in accordance with Health Net and regulatory guidelines, including the following activities: 

 

	 	(a)	Processing large ‘mass’ provider rollouts; and 

  

	 	(b)	Processing individual requests for PCP/PPG over-rides in accordance with Health Net policies and procedures. 

  

	7.12	Chat Services 

 “Chat Services” are the Functions associated with
providing chat services to Members in accordance with Health Net policies and procedures. 
  

	7.13	Real Time Adjustments (RTA) Services 

 “Real Time Adjustments (RTA)
Services” are the Functions associated with providing Real Time Adjustment capabilities for specific member, provider requests in accordance with Health Net policies and procedures. 

 

	7.14	Inquiries 

 “Inquiries” are the Functions associated with
responding to all written inquiries within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

 

	 	(a)	Member outreach; 

  

	 	(b)	Complete investigation; 

  

	 	(c)	Real time case file updates; 

  

	 	(d)	Sending required correspondence; 

  

	 	(e)	Address all resolve all actionable items; and 

  

	 	(f)	Case closure. 

  

	7.15	Member Warnings Services 

 “Member Warnings Services” are the
Functions associated with completing all member warning cases within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

  

					
	SOW#3 (Contact Center) Exhibit A		A-18		Health Net / Cognizant Confidential

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	 	(a)	Member and/or Provider outreach; 

  

	 	(b)	Assign warning level; 

  

	 	(c)	Process based on assigned level; 

  

	 	(d)	Complete investigation; 

  

	 	(e)	Real time case file updates; and 

  

	 	(f)	Sending required correspondence. 

  

	7.16	Prior Authorization Calls 

 “Prior Authorization Calls” are the
Functions associated with supporting customer support services for prior authorization calls during all hours of operations, including the following activities: 
  

	 	(a)	Authorization Status – CSI, OMNI or ABS 

  

	 	(b)	Checking CPT Codes to see if Authorization Required 

  

	 	(c)	Benefits 

  

	 	(d)	Verify COB and Eligibility 

  

	 	(e)	Claims 

  

	7.17	DMHC After Hours Calls Intake 

 “DMHC After Hours Calls Intake”
are the Functions associated with intake for DMHC after hours calls, including the following activities: 
  

	 	(a)	When a call is received from the DMHC and the DMHC representative states the call is in reference to complaint or grievance, the Representative shall obtain the caller’s name and phone number, as well as member
information and any information on the grievance provided. 

  

	 	(b)	The Representative shall use all available resources (HNCS/QCARE, OMNI, CSI, ABS, and Assume Identity) to verify eligibility and benefits (SHP & Commercial members). 

 

	 	(c)	The Representative shall reference the after- hours Medical Director On-Call List for the appropriate Medical Director. 

  

	 	(d)	If the after-hours Medical Director does not answer, the Representative shall leave a message with a call back number. 

  

	 	(e)	The Representative shall wait twenty (20) minutes and then call the next Medical Director listed on the on-call list. 

  

	 	(f)	If the Medical Director provides an immediate response (approval or denial), the Representative shall call the DMHC back with determination. (DMHC must be notified within one hour of initial call – if Medical
Director is not reached within this timeframe, call the DMHC back and give default authorization.) 

  

					
	SOW#3 (Contact Center) Exhibit A		A-19		Health Net / Cognizant Confidential

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	 	(g)	Documentation and tracking: 

  

	 	(i)	Macess: The Representative shall document in Macess under the Information Tab in the Hot Topic field “DMHC”. 

  

	 	(ii)	Q-care 

  

	 	(h)	The Representative shall send an e-mail to Health Net Legal Department within an hour with a copy to their manager and supervisor. (is there a template) 

 

	 	(i)	Reporting: 

  

	 	(i)	Monthly reports must be sent to the Health Net Compliance Department and cc the affected department Director. 

  

					
	SOW#3 (Contact Center) Exhibit A		A-20		Health Net / Cognizant Confidential

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EXHIBIT A-1 
 CONTACT
CENTER SERVICES 
 SOLUTION DESCRIPTION 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1		Health Net / Cognizant Confidential

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EXHIBIT A-1 
 CONTACT
CENTER SERVICES SOLUTION DESCRIPTION 
  

	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work
#3—Contact Center Services (this “Statement of Work”). Exhibit A (Contact Center Services) describes which functions Supplier is responsible for performing under this Statement of Work, This Exhibit A-1
describes the means by which and the manner in which Supplier will perform those Functions. This document provides an overview of Supplier’s service delivery architecture – displaying the geographic configuration and delivery
architecture of Supplier’s Solution (as it will exist at the completion of Phase 2 of the Transition as described in the Transition Description document), identifying all Service Delivery Centers of Supplier (and its Affiliates and other
Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how they will be interconnected to each other and to Health Net’s IT Environment. It then provides
additional descriptive information about each of the principal components of Supplier’s Solution. 
 This Exhibit A-1 includes the
following attachments, which are incorporated as part of this Exhibit A-1: 
  

	 	(a)	Exhibit A-1.1 (Approved Service Delivery Centers) 

  

	 	(b)	Exhibit A-1.2 (Service Delivery Configuration at the Completion of Phase 2 of the Transition) 

  

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings given them below unless otherwise specified or required by the context in which the term is used. Any capitalized term used but not defined in this Exhibit A-1 will have the meaning indicated in Schedule W (MSA Glossary),. 

 

			
	 Defined Term
	  	 Meaning

	“Solution”	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work – i.e., Supplier’s Service Delivery Centers and Service Delivery
Environment, including the platforms, systems and processes used to perform and deliver the Services.

  

	3.	SOLUTION OVERVIEW 

  

	3.1	Solution Summary 

 Supplier as the prime contractor has chosen Teleperformance as the
initial teaming partner to perform the Contact Center Services and reserves the right to migrate part of all of the Contact Center Services as necessary to one or more alternative Approved Subcontractors. The Contact Center Solution will meet the
following objectives: 

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1-1	  	Health Net / Cognizant Confidential

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	 	(a)	Deliver cost savings as per the business case model 

  

	 	(b)	Provide consistent high quality customer service experience through robust operations rigor and best practices 

  

	 	(c)	Deliver enhanced technology solutions leveraging a best of breed portfolio of hosted multi-channel capabilities 

  

 
  

	 	(d)	Supplier’s Solution is built on the following foundational aspects: 

  

	 	(i)	Delivery Solution 

  

	 	(A)	Continuity of service – Supplier’s primary focus will be to facilitate a seamless continuity of Services. For all call center operational people, process, and expertise, the priority will be to achieve
agreed upon level of service delivery and quality. Contact Center quality auditors shall monitor a minimum of ten (10) (no greater than fifty percent (50%) performed by Supervisor) calls for every Health Net CSR on the program (including
bilingual) per month using a QA form provided by Health Net. Once an agent has sustained QA SLA levels, the average number of audits per FTE will remain at ten (10) per month but agents with lower quality scores may receive more audits and the
agent meeting quality may receive less audits averaging the contract terms of ten (10)/agent/month. 

  

	 	(B)	Associate to support ratio – To enable focused monitoring and feedback, Teleperformance’s delivery model considers an extremely healthy Associate to Supervisor and QA ratio, which may vary by LOB within
the scope. The agent to supervisor ratio will be 1:18 and the QA ratio to agent will be 1:60. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-2		Health Net / Cognizant Confidential

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	 	(C)	Continuous Improvement – This Solution incorporates a combination of enterprise resources and a dedicated organization including but not limited to project management, client services and operations
management from early on in the engagement to identify quick and sustainable improvement opportunities, including resources specifically related to long-term program governance. 

 

	 	(ii)	Health Net Training 

 Teleperformance will build a dedicated Training function tasked
with the mandate of building adult learning foundation from which to support the Health Net operational enterprise, including but not limited to updated training materials, curriculum, and process documentation along with facilitation leadership
that will provide training to new hire associates and up-skill training to experienced resources. The solution for Training Services set forth in Schedule A-1 (Crossfunctional Services Solution) documents how curriculum changes will be communicated
to Health Net and approved for the Contact Center. 
  

	 	(iii)	Global Healthcare Delivery Expertise & Offshore Solution Engineering Protocols Hedge Risk 

Teleperformance will provide strategic guidance and in-market best practices from past delivery experience both near shore and offshore with
major U.S. Health Plans. Where appropriate, Teleperformance will collaborate with Health Net to clearly define any specific process changes, hand-offs and inter dependencies as it relates to the rest of the Services. 

 

	 	(iv)	Multi-Site, Multi-Geo Global Solution; Teleperformance – Health Net Operational Care Centers 

Teleperformance will use a multi-site, multi-geo operational solution including but not limited to leveraging domestic US, near shore Mexico,
and offshore Philippines locations as part of an integrated, comprehensive strategy that balances execution quality, labor arbitrage, disaster recovery/redundancy, and access to the largest global footprint of any contact center supplier that allows
Health Net to leverage the strengths of each region and cost efficiency to its competitive advantage. The multi-location structure provides geographic dispersion and the foundation for sound Business Continuity Planning (BCP). Teleperformance’s
US, Mexico and Philippines sites have deep contact center experience for the Healthcare industry. 
  

	 	(A)	Near shore and Offshore Teleperformance Service Delivery Center(s) will be utilized to handle transaction contact center work to leverage Teleperformance’s scale, expertise and lower costs. 

 

	 	(B)	Onshore US Service Delivery Center(s) that leverage Teleperformance employees and – as applicable—“re-badged” Health Net personnel to manage complex processes requirements and those processes
required to remain domestic for regulatory reasons. 

  

	 	(v)	Seamless and Transparent Integration with Call Center / Multi-Channel Innovations and Technologies 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-3		Health Net / Cognizant Confidential

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Supplier will provide ACD, IVR, and other related contact center technology infrastructure supporting the project engagement. This Solution
includes multiple sites in multiple geographies inclusive of all in scope operations; U.S. domestic, near shore (ie., Mexico), offshore (i.e., Philippines) with Supplier provided Technology solutions. The intent is to have a single technology
solution for Health Net that minimizes complexity and cost redundancy. 
  

	 	(e)	Risk Remediation Plan 

  
 

 
  

	3.2	High-level Service Delivery Architecture and Configuration 

 This section provides an
overview of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Service Delivery Centers) provides additional information about each of the Service Delivery
Centers Supplier will use to provide the Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if operations at any
primary Service Delivery Center are disrupted or disabled. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-4		Health Net / Cognizant Confidential

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	SOW#3 (Contact Center) Exhibit A-1		A-1-5		Health Net / Cognizant Confidential

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	 	(a)	Location Strategy 

 The location selection criteria that Teleperformance and Supplier
have applied to this Solution includes: 
  

	 	(i)	Business requirements – locations that promote compliance with all service objectives and contractual requirements 

  

	 	(ii)	Availability of talent pool – an ample labor supply which provides staffing for immediate and long term needs 

  

	 	(iii)	Skill requirements – a labor pool which both meets transition requirements and can be developed throughout the lifecycle of the program 

 

	 	(iv)	Regulatory limitations – the ability to meet all regulatory requirements as required for Health Net 

  

	 	(v)	Scale of operations – locations which provide sufficient room for the program to grow for both seasonality needs, membership growth and call type diversification 

 

	 	(vi)	Business continuity – locations linked together technologically and which can share common call types if needed to maintain continuity 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-6		Health Net / Cognizant Confidential

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	 	(vii)	Cost of operations – a three-shore strategy which meets the financial design of the relationship 

Consistent with Supplier and Teleperformance’s global operating model, significant technology capability and defined business processes,
teams working across multiple locations will operate as a single cohesive unit delivering seamless Contact Center Services in accordance with this Agreement. 
  

	3.3	Service Delivery Model 

 This section provides an overview of the commercial delivery
model Supplier will utilize in providing the Services under this Statement of Work. Exhibit H (Contact Center Subcontractors) provides additional information about each of the Supplier Affiliates and other Subcontractors who will be involved
in performing certain aspects of the Services to be provided under this Statement of Work. 
  

	 	(a)	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work
will be provided under a ‘Business-Process-as-a-Service’ delivery model—i.e., as a fully integrated vertical service in which Supplier is responsible for providing all the associated resource / service layers (facilities, IT
infrastructure, tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’ (e.g., fully processed
claims). 
  

	 	(b)	Operations Rigor 

 Supplier’s approach is based on best practices that include
having the team leads and supervisors available on the production floor to expedite feedback and continuous improvement with the following approach: 
  

	 	(i)	Core Focus 

 On team huddles, floor walks, daily performance reviews, daily associate
communication plan and customer calibration sessions. Adequate staffing levels will be maintained to accommodate appropriate shrinkages levels needed to account for team huddles, associate training, etc. 

 

	 	(ii)	Metrics 

 Set daily targets to challenge team daily and publish progress. Communicate daily
productivity and quality updates. 
  

	 	(iii)	Innovation 

 Supplier and Teleperformance will create an environment dedicated to fostering
associated ideas to improve the process and technology capabilities. This environment will focus on finding synergies and specific opportunities with IT teams and other towers to improve the end-to-end contact center process. Best practice sharing
to improve team performance and standardization. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-7		Health Net / Cognizant Confidential

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	 	(c)	Span of Control 

 Teleperformance will ensure that every FTE will get adequate
supervision and support to achieve agreed quality and productivity. We will have one (1) Quality Auditor for fifty (50) FTE and one (1) Supervisor for every eighteen (18) FTEs. Training sessions will be facilitated in batches of
FTEs with 1:28 FTE in classroom. Escalation/SME ratios are required until agents are meeting performance requirements and for escalated issue support. 
  

	 	(i)  	Commercial and SHP - 8% of FTE 

  

	 	(ii)  	Medicare – 10% of FTE 

  

	 	(iii)	MHN – 6% of FTE 

 Work Force Analyst ratios will be 1:100 and Schedulers at 1:100. This
team will provide day to day operational functions such as schedule adherence, agent schedules, adjusting staff based on volumes, scheduling inbound, outbound, training, PTO and other scheduling functions working closely with the operations and
client services teams. Teleperformance will receive detailed forecasts by LOB at the interval level from Supplier planning. 
  

	 	(d)	Typical span of control  

  

	 	(i)  	Manager 1:120 

  

	 	(ii)  	Supervisor 1:18 

  

	 	(iii)	Quality Auditor 1:50 

  

	 	(iv)	Trainer 1:28 Classroom; 1:100 Otherwise 

  

	 	(e)	Team Huddle 

 The team leads for individual processes will conduct daily meeting with the
associates at the beginning of their day to share any critical update, communication or plan for the day. The huddles set stage for what needs to be accomplished. Team huddles also form a platform for associates to share learning and any unique
finding from their previous day’s work and discussed with management which if found useful to the team will be implemented. 
  

	 	(f)	Quality 

 Teleperformance brings best practices and Industry specific quality /
compliance programs in its delivery model to for continuous improvement in service levels. The approach to ensuring quality is focused on three critical components: 
  

	 	(i)	Considering the importance of deep institutional knowledge, Process Quality through globally acknowledged proprietary processes and technologies at Teleperformance, such as CCMS and TOPS. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-8		Health Net / Cognizant Confidential

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	 	(ii)	Transaction Quality by using root cause methodology to ensure compliance to transaction level quality using DMAIC (Define, Measure, Analyze, Improve and Control) approach and statistical and non-statistical tools.

  

	 	(iii)	Quality improvement is measured by the quality audit document criteria of the Service Levels. Working with Health Net other improvements can be measured by CAHPS, STAR and improved retention. Details will be developed
annually and goals set jointly. 

  

	 	(iv)	An average of ten (10) audits/FTE/month will be completed. No more than 50% of audits will be performed by supervisors. If an agent is consistently meeting SLA quality metrics, less audits may be performed on those
agents and additional audits may be performed on agents not meeting quality Service Levels. Focus on outliers will improve overall Service Level quality metrics. 

  

	 	(g)	Continuous Improvement 

 The Supplier SOW lead will oversee all continuous improvement
activities associated directly with the Contact Center tower as well as participate in ongoing programs with other towers intended to improve the end-to-end experience for each member. Supplier will oversee and drive continuous improvement
activities channeling resources from both Teleperformance and Supplier to drive measurable improvements in services and technology. 
 The
core focus of the Continuous Improvement Program will be to manage all Contact Center initiatives utilizing a combined Six-Sigma/Lean methodology that works in conjunction with the Teleperformance resources to prioritize and manage all continuous
improvement activities. Weekly, monthly and quarterly reporting and reviews will occur to ensure improvements are reported regularly and audited for additional improvements. 

Potentially using the quality and call recording tool or analytics tool, top call drivers can be identified and analyzed from calls. This
information is put into categories impacts the health plan can make, impacts the agents can make improving “soft skills” and third improvement management can make in training and coaching. Examples the health plan can improve are improving
provider demographics on addresses, physicians taking new members, less auto assignments of PCPs and par/nonpar. Correct information in the applications will reduce incoming calls and therefore improve contract rate. Soft skills are key to improving
CSAT scores and potentially reducing callbacks. Agents are required to clearly and accurately articulate membership benefits. But the way they are communicated can be equally important. Improving training and coaching methods will improve scores and
even increase net promoter score (NPS) or recommending the plan to other prospects. The last is identifying unclear scripting or information in the knowledge base. Improving this data will provide accurate information, reducing callbacks due to
incorrect information. 
  

	 	(h)	Teleperformance Training 

 Teleperformance will establish a training academy for
management of training content and delivery of training programs. Teleperformance training will work closely with the Supplier Training Services personnel and facilitate necessary training. Training and curriculum changes will be approved by Health
Net. Based on system and process updates training material will be regularly updated. Refresher and leadership trainings will be scheduled based on the training needs and requirements derived from the following two factors: 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-9		Health Net / Cognizant Confidential

 Final 
  

 

	 	(i)	QA services audits and score boards – a training need analysis will be done on the basis of performance and quality audits, and training will be delivered for areas where the associate lags or needs additional
coaching. 

 Process updates and assessments – all associates will be briefed and trained on change in P&P and
Desktop procedures. 
  

	 	(i)	Training Requirements 

 Due to current application requirements Commercial, Medicare,
Medicaid and MHN are four unique training and up-training paths. Training includes in class and nesting or on the job training on the production floor with monitoring and assistance by SME and supervisors. Supplier will adhere to the following
training requirements, as such requirements may be revised during the Term: 
  

	 	(i)	Commercial Training All LOB’s - 5 weeks - +2 weeks nesting 

  

	 	(ii)	ACA Payment Only All LOB’s - 1 week 

  

	 	(iii)	Broker and Correspondence 1-1.5 weeks up training from commercial training 

  

	 	(iv)	Medicare Training CA MAPD - 4 weeks -+ 2 weeks nesting 

  

	 	(v)	Medicare OR MAPD Up-Train from CA MAPD - +4 days 

  

	 	(vi)	Medicare AZ MAPD Up-Train from CA MAPD - +4 days 

  

	 	(vii)	Medical / SHP Training - CA - 7-8 weeks - +2 weeks nesting 

  

	 	(viii)	Medical / SHP Training - AZ Up-Training from CA Medi-Cal -+ 2 weeks. 

  

	 	(ix)	Duals Training Up-Training from CA Medi-Cal - +4 weeks 

  

	 	(x)	MHN Training - 6 weeks - +2 weeks nesting 

  

	 	(j)	Language Requirements 

 Effective as of the BPaaS Services Commencement Date, Supplier
will be responsible for all language assistance charges incurred to support the Services. By end of Phase 2 Teleperformance and Supplier will support at least 95% of all Spanish calls using Spanish speaking Supplier Personnel located in Mexico, and
using Language Line for all other languages. As described in the Transition Manual all Spanish LOB’s will be transitioning to Mexico. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-10		Health Net / Cognizant Confidential

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	 	(k)	Organizational Structure 

 Supplier in conjunction with Teleperformance will deploy a
highly experienced delivery team for this engagement with Health Net. Health Net engagement will be anchored by professionals with years of delivery and domain experience. This team will be augmented by experts spanning all facets of service
delivery, technology, operations, domain and human resources. The RASCI document defines responsibilities and accountabilities. During the first sixty (60) days of transition, final determination of rebadged Health Net FTE will be defined to
the correct organization. 
  

	 	(i)	Supplier and Teleperformance will deploy a function based organization structure rather than location based, ensuring clearly defined functional responsibility and consistency in service quality across delivery
locations 

  

	 	(ii)	Supplier and Teleperformance will leverage the depth of knowledge, experience and legacy of Health Net culture acquired through re-badging and retention of key leaders from Health Net in key leadership roles

  

	 	(iii)	Supplier and Teleperformance’s team performing the Contact Center Services includes global functional leaders, mostly from re-badged Health Net organization, to own service delivery across global locations, with
location specific leaders at each of the delivery locations, directly reporting to them. 

  

	 	(iv)	Supplier and Teleperformance’s team performing the Contact Center Services includes local leadership talent that provides the local administrative and people connect, apart from their functional and domain
capabilities 

  
 

 
  

	 	(l)	Multi-Site, Multi-Geo Global Solution; Teleperformance – Health Net Operational Care Centers 

The Contact Center will have a multi-site, multi-geo operational solution including but not limited to leveraging domestic US, near shore
Mexico, and offshore Philippines locations as part of an integrated, comprehensive strategy that balances execution quality, 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-11		Health Net / Cognizant Confidential

 Final 
  

labor arbitrage. The multi-location structure provides both geographic dispersion with its inherent foundation for sound Business Continuity Planning (BCP), but also allows us to align similar
work with required agent skills in consolidated locations: 
  

	 	(i)	Offshore Service Delivery (Philippines) Center(s) – leveraging lower cost Teleperformance employees to provide cross skilled services and to manage complex processes across LOBs. 

 

	 	(ii)	Near Shore (Mexico or LATAM) Teleperformance Service Delivery Center(s) - to handle transaction contact center work to leverage our lower cost capabilities inherent to a non-US staffing footprint, primarily devoted to
Spanish Language Contacts. 

  

	 	(iii)	Onshore US Service Delivery Center(s) – leveraging Teleperformance employees required by contact– and “re-badged” Health Net personnel to manage complex processes requirements and those processes
required to remain domestic for regulatory reasons. 

  

	 	(m)	Seamless and Transparent Integration with Call Center / Multi-Channel Innovations and Leveraged Technology Integration 

 

 
  

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-12		Health Net / Cognizant Confidential

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	 	(n)	Transition Technology 

 The Contact Center will already be providing live agent services
to Health Net from three service locations; domestic services located in Shreveport, LA; Offshore services located in Philippines; and Spanish Services located in Chihuahua, MX. Voice and data connectivity and technology services will already be in
place to enable this Service Teleperformance envisages little prior Technology provisioning past this stage. All technology transition activities will be related to full integration and provisioning of Health Net/Supplier provided technology
capabilities, with Teleperformance day-to-day operational management solutions. See the Transition Manual for further integration details. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-13		Health Net / Cognizant Confidential

 Final 
  

 

	 	(o)	Integrated Technology Solution 

  
 

 
 Supplier will deliver a unified technology platform via the Information Technology Services that will act as
the foundation for integrated systems including MC Platform assets, Pega, ACD/IVR and future direction for multi-channel expansion. 

Supplier will supply C-SAT survey capability in order for Teleperformance to provide capability and reporting to meet FCR and customer
satisfaction surveys. In addition to industry standard C-SAT questions, Supplier’s CSAT survey will specifically address the member’s experience and interaction with Contact Center associates. 

Supplier and Teleperformance will work in parallel to deliver an operating model that capitalizes on this unified Technology Platform and
associated continuous improvement plan that will fully prioritize and leverage the full suite of the technologies into the combined operating model including Aspect SIP enabled VOIP ACD/IVR and corresponding technology capabilities. 

Supplier will own the end-to end network via the infrastructure tower and deliver a unified technology approach combining self service, unified
agent desktop, supervisor portals and dashboard reporting across the Contact Center. 
 Supplier will work directly with Teleperformance as
new technology solutions are enabled to rollout these across various operational delivery models. Supplier intends to work directly with Health Net to determine and prioritize capabilities associated with case management applications and unified
ACD/IVR and mutually determine how to prioritize and rollout capabilities and the impact on the existing delivery model. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-14		Health Net / Cognizant Confidential

 Final 
  

 

	 	(p)	Future State Technology Tier Solution 

 Subject to approval by the Governance Body, the
proposed customer support and contact center future state solution provides delivery of member services through multi-channel hub. This hub includes IVR, member self-service portal, email, Chat, Fax and on the phone customer service agents. Elements
of this solution include: 
  

	 	(i)	Receipt and resolution of member inquiries, including those to initiate and process a transaction 

  

	 	(ii)	Management of member contact process, including contact analysis 

  

	 	(iii)	Connection to and operation of multi-channel infrastructure to support and manage member contact process 

  

	 	(iv)	A single point of contact for member multi-channel inquiries 

  

	 	(v)	A consistent and standard response to member policy and procedural inquiries across channels 

Members can access services using any of the multi channels which are supported by future state contact center. The future state goal of the
member services contact center is to provide “High Touch” (easy to use and answering the question) customer service at the lowest possible cost per contact. 

In order to accomplish that goal, future state solution considers front end self-service tools that utilize IVR, selfservice member portal
integrated with an onshore/near shore/offshore mixed contact centers that utilizes robust case management, knowledge management tools to respond to inquiries coming through channels such as emails, chats, fax and phone. The future state considers
(subject to governance approval on technology budget) using a tiered approach: 
  

	 	(i)	Tier 0: Self Services driven by IVR and Self Service Member Portal 

  

	 	(ii)	Tier 1: Contact Center low cost channel agents that handle email, Fax, Chat and Phone inquiries 

  

	 	(iii)	Tier 2: Case Workers and Advisors, complex inquiry management to mine social CRM, use predictive modeling, proactive and reactive to escalated cases (critical once) 

 

	 	(iv)	Tier 3: Governance & Reporting 

  

	 	(v)	Tier 0 – Self Service 

 Based on proposed future state strategy and plan, Supplier and
Teleperformance will be implementing Aspect routing and Pega agent tools. It is being considered to integrate it with some of Teleperformance tools such as eWFM, time entry to increase efficiencies and effectiveness while overall solution improves
customer experience. 
 With Aspect’ all-in-one communications solution — will be implemented, bring sophisticated routing
capabilities that improve issue resolution, while reducing transfers and escalations. This directly results in volume reduction, increase first call resolution and improves customer experience. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-15		Health Net / Cognizant Confidential

 Final 
  

 

	 	(q)	Routing with intelligence - intelligent routing places customer interactions (phone, email, and chat) into the hands of the agents and associates who are best suited to handle them. They receive the information
they need prior to the contact transfer to eliminate repetition and facilitate faster issue resolution. 

 Together or
separately, our solution supports the following call routing processes to reduce costly transfers: 
  

	 	(i)	Caller-directed call routing. Use data entered by the caller via a touchtone pad (press one (1) for benefits, two (2) for claims, etc.) to route the call to the right resource. 

 

	 	(ii)	Data-directed call routing. Prompts callers to enter an account number, group number, contract number, etc. via a touch-tone phone. Our solution uses these inputs to search your database(s) (integrated) for
related customer or account information. 

  

	 	(iii)	Skills-based routing. Our system can perform “data dips” by examining the database for the information needed to route the call. For example, if a specific technical skill is needed to resolve a
particular issue, the system can look up records for skill sets, perform an availability query from the contact center, and then combine these two pieces of information to route the call to an available agent. 

 

	 	(r)	Aspect and Pega integration considerations (subject to governance budget approvals) 

Providing numerous on-screen communication tools and controls 
  

	 	(i)	When Aspect is integrated with Pega suite of agent tools, provide agents a complete range of telephony capabilities embedded right into user interface. This includes features like conferencing, workgroup directories and
status indicators, call hold, transfers, escalations, voicemail, and recording. Delays and dropped calls due to complicated phone controls are greatly decreased. 

  

	 	(ii)	The Self Service Member Portal is a web based self-service tool, uniquely configured for this Agreement, encourages members to become more self-sufficient by providing member driven experience where users have quick
access to integrated tools and content needed to address their queries. 

 By using a user-centric design process, our
future state considerations, places members at the heart of the design and is: 
  

	 	(i)	Personal: provides process, content and tools relevant to individual members 

  

	 	(ii)	Intuitive: an easily navigated solution that enables users to complete tasks accurately and inspires members confidence in and their willingness to use the solution 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-16		Health Net / Cognizant Confidential

 Final 
  

	 	(iii)	Consistent: common terms, processes, content, and visual elements across the solution so users trust and believe in the information, as it is the same on phone as it is online 

 

	 	(iv)	Integrated: supports members as they navigate to an answer through different screens and technologies, without difficulty 

Training Solution 
  

	 	(i)	Health Net-facing eLearning Module 

 Future state solution considers to develop a
mobile-friendly eLearning course featuring troubleshooting information on key identified customer inquiries. This includes creation of On Demand tutorial videos that are loaded directly into selfservice portal, which ultimately feeds the
customer-facing knowledge answer engine. This enables customers to conduct their own real-time troubleshooting and drives self-support. 
  

	 	(ii)	Proposed future state knowledge solution 

  

	 	(A)	Leverages question-to-answer matching platform that allows both consumers and service agents to enter complete questions in plain language—including spelling mistakes, grammatical errors and “text
speak”—and matches those questions to the knowledge management tool 

  

	 	(B)	Includes reporting and analytics that capture customer intentions with sophisticated tools that extract full value from all the data and “voice of the customer” feedback, including an administrative platform
that offers a wide range of standard and custom reports, and sophisticated quality analysis dashboards. 

  

	 	(C)	Can be integrated with live help platforms; chat, click to call and email to (i) identify the question, (ii) provides suggested answers, and (iii) allow the agent to insert a response with a single click.
By intelligently understanding the answer to the question organizations are able to improve agent efficiency, customer response times and self- help answer consistency/accuracy. 

 

	 	(iii)	As a key component of the proposed future state solution, the self-service tier 0 is integrated with the tier 1 one 800 number contact center. This integration includes 

 

	 	(A)	Consistent Content: agents use the same content available to members to assist members on the phone, creating a consistent and trusting service. 

 

	 	(B)	Daily Content Updates: by using the reports from the multi-channel interactions, the team determines what content needs updating and works with contact center staff to understand how the knowledgebase should be updated
to better support members 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-17		Health Net / Cognizant Confidential

 Final 
  

	 	(C)	Inquiry tracking: members are able to submit a request for assistance from the self-service portal, email, fax, chat, call and track status on the inquiry they made from all channels 

Tier 0 - Self-service Key Capabilities 

Our proposed future state solution acts as “virtual assistants” for members and providers, delivering the right answer and resolution
with exceptional speed and accuracy. This leads to a better overall self-service experience and lower costs. 
  

	 	(i)	Personalizing IVR interactions. Integrated voice response (IVR) solution integrates customer interaction and loyalty databases to ensure inquiries are routed and handled appropriately. 

 

	 	(ii)	Transforming online self-service. Intelligent Web self-service solution, accepts questions in the users ‘natural language,’ and delivers clear, accurate and specific answers to customer inquiries (rather than
requiring them to sift through long lists of possible search and FAQ results). 

 Tier 1 – Contact Center 

Though a significant amount of member transactions can be delivered online and through self-service tools, as proposed in the future state
solution, tier 2 supports managing alternative access points such as voice agent, chat agent, and email agent. 
 Members calling the 1-800
telephone numbers or emailing or chatting will be engaged by an agent in the customer service center. All inquiries will be routed to the appropriate contact point using the proposed multi-channel routing capability. 

Proposed future state solution provides agents with a single, intuitive application for managing all customer interactions while minimizing
applications, steps and barriers and Equipping agents with comprehensive customer details. 
 Tier 1 - Key Capabilities 

 

	 	(i)	Review and acknowledge the details of the customers’ prior issues, and can focus on moving ahead. Pull data from multiple back-end systems into one coherent view. 

 

	 	(ii)	Precise information needed to answer questions, resolve complex issues, and deliver high quality, relevant information via email, phone, and chat. 

 

	 	(iii)	Providing an integrated, “proactive” knowledgebase, access to scripted answers and providing direct access to accurate and concise answers. 

 

	 	(iv)	Type in a customer’s question as they ask it—or select a question submitted via email or chat—to receive a rapid, concise and accurate answer. 

 

	 	(v)	Providing guidance and real time decision assistance. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-18		Health Net / Cognizant Confidential

 Final 
  

	 	(vi)	Retrieve and incorporates user specific information into the responses it delivers to your agents. 

Tier 2 – Complex Case Workers and Advisors 

These are typically complex issues that need a very high level skills and expertise or in some cases having the ability to manage escalated
calls. This tier also handles member inquiries that cannot be handled both at the self service level or contact center agent level. 
 In
proposed future state Case managers are notified of escalated cases from Tier1 associates using the workflow tool. These case managers also work closely with HNT team on policy and procedure issues in addition to managing the content of the
knowledge base. 
 This team also mines social CRM sites, manages predictive modeling tools and conducts member retention and loyalty
reporting including member churn analysis. 
 Future state proposes to automate processes for improved issue resolution. 

Tier 2 - Key Capabilities 
  

	 	(i)	Automating workflow. Provides a consistent means to perform workflow-specific functions on a case, playing a major role in optimizing issue resolution. 

 

	 	(ii)	The workflow tool is configured to define when and how the system: initiates screen pops, suggests surveys, pops images and documents, tracks how a call was handled/resolved, schedules a follow-up (inbound or Outbound),
transfers ownership of a case or issue to another user, or escalates cases without agent intervention. 

 Tier 3 -
Governance & Program Reporting 
 Below is a description of how Teleperformance will work with the Supplier Service Integration
team on an ongoing basis. 
 For Contact Center Delivery Governance Teleperformance will rely on its PMO throughout the project to serve as
the primary point of contact and communication for oversight of key functions, identification of needs, inter-company contact and internal referral for implementation. Once issues and needs are identified, the Teleperformance PMO will work with
Health Net and Supplier Service Integration Team to clarify requirements, obtain documentation, provide feedback as needed and develop project plan methodologies, including tracking. Implementation will follow through the Client Services
organization, which has day-to-day responsibility for communication of needs to Operations and other affected internal stakeholders. At the operations level, Teleperformance uses combinations of training, team meetings, systems based communication
tools (such as CCMS) for both dissemination of changes and communication, as well as compliance tracking and documentation. 
 RASCI (the
RASCI below may be modified as accountabilities and responsibilities are more clearly defined). 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-19		Health Net / Cognizant Confidential

 Final 
  

 
 

 
 Our proposed future state considers a full range of reporting and analytics capabilities to help measure
effectiveness. 
 Tier 3 - Key Capabilities 
  

	 	(i)	Fine-tuning performance through extensive reporting, variety of reports, including “time on case” and “days to close” reports. 

 

	 	(ii)	Multichannel reports to identify trends in usage (i.e. fewer member/providers are calling and an increasing percentage are using chat or email). 

 

	 	(iii)	Exact reports, at the desired level of detail, with no effort required from contact center personnel. 

  

	 	(iv)	Leveraging complete interaction recording. Provides flexible options and configurations for recording voice interactions, capturing on-screen activities, and tracking agent performance. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-20		Health Net / Cognizant Confidential

 Final 
  

 

	 	(v)	Powerful tool for coaching and monitoring agents, helping them improve at a faster rate. 

  

	 	(s)	Technology Roadmap Supplier TO UPDATE with MILESTONES 

 Supplier will work with
Teleperformance and other suppliers to adapt the current operating model in conjunction with ongoing technology enhancements. These enhancements below will be mutually agreed to and defined in the Technology Roadmap. 

Implement ACD, IVR, and WFO solutions 
  

	 	(i)	Provide solutions for the Health Net Contact Center business functions, including: 

  

	 	(A)	Member and Provider calls for Commercial, Medicare, CA State Health Programs, Duals 

  

	 	(B)	Member and Provider calls for MHN 

  

	 	(ii)	ACD and IVR solutions with support for multiple languages 

  

	 	(iii)	ACD solutions, developed with the target technology, including: 

  

	 	(A)	Support for all existing toll-free phone numbers, including all numbers supported on the Rockwell (Commercial) and Symposium (MHN) ACDs 

 

	 	(B)	ACD messaging and option gathering 

  

	 	(C)	Skills-based routing 

  

	 	(D)	Intelligent and emergent messaging 

  

	 	(E)	Support for agent-initiated outbound calls 

  

	 	(iv)	IVR solutions, developed with the target technology, including: 

  

	 	(A)	Self service functions which will provide the most benefit to the call statistics and user experience 

  

	 	(B)	Support for member and provider callers and (for FED) DoD callers 

  

	 	(C)	Authentication of all callers 

  

	 	(D)	Development of Natural Language features 

  

	 	(E)	Intelligent context for IVR menus 

  

	 	(F)	Intelligent messaging 

  

	 	(G)	Recording of messages with professional voice talent 

  

	 	(H)	Support for work-at-home agents and virtual call centers 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-21		Health Net / Cognizant Confidential

 Final 
  

 

	 	(v)	Integration of ACD, IVR, and WFO solutions with the PEGA contact center desktop (Omni) 

  

	 	(vi)	Integration of IVR with host systems, leveraging Omni web services to meet host communication requirements, including expansion of those services if needed 

 

	 	(vii)	Roll-out of integrated WFO solutions, including the following modules: 

  

	 	(A)	speech analytics workforce scheduling e-training customer survey tied to the CSR 

  

	 	(B)	quality recording – 100% & real time on-demand quality evaluation 

  

	 	(viii)	Multi-channel support (email, mobile, SMS text, chat, voice, fax, and for COM, web “contact us”, social networking), including: 

 

	 	(A)	contact tracking of any channel type or of combinations thereof routing for all channel types scripted dialogs, used for multiple channel types 

 

	 	(ix)	A suite of reports and dashboards to be developed by the project team, focusing on compliance mandated reports, out-of-the box reports, and support needed for reports which the business will develop. Reporting needs
include: 

  

	 	(A)	Reports meeting all government requirements 

  

	 	(B)	Dashboards, system monitors, alerts, and other diagnostic tools to be developed or configured within the scope of this project 

  

	 	(C)	Cradle to Grave reporting of ACD history, indicating all stops within a contact and where the time was spent 

  

	 	(D)	Management reports, including IVR utilization 

  

	 	(E)	Logging contact activities (transactions, menus visited, etc.), integrated with Omni, for all channels (email, chat, IVR, fax, etc.) 

 

	 	(F)	Access to data for reporting, dashboards, alerts, CTI 

  

	 	(G)	Real-time and historic views of incidents and trends 

  

	 	(H)	Leveraging of analytics 

  

	 	(I)	Showing composite statistics for calls (including the full life of the call, e.g. ACD, IVR, CSR, and downstream transfers). 

  

	 	(1)	Preparation for post-implementation development of reports and dashboards, including product installations user access data access training 

 

	 	(x)	Development and Test environments 

  

	 	(xi)	Code management and migration tools and procedures 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-22		Health Net / Cognizant Confidential

 Final 
  

 

	 	(xii)	Stand up new hardware and install and configure vendor software for ACD, IVR, and WFO, integrating with the VoIP/SIP backbone infrastructure 

 

	 	(xiii)	Queue hold – dialer 

  

	 	(xiv)	Intelligent Outbound Dialer 

 This combined solution will be enabled and designed to provide a
number of enhanced operational and customer capabilities including 
  

	 	(A)	Drive to increased and enhanced self-service to increase the % of calls completed by self-service 

  

	 	(B)	Leverage IVR Analytics to identify ongoing opportunities to improve self-service through improved IVR design 

  

	 	(C)	Increase routing accuracy, to minimize call transfers 

  

	 	(1)	Improve customer satisfaction and service delivery via solutions that are scalable, reliable and stable 

  

	 	(D)	Leverage the latest industry technology to automate or streamline the CCC handling of external contacts, received through various channels, such as telephone calls (via the IVR or direct CSR involvement), email, chat,
web (healthnet.com and hnfs.com), faxes, and (for COM) social media 

  

	 	(t)	Technology Hybrid Overview 

 ACD/IVR capabilities will be fully leveraged across the
Health Net infrastructure while some elements of TPUSA operational capabilities will be enabled via connectors and integrations to Health Net suite. 
  

	 	(i)	Quality Assurance 

  

	 	(ii)	RTA & Workforce Management 

  

	 	(iii)	Payroll Systems 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-23		Health Net / Cognizant Confidential

 Final 
  

 
 

 
 Supplier will also provide all telephony and data connectivity from the ACD/IVR platform to Teleperformance
data centers: 
  

	 	(i)	Teleperformance will receive from Supplier a regular monthly forecast that will take into account membership fluctuations and historical daily volume distributions across call types. Teleperformance will produce
expected call distribution reports, and staffing plans to cover the forecast call volumes. 

  

	 	(ii)	Teleperformance will re-assign agents between “queues” based on their skills etc. in order to provide the most effective use of available resources across the LOBs and call types associated with a particular
location. Health Net/Supplier will provide TP with remote access to the ACD/IVR to facilitate queue and skill reassignment, etc. 

  

	 	(iii)	Teleperformance will attempt to minimize unnecessary call transfers between agents, after receipt. As an ongoing part of performance management, Teleperformance uses Call Management System (CMS) data to identify
multiple fundamental root causes, including system level misroutes, appropriate agent driven transfers and inappropriate transfers, and any system level changes required. From the information gained, Teleperformance and Supplier will work together
to manage transfer rates within control parameters, and manage exceptions based on root causes. These measures are reported within the customary set of reports traded with Health Net. 

 

	 	(iv)	Teleperformance manages the entire agent lifecycle of its employees through its CCMS tool/technology, which includes all aspects of personnel management including training, schedule management and eligibility.
Additionally, day-to-day operational management related to call handling, call review, and all aspects of Quality Monitoring are facilitated through the same tools. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-24		Health Net / Cognizant Confidential

 Final 
  

	 	(v)	C-SAT surveys will be provided to measure C-SAT and FCR metrics. Final determination of content and number of surveys will be determined during Transition, jointly between Health Net and Supplier. The questions are
documented in the Transition Manual. 

  

	 	(vi)	The Silver Link outbound dialer will be a responsibility of Supplier to provide to complete welcome calls. A forecast plan will be created during off-peak hours between Supplier and Teleperformance. 

 

	 	(vii)	TTY capability will be provided by IT Tower to meet compliance requirements. 

  

	 	(u)	Data Connectivity & Agent functionality 

 All incoming telephony (voice calls)
will be routed to Health Net/Supplier provisioned Aspect ACD/IVRs, and will receive any required treatment to enable self-service or routing functionalities prior to routing to the approximately located Teleperformance agent. Calls will be routed
using Supplier provided gateways and handset/softphones directly to a specific agent identified by unique login. Any appropriate CTI functionality and application connectivity necessary will be enabled by Supplier. 

All network circuits, and data connectivity to each Teleperformance Center will be provided and managed by Supplier, including provisioning of
failover circuitry etc., is controlled by Supplier. 
 Teleperformance is responsible for all network connectivity within a center. No
general purpose external internet connectivity is required. Teleperformance agents are connected remotely to data and applications functionality provided by Supplier. Secure desktop functionality will be provided leveraging VDI capabilities and
applications. Agent workstations will be provided by Teleperformance in accordance with the specifications provided by Supplier, and will connect to Health Net/Supplier systems leveraging Citrix systems capabilities hosted by Supplier. 

No Health Net, patient or provider data will be stored at any Teleperformance locations in order to ensure Teleperformance meets the Health
Net/Supplier requirements related to HIPAA and similar. All appropriate systems security at the agent desktop level, as well as any redaction of appropriate segments etc. of call recordings used to monitor agent 

performance etc. will be enabled using systems capabilities provided by Supplier. 

 

	 	(v)	Business Continuity and Disaster Recovery 

 The identified location strategy relies on
cross skilling of agents across multiple LOBs, and the ability to assign agents to different incoming queues as workload dictates. Calls will be routed across centers based primarily on fundamental skills or LOB requirements, for example only where
possible all voice calls requiring support in Spanish regardless of LOB will be routed to our centers in our Near Shore centers (e.g. Chihuahua); or calls with legal requirements to be treated in the USA. Teleperformance will rely on the underlying
call delivery and routing capabilities inherent in the Health Net/Supplier call delivery platform to provide call delivery continuity and disaster recovery capabilities between centers. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-25		Health Net / Cognizant Confidential

 Final 
  

Additionally, Teleperformance provides numerous strategies and capabilities to enable continued operations in the event of a local adverse
event. Each BCP is inherently site specific, and is designed to provide for continued operation where possible (e.g. alternate network connectivity, standby power etc.), as well as each BCP covers plans to ensure safety of employees and protection
of company resources, as well as options available for alternate delivery of operations should a center prove to be partially or completely unavailable. 

Teleperformance has developed a business impact analysis matrix for all services. Services are categorized as per criticality and disasters by
likelihood of occurrence, based on which the DR/BCP strategy is defined. The components of this include: 
  

	 	(i)	Configuration and maintenance of back-up sites (hot/warm/cold) 

  

	 	(ii)	Data back-up strategy and frequency 

  

	 	(iii)	Recovery drills and SLAs for service continuity 

  

	 	(iv)	Redundancy in network and other infrastructure (v) Back-ups for people 

 Teleperformance
has assigned a priority to each of these disaster categories and service criticality and has identified suitable back up sites accordingly. The critical elements of the BCP at each of these levels are: 

 

	 	(i)	Categorization of disasters. 

  

	 	(ii)	Categorization of recovery process based on criticality. A categorization of LOB priority is as follows: 

  

	 	(A)	MediCal Member 

  

	 	(B)	MHN Member 

  

	 	(C)	Medicaid AZ Member 

  

	 	(D)	Medicare CA, OR, AZ Member 

  

	 	(E)	Commercial Member CA, OR, AZ 

  

	 	(F)	All Provider 

  

	 	(G)	Ancillary Support Functions 

  

	 	(H)	All Broker 

  

	 	(iii)	Disaster scenarios and the recovery process. 

  

	 	(iv)	Escalation and communication process 

  

	 	(v)	Compliance and review process 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-26		Health Net / Cognizant Confidential

 Final 
  

	 	(w)	Security 

 Teleperformance’s solution for ensuring ongoing physical and logical
security of Health Net’s data in accordance with the requirements of the Agreement and Health Net’s security policies is as follows: 
  

	 	(i)	Teleperformance will implement and follow Health Net security standards and policies in order to comply with industry practices and regulations. Such security standards and policies include: 

 

	 	(ii)	Applying individual and least privileged role-based access 

  

	 	(iii)	Enforcing input and parameter validation and restriction where possible 

  

	 	(iv)	Utilizing Health Net’s single sign-on authentication mechanism (unless otherwise authorized by Health Net in writing) 

  

	 	(v)	Prohibiting the sharing of system sign-on IDs 

  

	 	(vi)	Employing secure methods of session management 

  

	 	(vii)	Facilitating individual user logging of transactions 

  

	 	(viii)	Implementing encrypted communication over open networks, as required by Health Net 

  

	 	(ix)	Teleperformance will (1) install firewalls at the network layer used to provide the Services; (2) not use (or permit any Teleperformance Personnel to use) any removable storage devices such as USB drives, or
floppy and CD disc drives; and (3) control Internet access by Teleperformance Personnel providing the Services. 

  

	 	(x)	Teleperformance will not download any information (including Health Net Confidential Information) to hard drives on desktops or laptops, or print any such information 

 

	 	(xi)	Teleperformance shall establish and administer security violation and unauthorized access attempt report mechanisms. In the event Teleperformance discovers a Security Incident or an unauthorized access attempt,
Teleperformance shall: 

  

	 	(xii)	Promptly contact Health Net and work with Health Net security to investigate such Security Incident or unauthorized access attempt in accordance with Health Net’s security policies and procedures. Teleperformance
shall provide information regarding such intrusion investigation to Health Net upon request 

  

	 	(xiii)	Promptly provide a written report to Health Net describing such Security Incident or unauthorized access attempt 

  

	 	(xiv)	Initiate commercially reasonable corrective actions to help minimize and prevent reoccurrence of such Security Incident or unauthorized access attempt 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-27		Health Net / Cognizant Confidential

 Final 
  

	 	(xv)	Prepare and retain documentation of investigations of such Security Incident or unauthorized access attempt and provide a copy of such documentation to Health Net 

 

	4.	CHANGES TO SUPPLIER’S SOLUTION 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1. That said, Supplier is charged with responsibility for the adequacy of its Solution – which is to say that
if Supplier’s Solution, as described in this Exhibit A-1 ̧ should prove inadequate at any point during this Statement of Work’s Term for Supplier to perform and deliver the Services in accordance with the obligations of the Agreement
(including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in accordance with such obligations. All such changes are to be made in
accordance with Schedule H (Contract Change Control) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such changes at its own cost and expense except in those cases (if
any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 
  

	5.	RESOURCES 

  

	5.1	Resource Mix 

 To achieve Health Net’s objectives of improvement in services
delivery, faster speed to market, focus on growth and significant reduction in cost, Teleperformance will leverage its global operating model. The Onshore/Near shore/Offshore resource mix for contact centers operations is listed in the following
table. 
  

	 	(i)	Commercial PG Member English and Spanish (Restricted) to USA 

  

	 	(ii)	Commercial PG Member English and Spanish (Non Restricted) to Philippines and Mexico 

  

	 	(iii)	Commercial Member CA, OR, AZ English to Philippines 

  

	 	(iv)	Commercial Member CA, OR, AZ Spanish to Mexico 

  

	 	(v)	Commercial Provider CA, OR, AZ English to Philippines 

  

	 	(vi)	ACA Member CA, OR, AZ English to Philippines 

  

	 	(vii)	ACA Member CA, OR, AZ Spanish to Mexico 

  

	 	(viii)	Medicare Member CA, OR, AZ - English to Philippines 

  

	 	(ix)	Medicare Member CA, OR, AZ - Spanish to Mexico 

  

	 	(x)	Medicare Provider English to Philippines 

  

	 	(xi)	Mental Health PG Member English and Spanish (Restricted) to USA 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-28		Health Net / Cognizant Confidential

 Final 
  

	 	(xii)	Mental Health PG Member English and Spanish (Non Restricted) to Philippines and Mexico 

  

	 	(xiii)	Mental Health (Member/Provider/Claims) English to Philippines 

  

	 	(xiv)	Mental Health (Member/Provider/Claims) Spanish to Mexico 

  

	 	(xv)	Correspondence to USA (potentially Philippines) 

  

	 	(xvi)	Medicaid CA Member English to Philippines 

  

	 	(xvii)	Medicaid AZ Member English to USA 

  

	 	(xviii)	Medicaid CA Member Spanish to Mexico 

  

	 	(xix)	Medicaid AZ Member Spanish to USA 

  

	 	(xx)	Medicaid CA Provider English to Philippines 

  

	 	(xxi)	Medicaid AZ Provider English to USA 

  

	 	(xxii)	Commercial Broker CA, OR AZ English to Philippines (potentially USA) 

  

	 	(xxiii)	Duals CA Member – English to Philippines 

  

	 	(xxiv)	Duals CA Member – Spanish to Mexico 

  

	 	(xxv)	Duals CA Provider – English to Philippines 

 Functional Support (work force, quality,
training, management of agents) will be located in the same locations as lines of business above. 
 Leadership, PMO, Client Services,
Resolution, Escalation, Project Support Services. Policies and Procedure, Curriculum functions and locations will be determined during implementation. 
  

	5.2	Resource Profile 

 Teleperformance has a well-defined methodology for recruitment and
selection of candidates. Teleperformance will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Teleperformance will select candidates with the proper qualifications and
experience in order to ensure a “best-fit” for Health Net. 
 The table below is an indicative illustration of requirements and the
minimum qualifications required to be selected for the contact center operations roles which Teleperformance will rely upon for our processes in ongoing selection of employees to the program. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1-29		Health Net / Cognizant Confidential

 Final 
  

 

			
	 Contact center agent
	  	 
	Qualification & Experience	  	Selection Process
		
	HS Graduates	  	HR Interview
		
	One year of contact center experience	  	Operations Interview
		
	English written and verbal communication skills.	  	Criminal background check
		
	 Knowledge of healthcare basics
	  	
		
	 Type thirty (30) WPM
	  	
		
	 Willingness to work flexible schedules
	  	

  

			
	 Team Manager
	  	 
	Qualification & Experience	  	Selection Process
		
	 Bachelor’s Degree or equivalent work experience.
  

Excellent Communication and Leadership skills
  

Three (3) to five (5) years’ experience leading large teams
	  	 HR Interview-screening for roles and responsibility
  

Operations Interview
  

Criminal Background Check.

  

			
	 Work Force Management
	  	 
	Qualification & Experience	  	Selection Process
		
	 Bachelor’s Degree or equivalent work experience
  

Excellent Communication and Leadership skills
  

Three (3) - five (5) years of call center experience.
  

Previous workforce management experience.
	  	 HR interviews and screening.
  

Interview with Business Leadership
  

Screening for leadership ability and cultural fit
  

Criminal background check.

  

	6.	OPERATING HOURS 

 Supplier and Teleperformance will at minimum replicate the operating
hours adhered to by Health Net’s Contact Center organization as of the Effective Date, as set forth in the table below. Supplier and Teleperformance acknowledges and agrees that performance of the Contact Center Services will regularly require
Supplier Personnel to perform additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Contact Center Services. 

Supplier and Teleperformance will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as
needed to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s and Teleperformance’s work during such extended hours of operations is within the scope of the Con-tact Center
Services. 

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1-30	  	Health Net / Cognizant Confidential

 Final 
  

Within the regular Hours of Operations listed below, Supplier and Teleperformance will have staff work according to defined shift schedules.
However, Supplier and Teleperformance will make reasonable efforts to permit Supplier and Teleperformance staff to work flexible shift times when that can be done without jeopardizing Supplier’s and Teleperformance’s ability to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. 
 The operating hours for the Contact
Center Services are given below. 
  

			
	 LOB/Work Group
	  	 Hours and Days of Operation (US Pacific time)

	Commercial	  	
		
	Commercial CA Member	  	M-F 8-6
		
	Commercial OR Member	  	M-F 7:30-5
		
	Commercial AZ Member	  	M-F 7-6 (Outside Daylight Savings time 6-5)
		
	ACA CA Member	  	M-Sa 8-8 11/15- 2/15; M-F 8-6 rest of the year
		
	ACA OR Member	  	M-Sa 8-8 11/15- 2/15; M-F 8-6 rest of the year
		
	ACA AZ Member	  	M-Sa 8-8 11/15- 2/15; M-F 8-6 rest of the year
		
	Commercial and ACA CA, OR Provider	  	M-F 8-5
		
	Commercial and ACA AZ Provider	  	M-F 7-6 (Outside of daylight savings 6-5)
		
	Medicare	  	
		
	Medicare CA Member	  	8-8 7 days 10/1- 2/15; M-F 8-8 rest of the year
		
	Medicare OR Member	  	8-8 7 days 10/1- 2/15; M-F 8-8 rest of the year
		
	Medicare AZ Member	  	8-8 7 days 10/1-2/15; M-F 8-8 rest of the year
		
	OEV (Outbound Enrollment Verification)	  	8-8 7 days 10/1-2/15; M-F 8-8 rest of the year
		
	Medicare CA/OR/AZ Provider	  	M-F 7-6 (Outside of daylight savings 6-5)
		
	State Health Plans	  	
		
	Medicaid CA Member	  	7 x 24 hrs.
		
	Medicaid AZ Member	  	7 x 24 hrs.
		
	Medicaid CA Provider	  	7 x 24 hrs.
		
	Medicaid AZ Provider	  	7 x 24 hrs.

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1-31	  	Health Net / Cognizant Confidential

 Final 
  

			
	 LOB/Work Group
	  	 Hours and Days of Operation (US Pacific time)

	Duals CA Member	  	7 x 24 hrs.
		
	Duals CA Provider	  	M-F 7-6
		
	Brokers	  	
		
	Commercial CA Broker	  	M-F 8-5
		
	Commercial OR Broker	  	M-F 8-5
		
	Commercial AZ Broker	  	M-F 8-5
		
	MHN	  	
		
	MHN Member	  	M-F 5-5
		
	MHN Provider	  	M-F 5-5
		
	MHN Claims	  	M-F 5-5

 NOTE: Commercial, Medicare and ACA AZ Provider—M-F 7am-6pm (outside Daylight Saving Time Period: M-F 6am-5pm) 

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1-32	  	Health Net / Cognizant Confidential

 Final 

EXHIBIT A-1.1 
 APPROVED
SERVICE DELIVERY CENTERS 
 The Service Delivery Centers at (or from) which Supplier is authorized to perform the Services under this Statement of Work
are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform certain aspects of the Services, their performance must be from an approved Service Delivery Center listed in this Exhibit
A-1.1. 
 Onshore Service Delivery Centers 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours of
Operation	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform

/ Systems
	  	 Back-up /

Fail-over

Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in Ser-
vice	  	 Multi-client

Site (Y/N)?

	 Shreveport, LA, USA TPUSA, Inc.
  

5800 Industrial Loop Shreveport, Louisiana USA 71129
	  	 Contact
 Center
	  	7x24;365	  	IB/OB Call, off phone case follow up	  	English, Spanish and Language Line support for all other	  	 Aspect, IEX (NICE), Peg- asystems,
 email, web,
IVR, Right- Fax, Macess, Lotus Notes, Health Net Connect, CSI, ABS, Clear- Tran, PSA
	  	Davao, Philippines, Chihuahua, Mexico, Rancho Cordova, CA, Woodland Hills, CA	  	TPUSA	  	TPUSA
leases
from	  	October
 2013
	  	Y, Health Net has secured and locked area
											
	Rancho Cordova, CA, USA	  	 Contact
 Center
	  	7x24; 365	  	IB/OB Call; off phone ancillary and support services	  	English, Spanish and Language Line support for all other	  	 Aspect, IEX (NICE), Peg- asystems,
 email, web,
IVR, Right- Fax, Macess, Lotus Notes, Health Net Connect, CSI,
	  	Davao, Philippines, Chihuahua, Mexico, Woodland Hills, CA	  	Health
 Net
	  	Health
Net
leases
from	  	N/A	  	Y Other Health Net functions; secured and locked area – until 2/28/17

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-1	  	Health Net / Cognizant Confidential

 Final 

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours of
Operation	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform

/ Systems
	  	 Back-up /

Fail-over

Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in Ser-
vice	  	 Multi-client

Site (Y/N)?

		  		  		  		  		  	 ABS, Clear-
 Tran, PSA
	  		  		  		  		  	
											
	Woodland Hills, CA, USA	  	 Contact
 Center
	  	7x24; 365	  	IB/OB Call; off phone ancillary and support services	  	English, Spanish and Language Line for support of all other	  	Aspect, As- pect, IEX (NICE), Peg- asystems, Lotus Notes, Health Net Connect, CSI, ABS, Clear- Tran, PSA	  	Davao, Philippines, Chihuahua, Mexico, Rancho Cordova, CA	  	Health
 Net
	  	Health
Net
leases
from	  	N/A	  	Y Other Health Net functions; secured and locked area until 2/28/17

 Holidays observed in the above-listed centers: 

Actual hours of operation will follow Health Net required days of operation regardless of local holidays. 

Six (6) annual holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day. 

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-2	  	Health Net / Cognizant Confidential

 Final 

Near-shore Service Delivery Centers 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	Hours of
Operation	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform

/ Systems
	  	 Back-up /

Fail-over

Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in Ser-
vice	  	 Multi-client
Site

(Y/N)?

	 Chihuahua, Mexico
  

Teleperformance
 Mexico S.A.

 
 Miguel de Cervantes Saavedra

100, Complejo
	  	 Contact
 Center
	  	7x24;365	  	IB/OB and off phone case follow up	  	Spanish and English, Language Line for all other	  	 Aspect, IEX (NICE), Peg- asystems,
 email, web,
IVR, Right- Fax, Macess, Lotus Notes, Health Net Connect, CSI, ABS, Clear- Tran, PSA
	  	Davao, Philippines, Chihuahua, Mexico, Woodland Hills, CA	  	TP Mexico	  	TP
Mexico
leases
from	  	August
 2014
	  	Y, secured and locked area

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-3	  	Health Net / Cognizant Confidential

 Final 

Holidays observed in the above-listed centers: 
 Actual hours
of operation will follow Health Net required days of operation regardless of local holidays. 
 Mexico Holiday Schedule: 

 

	(a)	January 1st—New Year’s Day 

  

	(b)	February 5th—Constitution Day 

  

	(c)	March 21st—Benito Juarez Day (Presidents Day) (d) May 1st—Labor Day 

  

	(e)	September 16th—Independence Day 

  

	(f)	November 20th—Mexican Revolution Day 

  

	(g)	December 25th—Christmas Day 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1.1-4		Health Net / Cognizant Confidential

 Final 
  

Offshore Service Delivery Centers 
  

																					
	 Primary

Location
	  	 Type of
Facility
	  	Hours of
Operation	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform /

Systems
	  	
Back-up /
Fail-over
Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in Service	  	 Multi-client
Site

(Y/N)?

	 Davao, Philippines 2nd Floor, SM City Davao Annex, Quimpo Blvd, Dabao

8000
	  	 Contact
 Center
	  	7x24, 365	  	IB/OB call, off phone case follow up and correspondence	  	English and Language Line for all other	  	 Aspect, IEX (NICE), Pegasystems,
 email, web, IVR,
Right- Fax, Macess, Lotus Notes, Health Net Connect,
 CSI, ABS, ClearTran,

PSA
	  	Shreveport, LA, Chihuahua, Mexico, Rancho Cordova, CA, Woodland Hills, CA	  	TP
Philippines	  	TP
 Philippinesleases
 from
	  	August,
 2014
	  	Y, secured and locked
											
	TBD Philippines Teleperformance Philippines	  	 Contact
 Center
	  	7x24, 365	  	IB/OB call, off phone case follow up and correspondence	  	English and Language line for all other	  	 Aspect, IEX (NICE), Pegasystems,
 email, web, IVR,
Right- Fax, Macess, Lotus Notes, Health Net Connect,
 CSI, ABS, ClearTran, PSA    
	  	Davao, Philippines, Shreveport, LA, Chihuahua, Mexico, Rancho Cordova, CA, Woodland Hills, CA	  	TP
Philippines	  	TP
Philippines	  	December,
 2014
	  	Y secured and locked

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-5	  	Health Net / Cognizant Confidential

 Final 
  

																					
	 Primary

Location
	  	 Type of
Facility
	  	Hours of
Operation	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform /

Systems
	  	
Back-up /
Fail-over
Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in Service	  	 Multi-client
Site

(Y/N)?

	TBD Philippines	  	Contact Center	  	7x24;
 365
	  	IB/OB call, off phone case follow up and correspondence	  	English and Language Line for all other	  	 Aspect, IEX (NICE), Pegasystems,
 email, web, IVR,
Right- Fax, Macess, Lotus Notes, Health Net Connect,
 CSI, ABS, ClearTran,

PSA
	  	Davao, Philippines, Shreveport, LA, Chihuahua, Mexico, Rancho Cordova, CA, Woodland Hills, CA	  	TP
Philippines	  	TP
Philippines
leases
from	  	February,
 2015
	  	Y, secure and locked area
											
		  	Contact Center	  	7x24;
 365
	  	IB/OB call, off phone case follow up and correspondence	  	English and LanguageLine for all other	  	 Aspect, IEX (NICE), Pegasystems,
 email, web, IVR,
Right- Fax, Macess, Lotus Notes, Health Net Connect,
 CSI, ABS, ClearTran,

PSA
	  	Davao, Philippines, Shreveport, LA, Chihuahua, Mexico, Rancho Cordova, CA, Woodland Hills, CA	  		  		  	May,
 2015
	  	Y, Secure and lock area

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-6	  	Health Net / Cognizant Confidential

 Final 

Actual hours of operation will follow Health Net required days of operation regardless of local holidays. 

Holidays observed in the above-listed centers: 
  

					
	 MONTH
	  	 TYPE OF HOLIDAY
	  	 HOLIDAY DESCRIPTION

	JANUARY	  	LEGAL HOLIDAY	  	NEW YEAR
	JANUARY	  	SPECIAL HOLIDAY	  	CHINESE NEW YEAR
	FEBRUARY	  	SPECIAL HOLIDAY	  	PARANAQUE DAY
	MARCH	  	SPECIAL HOLIDAY	  	DAVAO DAY
	APRIL	  	LEGAL HOLIDAY	  	DAY OF VALOR
	APRIL	  	LEGAL HOLIDAY	  	MAUNDY THURS
	APRIL	  	LEGAL HOLIDAY	  	GOOD FRIDAY
	APRIL	  	SPECIAL HOLIDAY	  	BLACK SATURDAY
	MAY	  	LEGAL HOLIDAY	  	LABOR DAY
	JUNE	  	LEGAL HOLIDAY	  	INDEPENDENCE DAY
	JUNE	  	SPECIAL HOLIDAY	  	MAKATI DAY
	JULY	  	LEGAL HOLIDAY	  	EIDUL FITR
	JULY	  	SPECIAL HOLIDAY	  	PASIG DAY
	AUGUST	  	LEGAL HOLIDAY	  	NAT’L HEROES
	AUGUST	  	SPECIAL HOLIDAY	  	NINOY AQUINO DAY
	AUGUST	  	SPECIAL HOLIDAY	  	QUEZON CITY DAY
	SEPTEMBER	  	SPECIAL HOLIDAY	  	OSMEÑA DAY
	OCTOBER	  	LEGAL HOLIDAY	  	EIDUL ADHA
	OCTOBER	  	SPECIAL HOLIDAY	  	CHARTERS DAY
	NOVEMBER	  	SPECIAL HOLIDAY	  	ALL SAINTS DAY

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-7	  	Health Net / Cognizant Confidential

 Final 
  

 

					
	 MONTH
	  	 TYPE OF HOLIDAY
	  	 HOLIDAY DESCRIPTION

	NOVEMBER	  	LEGAL HOLIDAY	  	BONIFACIO DAY
	DECEMBER	  	LEGAL HOLIDAY	  	CHRISTMAS DAY
	DECEMBER	  	LEGAL HOLIDAY	  	RIZAL DAY
	DECEMBER	  	SPECIAL HOLIDAY	  	DEC.24
	DECEMBER	  	SPECIAL HOLIDAY	  	DEC.26
	DECEMBER	  	SPECIAL HOLIDAY	  	DEC.31
	DECEMBER	  	SPECIAL HOLIDAY	  	PASAY DAY
	DECEMBER	  	SPECIAL HOLIDAY	  	ANTIPOLO DAY

  

					
	SOW#3 (Contact Center) Exhibit A-1	  	A-1.1-8	  	Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-1.2 
 SERVICE
DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 
 Contact Center Organization Structure (Phase 3) 

 
 

 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1.2-1		Health Net / Cognizant Confidential

 Final 
  

 
  

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1.2-2		Health Net / Cognizant Confidential

 Final 
  

Contact Center Organization Structure (Teleperformance) 
  

 
 The Teleperformance Delivery structure will be providing up to 4 positions of ongoing PMO and consulting resources to
promote governance, technology application, and program/project management throughout the lifecycle of the relationship and through ongoing operations. This will be delivered through Teleperformance Professional Services, under the close direction
of the Vice President. 
 Subcontractors may be used to deliver some services under this agreement, however, at the time of this writing, Teleperformance
has not identified any such required services and will provide any such identification going forward in accordance with governance practices outlined in the agreement. 

  

					
	SOW#3 (Contact Center) Exhibit A-1		A-1.2-3		Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-3 
 CONTACT
CENTER ORGANIZATION CHART 

  

					
	SOW#3 (Contact Center) Exhibit A-3		 		Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-3 
 CONTACT
CENTER ORGANIZATION CHART 
 This Exhibit A-3 (Contact Center Organization Chart) contains organization charts showing, at a specific recent
point in time prior to the Effective Date, the positions (including both filled and currently open positions) that represent the Health Net organizational unit(s) whose Functions are being outsourced to Supplier under this Statement of Work. This
document is included as part of this Statement of Work as a supplemental means of depicting the Functions that comprise the Contact Center Services for which Supplier is assuming responsibility from Health Net under this Statement of Work. It is
not included for the purpose of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s Charges for the Contact Center Services. Any changes in the organization charts between the Agreement’s Effective
Date and the BPaaS Services Commencement Date shall not be interpreted to represent a change in the scope of the Contact Center Services in the absence of Health Net specifically adding or removing Functions from Exhibit A (Contact Center
Services) of this Statement of Work. 

  

					
	SOW#3 (Contact Center) Exhibit A-3		 		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-2		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-3		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-4		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-5		Health Net / Cognizant Confidential

      

Customer Contact Center Organizational Chart 
  

 

  

					
	SOW#3 (CONTACT CENTER) Exhibit A-3		A-3-6		Health Net / Cognizant Confidential

 Final 
  

EXHIBIT B-1 
 SERVICE
LEVEL METRICS 
  

	1.	CONTACT CENTER OPERATIONAL LEVELS 

 All Service Levels are subject to the Service Level
Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement and the Exhibits thereto. 
 *Note: All
Service Levels will be subject to the Service Level methodology set forth in the applicable provisions of the Agreement and Exhibits. All Service Levels will be measured per LOB with the Weighting Factor evenly split between each applicable LOB.

  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

	 Email
 Answer Time

– Inquiry Response Time
	 	 Inquiry Response Time measures the time it takes for a CSR to respond to a Customer who has inquired via email.

 
 Inquiry Response Time is calculated by dividing (i) the number of inquiries with a
Response Time as defined by the specified SLA or less by (ii) the number of inquiries.
  

“Response Time” means the time between (i) when a message is Received by the Contact Center to (ii) when a CSR responds to the Customer
in the medium of the Customers choice.
  

“Received” means, for purposes of this Service Level, that point in time when an inquiry has entered into the Contact
Center work queue.
	 	Daily	 	 Macess, Omni,
 database
	 	 All LOBS Members 100% of inquiries responded to within one (1) Business Day

 
 Providers 100% of inquiries responded to within two (2) Business Days Contact Center
agents must reply on receipt to the    
	 	Y	 		 	A	 	N

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	sender within the 1-2 days for 100% SLA. If the response from other departmen ts takes more than one day, the follow up may go beyond the 1-2 day to complete FCR date.	 		 		 		 	
									
	 MHN Claims
 – Inquiry Response
Time
	 	 Inquiry Response Time measures the time it takes for a CSR to respond to a claims submission request.

 
 Inquiry Response Time is calculated by dividing (i) the number of inquiries with a
Response Time of thirty (30) Business Days or less by (ii) the number of inquiries.
  

“Response Time” means the time between (i) when a message is Received by the Contact Center to (ii) when a CSR responds to the Customer
in the medium of the Customers choice.    
	 	Daily	 	Unity	 	100% of inquiries responded to within thirty (30) Business Day	 	Y	 		 	B	 	N

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	“Received” means, for purposes of this Service Level, that point in time when an inquiry has entered into the Contact Center work queue.	 		 		 		 		 		 		 	
									
	 Service
 Levels
	 	 Call Answer Time measures the amount of time it takes from the point that a call is

routed to a Customer Service Representative (“CSR”) from Health Net’s Interactive Voice Response Unit
(“IVR”) until a CSR answers the call.
  
 Measures the percentage
of callers that reach a live CSR within a defined number of Seconds On Hold.
  

“Seconds On Hold” and “Minutes On Hold” are measured from the time the caller selects the option to speak to a
CSR in IVR to the time the caller is connected to a live CSR.
  
 (1) Measured by dividing
(i) the number of Commercial Member (including ACA) calls answered in thirty (30) Seconds On Hold or less by (ii) the total number of Commercial Member calls offered.
  

(2) Measured by dividing (i) the number of Commercial Provider calls answered in forty- five (45) Seconds On Hold or less by (ii) the total number of
Commercial Provider (including ACA) calls offered
  
	 	Monthly	 	 ACD,
 database, Macess, Omni
	 	 Each of the following metrics will account for an equal allocation of the overall weighting for this SLA. For clarity, a miss on one line of
business will not constitute a miss of the entire Service Level SLA for the month.
  
	 	Y	 		 	B	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-3	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 (3) Measured by dividing (i) the number of Medicare Provider calls answered in forty-five (45) Seconds On Hold or less by (ii) the total
number of Medicare Provider calls offered.
  
 (4) Measured by dividing (i) the number of
SHP (MediCal, Cal-Viva, Healthy Family, and DUALs) Provider calls answered in forty-five (45) Seconds On Hold or less by (ii) the total number of SHP DUALs Provider calls offered.

 
 (5) Measured by dividing (i) the number of AZ Medicaid (AHCCCS) Provider calls answered in
forty-five (45) Seconds On Hold or less by (ii) the total number of Medicaid (AHCCCS) Provider calls offered.
  

(6) Measured by dividing (i) the number of MHN Member calls answered in thirty (30) Seconds On Hold or less by (ii) the total number of MHN Member calls
offered.
  
 (7) Measured by dividing (i) the number of MHN Provider calls answered in
forty-five (45) Seconds On Hold or less by (ii) the total number of MHN Provider calls offered.
  
	 		 		 	 (1) Commercial Member (Non performance Group) – Percentag e of calls answered in 30 seconds or less >= 60%

 
 2) Commercial Provider – Percentage of calls answered in 45 seconds or less >=
60%
  
 (3) Medicare Provider—Percentag e of calls answered in 45 seconds or less
>= 60%
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 8) Measured by dividing (i) the number of Performance Group (PGs) Member calls answered in thirty (30) Seconds On Hold or less by (ii) the
total number of Performance Group Member calls offered.
  
 9) Measured by dividing (i)
the number of Broker calls answered in thirty (30) Seconds On Hold or less by (ii) the total number of Broker calls offered.
	 		 		 	 (4) SHP Provider—Percentage of calls answered in 45 seconds or less >=60%

 
 (5) AZ Medicaid Provider—Percentage of calls answered in 30 seconds or less >=
75%
  
 (6) MHN Member—Percentage of calls answered in 30 seconds or less >=
80%    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 (7) MHN Provider—Percentag e of calls answered in 30 seconds or less >= 80%

 
 (8) PGs Members - Percentage of calls answered in 30 seconds or ASAs levels based upon
contractua l obligations (see PG Attachment)
  
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	(9) Brokers—Percentage of calls answered in 30 seconds or less >= 80%	 		 		 		 	
									
	 Call
 Abandon
	 	 Call Abandon Rate measures calls that are terminated by the caller prior to reaching a

CSR.
  

(1) Commercial Member Call Abandon Rate will be calculated by dividing (i) the sum of (A) total number of Commercial Member IVR calls terminated by the caller
after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by the total number of Commercial Member Calls offered.
  

(2) Commercial Provider Call Abandon Rate will be calculated by dividing (i) the sum of (A) total number of Commercial Provider IVR calls terminated by the
caller after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by the total number of Commercial Provider Calls offered.

 
 (3) Medicare Provider Call Abandon Rate will be calculated by dividing (i) the sum of
(A)    
	 	Monthly	 	 ACD,
 database
	 	 Each of
 the following metrics will account for
an equal allocation of the overall weighting for this SLA. For clarity, a miss on one line of business will not constitute
 a miss of the entire Call
Abandon SLA for the month.
	 	Y	 		 	B	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-7	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 total number of Medicare Provider IVR calls terminated by the caller after making the selection on the IVR or phone switch to speak to a CSR
and prior to the CSR answering the call, by the total number of Medicare Provider Calls offered.
  

4) SHP (Medi-Cal, Cal-Viva, Healthy Family, and DUALs) Provider Call Abandon Rate will be calculated by dividing the sum of (A) total number of SHP Provider
IVR calls terminated by the caller after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by (B) the total number of SHP Provider Calls offered.

 
 (5) AZ Medicaid Provider Call Abandon Rate will be calculated by dividing the sum of (i)
total number of AZ Medicaid Provider IVR calls terminated by the caller after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by (ii) the total number of AZ Medicaid Provider Calls
offered.
  
 6) MHN Member Call Abandon Rate will be calculated by dividing the sum of (i)
total number of MHN Member IVR calls terminated by the caller after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by (ii) the total number of MHN Member Calls offered.
	 		 		 	 (1) Commerci al Member –
 <= 7.0%

 
 2) Commercial

Provider –
 <= 7.0%

 
 (3) Medicare Provider - <= 5.0%

 
 (4) SHP Provider - <= 6.5%

 
 (5) AZ Medicaid Provider – <= 5.0%

 
 (6) MHN Member –

<= 5.0%
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-8	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 (7) MHN Provider Call Abandon Rate will be calculated by dividing the sum of (i) total number of MN Provider IVR calls terminated by the
caller after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by (ii) the total number of MHN Provider Calls offered.
  

(8) Performance Group (PG) Member Call Abandon Rate will be calculated by dividing the sum of (i) total number of PG Member IVR calls terminated by the caller
after making the selection on the IVR or phone switch to speak to a CSR and prior to the CSR answering the call, by (ii) the total number of PG Member Calls offered.
  

(9) Brokers Call Abandon Rate will be calculated by dividing the sum of (i) total number of Brokers IVR calls terminated by the caller after making the
selection on the IVR or phone switch to speak to a CSR and
 prior to the CSR answering the call, by (ii) the total number of Brokers Calls offered.
	 		 		 	 (7) MHN Provider –
 <=5.0%

 
 (8) PGs Members - Abandonment levels based upon contractual obligations (see PG
Report)
  
 (9) Brokers –

<= 5.0%
	 		 		 		 	
									
	 Answer Time
 – Inquiry Response
Time
	 	 Inquiry Response Time measures the time it takes for a CSR to respond to a Customer who has inquired via voice mail or white mail.

 
 Inquiry Response Time is calculated by dividing (i) the number of inquiries with a
Response Time of one (1) Business Days or less by (ii) the number of inquiries.
	 	Monthly	 	 Macess,
 Omni, ODW
	 	 Medicare
 - 100% of inquiries responded to
within one (1) Business
	 	Y	 		 	A	 	N

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-9	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 “Response Time” means the time between (i) when a message is Received by the Contact Center to (ii) when a CSR
responds to the Customer in the medium of the Customers choice.
  

“Received” means, for purposes of this Service Level, that point in time when an inquiry has entered into the Contact
Center work queue.
	 		 		 	Day	 		 		 		 	
									
	 Call
 Handling – First Call
Resolution
	 	 First Call Resolution measures the percentage of calls that are resolved by CSRs on the initial call.

 
 Calculation based upon (i) number of calls closed by CSR on same day of call divided by
(ii) total number of calls (claims calls are not included)
  
 “After Call
Satisfaction Survey” means the survey to be administered to Calls after the customer’s call to the Contact Center is completed.
	 	Monthly	 	 Macess,
 Omni, ODW
	 	 All LOBs
 First Call

Resolution
 >= 85%
	 	Y	 		 	C	 	Y
									
	Spanish Calls	 	 Spanish Callers to be assisted by CSRs that speak Spanish without the need of a language assistance service.

 
 Calculation based upon (i) number of Spanish calls handled by vendor CSRs divided by (ii)
total number of Spanish calls offered
	 	Monthly	 	 ACD,
 database, Omni, Qcare
	 	>=95%	 	Y	 		 	A	 	N
									
	 Quality –
 Quality
	 	Quality Monitoring Average measures the quality of CSR interactions with Customers,    	 	Monthly	 	 Macess,
 Omni, call
	 	 All LOBs
 Quality
	 	Y	 		 	A	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-10	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

	 Monitoring
 Average
	 	 including the accuracy of information provided to Customers, adherence to established procedures and customer relations skills, and accuracy
of CSRs in entering data into the CRM system during or following an interaction.
  

Supplier will perform a minimum of Ten (10) audits per associate per month for all applicable established channels of interaction (e.g., email, web support,
white mail, phone calls, etc.). For each monitored interaction Supplier will complete a scorecard as approved by Health Net. Supplier will rate each CSR’s performance using the scorecard in a fair, accurate and consistent manner. Scoring for
each interaction will be calculated by dividing (i) the total number of quality attributes passed by the CSR, by (ii) the total number of quality attributes measured (0% to 100%).

 
 At Health Net’s request, from time to time, the parties will conduct calibration
sessions in which a sampling of interactions will be jointly monitored and rated by both parties to ensure consistency in the rating of performance. At the end of the measurement period, Supplier will calculate the average score received by each CSR
during the measurement period (“CSR Average Score”).
  
 Quality
Monitoring Average will be calculated by dividing (i) the sum of the CSR Average Scores, by (ii) the total number of    
	 		 	recording systems, database	 	Monitoring Average >= 97.5%	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-11	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 CSRs whose calls were monitored and scored.
  

The aggregate quality scoring target per LOB is ninety seven and one half percent (97.5%) for all evaluations completed on employees with a minimum tenure of
90 days, in accordance with the Quality Assurance form used by Health Net (“QA Form”). The exclusion of tenured agents with less than 90 days will be effective during the Transition Phase 2 as described in Exhibit A-2 Transition
Description only, and will apply to the period of measurement for each line of business transition. The exclusion will apply to the calculation measurement only. All other usage of QA monitoring for performance management in areas such as HIPAA
compliance will be in effect.
  
 There is no exception of minimum tenure of agents for PG
accounts (Commercial and MHN).
	 		 		 		 		 		 		 	
									
	 Quality – Customer
 Satisfaction
	 	 Customer Satisfaction measures the level of Customer satisfaction in their interactions with the Contact Center. Supplier shall administer
surveys to a random sample of Customers who have had a recent contact with the Contact Center.
  

Customer Satisfaction is calculated by dividing (i) the total number of Survey responses with overall ratings of [TBD] (i.e. “very satisfied”
or “extremely satisfied”), by    
	 	Quarterly	 	ACD, database	 	 All LOBs
 >= 90%
	 	Y	 		 	B	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-12	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 (ii) the total number of Survey responses.
  

CSAT surveys not currently available for any LOBs.
  

Survey to include the question “Are you satisfied with the service provided by the associate who assisted you today?
	 		 		 		 		 		 		 	
									
	 Case
 Handling – Case Closure
	 	 Case Closure Time measures the time to close a case once it has been opened. Case Closure Time is measured as the time elapsed between when a
case is first Opened to when the case is Closed. Measured in one (1) Business Day, three (3) Business Day and seven (7) Business Day increments. The metric excludes any claims cases regarding; new day, adjustments, and COB claims.

 
 (1) Measured by dividing (i) the number of cases with a Case Closure Time of one (1)
Business Day or less, by (ii) the number of cases received less the number of claims cases
  

(2) Measured by dividing (i) the number of cases with a Case Closure Time of three (3) Business Days or less, by (ii) the number of cases received. less the
number of claims cases
  
 (3) Measured by dividing (i) the number of cases with a Case
Closure Time of seven (7)    
	 	Monthly	 	 Macess,
 Omni, ODW
	 	 All LOBs
 (1) Case Closure Time within one (1)
Business Day
 >= 90%
  

(2) Case Closure Time within three (3) Business Days >= 95%
  

(3) Case Closure Time within seven (7) Business
	 	Y	 		 	B	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-13	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	 Business Days or less, by (ii) the number of cases received less the number of claims cases

 
 “Opened” means when an inquiry is received within the Contact
Center either orally or written, and the interaction or request is documented by Supplier Contact Center Associates.
  

“Closed” means when all actions are completed related to an inquiry and there is no follow up required by the Contact Center
Associate
	 		 		 	 Days >= 98%
  

(11) PGs Members – Case Closure based upon contractua l obligation s (see PG Report)
	 		 		 		 	
									
	 Pre-Natal
 forms
	 	Triage prenatal forms to the care mgmt. team to ensure information is accurate and to link PCP/PPG OBGYN/hospital within the same network. High risk pregnancy needs to be taken care of within 5 days. The definition of High-Risk
pregnancy will be mutually agreed upon by the Parties.	 	Monthly	 	 Qcare,
 Omni
	 	 SHP Customer service has 5 days to triage and forward high risk pregnancy

to care mgmt. team.
	 	Y	 		 	B	 	N
									
	TOC/COC	 	 Customer service needs to complete
 TOC/COC
forms and process the work within 5 days.
  
 NON SPD Transitions of care and continuation
of care need to be completed within 5 days.    
	 	Monthly	 	Qcare, Omni	 	 SHP Customer
 service has 5days to review form,
validate
	 	Y	 		 	B	 	N

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-14	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 	**SPD and Cal- MediConnect are routed to PPCs	 		 		 	and forward to the PPC and/or UM team.	 		 		 		 	
									
	Material request	 	Members requesting materials (handbooks, provider directories, etc.)	 	Monthly	 	Qcare, Omni	 	SHP Customer service to request materials to fulfillment within 72 hours	 	Y	 		 	B	 	N
									
	 CAHPS
 Survey
	 	 Score 88% or better for the Customer Service question on the Medicare Advantage Prescription Drug CAHPS Survey (MA-PD CAHPS) for Stars
Ratings
  
 Note- The target needs to be reset annually to align to the new cut
points.
  
 Score 88% or better for the Customer Service question on the Medicare
Advantage Prescription Drug CAHPS Survey (MA-PD CAHPS) for Stars Ratings
  
 Note- The
target needs to be reset annually to align to the new cut points.
 Goal is 4 Stars or higher
	 	Annually	 	CAHPS Survey	 	88% or better for customer service questions on the CAHPS survey 88% or better for Stars Ratings	 	Y	 		 	B	 	Y
									
	 Provider
 Transfer Unit
	 	Process all provider transitions and hospital terminations within regulatory timelines and agreed upon internal service levels for all products and lines of business    	 	Monthly	 	Macess, Omni, ODW	 	 Commercial PPG Level =
 60
day
	 	Y	 		 	B	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-15	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 member notification PCP Level = 30 day Capitated hospital term—60 days

FFS hospital term—5 days posteff date
  

Medicare PPG
 Level—30 day member
notification
 PCP—30 day member notification Capitated hospital term—30 days

FFS hospital term—30 days    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-16	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 Medi-Cal
 PPG Level—30 day member
notification
 PCP—30 day member notification Capitated hospital term—30 days

FFS hospital term—5 days posteff date
  

Commercial
 PNM will notify

PDM via
 email (NCF) within 5 business days of receipt of a
PPG,    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-17	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 PCP or
 Hospital terminatio n

PDM will forward email (NCF) within 5 business days of receipt of a PPG, PCP or Hospital

terminatio n
 -The notice form aka NOC

should be
 received by PTU at lease 45 days prior to the effective
date of the change for PCP changes
 -The notice form aka    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-18	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 NOC
 should be received by PTU at least 75 days
prior to the effective
 date of the change for PPG changes
  

Medicare PNM will notify PDM via email (NCF) within 5 business days of receipt of a PPG, PCP or Hospital

terminatio n
 PDM will forward email (NCF)

within 5
 business days of    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-19	  	Health Net / Cognizant Confidential

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	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 receipt of
 a PPG, PCP or Hospital terminatio
n
 -The notice form aka NOC should be received by PTU at lease 45 days prior to the effective

date of the change for PPG and PCP changes
  

Medi-Cal PNM will notify PDM via email (NCF) within 5 business days of receipt of a PPG, PCP or    
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-20	  	Health Net / Cognizant Confidential

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	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

		 		 		 		 	 Hospital
 terminatio n

PDM will forward email (NCF) within 5 business days of receipt of a PPG, PCP or Hospital

terminatio n
 -The notice form aka NOC should be

received
 by PTU at lease 45 days prior to the effective date of
the change for PPG and PCP changes
	 		 		 		 	
	 Inquiry
 Response
	 	This service level measures the timeliness of responses to inquiries from Regulatory	 	Monthly	 	Macess, Omni,	 	100% of all    	 	Y	 		 	C	 	Y

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-21	  	Health Net / Cognizant Confidential

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	 Category / Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service Level
	 	 Critical

(Y/N)
	 	 Weighting

Factor
	 	 Code
	 	 Continuous

Improvement

	 Timeliness -
 (Regulatory, Legal,
Compliance)
	 	 Affairs, Compliance, Legal or any

regulatory/compliance area (such as DOI, ADOI, DMHC,Better Business Bureau, Legal, etc), which shall be calculated in accordance with the following
formula:
  

(Total # Inquiry Resp—# Late Inquiry Resp) Total # Inquiry Responses

 
 X 100%

Where:
  

“# Late Inquiry Responses” means the number of responses to inquiries that are not Completed within the specified timeframes.
	 		 	ODW	 	 inquiries
 received shall be Complete d within
the timeline specified within the request or
 72 hours (15 days for Better Business Bureau) whichever

is shorter.
	 		 		 		 	

  

					
	SOW#3 (Contact Center) Exhibit B-1	  	B-1-22	  	Health Net / Cognizant Confidential

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EXHIBIT D 
 KEY SUPPLIER
PERSONNEL 
 Subject to Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions
filled by the individuals listed in the table below. 
  

			
	 Key Supplier Position
	  	 Initially Approved Individual

	Customer Care Tower Lead - Teleperformance	  	TBD
	Operations Lead	  	TBD
	Operations Lead - Mexico	  	TBD
	Operations Lead - Philippines	  	TBD
	Account Manager	  	TBD
	Account Manager	  	TBD
	Account Manager	  	TBD
	Account Manager	  	TBD
	Account Manager	  	TBD
	Compliance Consultant	  	TBD

  

					
	SOW#3 (Contact Center) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

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EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 of the Terms and Conditions, this
Schedule H identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth below. 

 

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	***	  		  	
		  		  	
		  		  	
		  		  	

  

					
	SOW#3 (Contact Center) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

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AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #4 (IT SERVICES) 

  

					
	SOW #4 (Information Technology)         		 		Health Net / Cognizant Confidential

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AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #4 (IT SERVICES) 

This Statement of Work #4 (IT Services), dated November 21, 2014, but effective as of November 2, 2014 (“the SOW
Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health Net”), and
Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 211 Quality Circle College Station, TX 77845 (each, a “Party” and collectively, the
“Parties”). This SOW #4 (IT Services) is entered into and shall be governed by the terms of that certain Amended and Restated Master Services Agreement entered into between the Parties dated
November 21, 2014 (the “Agreement”). This Statement of Work #4 (IT Services) replaces and supersedes in all respects the Statement of Work #4 dated November 2, 2014. 

 

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #4 (IT Services) describes the IT
Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (IT Services) to this SOW #4 (IT Services), and sets forth certain terms and conditions relating to them, including, among other things: 

 

	 	(a)	The scope of the IT Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; (d) The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

	1.2	Structure 

 This SOW #4 (IT Services) is comprised of this cover document and the
following Exhibits: 
  

					
	 Table 1: Exhibits to SOW #4 (IT Services)

	 Item #
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	 Exhibit A
 (Services)
	  	Describes the scope of the IT Services.
			
	2	  	 Exhibit A-1

(Scope Model)
	  	 Provides the Scope Model for the IT Services and includes as exhibits:

•    Exhibit A-1-1 (Process Definitions)

•    Exhibit A-1-2 (Element Definitions)

•    Exhibit A-1-3 (Reserved)

•    Exhibit A-1-4 (Reserved)

•    Exhibit A-1-5 (HNFS
Requirements)

  

					
	SOW #4 (Information Technology)         	  	1	  	Health Net / Cognizant Confidential

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	 Table 1: Exhibits to SOW #4 (IT Services)

	 Item #
	  	 Exhibit
	  	 Purpose of Exhibit

	3	  	 Exhibit A-3
 (Solution

Description)
	  	 Describes Supplier’s solution for the provision of the IT Services and includes individual solutions as exhibits:

•    Exhibit A-3-1 (Solution Description – ITO Phase I)

•    Exhibit A-3-2 (Solution Description – ITO Phase II)

•    Exhibit A-3-3 (Solution Description – BPaaS)

•    Exhibit A-3-4 (Solution Description – People/Process)

•    Exhibit A-3-6 (Solution Description – BPaaS Non- BPaaS
Security)

			
	4	  	 Exhibit B (IT
 Service
Levels)
	  	 Provides the Service Levels applicable to the IT Services and includes as exhibits:

•    Exhibit B-1 (Service Level Metrics)

•    Exhibit B-2 (Critical Services)

•    Exhibit B-3 (Resolvable Call Categories)

•    Exhibit B-4 (Service Request Completion Times)

•    Exhibit B-5 (Procurement Request Completion Times)

•    Exhibit B-6 (Reports)

			
	5	  	 Exhibit D (IT Key

Supplier Positions)
	  	Identifies the Key Supplier Positions applicable to the IT Services.
			
	6	  	 Exhibit H (IT

Subcontractors)
	  	Identifies the Subcontractors approved by Health Net to provide certain of the IT Services.

  

	1.3	Exhibit A-1-2 Element Definitions – Infrastructure Software 

 The Infrastructure
Software Tab of Exhibit A-1 (Scope Model) lists the Infrastructure Elements Categories and assigns Actors roles to those Categories. The Elements applicable to each Category are listed in A-1-2 Elements Definitions. During Phase 1, Supplier and
Health Net will assign all of the Infrastructure Software running or anticipated to be running in either the Supplier’s Data Centers or at Health Net locations to the appropriate Infrastructure Software Elements. All Infrastructure Software
shall be assigned to an Infrastructure Software Element such that all Infrastructure Software is represented on the Infrastructure Scope Model. 
  

	1.4	Special Order of Precedence of SOW #4 Documents 

 To the extent there is any conflict or
inconsistency as to the responsibilities of either Party between (a) Exhibit A-1 (Scope Model), on the one hand; and (b) Exhibit A-3 (Solution Description), on the other hand, then the Exhibit A-1 (Scope Model) shall prevail. The Parties
explicitly acknowledge that Exhibit A-3 (Solution Description) may not address every aspect of the Services, including each of Supplier’s responsibilities otherwise covered in the Recurring Scope Exhibits. 

 

	1.5	BPaaS and non-BPaaS IT 

 This SOW #4 (IT Services) describes the IT Services and
related terms that are required to support both the BPaaS Services (“BPaaS IT”) and other information technology requirements of Health Net that are unrelated to the BPaaS Services (“Non-BPaaS IT”). Unless
expressly stated otherwise, all IT Services and related terms in this SOW #4 (IT Services) apply to both BPaaS IT and Non-BPaaS IT requirements. 

  

					
	SOW #4 (Information Technology)         	  	 	  	Health Net / Cognizant Confidential

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	1.6	Enterprise Security Processes 

 The Scope Model designates Health Net as responsible for
certain Enterprise Security processes. In some cases these Enterprise Security processes may overlap with other Security processes that Supplier is responsible to perform. The intent of this overlap it to give Health Net the option (but not the
obligation) to perform these functions itself and “shadow” functions performed by Supplier. The fact that Health Net is responsible for certain Enterprise Security processes shall not in any way limit Supplier’s responsibility and
accountability for meeting its obligations with respect to information security under the Agreement. 
  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #4 (IT Services) shall have the
meanings given them in the Agreement. 
  

	3.	ADDITIONAL IT SERVICES 

 In addition to the IT Services set forth in Exhibit A (Scope Model), the
IT Services include (a) Audit Support Services, and (b) Health Net Policy Support Services as set forth in this Section 3. 
  

	3.1	VIP Support Services 

 Supplier will provide additional services (“VIP
Services”) as necessary to support individuals designated as VIPs (defined in Exhibit C-6) by Health Net. The VIP Services include: 
  

	 	(a)	In addition to the standard End User Services, VIP support Services may require Supplier to dispatch technicians to the VIP’s home or other remote locations (e.g., hotel, conference center). 

 

	 	(b)	Supplier shall perform VIP Services for all VIPs, regardless of their location. At the following Health Net Facilities, Supplier shall have at least one deskside support Supplier Personnel who is specifically trained to
and has the particular skills necessary to effectively and efficiently support VIPs and who will have primary responsibility for performing the VIP support Services for VIPs located at such Health Net Facilities: (1) Health Net Headquarters at
Woodland Hills, CA, and (2) Health Net’s Rancho Cordova Facility. 

  

	 	(c)	VIP support shall be performed based on Exhibit B (IT Service Levels) 

  

	3.2	Health Net Policy Support 

 “IT Policy Services” means those
Functions associated with the development and implementation of “Health Net IT Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies) governing or pertaining to the IT Services,
more specifically, the conduct of Health Net’s IT Services. 
 Below are some examples of selected IT Policy Development Services
Functions, which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only: 
  

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net IT Policies; 

  

					
	SOW #4 (Information Technology)         		 		Health Net / Cognizant Confidential

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	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net IT Policies; 

 

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

 

	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect IT Services and participate in operational implementation and/or affected system changes of legal
and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net IT Policies and submit them to the relevant Health Net and Supplier stakeholders for review and
comment; 

  

	 	(d)	Prepare updated versions of Health Net IT Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net IT Policies and access to Health Net personnel to such communications and training; and 

 

	 	(f)	Implement Heath Net-approved Health Net IT Policies by Supplier Personnel involved in the performance of the IT Services. 

  

	4.	CHANGES TO SUPPLIER SOLUTION 

 As a general principal, Supplier has both the right and the obligation to
perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-3 (Solution Description). That said, Supplier is charged with responsibility for the adequacy of its Solution, which is to say
that if the Supplier’s Solution, as described in Exhibit A-3 (Solution Description), should prove inadequate at any point during the Statement of Work Term for Supplier to perform and deliver the Services in accordance with the
obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in accordance with such obligations. All
such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such changes at its own cost and expense
except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them as defined in Schedule C-11 and as required by State or Federal Laws. 

  

					
	SOW #4 (Information Technology)         		 		Health Net / Cognizant Confidential

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	5.	OPERATIONAL REPORTING 

 Supplier shall generate and provide to Health Net (a) each operational
report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is no longer required, (b) such other operational reports as Health Net may reasonably request from
time to time, and (c) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and evolutions of the IT Services during the term of this Statement of Work. 

 

	6.	OPERATING HOURS 

 Supplier will at minimum mirror the regular operating hours adhered to by Health
Net’s IT organization as of the Effective Date. Supplier acknowledges and agrees that performance of the IT Services will regularly require Supplier Personnel to perform additional/overtime work outside regular operating hours, and that such
additional/overtime work is within the scope of the IT Services. 
 Supplier will extend its hours of operations (for example, through overtime, weekend and
holiday work) from time to time as needed to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of operations is within the scope of the IT
Services. 
  

	7.	APPLICABILITY OF THE AGREEMENT 

 This SOW #4 (IT Services) is hereby made a part of, and is
subject to and governed by, the Agreement. This SOW #4 (IT Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW #4 (Information Technology)         		 		Health Net / Cognizant Confidential

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IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #4 (IT Services) to be signed and delivered by its duly
authorized officer, all as of the SOW Effective Date set forth above. 
  

			
	Health Net, Inc.		Cognizant Healthcare Services, LLC

  

									
	By:		  
				By:		  

  

									
	Print Name:		  
				Print Name:		  

  

									
	Title:		  
				Title:		  

  

									
	Date:		  
				Date:		  

  
  

  

					
	SOW #4 (Information Technology)         		 		Health Net / Cognizant Confidential

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EXHIBIT A 
 TO SOW #4 (IT
SERVICES) 
  

	1.	INTRODUCTION 

  

	1.1	Overview of Services 

  

	 	(a)	This Exhibit A describes the specific Services to be provided by Supplier under this IT SOW, as well as the dependent or related Functions for which Health Net is retaining responsibility. It does so by means of a Scope
Model – a table or tables that encompass the portions of Health Net’s operations and Operating Environment within the scope of or relevant to the Services under this IT SOW and maps the standard processes performed within the relevant area
of operations (referred to as the Processes) against various categories of associated operational infrastructure components or services (referred to as Elements). Each cell of the Scope Model represents the intersection of a Process with an Element
and designates the party (referred to as the Actor) responsible for performing that Process in relation to such Element. Where Supplier is designated as an Actor, the Scope Model describes which Functions Supplier is responsible for performing as
part of the Services (the ‘What’), not the manner in which Supplier is responsible for performing them (the ‘How’). The manner in which Supplier is to perform the Services is set forth elsewhere in this IT SOW and the Agreement,
including Exhibit A-3 and Exhibit B (Service Levels). 

  

	 	(b)	As part of the Services, Supplier will provide to and perform for Health Net the Functions for which Supplier is identified as being the responsible Actor in the Scope Model. As part of such responsibility, Supplier
will perform the associated activities identified in Exhibit A-1-1 (Process Definitions), including the Embedded Processes that are required or relevant under the circumstances. 

 

	 	(c)	Health Net (or an Other Third Party for whom Supplier is not responsible) will be responsible for performing those Functions for which Health Net or such an Other Third Party is identified as the responsible Actor in
the Scope Model, including the Embedded Processes that are required or relevant under the circumstances. 

  

	 	(d)	Except as otherwise provided in the applicable Schedule C – 11 Financial Responsibility Matrix, the responsible Actor designated in a Process-Element intersection is responsible not only for performing the
indicated Process in relation to such Element, but also for providing all types of resources necessary to perform those Processes. Where Supplier is the designated Actor in a Process-Element intersection and another Actor is designated as having
Financial Responsibility for providing certain types of resources (e.g., Equipment, Software, labor, facilities, third-party services, business processes, recruiting and training) required by Supplier to so perform, Supplier’s responsibility to
perform is subject to Supplier receiving timely access to the required resources from the Actor designated as having Financial Responsibility for those resources. 

 

	 	(e)	Where the documents comprising this Exhibit A include references to specific resources (e.g., tools, systems, Equipment or Software) that will be used by Supplier in performing the Services, if Supplier
implements any successors or replacements to such resources, the applicable references will be deemed to include such successor or replacement resources. 

  

					
	SOW #4 (Information Technology) Exhibit A		A-1		Health Net / Cognizant Confidential

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	1.2	Additional Services 

  

	 	(a)	The IT Services include the Cross Functional Services described in Section 3 of Schedule A (Cross-Functional Services) and the Functions included as part of the Embedded Processes described in Section 4
of Schedule A (Cross-Functional Services), each as they relate to the Functions included as part of the IT Services. For clarity, this includes Supplier’s responsibility to manage all activities performed by Supplier Managed Third
Parties in accordance Section 3.8 (Managed Third Party Management Services) of Schedule A (Cross-Functional Services). 

  

	 	(b)	The IT Services also include all Functions performed by or associated with the Health Net personnel referenced in Schedule Z, all of which are either being transferred to Supplier or displaced by Supplier roles as a
result of the execution of this IT SOW. Such Functions will be deemed to be part of the IT Services to be performed by Supplier as if expressly set forth in this IT SOW. 

 

	1.3	Quality Reviews 

 Without limiting Health Net’s rights under Section 18
(Audits and Records) of the Terms and Conditions, Health Net reserves the right to perform quality reviews and audits of Supplier’s performance of the IT Services when and to the extent it desires in its sole discretion. For the
avoidance of doubt, Health Net is not obligated to perform any level of such quality reviews and audits, except to the extent required by applicable Law. 
  

	1.4	Reporting 

 Supplier shall generate and provide to Health Net (i) each operational
report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is no longer required, (ii) such other operational reports as Health Net may reasonably request from
time to time consistent generally with the level of operational reporting performed internally by Health Net prior to the BPaaS Services Commencement Date, and (iii) such modifications to or replacements for the foregoing reports as may be
necessary to reflect changes to and evolutions of the IT Services during the term of this IT SOW. 
  

	1.5	Infrastructure Software - Mapping Products to Elements 

 The Infrastructure Software
Scope Model lists the Infrastructure Elements Categories and assigns Actors roles to those Categories. The Elements applicable to each Category are listed in A-3 Elements Definitions. During Phase 1, Supplier and Health Net shall assign the
Infrastructure Software running or anticipated to be running in either the Supplier Data Centers or at Health Net locations to the appropriate Infrastructure Software Elements. Following this exercise, all Infrastructure Software shall be assigned
to an Infrastructure Software Element such that all Infrastructure Software is represented on the Infrastructure Scope Model. 
  

	1.6	Supplier Facilities 

 The Supplier Facilities from which Supplier is permitted to provide
the Services are listed in Schedule F of the Agreement. 

  

					
	SOW #4 (Information Technology) Exhibit A		A-2		Health Net / Cognizant Confidential

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	2.	EXHIBIT A CONTENT 

 Exhibit A is comprised of this cover document and the following
Exhibits: 
  

					
	 Table 1: Exhibits to IT
SOW

	 Item #
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	 Exhibit A-1 (Scope

Model)
	  	Contains the Scope Model for this IT SOW. It allocates among the pertinent Actors functional responsibility for the Processes that are relevant to the scope of this IT SOW. As a means of identifying required interactions between
Supplier and Health Net, and between Supplier and other third-party providers of related products and services to Health Net, the Scope Model’s scope of coverage is, by design, broader than the scope of Supplier’s Services under this IT
SOW. Exhibit A-1 includes the following additional Exhibits:
			
	2	  		  	Exhibit A-1-1 (Process Definitions) sets forth the definitions of the Processes used in the Scope Model. The Process definitions are intended to provide industry-standard descriptions of the processes that are typically
performed by companies in the area of operations that is within the scope of this IT SOW.
			
	3	  		  	Exhibit A-1-2 (Element Definitions) sets forth the definitions of the Elements used in the Span axis of the Scope Model.
			
	4	  	 Exhibit A-3 (Solution

Description)
	  	Describes Supplier’s solution for the provision of the IT Services. Exhibit A-3 includes the following additional Exhibits:
			
	5	  		  	Exhibit A-3-1 (Solution Description – ITO Phase 1)
			
	6	  		  	Exhibit A-3-2 (Solution Description – ITO Phase 2)
			
	7	  		  	Exhibit A-3-3 (Solution Description – BPaaS Services)
			
	8	  		  	Exhibit A-3-4 (Solution Description – People / Processes)
			
	9	  		  	Exhibit A-3-6 (Solution Description – Security Solution)

  

	3.	DEFINITIONS AND INTERPRETATION 

 The following terms, when used in this IT SOW, will have
the meanings given them below unless otherwise specified or required by the context in which the term is used. Any capitalized term used but not defined in this Exhibit 2 will have the meaning indicated in Schedule W (Glossary) or elsewhere in the
Agreement. 
  

			
	Defined Term	  	Meaning
	“Actor”	  	An entity (or group within an entity) assigned functional responsibility for a Process-Element intersection in the Scope Model – i.e., assigned responsibility for performing the indicated Process with respect to the
indicated Element category.
		
	“Elements”	  	Entries on the Span axis of a Scope Model. Elements may represent a category of components (e.g., Servers), services (e.g., Managed WAN), individual products (e.g., VPN Concentrator or individual
applications.

  

					
	SOW #4 (Information Technology) Exhibit A	  	A-3	  	Health Net / Cognizant Confidential

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	Defined Term	  	Meaning
	“Other Third Party”	  	An Actor other than Health Net or Supplier. Certain Other Third Parties may be identified by name in a Scope Model, others by the general designation of “Other Third Party,” and others by type of provider.
		
	“Operating Environment”	  	Collectively, the Equipment, Software, systems, communications networks and connectivity, facilities, and other infrastructure components owned, controlled, or operated by Health Net (or its Affiliates or third-party services
providers on behalf of Health Net and Service Recipients) and used to receive, use transmit and otherwise enjoy the benefits of the Services.
		
	“Processes”	  	The groupings of activities on the Process axis of a Scope Model, which may pertain to an individual (level 3) process (e.g., Technology Architecture Development, Solution Development) or a group of related (level 2)
processes (e.g., Domain Architecture, Solution Formation).
		
	“Service Delivery Environment”	  	Collectively, the Equipment, Software, systems, communications networks and connectivity, facilities, and other infrastructure components owned, controlled, or operated by Supplier (or its Affiliates or other Subcontractors) and
used by Supplier Personnel in rendering the Services.
		
	“Span”	  	The axis of a Scope Model that depicts Health Net’s Operating Environment and / or Supplier’s Service Delivery Environment or, alternatively, categories of services that are relevant to the Processes on the Process axis of
the Scope Model.

  

	4.	KEEPING SCOPE MODEL DOCUMENTS UP TO DATE 

 At least once a year during the IT SOW Term,
and more often as necessary to reflect the effects of agreed Changes, the parties will review the Scope Model and update it (and, as necessary, the associated Process and Element definitions) to reflect the following: 

 

	 	(a)	Changes in any of the Actors or the responsibilities assigned to any of the Actors in the Scope Model; or 

  

	 	(b)	Additions, deletions, or other modifications to the Scope Model’s Span, including as necessary to reflect changes in the Health Net locations served by Supplier or in Supplier’s Service Delivery Centers.

 In as much as the Scope Model documents the allocation of functional responsibility to Actors other than Health Net and
Supplier, Health Net has the right to make unilateral changes in the 

  

					
	SOW #4 (Information Technology) Exhibit A	  	A-4	  	Health Net / Cognizant Confidential

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Scope Model from time to time to reflect changes in any of the Other Third Parties or their assigned responsibilities (including by
(i) adding or deleting Elements (including adding new Elements to A-1-2 (Element Definitions)) or (ii) changing the designated Actor(s)) provided such changes do not alter Supplier’s scope of Services or affect
Supplier’s performance of the Services in any material respect. Any such changes to the Scope Model will not be considered to be Changes for purposes of the Change Control Procedure. If such changes alter Supplier’s scope of Services or
affect Supplier’s performance of the Services in any material respect, such changes will be handled via the Change Control Procedure. 

  

					
	SOW #4 (Information Technology) Exhibit A		A-5		Health Net / Cognizant Confidential

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Exhibit A-1 
 Scope Model

  

					
	SOW #4 (IT) Exhibit A-1		A-1-1, Cover Page Tab		Health Net / Cognizant Confidential

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Phase 2 Scope Model tabs:  
 Phase 2 Infra
Hardware 
 Phase 2 Infra Software 

Phase 2 Applications 
 Phase 2
Legend 
 Phase 3 Scope Model tabs:  

Phase 3 Infra Hardware 
 Phase 3
Infra Software 
 Phase 3 Applications 

Phase 3 Legend 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-2, Summary Tab		Health Net / Cognizant Confidential

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	SOW #4 (IT) Exhibit A-1		A-1-3, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

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	SOW #4 (IT) Exhibit A-1		A-1-4, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

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	SOW #4 (IT) Exhibit A-1		A-1-5, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-6, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-7, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-8, Phase 2 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-9, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-10, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-11, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-12, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-13, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-14, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-15, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-16, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-17, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-18, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-19, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-20, Phase 2 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-21, Phase 2 Applications Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-22, Phase 2 Applications Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-23, Phase 2 Legend Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-24, Phase 3 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-25, Phase 3 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-26, Phase 3 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-27, Phase 3 Infra Hardware Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-28, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-29, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-30, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-31, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-32, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-33, Phase 3 Infra Software Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-34, Phase 3 Applications Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-35, Phase 3 Applications Tab		Health Net / Cognizant Confidential

 Final 
 

 

  

					
	SOW #4 (IT) Exhibit A-1		A-1-36, Phase 3 Legend Tab		Health Net / Cognizant Confidential

 Final 
  

EXHIBIT A-1-1 
 PROCESS
DEFINITIONS 

  

					
	SOW#4 (IT) Exhibit A-1-1		 		Health Net / Cognizant Confidential

  
 

 
 IT Process Definitions 

Version 3.1.0 
 Table of Contents 

 

					
	Section I.		 IT Process Definitions
		
	Section II.		 Embedded Processes
		
	Section III.		 Glossary
		

  

					
	

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	I.	IT Process Definitions 

  

					
	 Processes
	  	 Definitions

			
	1	  	 Governance and

Leadership
	  	
			
	1.1	  	IT Management	  	
			
	1.1.1	  	IT Leadership	  	 The purpose of “IT Leadership” is to lead the IT organization in delivering IT services that meet the business requirements of its
Clients.
  
 IT Leadership includes the following activities:

			
		  		  	 1.     Promoting and maintaining the alignment of IT services with the needs of its Clients;

			
		  		  	 2.     Leading the IT organization so as to deliver on the requirements and objectives of Clients,
including:

			
		  		  	 (a)    Enabling Clients to exploit business opportunities and maximize their individual and collective
potential;

			
		  		  	 (b)    Promoting the responsible use of IT assets and services; and

			
		  		  	 (c)    Providing macro-level guidance as to how, when and where IT is to deliver its services; and

			
		  		  	 3.     Promulgating the desired values, philosophies, strategies and performance of IT throughout the IT
organization and the enterprise.

			
	1.1.2	  	IT Governance	  	 The purpose of “IT Governance” is to establish the framework for decision rights and the platform for the oversight of the key
aspects of the IT environment and services.
  
 IT Governance includes the following
activities:

			
		  		  	 1.     Assigning, establishing and enforcing decision rights throughout the IT organization;

			
		  		  	 2.     Establishing appropriate oversight of IT compliance, risk management, program management, IT finance,
Client relations, performance management, actor management, service integration and other key aspects of IT, including:

			
		  		  	 (a)    Assigning personnel with responsibility to oversee the underlying
functions;

  

					
	

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		  		  	 (b)    Providing adequate resources and authority to such personnel to carry out their oversight-based activities;
and

			
		  		  	 (c)    Establishing committees and meetings, including assigning committee heads and establishing meeting
schedules; and

			
		  		  	 3.     Reviewing recommendations, requests for review and other similar interactions from Process owners and,
as applicable, Actors and providing feedback, including advice and consent when appropriate.

			
	1.1.3	  	 Risk
 Management
	  	 The purpose of “Risk Management” is to monitor, identify, assess and develop actions to mitigate and remediate IT risk.

 
 Risk Management includes the following activities:

			
		  		  	 1.     Obtaining and maintaining a comprehensive understanding of all relevant aspects of the IT and Client
environments that may give rise to Risk Events or may result in IT risk, including:

			
		  		  	 (a)    Systems associated with the delivery of IT services, including the access and storage points for
confidential customer and Client information;

			
		  		  	 (b)    IT plans or other similar information that could help identify exposure to risks that could limit the
enterprise’s ability to implement its strategic priorities;

			
		  		  	 (c)    Business recovery and continuity plans to gain insight into the critical systems and control
environment;

			
		  		  	 (d)    Due diligence and monitoring activities associated with the management of External Actors;

			
		  		  	 (e)    IT operational reports providing information regarding potential performance or control
issues;

			
		  		  	 (f)    Quality control reviews performed by Process or Element owners pertaining to controls that could help
identify noncompliance with policy or areas of weakness;

			
		  		  	 (g)    IT audit findings that could shed light on the veracity and responsiveness of the Actors’ commitments
to policy compliance and operational control; and

			
		  		  	 (h)    Viewpoints of Actors’ senior management as they pertain to resource limitations, real and perceived
threats, priorities and key controls;

  

					
	

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		  		  	 2.     Analyzing the IT and Client environments and associated information for the purpose of:

			
		  		  	 (a)    Identifying the universe of Risk Events;

			
		  		  	 (b)    Estimating the likelihood of occurrence of Risk Events;

			
		  		  	 (c)    Identifying and estimating the impact of Risk Events on the enterprise from the applicable perspectives
(e.g., strategic, operational, financial, reputation) and that appropriately take into consideration lost revenue, flawed business decisions, data recovery and reconstruction time and expense, costs of litigation and potential judgments, loss of
market share, and increases to premiums or denials of insurance coverage;

			
		  		  	 (d)    Developing comprehensive risk assessments of IT operations and activities; and

			
		  		  	 (e)    Developing Key Risk Indicators to enable monitoring of changes in risk.

			
		  		  	 3.     Documenting the identified risks in a “Risk Register” and sharing the content with other
Actors as appropriate.

			
		  		  	 4.     Identifying and developing a prioritization of actions that is appropriate for the complexity of the
enterprise that is designed to:

			
		  		  	 (a)    Reduce risk exposure; and

			
		  		  	 (b)    Establish mitigating controls for safe, sound and efficient IT operations;

			
		  		  	 5.     Reporting the recommended prioritization of actions to the applicable Process or Element owner(s) and
incorporating feedback into the prioritization;

			
		  		  	 6.     Submitting appropriately approved actions to the applicable Process or Element owner(s);

			
		  		  	 7.     Monitoring, analyzing and reporting on risk reduction, mitigation and remediation activities, including
the extent to which risk assessment and prioritization results are integrated into various operational aspects of IT, including:

			
		  		  	 (a)    Technology budgeting, investment and deployment
decisions;

  

					
	

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		  		  	 (b)    Contingency planning;

			
		  		  	 (c)    Policies and procedures;

			
		  		  	 (d)    Controls;

			
		  		  	 (e)    Staffing and expertise;

			
		  		  	 (f)    Insurance;

			
		  		  	 (g)    Performance benchmarks;

			
		  		  	 (h)    Service levels; and

			
		  		  	 (i)     Policy enforcement and compliance; and

			
		  		  	 8.     Reviewing business requirements and proposed solutions, and providing feedback regarding risk and
control to the applicable Process owner(s).

			
	1.1.4	  	 Compliance
 Management
	  	 The purpose of “Compliance Management” is to cause all applicable External Compliance Requirements and External Actor Compliance
Requirements to be fulfilled and to monitor the fulfillment of such requirements.
  

Compliance Management includes the following activities:

			
		  		  	 1.     Identifying the External Compliance Requirements applicable to the IT environment;

			
		  		  	 2.     Obtaining from External Actors, comprehensive written descriptions of their External Actor Compliance
Requirements, including detailed statements describing how such requirements are being fulfilled;

			
		  		  	 3.     Developing, documenting and disseminating to Actors the policies designed to fulfill the External
Compliance Requirements for the IT environment;

			
		  		  	 4.     Developing and documenting the procedures and controls designed to detect and prevent noncompliance
with the External Compliance Requirements;

			
		  		  	 5.     Developing and implementing an ongoing compliance (i.e., External Compliance Requirements) and ethics
training program for all Actors, including those at senior levels;

			
		  		  	 6.     Determining the extent to which the IT environment is in compliance with the External Compliance
Requirements, including, when appropriate, implementing:

  

					
	

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		  		  	 (a)    Auditing and monitoring systems designed to assist in the detection of noncompliance;

			
		  		  	 (b)    Systems to report or seek guidance regarding potential or actual noncompliance; and

			
		  		  	 (c)    Mechanisms designed to protect anonymity and confidentiality;

			
		  		  	 7.     Determining the extent to which External Actors are in compliance with their respective External Actor
Compliance Requirements, including (when appropriate):

			
		  		  	 (a)    Obtaining from the External Actors appropriate written statements regarding their compliance with the
requirements; and

			
		  		  	 (b)    Obtaining audits and assessments of External Actors by appropriately recognized independent
organizations;

			
		  		  	 8.     Documenting and disseminating information regarding the compliance program to the applicable Process or
Element owner(s) and other personnel as appropriate;

			
		  		  	 9.     Enforcing and encouraging compliance through appropriate mechanisms, including:

			
		  		  	 (a)    Establishing disciplinary and incentive measures; and

			
		  		  	 (b)    Documenting and reporting instances of noncompliance to the applicable Process or Element owner(s),
offending Actors and other personnel as appropriate;

			
		  		  	 10.   Responding to and taking reasonable steps to prevent incidents of noncompliance with the External Compliance
Requirements;

			
		  		  	 11.   Identifying personnel or Actors within the IT environment that have shown either a disregard for compliance or a
tendency toward improper conduct and notifying the applicable Process owner(s) and other personnel as appropriate; and

			
		  		  	 12.   Reviewing business requirements and proposed solutions to:

			
		  		  	 (a)    Identify and communicate the applicable External Compliance Requirements; and

			
		  		  	 (b)    Provide feedback to the applicable Process or Element owner(s), including advice and consent.

			
	1.2	  	Client Relations	  	

  

					
	

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	1.2.1	  	Internal Client Relationship Management	  	 The purpose of “Internal Client Relationship Management” is to coordinate and manage the activities necessary to initiate, enhance
and maintain the IT services that support Internal Clients.
  
 Internal Client
Relationship Management includes the following activities:

			
		  		  	 1.     Identifying Internal Clients;

			
		  		  	 2.     Acting as an advocate for Internal Clients with IT by promoting and actively seeking resolution of
issues related to the delivery, performance and pricing of IT services;

			
		  		  	 3.     Obtaining issue handling and escalation requirements from Internal Clients and providing to the
applicable Process owner(s);

			
		  		  	 4.     Tracking Internal Client issues, escalations and resolutions;

			
		  		  	 5.     Obtaining Internal Client interaction requirements and providing to the applicable Process
owner(s);

			
		  		  	 6.     Facilitating IT service activities with Internal Clients;

			
		  		  	 7.     Advising Internal Clients of potential opportunities to create value using IT services;

			
		  		  	 8.     Working with Internal Clients to identify and specify strategic IT-related business missions,
objectives and concepts, including obtaining the input of the applicable Process owner(s);

			
		  		  	 9.     Coordinating the provision of broad-based input (e.g., technical, resource, process) to Internal
Clients regarding new business requirements that may affect the IT environment, including:

			
		  		  	 (a)    Guidance on technical solutions in the pre-business requirements development phase; and

			
		  		  	 (b)    Pricing, risk and duration information;

			
		  		  	 10.   Reviewing periodically with Internal Clients relevant information regarding ongoing and project-based activities,
including IT delivery of Client-specific results regarding:

			
		  		  	 (a)    Performance (e.g., measures and metrics, performance credits);

			
		  		  	 (b)    Projects (e.g., pipeline, status, issues, supply limitations);

			
		  		  	 (c)    Financials (e.g., allocations, chargebacks, invoices);
and

  

					
	

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		  		  	 (d)    Satisfaction surveys (e.g., Client, stakeholder);

			
		  		  	 11.   Reviewing the Service Catalog with Internal Clients and providing feedback to the applicable Process
owner(s);

			
		  		  	 12.   Attending, as applicable and appropriate, Internal Client management meetings or other similar forums to provide
perspective, support and feedback regarding the IT services, including planned future delivery capabilities and performance of IT services;

			
		  		  	 13.   Coordinating the provision of technical input and guidance into the development of Internal Client responses to
requests for proposals or other similar constructs used by its customers for goods and/or services; and

			
		  		  	 14.   Attending Actor disagreement and dispute forums pertaining to issues with Internal Clients.

			
	1.2.2	  	External Client Relationship Management	  	 The purpose of “External Client Relationship Management” is to coordinate and manage the applicable activities necessary to
initiate, enhance and maintain the IT services that support External Clients.
  
 External
Client Relationship Management includes the following activities:

			
		  		  	 1.     Identifying External Clients;

			
		  		  	 2.     Acting as an advocate for External Clients by promoting and actively seeking resolution of issues
related to the delivery, performance and pricing of IT services;

			
		  		  	 3.     Obtaining issue handling and escalation requirements from External Clients and providing to the
applicable Process owner(s);

			
		  		  	 4.     Tracking External Client issues, escalations and resolutions;

			
		  		  	 5.     Obtaining External Client interaction requirements and providing to the applicable Process
owner(s);

			
		  		  	 6.     Facilitating IT service activities with External Clients;

			
		  		  	 7.     Coordinating the provision of input (e.g., technical, resource, process) to External Clients regarding
new business requirements that may affect the IT environment, including:

  

					
	

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		  		  	 (a)    Guidance on technical solutions in the pre-business requirements development phase; and

			
		  		  	 (b)    Pricing, risk and duration information;

			
		  		  	 8.     Reviewing periodically with External Clients relevant information regarding ongoing and project-based
activities, including IT delivery of Client-specific results regarding:

			
		  		  	 (a)    Performance (e.g., measures and metrics, performance credits);

			
		  		  	 (b)    Projects (e.g., pipeline, status, issues, supply limitations);

			
		  		  	 (c)    Financials (e.g., allocations, chargebacks, invoices); and

			
		  		  	 (d)    Satisfaction surveys (e.g., Client, stakeholder);

			
		  		  	 9.     Reviewing the Service Catalog with External Clients and providing feedback to the applicable Process
owner(s); and

			
		  		  	 10.   Attending Actor disagreement and dispute forums pertaining to issues with External Clients.

			
	1.2.3	  	 Demand
 Management
	  	 The purpose of “Demand Management” is to align Internal Client demand and consumption of IT services with the applicable resource
and operational constraints, and to optimize demand by coordinating requests across Internal Clients and encouraging standards.
  

Demand Management includes the following activities:

			
		  		  	 1.     Informing, directly or indirectly through the owner of Internal Client Relationship Management,
Internal Clients of their consumption of IT services and, to the extent applicable, the ramifications of such behavior;

			
		  		  	 2.     Obtaining information regarding historical, current and future requests for IT services;

			
		  		  	 3.     Evaluating the impact (e.g., strategic, tactical, operational) on IT and its Internal Clients based on
historical and expected future receipt of requests for IT services;

			
		  		  	 4.     Rationalizing demand by regular review of work pipelines and identifying opportunities for
collaboration, standardization and reuse; and

  

					
	

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		  		  	 5.     Developing and promulgating methodologies and/or tools that help in capturing, documenting and managing
the impact, decisions and results associated with consumption and demand behavior.

			
	1.3	  	 Enterprise
 Architecture
	  	
			
	1.3.1	  	Enterprise Architecture Development	  	 The purpose of “Enterprise Architecture Development” is to design the underlying IT framework that defines and describes the
applicable characteristics of the IT-enabled platforms, information,
 applications and security required by Clients to attain their objectives and achieve
their business visions.
 Enterprise Architecture Development includes the following activities:

			
		  		  	 1.     Defining the guiding principles, high-level objectives and scope of architecture
development;

			
		  		  	 2.     Identifying, documenting and assessing business requirements, drivers and mandates, including those
derived internally and those derived from external sources such as External Clients, regulations and other compliance mandates;

			
		  		  	 3.     Identifying high-level alternative approaches, including transition timelines and interim
states;

			
		  		  	 4.     Developing, documenting and disseminating the Enterprise Architecture deliverables for use by the
applicable Process owner(s) of Domain Architecture;

			
		  		  	 5.     Defining the architectural deliverables to be developed by the applicable Process owner(s) of Domain
Architecture, including:

			
		  		  	 (a)    Architectural-level deliverables (e.g., vision statement, IT industry best practices);

			
		  		  	 (b)    Conceptual-level deliverables (e.g., conceptual models, high-level event process models, event-process
matrices);

			
		  		  	 (c)    Solution-level deliverables (e.g., logical models, detailed event process models); and

			
		  		  	 (d)    Implementation-level deliverables (e.g., detailed designs);

			
		  		  	 6.     Developing service continuity requirements,
including:

  

					
	

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		  		  	 (a)    Identifying and documenting Client business recovery requirements, expectations and
constraints;

			
		  		  	 (b)    Defining success criteria; and

			
		  		  	 (c)    Developing and providing service continuity plan requirements to the applicable Process
owner(s);
and

			
		  		  	 7.     Managing development of Domain Architecture, including:

			
		  		  	 (a)    Establishing timelines;

			
		  		  	 (b)    Identifying transition steps/interim states;

			
		  		  	 (c)    Providing instructions regarding deliverable timing and quality requirements; and

			
		  		  	 (d)    Measuring the performance of Domain Architecture.

			
	1.3.2	  	Domain Architecture Approval	  	 The purpose of “Domain Architecture Approval” is to perform the activities necessary to evaluate and approve each Domain
Architecture.
  
 Domain Architecture Approval includes the following
activities:

			
		  		  	 1.     Confirming that, both individually and collectively, the Domain Architecture deliverables will satisfy
the requirements, drivers and mandates identified by the Enterprise Architecture;

			
		  		  	 2.     Confirming that individual Domain Architectures do not conflict with other Domain
Architectures;

			
		  		  	 3.     Authorizing deviation from the requirements, drivers and mandates identified by the Enterprise
Architecture; and

			
		  		  	 4.     Obtaining approvals from the appropriate personnel designated to approve Domain
Architectures.

			
	1.3.3	  	Enterprise Architecture Approval	  	 The purpose of “Enterprise Architecture Approval” is to perform the activities necessary to evaluate and approve the Enterprise
Architecture.
  
 Enterprise Architecture Approval includes the following
activities:

			
		  		  	 1.     Confirming that the Enterprise Architecture requirements, drivers and mandates are necessary and
sufficient to balance Client needs and constraints;

  

					
	

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		  		  	 2.     Confirming that the Enterprise Architecture will satisfy the requirements, drivers and
mandates;

			
		  		  	 3.     Authorizing deviation from Client requirements, drivers and mandates; and

			
		  		  	 4.     Obtaining approvals from the appropriate personnel designated to approve Enterprise
Architectures.

			
	1.4	  	 Delivery
 Strategy
	  	
			
	1.4.1	  	Delivery Strategy Development	  	 The purpose of “Delivery Strategy Development” is to define how the IT services will be delivered.

 
 Delivery Strategy Development includes the following activities:

			
		  		  	 1.     Developing alternative Delivery Models in response to changes in the underlying goals, objectives and
Domain Architecture, as well as technologies and services available in the marketplace;

			
		  		  	 2.     Determining the assignment of Actor responsibility for each Element and Process (or groups thereof)
pertinent to the Delivery Model such that the assignment supports the applicable Domain Architecture(s), the Enterprise Architecture, and the applicable Client needs;

			
		  		  	 3.     Determining high-level characteristics (e.g., internal, external, local, regional, global) of the
Actors and their span of service delivery (e.g., geographic, Client, facility types, technology grouping);

			
		  		  	 4.     Using Delivery Model constructs to develop detailed statements of responsibility for each
Actor;

			
		  		  	 5.     Defining and documenting delivery requirements to be incorporated into sourcing strategies by the
applicable Process owner(s) of Sourcing Strategy Development, including:

			
		  		  	 (a)    Strategic segmentation of the Processes;

			
		  		  	 (b)    Advice and consent guidelines regarding selection of Actors;

			
		  		  	 (c)    Service delivery integration requirements, including, as applicable, specific process and tool
platforms;

			
		  		  	 (d)    Interaction requirements between Actors;

  

					
	

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		  		  	 (e)    Application of specific commercialization models;

			
		  		  	 (f)    Use of various service delivery performance regimes, measures and metrics;

			
		  		  	 (g)    Use of specific procurement processes; and

			
		  		  	 (h)    Required level of organizational readiness; and

			
		  		  	 6.     Developing requirements for the integration of Actors.

			
	1.4.2	  	Delivery Strategy Approval	  	 The purpose of “Delivery Strategy Approval” is to perform the activities necessary to evaluate and approve the delivery strategy,
including the Delivery Models.
  
 Delivery Strategy Approval includes the following
activities:

			
		  		  	 1.     Confirming that the Delivery Models and delivery requirements satisfy the underlying goals, objectives,
and the applicable Client need, and comply with, or have received the necessary exceptions from the applicable Process owner(s) of Enterprise Architecture and Domain Architecture; and

			
		  		  	 2.     Obtaining approvals from the appropriate personnel designated to approve delivery
strategies.

			
	1.5	  	 Sourcing
 Strategy
	  	
			
	1.5.1	  	Sourcing Strategy Development	  	 The purpose of “Sourcing Strategy Development” is to identify the actions necessary to achieve the commercial aspects associated
with the configuration of Actors described in the delivery strategy, and to maintain alignment between these actions, the marketplace and Client requirements.
  

Sourcing Strategy Development includes the following activities:

			
		  		  	 1.     Analyzing organizational strategies, plans and constraints;

			
		  		  	 2.     Identifying sourcing objectives, desired outcomes and potential risks;

			
		  		  	 3.     Developing and documenting sourcing strategies;

			
		  		  	 4.     Identifying, prioritizing and sequencing (e.g., parallel, serial, staggered) and scheduling the number
and type of sourcing activities to be performed in a given timeframe; including:

  

					
	

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		  		  	 (a)    Developing mechanisms to describe the relative sequence and timing for the major aspects of the sourcing
activities for each underlying transaction; and

			
		  		  	 (b)    Identifying and documenting the points of linkage or dependence between the transactions;

			
		  		  	 5.     Developing performance measures to track the effectiveness of sourcing strategies against
organizational performance;

			
		  		  	 6.     Tracking the achievement of the sourcing strategies;

			
		  		  	 7.     Obtaining and analyzing market information and trends, including with respect to services and
suppliers;

			
		  		  	 8.     Identifying suppliers capable of performing the responsibility(ies) as allocated in the relevant
delivery strategy and satisfying the associated delivery requirements, including:

			
		  		  	 (a)    Identifying the tier(s) or other segmentation schemas of suppliers to be considered for those components of
IT services to be sourced externally;

			
		  		  	 (b)    Documenting the specific portfolio of suppliers to be considered for transactions;

			
		  		  	 (c)    Determining special handling requirements with respect to expected changes in the then-current population of
External Actors providing components of IT services; and

			
		  		  	 (d)    Identifying supplier integration requirements (e.g., technical, commercial, process);

			
		  		  	 9.     Determining whether changes to the existing portfolio of Actors would be beneficial;

			
		  		  	 10.   Identifying, in response to new Delivery Models or need for supplier replacement, optimal methods of procuring
and/or divesting (e.g., competitive procurement, termination of External Actors, renewal of External Actors, expansion/contraction of External Actor responsibility) those components of IT services to be performed by suppliers;

			
		  		  	 11.   Developing mature, standardized and repeatable sourcing transaction approaches and process models;

			
		  		  	 12.   Identifying and documenting the commercial terms required to achieve the desired level of Actor integration,
interoperability and independence;

  

					
	

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		  		  	 13.   Confirming that the sourcing strategy will satisfy the delivery strategy; and

			
		  		  	 14.   Obtaining approvals from the appropriate personnel designated to approve sourcing strategies.

			
	1.5.2	  	 Sourcing
 Execution
	  	 The purpose of “Sourcing Execution” is to conduct the specific sourcing activities to establish or modify commercial relationships
with Actors.
  
 Sourcing Execution includes the following activities:

			
		  		  	 1.     Obtaining and reviewing sourcing strategies;

			
		  		  	 2.     Preparing for and initiating activities related to contracts or services to be renewed, re-competed or
restructured;

			
		  		  	 3.     Developing transaction structures;

			
		  		  	 4.     Developing transaction-based organizational structures and teams;

			
		  		  	 5.     Developing communication requirements and providing to the applicable Process owner(s);

			
		  		  	 6.     Preparing requirements packages that define the products and/or services to be sourced;

			
		  		  	 7.     Soliciting and reviewing supplier proposals in response to requirements packages;

			
		  		  	 8.     Using an appropriate mix of objective and subjective measures to determine entities that best meet the
specified requirements;

			
		  		  	 9.     Negotiating statements of work, implementation solutions, Service Level Agreements, pricing and
business terms, including other operational, financial, regulatory or legal aspects relevant to transactions;

			
		  		  	 10.   Preparing and negotiating contractual documents;

			
		  		  	 11.   Obtaining approvals from the appropriate personnel designated to approve sourcing transactions; and

			
		  		  	 12.   Executing contractual documents.

  

					
	

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	1.5.3	  	 Sourcing
 Approval
	  	 The purpose of “Sourcing Approval” is to perform those activities necessary to evaluate and approve new commercial arrangements and
changes to existing commercial arrangements.
  
 Sourcing Approval includes the following
activities:

			
		  		  	 1.     Confirming that sourcing transactions are sufficient and appropriately balance stakeholder needs and
constraints, including with respect to timing and overall solution;

			
		  		  	 2.     Confirming that sourcing transactions satisfy the delivery and sourcing strategies, and are otherwise
reasonable;

			
		  		  	 3.     Confirming that the costs and benefits of sourcing transactions meet the requisite hurdles, including
those for investment approval;

			
		  		  	 4.     Confirming that the appropriate risk analyses have been performed and the identified risks are
adequately mitigated and in line with the applicable standards;

			
		  		  	 5.     Confirming that the organizational impact of sourcing transactions has been appropriately considered,
including as it pertains to Clients;

			
		  		  	 6.     Obtaining stakeholder buy-for sourcing transactions; and

			
		  		  	 7.     Obtaining approvals from the appropriate personnel designated to approve sourcing
transactions.

			
	1.6	  	IT Finance	  	
			
	1.6.1	  	 Financial
 Control
	  	 The purpose of “Financial Control” is to identify, measure, accumulate, analyze, prepare, interpret and communicate IT-based
financial and related information.
  
 Financial Control includes the following
activities:

			
		  		  	 1.     Establishing financial policies and formulating financial plans that will subsequently be expressed in
financial terms;

			
		  		  	 2.     Providing guidance for financial management decisions, including the generation, analysis, presentation
and interpretation of various financial and other related information;

  

					
	

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		  		  	 3.     Contributing to the monitoring and control of financial performance through the provision of reports,
analysis and interpretation of such reports, and the implementation of financial controls;

			
		  		  	 4.     Contributing to periodic reporting of accounting as required by statute or regulation for shareholders,
government agencies and other parties external to the business;

			
		  		  	 5.     Obtaining and reviewing relevant financial and other related information for all Actors;
and

			
		  		  	 6.     Reporting financial issues, concerns and risks to the applicable Process owner(s).

			
	1.6.2	  	 Budgeting and

Forecasting
	  	 The purpose of “Budgeting and Forecasting” is to (a) develop a comprehensive IT budget, including funding allocations and expense
constraints, (b) establish a framework for operational units of
 Internal Actors to track and manage against their respective budgets, including capital and
operational budgets, and (c) forecast future budget requirements.
  
 Budgeting and
Forecasting includes the following activities:

			
		  		  	 1.     Determining IT budgets and how such budgets will be allocated across each Actor’s various
operational units, including:

			
		  		  	 (a)    Developing, maintaining and disseminating budget guidelines and parameters (e.g., standards, frameworks,
timelines and other principles), which guidelines and parameters are intended to govern the creation and management of budgets;

			
		  		  	 (b)    Providing assistance to Internal Actors in developing budgets;

			
		  		  	 (c)    Collecting and compiling each Actor’s budgets;

			
		  		  	 (d)    Reviewing and confirming that Actor-developed budgets comply with the relevant budget guidelines and
parameters, and advising Actors of discrepancies; and

			
		  		  	 (e)    Obtaining approvals from the appropriate personnel designated to approve budgets;

			
		  		  	 2.     Measuring and reporting on actual financial performance as compared to the budget;
and

  

					
	

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		  		  	 3.     Forecasting and reporting future budget performance.

			
	1.6.3	  	 Allocation and

Chargeback
	  	 The purpose of “Allocation and Chargeback” is to use resource accounting, cost allocation, and chargeback systems to accurately and
equitably allocate the cost of IT services to Clients.
  
 Allocation and Chargeback
includes the following activities:

			
		  		  	 1.     Understanding the scope of services provided by each Actor and the associated pricing or
costs;

			
		  		  	 2.     Understanding the services and charges included within the Service Catalog and working with the
applicable Process owner(s) of Service Catalog Management to revise such charges when warranted;

			
		  		  	 3.     Obtaining and analyzing IT service consumption information by relevant Client or other
grouping;

			
		  		  	 4.     Assigning IT service costs to appropriate financial organizational groups (e.g., cost centers);
and

			
		  		  	 5.     Implementing and administering a chargeback system that records, allocates and communicates IT service
costs in an understandable, controllable manner.

			
	1.6.4	  	Invoice Review	  	 The purpose of “Invoice Review” is to confirm that invoices submitted by Actors and other IT-based suppliers are proper and
accurate.
  
 Invoice Review includes the following activities:

			
		  		  	 1.     Obtaining invoices from Actors and other suppliers;

			
		  		  	 2.     Reviewing invoices to confirm they are:

			
		  		  	 (a)    Not previously paid or in the process of being paid;

			
		  		  	 (b)    For goods and services that were approved to be purchased;

			
		  		  	 (c)    For the correct amounts in the correct currencies;

			
		  		  	 (d)    Appropriately adjusted for available credits and/or rebates; and

			
		  		  	 (e)    Consistent with the terms of the underlying commercial
arrangements;

  

					
	

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		  		  	 3.     Administering invoices that do not conform to expectations or that prompt questions,
including:

			
		  		  	 (a)    Tracking the status of such invoices;

			
		  		  	 (b)    Communicating and working with the entities that rendered such invoices to determine the proper
handling;

			
		  		  	 (c)    Obtaining suitably revised invoices or adequate additional information to enable the continuation of the
invoice review process;

			
		  		  	 (d)    Rejecting invoices where suitably revised invoices or adequate additional information does not enable
continuation of the invoice review process; and

			
		  		  	 (e)    Escalating invoices to the owner of Commercial Management and other personnel as appropriate when the
invoice issuer will not cooperate with resolution of the issue or provide reasonably requested supporting information;

			
		  		  	 4.     Verifying that the goods and services referenced on invoices were actually received and of the
appropriate quantity and quality;

			
		  		  	 5.     Coordinating with the appropriate personnel to properly identify invoices and answer questions
regarding the invoices;

			
		  		  	 6.     Assigning the applicable financial or other coding (e.g., cost center numbers) to invoices;
and

			
		  		  	 7.     Submitting invoices to the owner of Invoice Approval.

			
	1.6.5	  	Invoice Approval	  	 The purpose of “Invoice Approval” is to approve payment of reviewed invoices.

 
 Invoice Approval includes the following activities:

			
		  		  	 1.     Obtaining invoices from the owner of Invoice Review;

			
		  		  	 2.     Reviewing invoices for proper coding and timely submission;

			
		  		  	 3.     Confirming the appropriateness of payment of invoices;

			
		  		  	 4.     Verifying that payment amounts match their corresponding invoices (as appropriately adjusted for
available credits and rebates);

			
		  		  	 5.     Obtaining approvals from the appropriate personnel designated to approve invoices;
and

  

					
	

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		  		  	 6.     Submitting approved invoices to the owner of Invoice Payment.

			
	1.6.6	  	 Invoice
 Payment
	  	 The purpose of “Invoice Payment” is to pay approved invoices.

 
 Invoice Payment includes the following activities:

			
		  		  	 1.     Obtaining invoices from the owner of Invoice Approval; and

			
		  		  	 2.     Issuing payment of invoices in the proper form (e.g., check, ACH, wire), currency and
timeframe.

			
	2	  	Service Management and Integration	  	
			
	2.1	  	 Actor
 Management
	  	
			
	2.1.1	  	 Services
 Management
	  	 The purpose of “Services Management” is to collect, understand and communicate to the applicable supply-side Process owner(s) of
Service Delivery Management the demands of the IT enterprise, to work with the applicable supply-side Process owner(s) of Service Delivery Management, and to monitor and to evaluate the manner in which the demands of the IT enterprise are being
met.
  
 Services Management includes the following activities:

			
		  		  	 1.     Obtaining, organizing and validating the relevant drivers of demand for IT services by Clients and the
IT environment in general from the applicable Process owner(s);

			
		  		  	 2.     Gaining and maintaining a comprehensive understanding of:

			
		  		  	 (a)    How each Process owner delivers its IT services;

			
		  		  	 (b)    Actor performance from both objective (e.g., SLA) and subjective perspectives;

			
		  		  	 (c)    The appetite for risk in the enterprise as it relates to operational IT service delivery
alternatives;

			
		  		  	 (d)    The scope of services provided by the applicable Actors (e.g., the Service Catalog) and the costs and
benefits of ordering services within the existing scope, expanding or contracting the existing scope, or ordering services that are not currently in scope for a given Actor; and

  

					
	

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		  		  	 (e)    Each applicable External Actor’s capabilities pertaining to its service delivery role both in the IT
environment and for third parties receiving similar services from such External Actor;

			
		  		  	 3.     Establishing and maintaining a close working relationship with the applicable Process owner(s) of
Service Delivery Management;

			
		  		  	 4.     Acting as an advocate for the demand side of the IT environment, Clients and the enterprise,
including:

			
		  		  	 (a)    Providing relevant information to the applicable Process owner(s) of Service Delivery Management, including
historical and institutional knowledge regarding the systems, data, configuration, organization, Clients, culture and preferences of the enterprise;

			
		  		  	 (b)    Establishing and communicating the demand-side service delivery expectations and demand drivers to the
applicable Process owner(s) of Service Delivery Management; and

			
		  		  	 (c)    Enforcing accountability among the applicable Process owner(s) of Service Delivery Management for meeting
the enterprise’s demands for action, quality, cooperation, urgency and improvement pertaining to the delivery of IT services consistent with the capabilities and broad commitments made by the applicable Process owner(s) of Service Delivery
Management and other applicable service delivery Actors;

			
		  		  	 5.     Taking the actions necessary with the applicable Process owner(s) of Service Delivery Management to
minimize both the effect and number of instances of service-impacting episodes on the enterprise;

			
		  		  	 6.     Verifying that External Actor obligations regarding the External Actor personnel are fulfilled,
including (when appropriate):

			
		  		  	 (a)    Screening the External Actor personnel consistent with the applicable policies before instituting such
personnel within, or in support of, the IT and Client environments;

  

					
	

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		  		  	 (b)    Reviewing the résumés of candidates submitted for review by External Actors, interviewing
those selected for further review and providing feedback, including advice and consent;

			
		  		  	 (c)    Providing feedback, including advice and consent, to External Actors regarding their proposed changes to the
then-current personnel fulfilling positions designated as key;

			
		  		  	 (d)    Validating that External Actors provide a sufficient number of personnel who possess the requisite
education, skills and certification to provide the IT services; and

			
		  		  	 (e)    Advising External Actors of the need to remove certain of the External Actor personnel from providing IT
services within or in support of the IT or Client environments;

			
		  		  	 7.     Reviewing policy and procedure manual documentation that is developed and submitted by Actors for
review and approval, including:

			
		  		  	 (a)    Requesting and obtaining feedback on such documentation by the applicable Process owner(s) and other
personnel as appropriate; and

			
		  		  	 (b)    Providing feedback to the submitting Actors, including advice and consent;

			
		  		  	 8.     Enforcing External Actor obligations regarding the use of subcontractors, including:

			
		  		  	 (a)    Obtaining and reviewing information from the applicable Process owner(s) regarding the performance of the
subcontractors of External Actors;

			
		  		  	 (b)    Approving and rejecting External Actor requests to make changes to both its portfolio of approved
subcontractors and scope of responsibilities to be subcontracted; and

			
		  		  	 (c)    Determining if previously approved subcontractors of an External Actor are no longer acceptable for use
within or in support of the IT and Client environments, or parts thereof, and advising, as appropriate, the relevant Actor(s) and applicable Process owner(s) of Commercial Management;

  

					
	

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		  		  	 9.     Obtaining and reviewing documentation and other relevant information regarding deliverables produced by
Actors, including requests by Actors for the acceptance of deliverables, and providing feedback, including advice and consent when appropriate to the relevant Actor(s) and applicable Process owner(s);

			
		  		  	 10.   Attending IT service delivery-related meetings, both recurring and ad hoc, including those where the applicable
Process owner(s) of Service Delivery Management may also be present, and providing input, including (when appropriate):

			
		  		  	 (a)    Making recommendations;

			
		  		  	 (b)    Providing historical, Client or other information regarding the IT environment and the
enterprise;

			
		  		  	 (c)    Countermanding decisions by other Process owner(s), including those of Service Delivery Management;
and

			
		  		  	 (d)    Waiving an Actor’s SLA obligations;

			
		  		  	 11.   Verifying that the applicable Process owner(s) of Service Delivery Management follow through with their short-to
long-term service delivery commitments;

			
		  		  	 12.   Articulating the short- to long- term results of a comprehensive set of service delivery characteristics to the
applicable Process owner(s), the enterprise and other personnel, as appropriate, including the:

			
		  		  	 (a)    Status, activities and timeframes regarding noteworthy Incidents and Problems, both ongoing and
resolved;

			
		  		  	 (b)    Type, duration and purpose of IT change that will impact the enterprise;

			
		  		  	 (c)    Performance and financial shortfalls of service delivery Actors; and

			
		  		  	 (d)    Delivery and integration shortcomings of service delivery Actors (e.g., management, knowledge, personnel,
process, organization, culture, tools);

			
		  		  	 13.   Escalating issues that cannot be reasonably resolved with the applicable Process owner(s) of Service Delivery
Management to the applicable Process owner(s) or other appropriate personnel; and

  

					
	

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		  		  	 14.   Attending Actor disagreement and dispute forums regarding matters pertaining to IT service delivery.

			
	2.1.2	  	Incident Oversight	  	 The purpose of “Incident Oversight” is to oversee, inform and communicate to the applicable Process

owner(s) of Incident Management and other Processes the relevant preferences for resolving Incidents, work with the applicable Process owner(s) of Incident
Management to plan for, monitor and evaluate the manner in which Incidents are addressed and, if necessary, to take over various operational roles pertaining to the handling of an Incident.

 
 Incident Oversight includes the following activities:

			
		  		  	 1.     Gaining and maintaining a comprehensive understanding of each delivery Actor’s role as it pertains
to the management and resolution of Incidents, including, for the Process owner(s) of Incident Management and Incident Management Execution, their relevant methodologies, processes and tools;

			
		  		  	 2.     Establishing and maintaining a close working relationship with the applicable Process owner(s) of
Incident Management and Incident Management Execution;

			
		  		  	 3.     Acting as an advocate for the demand side of the IT environment, Clients and the enterprise;
including:

			
		  		  	 (a)    Gaining and maintaining an understanding of the perspectives and preferences of Clients, the enterprise and
IT leadership regarding the handling of Incidents;

			
		  		  	 (b)    Establishing and communicating the demand-side Incident resolution expectations to the applicable Process
owner(s), including Incident Management;

			
		  		  	 (c)    Providing information to the applicable Process owner(s) of Incident Management regarding notices to be
issued regarding Incidents; and

			
		  		  	 (d)    Enforcing accountability among the applicable Process owner(s) of Incident Management and other relevant
Processes for meeting the enterprise’s demands for action, quality, cooperation and urgency pertaining to the management and resolution of Incidents;

			
		  		  	 4.     Overseeing all Incidents across their lifecycles,
including:

  

					
	

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		  		  	 (a)    Gaining information about Incidents from the applicable Process owner(s) of Incident Management, Incident
Management Execution and other relevant Processes, including attending recurring or ad hoc meetings where Incidents are being discussed;

			
		  		  	 (b)    Obtaining and evaluating information regarding the management and resolution of Incidents, including the
personnel and other resources assigned to specific Incidents;

			
		  		  	 (c)    Obtaining and providing available information (e.g., historical, Client) regarding the IT environment and
the enterprise that is reasonably requested by the applicable Process owner(s) of Incident Management or that could be of importance to the resolution of Incidents by the applicable Process owner(s) of Incident Management, Incident Management
Execution and other Processes;

			
		  		  	 (d)    Acting as an intermediary between the applicable Process owner(s) of Incident Management and the applicable
internal personnel of the enterprise (e.g., Clients, IT leadership, other Process owners) to facilitate temporary change in resource allocation, policy or requirements to help mitigate the impact of an Incident;

			
		  		  	 (e)    Reviewing proposed Incident resolution solutions and providing input and preferences to the Process owner(s)
of Incident Management;

			
		  		  	 (f)    Requesting alternative Incident resolution solutions from the Process owner(s) of Incident Management when
proposed solutions do not meet the needs and preferences of Clients, the enterprise or IT leadership;

			
		  		  	 (g)    Mandating specific actions and/or solutions to be implemented by the Process owner(s) of Incident Management
in response to an Incident;

			
		  		  	 (h)    Waiving an Actor’s SLA obligations;

			
		  		  	 (i)     Evaluating the effectiveness of the applicable Process owner’s(s’) performance of Incident
Management and other Processes as it pertains to an Incident and, when deemed warranted, taking control of Incident Management and/or other Processes as necessary for such Incident;

  

					
	

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		  		  	 (j)     Declaring disasters in the IT environment and setting in motion the applicable components of the ITBCP
and/or the equivalent for External Actors; and

			
		  		  	 (k)    Providing informative updates regarding the resolution of Incidents to the Process owner(s) of Services
Management for communication to the applicable personnel; and

			
		  		  	 5.     Escalating issues that cannot be reasonably resolved with the applicable Process owner(s) of Incident
Management to the applicable Process owner(s) or other appropriate personnel.

			
	2.1.3	  	Commercial Management	  	 The purpose of “Commercial Management” is to manage the commercial aspects of relationships with External Actors so that the
underlying arrangements are in line with the needs of the IT environment.
  
 Commercial
Management includes the following activities:

			
		  		  	 1.     Understanding all aspects of the then-current contractual agreements with External
Actors;

			
		  		  	 2.     Serving as the primary point of contact for Internal Actors for the interpretation and modification of
contractual agreements with External Actors;

			
		  		  	 3.     Managing and administering contractual agreements with External Actors, including:

			
		  		  	 (a)    Reviewing the circumstances regarding an External Actor’s rejection of requests for service where the
pricing and other terms are already specified in such Actor’s service agreement, and working with the applicable Actor to resolve such matters;

			
		  		  	 (b)   Tracking and providing the requisite notices and other contract-based information to the applicable
Actors;

			
		  		  	 (c)    Tracking and reporting actual costs incurred against contractual commitments;

			
		  		  	 (d)   Monitoring and verifying performance with respect to all Actor obligations;

			
		  		  	 (e)    Obtaining budgets and budget projections in the appropriate
format;

  

					
	

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		  		  	 (f)    Validating the assessment, calculation and payment of credits related to service level failures and other
types of credits and rebates;

			
		  		  	 (g)    Validating the assessment, calculation and payment of variable unit rate charges and adjustments (e.g.,
ARCs, RRCs and actual volumes versus baseline volumes);

			
		  		  	 (h)    Monitoring and validating COLA adjustments;

			
		  		  	 (i)     Reviewing and negotiating to conclusion the proposed contract changes of External Actors to implement
requested change to the IT environment or IT services;

			
		  		  	 (j)     Reviewing the outcomes of dispute-based processes, forums and committees, and developing and
negotiating to conclusion the corresponding contract changes (if any) to implement the agreed-to changes;

			
		  		  	 (k)    Revising service agreements with Actors to reflect properly authorized changes in scope, services, service
levels and other conditions; and

			
		  		  	 (l)     Monitoring and reporting on expiring contracts and contracts intended to be renewed, re-competed or
restructured;

			
		  		  	 4.     Recording the decisions and accommodations made with respect to External Actors and providing such
information to the applicable Process owner(s);

			
		  		  	 5.     Inspecting, examining and auditing the systems, records, data, practices and procedures of External
Actors used in rendering IT services or pertain to IT services (e.g., invoices for services, allocation of credits, determination of costs, asset counts, regulatory compliance, service level reports, number of personnel or FTE, quality and skill
sets of personnel, personnel turnover rates, service continuity plans, procedure manuals);

			
		  		  	 6.     Identifying, documenting, and reporting instances of External Actor noncompliance with standards or
contracted terms to the applicable Process owner(s) and other personnel as appropriate;

			
		  		  	 7.     Attending all Actor disagreement and dispute forums and presiding over those of a commercial nature;
and

			
		  		  	 8.     Performing the oversight and administrative functions associated with Third Party Contract Managers,
including:

  

					
	

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		  		  	 (a)    Providing the applicable notices regarding the addition or removal of Third Party Contracts from the pool(s)
of such contracts to be managed by Third Party Contract Managers;

			
		  		  	 (b)    Developing and promulgating the commercial policies and standards to be enforced and performed by Third
Party Contract Managers;

			
		  		  	 (c)    Developing and promulgating the guidelines for Third Party Contract Managers to use in negotiating,
documenting, implementing and revising Third Party Contracts, including, as applicable, providing or reviewing contract templates;

			
		  		  	 (d)    Reviewing the strategic and operational plans of Third Party Contract Managers pertaining to the management
of Third Party Contracts, and providing feedback, including advice and consent;

			
		  		  	 (e)    Reviewing the supplier selection processes and negotiation strategies of Third Party Contract Managers and
providing feedback, including advice and consent;

			
		  		  	 (f)    Issuing orders to Third Party Contract Managers to revise the terms of a Third Party Contract (e.g., scope,
performance, pricing, commercials) and appropriately reviewing and approving such modifications;

			
		  		  	 (g)    Reviewing the assessments and recommendations of Third Party Contract Managers pertaining to poorly
performing Third Party Contracts and providing feedback, including advice and consent; and

			
		  		  	 (h)    Reviewing reports developed by Third Party Contract Managers showing the Third Party Contracts with upcoming
term-based events (e.g., renewal, expiration) and providing feedback regarding the desired outcome for each.

			
	2.1.4	  	Actor Integration	  	 The purpose of “Actor Integration” is to integrate the non-technical aspects of Actors into a cohesive IT service delivery fabric
that is prepared with adequate knowledge of the traditions, customs and policies of the IT environment and Client perception of the IT services.
  

Actor Integration includes the following activities:

  

					
	

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		  		  	 1.     Obtaining from the applicable Process owner(s) (e.g., IT Management, Client Relations), Clients, Actors
and other personnel as appropriate, insight and information regarding the fit of Actors and their personnel within the enterprise and the IT environment;

			
		  		  	 2.     Providing Actors with the information necessary to operate within the IT environment in an informed
manner, including the:

			
		  		  	 (a)    Relevant policies, procedures and standards;

			
		  		  	 (b)    Roles and responsibilities of all Actors;

			
		  		  	 (c)    Leadership and governance structures, including the assignment and manner of enforcement of decision
rights;

			
		  		  	 (d)    Cultural norms of the IT environment and the relevant similar aspects of the enterprise;

			
		  		  	 (e)    Business(es) of the enterprise, including its general drivers, risks, direction, priorities, concerns and
trends; and

			
		  		  	 (f)    Confidentiality requirements of each Actor as it pertains to other Actors needing to access its owned or
managed facilities and resources;

			
		  		  	 3.     Providing External Actors with the applicable information (e.g., policies, procedures, controls,
regulatory requirements, standards, guidelines) regarding:

			
		  		  	 (a)    Accessing the networks or facilities in the IT and Client environments;

			
		  		  	 (b)    Screening of External Actor personnel as required, including the collection of relevant biometric data
(e.g., fingerprints, retina scans) before such personnel perform IT services within, or in support of, the IT or Client environments;

			
		  		  	 (c)    Off-boarding of External Actor personnel, including, as applicable, the return of security badges, keys and
confidential information, and terminating access privileges to systems and data within the IT and Client environments;

			
		  		  	 (d)    Subcontracting; and

			
		  		  	 (e)    Accessing, using and managing Client
information;

  

					
	

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		  		  	 4.     Informing Actors of the expectations regarding their assimilation into the non-technical aspects of the
IT environment; including the:

			
		  		  	 (a)    Mechanisms to be used in evaluating such assimilation; and

			
		  		  	 (b)    Methods by which issues occurring between Actors are expected to be resolved;

			
		  		  	 5.     Facilitating communication, role clarity and non-technical process definition between and among Actors,
certain strategic Internal Actor Process owners, Clients and other personnel as appropriate, including:

			
		  		  	 (a)    Maintaining updated contact information for the relevant personnel associated with all Actors, relevant
Client personnel and other personnel as appropriate; and

			
		  		  	 (b)    Maintaining current organizational information for the IT environment and the enterprise;

			
		  		  	 6.     Establishing methods and forums in which Actors can exchange information and ideas to:

			
		  		  	 (a)    Enhance the camaraderie among the personnel of all Actors; and

			
		  		  	 (b)    Improve the mechanisms used to keep Actors informed of relevant changes;

			
		  		  	 7.     Obtaining, analyzing and, as appropriate, sharing with Actors, information from Clients regarding
relevant Actor characteristics (e.g., stakeholder satisfaction surveys);

			
		  		  	 8.     Providing a forum for the resolution of disagreements and disputes among Actors and between Actors and
Clients, including acting as a central point of contact for:

			
		  		  	 (a)    Registering Actor and Client disagreements and disputes;

			
		  		  	 (b)    Scheduling Actor disagreement and dispute forums and informing Actors, Clients and other personnel of their
need to participate in such forums;

			
		  		  	 (c)    Requesting Actors to provide information and resources in advance of or during Actor disagreement and
dispute forums to help facilitate orderly, efficient and valuable analysis and discussions; and

  

					
	

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		  		  	 (d)    Publishing the outcomes from Actor disagreement and dispute forums to the applicable Actors, Process
owner(s), Clients and other personnel; and

			
		  		  	 9.     Attending all Actor disagreement and dispute forums and presiding over those that are not of a
commercial nature.

			
	2.1.5	  	HR Management	  	 The purpose of “HR Management” is to design and implement an HR framework for the workforce of Internal Actors.

 
 HR Management includes the following activities:

			
		  		  	 1.     Maintaining a current understanding of the HR-based requirements (e.g., staffing levels, skill sets,
work locations) of that part of the IT environment performed by Internal Actors, including the timeframes in which such requirements are needed;

			
		  		  	 2.     Developing, in compliance with the applicable regulations, the strategies, programs, policies, channels
and requirements for the Internal Actors to:

			
		  		  	 (a)    Evaluate personnel to determine their individual capabilities (e.g., skill sets, performance levels,
trainability, aptitude);

			
		  		  	 (b)    Determine the optimal approach for obtaining the required workforce with the required skills in the required
locations at the required times;

			
		  		  	 (c)    Acquire the relevant training for personnel designated to be re-trained, measure the success of such
training and adapt accordingly;

			
		  		  	 (d)    Release personnel, including by transfer to External Actors;

			
		  		  	 (e)    Recruit and on-board personnel, including by transfer from External Actors;

			
		  		  	 (f)    Communicate changes with respect to personnel (e.g., relocation, outsourcing, outsourcing re-badging,
layoffs, training, recruiting, evaluation, compensation);

			
		  		  	 (g)    Provide career path plans;

			
		  		  	 (h)    Develop succession plans;

			
		  		  	 (i)     Determine compensation levels, including periodic adjustments and bonuses;
and

  

					
	

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		  		  	 (j)     Implement compensation and benefit changes;

			
		  		  	 3.     Obtaining and reviewing solutions developed by External Actors and prospective External Actors that
involve the transfer of Internal Actor personnel to such External Actors and providing feedback to the applicable Process owner(s) and other personnel as appropriate;

			
		  		  	 4.     Obtaining, reviewing and appropriately fulfilling requests for information regarding Internal Actor
personnel made by External Actors and prospective External Actors to facilitate the transfer of such personnel to such External Actors;

			
		  		  	 5.     Developing and communicating plans to accommodate the on-boarding of External Actor personnel to the
applicable Process owner(s), External Actors and other personnel as appropriate; and

			
		  		  	 6.     Attending Actor disagreement and dispute forums pertaining to personnel issues.

			
	2.1.6	  	Organizational Change Management	  	 The purpose of “Organizational Change Management” is to prepare the workforce of Internal Actors for major change initiatives.

 
 Organizational Change Management includes the following activities:

			
		  		  	 1.     Preparing, motivating and equipping personnel to successfully address the challenges associated with
change initiatives;

			
		  		  	 2.     Identifying change owners and associated stakeholders, and establishing and implementing sponsorship
for organizational change activities;

			
		  		  	 3.     Assessing readiness for organizational change and developing strategies and mitigation plans to
adequately address shortcomings;

			
		  		  	 4.     Communicating results of organizational change readiness assessments to stakeholders;

			
		  		  	 5.     Identifying and implementing methods, procedures, and approaches for managing organizational
change;

			
		  		  	 6.     Identifying and taking action to address barriers and resistance to change; and

			
		  		  	 7.     Managing internal and external change-related
communications.

  

					
	

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	2.2	  	 Portfolio
 Management
	  	
			
	2.2.1	  	 Service Catalog

Management
	  	 The purpose of “Service Catalog Management” is to develop and maintain a complete list of the IT services offered to Clients.

 
 Service Catalog Management includes the following activities:

			
		  		  	 1.     Developing, documenting and communicating policy regarding the content to be maintained within the
Service Catalog;

			
		  		  	 2.     Producing and maintaining a Service Catalog and its contents, in alignment with the applicable
Processes;

			
		  		  	 3.     Defining, for each item listed in the Service Catalog the relevant information,
including:

			
		  		  	 (a)    A description of the service;

			
		  		  	 (b)    The expected timeframe or service level for fulfilling the service;

			
		  		  	 (c)    Who is entitled to request the service;

			
		  		  	 (d)    The charge (if any) of obtaining the service; and

			
		  		  	 (e)    How to order the service, including the required approvals; and

			
		  		  	 4.     Interacting with the applicable Process owner(s) to obtain insight into changes to be incorporated in
the Service Catalog.

			
	2.2.2	  	 Performance
 Management
	  	 The purpose of “Performance Management” is to develop a performance regime that provides systems of measurement for IT
services.
  
 Performance Management includes the following activities:

			
		  		  	 1.     Obtaining the performance requirements, including through discussions with the applicable Process
owner(s) of Client Relations, Services Management, Incident Oversight, Service Delivery Management, Commercial Management and Actor Integration;

			
		  		  	 2.     Developing performance measures and associated levels to help meet the business requirements of Clients
and to help verify that the IT environment functions as designed;

  

					
	

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		  		  	 3.     Developing performance terms to be included in SLAs (e.g., performance reporting, changes to measures
and levels, financial and non-financial implications of non-performance) and providing such information to the applicable Process owner(s);

			
		  		  	 4.     Developing SLAs for the:

			
		  		  	 (a)    IT service responsibilities of Actors; and

			
		  		  	 (b)    IT services to be provided to Clients;

			
		  		  	 5.     Developing, maintaining and analyzing stakeholder satisfaction surveys (e.g., IT executives, Client
executives, Client end users) designed to understand the extent to which the services of IT or a specific Actor are meeting the needs;

			
		  		  	 6.     Reviewing Actor-developed plans to resolve shortcomings identified by stakeholder satisfaction surveys
and related mechanisms, and providing feedback to the applicable Process owner(s), including Services Management and, as appropriate, the relevant Actors and Clients;

			
		  		  	 7.     Assessing various technologies, products and services related to the management of performance-based
information;

			
		  		  	 8.     Establishing and promulgating requirements for performance measurement, reporting and
integration;

			
		  		  	 9.     Obtaining performance reports, including:

			
		  		  	 (a)    SLA reporting from the applicable Process owner(s), including Service Level Management; and

			
		  		  	 (b)    Quality control reviews performed by the applicable Process owner(s);

			
		  		  	 10.   Reviewing performance reports to identify performance and quality shortfalls, trends and other information of
value to the performance regime, Actors or other Process owners, including:

			
		  		  	 (a)    Verifying the correct calculation of incentive and disincentive payments/credits;

			
		  		  	 (b)    Validating the information provided and comparing such information with Client-perceived experience;
and

  

					
	

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		  		  	 (c)    Verifying that adequate quality control reviews are performed by the applicable Process owner(s) and that
the results of such reviews are captured, analyzed and used by the Process owner(s) to implement the necessary corrective action(s);

			
		  		  	 11.   Discussing performance results and reporting with the applicable Process owner(s), including those of Service
Level Management, to understand the underlying issues, problems and shortfalls and, to the extent applicable, commitments by Actors to resolve such matters;

			
		  		  	 12.   Developing recommendations regarding the acceptance or waiver of specific service level credits;

			
		  		  	 13.   Identifying SLA-enabled changes (e.g., re-balancing the allocation of service level credits, changing the
portfolio of critical service levels, adding/deleting service measures) to Actor-specific performance requirements to help achieve the desired outcomes; and

			
		  		  	 14.   Developing and publishing reports and recommendations for the applicable Process owner(s) to discuss, as
appropriate, performance related matters with Actors and Clients, including changes to be made to SLAs, stakeholder satisfaction surveys and quality control reviews.

			
	2.2.3	  	Benchmarking	  	 The purpose of “Benchmarking” is to determine performance characteristic differences between those produced by the IT environment
and other applicable operations and standards.
  
 Benchmarking includes the following
activities:

			
		  		  	 1.     Maintaining knowledge of the relevant geographic-, Client- and industry- specific measurements and
associated standards;

			
		  		  	 2.     Identifying the appropriate performance measures (e.g., operational, financial, organizational) to be
benchmarked;

			
		  		  	 3.     Advising the applicable Process owner(s) of the information required to be provided for benchmarking
purposes;

			
		  		  	 4.      Obtaining and reviewing the relevant IT environment performance results;

			
		  		  	 5.      Determining the most appropriate manner to perform
benchmarkings;

  

					
	

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		  		  	 6.     Performing benchmarking exercises, including, to the extent applicable, providing appropriate oversight
of external benchmarking specialists; and

			
		  		  	 7.     Analyzing and reporting the results of benchmarking exercises to the applicable Process
owner(s).

			
	2.2.4	  	 Knowledge
 Management
	  	 The purpose of “Knowledge Management” is to gather information regarding the IT and Client environments and the IT services and
make such information available to the applicable Process owner(s) for reuse, awareness and learning across the IT environment, and to cause institutional knowledge to be documented and retained.

 
 Knowledge Management includes the following activities:

			
		  		  	 1.     Developing plans for identifying, retaining and increasing institutional knowledge of the IT
environment;

			
		  		  	 2.     Assessing various technologies, products and services related to the management of knowledge, including
the storage, update and accessibility of knowledge;

			
		  		  	 3.     Establishing a uniform set of practices, methodologies and tools for the preservation of IT and Client
knowledge, including:

			
		  		  	 (a)    Making knowledge of the IT and Client environments and IT services available, as appropriate, to those
requiring such information to perform their designated roles;

			
		  		  	 (b)    Preserving organizational memory and decision-making;

			
		  		  	 (c)    Leveraging the knowledge and expertise of Actors and their personnel to facilitate organizational learning
and innovation;

			
		  		  	 (d)    Preserving and managing knowledge in the workforce (e.g., the expertise
and know-how possessed by certain individuals), including when key personnel retire, when functions are sourced from one Actor to another, and when personnel shift to other positions or pursue other employment opportunities; and

			
		  		  	 (e)    Obtaining appropriately approved updates to IT policies and procedures from all Process owners and Actors
and maintaining a library of such information on a current and historical basis;

  

					
	

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		  		  	 4.     Causing lessons learned and best practices to be appropriately captured after operational events (e.g.,
Incidents, Problems, changes); and

			
		  		  	 5.     Establishing and managing the channels through which knowledge flows (e.g., town hall meetings,
round-table discussions, mentoring programs), and key attributes of such flows (e.g., processes, timeframes, format, media).

			
	2.3	  	 Domain
 Architecture
	  	
			
	2.3.1	  	Information Architecture Development	  	 The purpose of “Information Architecture Development” is to design the Information Architecture so as to enable a common, shared,
distributed, accurate and consistent data resource, including through (a) the design of data models and databases that serve the applicable participants, and (b) the development of strategies, standards and policies required to develop and implement
such models and databases.
  

InformationArchitecture Development includes the following activities:

			
		  		  	 1.     Developing high-level Information Architecture alternatives that comply with the Enterprise
Architecture and selection criteria (e.g., cost performance, complexity, risk) and selecting the best choice from among the alternatives, including:

			
		  		  	 (a)    Identifying benefits, potential risks and mitigating responses for each alternative; and

			
		  		  	 (b)    Documenting the rationale for using each alternative;

			
		  		  	 2.     Selecting Information Architecture alternatives that best satisfy the selection criteria,
including:

			
		  		  	 (a)    Evaluating each alternative against the selection criteria;

			
		  		  	 (b)    Assessing, based on the evaluation of the alternatives, the adequacy of the selection criteria and
updating these criteria as necessary; and

			
		  		  	 (c)    Identifying and resolving issues with the alternatives and
requirements;

  

					
	

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		  		  	 3.     Completing, based on the selected Information Architectures, Information Architecture deliverables
defined by the applicable Process owner(s) of Enterprise Architecture Development, which may include:

			
		  		  	 (a)    Architecture-level deliverables (e.g., vision statement, industry best practices);

			
		  		  	 (b)    Conceptual-level deliverables (e.g., conceptual data models, high-level use cases, high-level event
process models, data entity-process relationship models);

			
		  		  	 (c)    Solution-level deliverables (e.g., logical data model, detailed event process models, package evaluation
criteria, data attribute-process relationship models); and

			
		  		  	 (d)    Implementation-level deliverables (e.g., database design, presentation layer design, designed application
modules); and

			
		  		  	 4.     Reviewing and updating the Information Architecture as required or in response to new technologies or
as directed by the applicable Process owner(s) of Enterprise Architecture Development.

			
	2.3.2	  	Application Architecture Development	  	 The purpose of “Application Architecture Development” is to design the Application Architecture, including the data and business
process models to reflect applications, that will (a) simplify and facilitate the work activities of the applicable Client processes, (b) specify the requirements of information storage and retrieval required to accommodate the applicable
objectives, and (c) appropriately address geographic considerations and how the information will be used.
  

ApplicationArchitecture Development includes the following activities:

			
		  		  	 1.     Developing high-level Application Architecture alternatives that comply with the Enterprise
Architecture and selection criteria (e.g., cost, performance, complexity, risk) and selecting the best choice from among the alternatives, including:

			
		  		  	 (a)    Identifying benefits, potential risks and mitigating responses for each alternative; and

			
		  		  	 (b)    Documenting the rationale for using each
alternative;

  

					
	

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		  		  	 2.   Selecting Application Architecture alternatives that best satisfy the selection criteria, including:

			
		  		  	 (a)   Evaluating each alternative against the selection criteria;

			
		  		  	 (b)   Assessing, based on the evaluation of the alternatives, the adequacy of the selection criteria and updating these
criteria as necessary; and

			
		  		  	 (c)   Identifying and resolving issues with the alternatives and requirements;

			
		  		  	 3.   Completing, based on the selected Application Architectures, Application Architecture deliverables defined by the
applicable Process owner(s) of Enterprise Architecture Development, which may include producing:

			
		  		  	 (a)   Architecture-level deliverables (e.g., vision statement, industry best practices);

			
		  		  	 (b)   Conceptual-level deliverables (e.g., high-level application design, major business process diagrams, high-level
event process models);

			
		  		  	 (c)   Solution-level deliverables (e.g., application system evaluation documentation, middleware design diagrams and
solution requirements, detailed event process models); and

			
		  		  	 (d)   Implementation-level deliverables (e.g., distributed systems diagram, application—server mapping diagram);
and

			
		  		  	 4.   Reviewing and updating the Application Architecture as required or in response to new applications or as directed by
the applicable Process owner(s) of Enterprise Architecture Development.

			
	2.3.3	  	Infrastructure Architecture Development	  	 The purpose of “Infrastructure Architecture Development” is to design the Infrastructure Architecture, including identifying the
technology platforms that will link the Information Architecture and the Application Architecture, and define operational and performance attributes, including backup, redundancy and availability in accordance with industry best practices and Client
requirements.
  
 InfrastructureArchitecture
Development includes the following activities:

  

					
	

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		  		  	 1.     Developing high-level Infrastructure Architecture alternatives that comply with the Enterprise
Architecture and selecting the best choice from among the alternatives, including:

			
		  		  	 (a)    Identifying benefits, potential risks and mitigating responses for each alternative; and

			
		  		  	 (b)    Documenting the rationale for using each alternative;

			
		  		  	 2.     Selecting Infrastructure Architecture alternatives that best satisfy the selection criteria,
including:

			
		  		  	 (a)    Evaluating each alternative against the selection criteria;

			
		  		  	 (b)    Assessing, based on the evaluation of the alternatives, the adequacy of the selection criteria and updating
these criteria as necessary; and

			
		  		  	 (c)    Identifying and resolving issues with the alternatives and requirements;

			
		  		  	 3.     Completing, based on the selected Infrastructure Architectures, the Infrastructure Architecture
deliverables defined by the applicable Process owner(s) of Enterprise Architecture Development, which may include producing:

			
		  		  	 (a)    Architecture-level deliverables (e.g., vision statement, IT industry best practices);

			
		  		  	 (b)    Conceptual-level deliverables (e.g., high-level technology design, major business process diagrams,
high-level event process models);

			
		  		  	 (c)    Solution-level deliverables (e.g., system technology evaluation documentation, network topology diagram);
and

			
		  		  	 (d)    Implementation-level deliverables (e.g., Client location map, server location map, object expected/maximum
volume requirements); and

			
		  		  	 4.     Reviewing and updating the Infrastructure Architecture as required or in response to new technologies
or as directed by the applicable Process owner(s) of Enterprise Architecture Development.

  

					
	

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	2.3.4	  	Security Architecture Development	  	 The purpose of “Security Architecture Development” is to design the Security Architecture, including the plans, principles and
specifications that describe (a) the security services that a system is required to provide to address the security policies, (b) the technologies required to implement such security services, and (c) the performance levels and configurations
required of such technologies and services.
  
 Security Architecture Development includes
the following activities:

			
		  		  	 1.     Developing Security Architecture alternatives that comply with the security policies and the
Enterprise Architecture and selection, criteria (e.g., cost, performance, complexity, risk) and selecting the best choice from among the alternatives, including:

			
		  		  	 (a)    Identifying benefits, potential risks and mitigating responses for each alternative; and

			
		  		  	 (b)    Documenting the rationale for using each alternative;

			
		  		  	 2.     Selecting Security Architecture alternatives that best satisfy the selection criteria,
including:

			
		  		  	 (a)    Evaluating each alternative against the selection criteria;

			
		  		  	 (b)    Assessing, based on the evaluation of the alternatives, the adequacy of the selection criteria and updating
these criteria as necessary; and

			
		  		  	 (c)    Identifying and resolving issues with the alternatives and requirements;

			
		  		  	 3.     Completing, based on the selected Security Architectures, the Security Architecture deliverables
defined by the applicable Process owner(s) of Enterprise Architecture Development, which may include producing:

			
		  		  	 (a)    Architecture-level deliverables (e.g., vision statement, industry best practices);

			
		  		  	 (b)    Conceptual-level deliverables (e.g., high-level technology design, major business process diagrams,
high-level event process models);

			
		  		  	 (c)    Solution-level deliverables (e.g., system technology evaluation documentation, network topology diagram);
and

  

					
	

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		  		  	 (d)    Implementation-level deliverables (e.g., Client location map, server location map, object expected/maximum
volume requirements); and

			
		  		  	 4.     Reviewing and updating the Security Architecture as required, in response to uncovered threats, or as
directed by the applicable Process owner(s) of Enterprise Architecture Development.

		  		  	
	2.4	  	 Process
 Architecture
	  	
		  		  	
	2.4.1	  	Process Architecture Development	  	 The purpose of “Process Architecture Development” is to define the framework that will guide process development for Process
groupings 1.3 (Enterprise Architecture) and 2.3 (Domain Architecture) through 3.14 (Project Management) for the applicable Process owners and promulgate specific linkages between and among such Processes.

 
 Process Architecture Development includes the following activities:

			
		  		  	 1.     Maintaining an awareness of the work of the relevant best practice organizations and standards
bodies;

			
		  		  	 2.     Assessing various technologies and products related to the management of IT processes;

			
		  		  	 3.     Understanding the then-current process configuration of the IT environment, its levels of performance
and its compliance with the process architecture;

			
		  		  	 4.     Understanding the needs of those who will receive the outcomes of the Processes (e.g., interaction,
information, speed, location, quality, cost);

			
		  		  	 5.     Providing instructions, objectives, guiding principles, performance levels, templates, toolsets,
standards and other related information to enable the applicable Process owner(s) to develop linkages to other Processes;

			
		  		  	 6.     Performing an advise and consent role with respect to Actors’ process development work;
and

			
		  		  	 7.     Defining, for use by the applicable Process owner(s), specific linkages between and among various
Processes (e.g., inputs, outputs, sequence, flow).

			
	2.5	  	Standards	  	

  

					
	

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	2.5.1	  	Standards Policies Establishment	  	 The purpose of “Standards Policies Establishment” is to develop, document and maintain a set of guiding principles for the
development or adoption of technical specifications, practices and procedures.
 Standards Policies Establishment includes the following
activities:

			
		  		  	 1.     Determining the requirements (e.g., Client, regulatory, security, audit, contractual) and factors
(e.g., Internal Client business relationships) on which the policies will be based;

			
		  		  	 2.     Maintaining a repository of the current and historical policies and exceptions, and the underlying
supporting material on which they were derived;

			
		  		  	 3.     Identifying and developing policies, including guidelines for exceptions to standards;

			
		  		  	 4.     Establishing timelines for the development or adoption, review and maintenance of
standards;

			
		  		  	 5.     Instructing the owner of Standards Development with respect to the content, adoption criteria,
timing and quality expectations of standards; and

			
		  		  	 6.     Identifying and establishing policies for measuring compliance with standards.

			
	2.5.2	  	 Standards
 Development
	  	 The purpose of “Standards Development” is to develop, identify for adoption, document and maintain standards in accordance with the
applicable policies.
  
 Standards Development includes the following
activities:

			
		  		  	 1.     Obtaining the policies, exceptions and guiding principles from the applicable Process owner(s) of
Standards Policies Establishment;

			
		  		  	 2.     Identifying the applicable criteria on which the development of standards will be
based;

			
		  		  	 3.     Maintaining ongoing knowledge of the relative components of the relevant marketplace, including the
manufacturers, their goods, and the performance of such goods in similar environments;

  

					
	

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		  		  	 4.     Obtaining information as required to develop standards, including information promulgated by the
applicable Process owner(s) of Enterprise Architecture and Domain Architecture;

			
		  		  	 5.     Developing standards and documenting the factors on which such standards were based, including, as
appropriate, alternatives considered and the rationale for the decisions;

			
		  		  	 6.     Providing standards and supporting material to the applicable Process owner(s) of Standards
Approval;

			
		  		  	 7.     Reviewing and revising standards based on new factors, new policies and requests for modification from
the applicable Process owner(s) of Standards Policy Establishment and/or Standards Approval; and

			
		  		  	 8.     Publishing approved standards to the applicable Process owner(s).

			
	2.5.3	  	 Standards
 Approval
	  	 The purpose of “Standards Approval” is to perform the activities necessary to evaluate and approve proposed standards developed by
Standards Development.
  
 Standards Approval includes the following
activities:

			
		  		  	1.      Confirming that the proposed standards:
			
		  		  	 (a)    Comply with the requirements of the Enterprise Architecture;

			
		  		  	 (b)    Comply with the requirements of the relevant Domain Architecture(s);

			
		  		  	 (c)    Comply with the policies established by the applicable Process owner(s) of Standards Policies
Establishment;

			
		  		  	 (d)    Meet the underlying business requirements; and

			
		  		  	 (e)    Do not create operational or technical conflicts with other standards;

			
		  		  	 2.     Advising the applicable Process owner(s) of Standards Development of proposed standards that are not
accepted and providing information regarding why such conclusions were reached and/or the types of changes required to be made;

			
		  		  	 3.     Obtaining approvals from the appropriate personnel designated to approve standards;
and

  

					
	

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		  		  	 4.     Communicating, when warranted, approval of proposed standards to the applicable Process owner(s) of
Standards Development.

			
	2.5.4	  	Standards Audit	  	 The purpose of “Standards Audit” is to determine the extent to which standards have not been followed.

 
 Standards Audit includes the following activities:

			
		  		  	 1.     Maintaining a complete listing of current and historical standards;

			
		  		  	 2.     Developing methods for auditing compliance with standards, including addressing the measurement
policies developed by Standards Policies Establishment;

			
		  		  	 3.     Measuring noncompliance with the applicable standards;

			
		  		  	 4.     Identifying, documenting, and reporting instances of noncompliance with standards to the offending
Process owners and other personnel as appropriate; and

			
		  		  	 5.     Escalating, as applicable, noncompliance with standards to the applicable Process owner(s) and other
personnel as appropriate.

			
	2.6	  	 Solution
 Requirements
	  	
			
	2.6.1	  	Business Requirements Documentation	  	 The purpose of “Business Requirements Documentation” is to document business requirements (e.g., inputs, outputs, scheduling,
performance).
  
 Business Requirements Documentation includes the following
activities:

			
		  		  	 1.     Identifying stakeholders and documenting their needs, expectations and constraints (including
quality, schedule and cost);

			
		  		  	 2.     Documenting business drivers and relevant business interfaces, including those that are internal and
external to the enterprise, as well as those that are automated and manual);

			
		  		  	 3.     Documenting schedule and business case requirements;

			
		  		  	 4.     Transforming expressed stakeholder needs, expectations, constraints, and interfaces into documented
business requirements; and

  

					
	

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		  		  	 5.     Providing business requirements to the applicable Process owner(s) of Solution
Integration.

			
	2.6.2	  	Security Requirements Development	  	 The purpose of “Security Requirements Development” is to analyze business and security requirements and refine them to a sufficient
level of detail so that solutions can be developed.
  
 Security Requirements Development
includes the following activities:

			
		  		  	 1.     Obtaining, reviewing and analyzing business and security requirements from the applicable Process
owner(s) of Business Requirements Documentation and solution requirements from the applicable Process owner(s) of Security Oversight, Security Policy Development, Security Operations and Security Analysis;

			
		  		  	 2.     Establishing and maintaining required capabilities lists;

			
		  		  	 3.     Analyzing and quantifying functional capabilities required by Clients;

			
		  		  	 4.     Analyzing and quantifying non-functional capabilities required by Clients (e.g., availability,
performance, adaptability to change, re-use); and

			
		  		  	 5.     Establishing solution requirements, including:

			
		  		  	 (a)    Specifying required alignment with the reference Security Architecture(s), approved standards and risk
mitigation objectives;

			
		  		  	 (b)    Developing technical requirements for solution design;

			
		  		  	 (c)    Identifying system interface requirements, both internal and external to such solutions;

			
		  		  	 (d)    Developing functional, performance, maintenance, support and disposal concepts, and scenarios;

			
		  		  	 (e)    Defining environments in which solutions will operate, including boundaries and constraints;

			
		  		  	 (f)    Documenting and providing technical requirements and associated material to the applicable Process owner(s);
and

  

					
	

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		  		  	 (g)    Revising technical requirements based on feedback from the applicable Process owner(s), including the
Process owner(s) of Security Solution Development, Security Operations and Security Analysis.

			
	2.6.3	  	 Solution
 Integration
	  	 The purpose of “Solution Integration” is to develop integrated solutions that meet their respective business requirements.

 
 Solution Integration includes the following activities:

			
		  		  	 1.     Developing an approach to produce integrated solutions that are consistent with the required level of
quality, schedule and cost;

			
		  		  	 2.     Developing solution requirements and constraints (e.g., technical, financial, geographic, process)
specific to business requirements, including obtaining the External Compliance Requirements and feedback regarding risk and control applicable to such business requirements from the applicable Process owner(s) of Compliance Management and Risk
Management;

			
		  		  	 3.     Providing solution requirements and business requirements to the applicable Process owner(s) of
Technical Requirements Development;

			
		  		  	 4.     Resolving development and integration issues pertaining to technical requirements and
solutions;

			
		  		  	 5.     Reviewing solutions and interactions between solution components, and confirming that overall solutions
meet their respective underlying requirements, including obtaining, as applicable, advice and consent from the applicable Process owner(s);

			
		  		  	 6.     Reviewing estimates provided by the applicable Process owner(s) of Resource Estimation and confirming
they contain the information necessary to develop the required business cases and are otherwise reasonable;

			
		  		  	 7.     Informing the applicable Process owner(s) of Solution Formation of errors or required changes,
including those pertaining to technical requirements, solutions or sub-components of solutions and estimations;

			
		  		  	 8.     Confirming that the costs and benefits of solutions meet the relevant hurdles for investment
approval;

  

					
	

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		  		  	 9.     Confirming that the risk profile of solutions are reasonable and in-line with the relevant
requirements; and

			
		  		  	 10.   Consolidating solutions into comprehensive business cases, including the applicable development of financial
information, that describe the relevant information necessary for the applicable Process
owner(s) of Solution Approval and other personnel as appropriate to make sound business decisions.

			
	2.6.4	  	Security Solution Approval	  	 The purpose of “Security Solution Approval” is to provide a final review of solutions developed in response to security
requirements or proposals presented by Actors on an unsolicited basis and, as applicable, providing feedback, including advice and consent.
  

Security Solution Approval includes the following activities:

			
		  		  	 1.     Reviewing the applicable aspects of security solutions;

			
		  		  	 2.     Confirming that the security solutions are consistent with their respective security
requirements;

			
		  		  	 3.     Confirming that the applicable Process owner(s) of Risk Management and Compliance Management find that
each solution adequately addresses the associated risks, controls and compliance requirements;

			
		  		  	 4.     Confirming that the financial and other terms to implement each solution on a commercial basis are
either:

			
		  		  	 (a)    Consistent with the then-current terms of the service agreement(s) with the applicable External Actor(s)
(i.e., no changes are necessary); or

			
		  		  	 (b)    Negotiated and documented to the satisfaction of the applicable Process owner(s) of Commercial Management
and the applicable External Actor(s);

			
		  		  	 5.     Advising the applicable Actors and Process owner(s) of Security Solution Approval if changes to
solutions, solution sub-components or commercial terms are needed;

			
		  		  	 6.     Obtaining approvals from the appropriate personnel designated for approving solutions as and when
appropriate; and

			
		  		  	 7.     Communicating, when warranted, the final disposition (e.g., approved, disapproved) of solutions to the
applicable Actors, Process owner(s) and other personnel as appropriate.

  

					
	

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	2.6.5	  	 Solution
 Approval
	  	 The purpose of “Solution Approval” is to provide a final review of solutions developed in response to business requirements or
proposals presented by Actors on an unsolicited basis and, as applicable, providing feedback, including advice and consent.
  

Solution Approval includes the following activities:

			
		  		  	 1.     Reviewing the applicable aspects of solutions and their respective business cases;

			
		  		  	 2.     Confirming that the business cases are consistent with their respective business
requirements;

			
		  		  	 3.     Confirming that the applicable Process owner(s) of Risk Management and Compliance Management find that
each solution adequately addresses the associated risks, controls and compliance requirements;

			
		  		  	 4.     Confirming that the financial and other terms to implement each solution on a commercial basis are
either:

			
		  		  	 (a)    Consistent with the then-current terms of the service agreement(s) with the applicable External Actor(s)
(i.e., no changes are necessary); or

			
		  		  	 (b)    Negotiated and documented to the satisfaction of the applicable Process owner(s) of Commercial Management
and the applicable External Actor(s);

			
		  		  	 5.     Advising the applicable Actors and Process owner(s) of Solution Integration if changes to solutions,
solution sub-components or commercial terms are needed;

			
		  		  	 6.     Obtaining approvals from the appropriate personnel designated for approving solutions as and when
appropriate; and

			
		  		  	 7.     Communicating, when warranted, the final disposition (e.g., approved, disapproved) of solutions to the
applicable Actors, Process owner(s) and other personnel as appropriate.

			
	2.7	  	 Service
 Management
	  	
			
	2.7.1	  	 Service Delivery

Management
	  	 The purpose of “Service Delivery Management” is to manage the performance of Actors to optimize the delivery of IT services.

 
 Service Delivery Management includes the following
activities:

  

					
	

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		  		  	 1.     Setting the service delivery expectations for Actors, including:

			
		  		  	 (a)    Developing, documenting, disseminating and monitoring actions to be implemented, including with regard to
designated timeframe(s); and

			
		  		  	 (b)    Discussing action compliance and noncompliance with the relevant Actors;

			
		  		  	 2.     Coordinating work between and among Actors and Processes so that IT services are performed
appropriately, including establishing recurring and one-time meetings;

			
		  		  	 3.     Establishing and maintaining a close working relationship with the applicable Process owner(s) of
Services Management;

			
		  		  	 4.     Coordinating with the applicable Process owner(s) of Services Management and implementing directions
provided by such Process owner(s);

			
		  		  	 5.     Establishing frameworks for measuring Actor delivery and contribution to optimized IT
services;

			
		  		  	 6.     Obtaining and analyzing information regarding the performance of Actors;

			
		  		  	 7.     Developing recommended change in Actor responsibility and discussing such changes with the applicable
Process owner(s) and other personnel as appropriate;

			
		  		  	 8.     Developing proposed projects and initiatives based on strategic direction provided by the applicable
Process owner(s);

			
		  		  	 9.     Advising Actors as to the extent to which their performance meets expectations;

			
		  		  	 10.   Addressing Actor performance issues on an ongoing basis (e.g., performance trends, project
delivery);

			
		  		  	 11.   Reviewing proposed changes to Actor SLAs and providing feedback to the applicable Process owner(s);

			
		  		  	 12.   Providing feedback regarding Actor performance remediation requirements to the applicable Process
owner(s);

			
		  		  	 13.   Obtaining and analyzing information from the applicable Process owner(s) regarding expected future change to IT
services and/or the IT environment and:

  

					
	

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		  		  	 (a)    Developing or modifying the appropriate strategies and activities necessary to adequately address the
required change, including making recommendations for change in the allocation of Actor responsibility or change in the portfolio of Actors;

			
		  		  	 (b)    Obtaining the advice or approval of the appropriate personnel designated to approve IT environment and IT
service changes; and

			
		  		  	 (c)    Implementing appropriately approved IT environment and IT service changes by communicating such changes to
the applicable Process owner(s); and

			
		  		  	 14.     AttendingActor disagreement and dispute forums regarding matters pertaining to service
delivery.

			
	2.7.2	  	 Incident
 Management
	  	 The purpose of “Incident Management” is to direct the restoration of service in response to Incidents, to minimize the adverse
impact on Clients as a result of Incidents, and to maintain the required levels of service.
  

Incident Management includes the following activities:

			
		  		  	 1.     Defining the Incident management processes (e.g., detection, investigation, diagnosis, escalation,
notification, resolution, recovery, closure, reporting), which are to include specification of the individuals to be involved in each aspect of managing Incidents;

			
		  		  	 2.     Establishing and maintaining a close working relationship with the applicable Process owner(s) of
Incident Oversight;

			
		  		  	 3.     Reviewing the severity levels assigned to Incidents, and revising such levels as
appropriate;

			
		  		  	 4.     Assessing service restoration plans to confirm development of comprehensive solutions that take into
account the relevant conditions, events and needs;

			
		  		  	 5.     Reviewing Incident recovery actions developed by the applicable Process owner(s) of Incident Management
Execution and providing guidance as required;

  

					
	

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		  		  	 6.     Coordinating the roles and responsibilities of the Processes to be involved in the resolution of
Incidents, including, where appropriate, establishing separate teams to concentrate on specific Incidents or sub-components of Incidents;

			
		  		  	 7.     Coordinating with the applicable Process owner(s) of Incident Oversight and implementing directions
provided by such Process owner(s);

			
		  		  	 8.     Confirming the appropriate closure of Incidents;

			
		  		  	 9.     Reviewing the process models and/or workflows developed by the applicable Process owner(s) of Incident
Management Execution for pre-defined Incidents (e.g., recurring Incidents, Incidents requiring special handling) and providing guidance as required;

			
		  		  	 10.   Conducting Incident management review meetings with the applicable Process owner(s), Clients and other personnel
as appropriate; and

			
		  		  	 11.   Identifying Process owners and Clients requiring training to reduce the number of Incidents, detect Incidents
earlier and restore normal service following Incidents faster.

			
	2.7.3	  	 Problem
 Management
	  	 The purpose of “Problem Management” is to direct the resolution of Problems to minimize the adverse impact on business operations,
maintain the required levels of service and prevent the recurrence of Problems.
  

Problem Management includes the following activities:

			
		  		  	 1.     Defining the Problem management processes (e.g., root cause analysis, determination, investigation,
diagnosis, resolution, recovery, closure, reporting), which are to include specification of the individuals to be involved in each aspect of managing Problems;

			
		  		  	 2.     Maintaining information about Problems and their appropriate workarounds to reduce the number and
impact of Incidents over time (e.g., known error database);

			
		  		  	 3.     Classifying Problems in terms of their adverse impact on Clients;
and

  

					
	

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		  		  	 4.     Coordinating the roles and responsibilities of the Processes to be involved in the resolution of
Problems, including where appropriate, establishing separate teams to concentrate on specific Problems or sub-components of Problems;

			
		  		  	 5.     Confirming the appropriate closure of Problems;

			
		  		  	 6.     Conducting Problem management review meetings with the applicable Process owner(s) and Clients to
identify ways to avoid such Problems occurring in the future, including capturing post-resolution knowledge; and

			
		  		  	 7.     Identifying Process owners and Clients requiring training to reduce the number of Problems, detect
Problems earlier and restore normal service following Problems faster.

			
	2.7.4	  	Configuration and Asset Management	  	 The purpose of “Configuration and Asset Management” is to direct the activities necessary to collect, track, manage, maintain and
report on the physical presence, financial information, contractual terms, configuration states and associations among the assets/CIs in the environment.
  

Configuration and Asset Management includes the following activities:

			
		  		  	 1.     Obtaining the objectives and requirements for asset and CI information from the applicable Process
owner(s);

			
		  		  	 2.     Establishing the detailed specifications for what asset and configuration information is to be
maintained and obtaining approvals from the appropriate personnel designated to approve such specifications;

			
		  		  	 3.     Providing, implementing and operating a CMDB and the appropriate tools to:

			
		  		  	 (a)    Record and track the applicable asset and configuration information through the full lifecycle (e.g.,
purchase, configuration, installation, repair, redeployment, removal, disposal);

			
		  		  	 (b)    Understand how CIs, when combined, constitute broader categories of technology (e.g., network, system,
storage);

			
		  		  	 (c)    Determine the associations between CIs themselves and, as applicable, with other relevant items (e.g.,
personnel, business units, buildings, Client or IT services);

  

					
	

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		  		  	 (d)    Forecast changes in asset populations and configurations;

			
		  		  	 (e)    Identify the underlying components or sub-components;

			
		  		  	 (f)    Monitor changes made to the CMDB and advise the applicable Process owner(s) of inconsistent or suspect
information; and

			
		  		  	 (g)    Facilitate the redeployment and/or reuse of assets;

			
		  		  	 4.     Developing policies for how the information is to be maintained in the CMDB;

			
		  		  	 5.     Developing requirements for how various activities of other Processes are to interface with the
CMDB;

			
		  		  	 6.     Making asset and configuration information available to the applicable Process owner(s);

			
		  		  	 7.     Compiling, and making available for review and/or publication, management reports regarding assets and
their association with other information in the CMDB;

			
		  		  	 8.     Monitoring and enforcing software license compliance, including:

			
		  		  	 (a)    Monitoring the IT environment for software and reporting instances of detected and undetected licenses, as
well as instances of unapproved software;

			
		  		  	 (b)    Fulfilling inquiries regarding the extent to which specific software signatures are present within the IT
environment;

			
		  		  	 (c)    Fulfilling inquiries requiring the validation of the presence and version of specific software installed on
a particular Element or group of Elements within defined boundaries; and

			
		  		  	 (d)    Developing periodic reporting of license information and the level of compliance with the terms of the
licenses and providing such reporting to the applicable Process owner(s);

			
		  		  	 9.     Monitoring hardware and software warranties within the IT environment, including:

			
		  		  	 (a)    Developing periodic and ad hoc reporting regarding the status of such warranties (e.g., in force, about to
expire);

  

					
	

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		  		  	 (b)    Identifying Elements that, based on then-current objectives, merit the purchase or renewal of warranties or
similar mechanisms; and

			
		  		  	 (c)    Advising the applicable Process owner(s) of warranty optimization strategies and obtaining approvals from
the appropriate personnel designated to approve and implement such strategies; and

			
		  		  	 10.   Performing, as necessary, audits of the CMDB and the practices of Process owners that provide input into the CMDB,
to:

			
		  		  	 (a)    Determine if the required level of accuracy is being produced by the overall system of configuration
management processes performed by the applicable Process owner(s); and

			
		  		  	 (b)    Provide useful input regarding CMDB accuracy to the applicable Process owner(s).

			
	2.7.5	  	 Change
 Management
	  	 The purpose of “Change Management” is to control changes to the IT environment or IT services in a manner that minimizes the number
and impact of associated Incidents and Problems.
  
 Change Management includes the
following activities:

			
		  		  	 1.     Maintaining a well-grounded understanding of the type, reason, volume and frequency of change made to
the IT environment;

			
		  		  	 2.     Maintaining awareness of the pipeline of change to the IT environment;

			
		  		  	 3.     Understanding the applicable Client policies and change procedures and aligning the relevant IT change
processes as appropriate;

			
		  		  	 4.     Developing, documenting and maintaining the processes by which change is introduced to the IT
environment, including:

			
		  		  	 (a)    Policies for the classification of change requests;

			
		  		  	 (b)    Activities for all classes of change (e.g., standard, recurring, special handling, emergency);

			
		  		  	 (c)    Policies for change approval, including, as applicable and appropriate for specific Clients and classes of
change, those that can be implemented in an expedited or pre-approved manner;

  

					
	

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		  		  	 (d)    Activities to be taken to handle unanticipated events that may occur during change execution;

			
		  		  	 (e)    Identification of dependencies;

			
		  		  	 (f)    Identification of the Process owners required to be involved in the change-based processes and their
respective roles;

			
		  		  	 (g)    Expected timeframes and thresholds for the completion of the change processes;

			
		  		  	 (h)    Escalation and notification procedures; and

			
		  		  	 (i)     Requirements for preserving and/or archiving of change records;

			
		  		  	 5.     Obtaining and assessing change requests, including those obtained from the applicable Process owner(s)
of Change Management Execution, and identifying impractical or unnecessary change requests, and providing feedback to the requestors;

			
		  		  	 6.     Classifying and prioritizing change requests, including assessing the appropriate factors (e.g., risk,
cost, impact, security) applicable to such requests;

			
		  		  	 7.     Verifying the consistency and compatibility of the documentation for changes compiled by the applicable
Process owner(s) of Change Management Execution;

			
		  		  	 8.     Scheduling changes;

			
		  		  	 9.     Registering completed changes and closing change requests;

			
		  		  	 10.     Developing, maintaining and documenting linkages with other Processes to establish traceability of
changes, detect unauthorized changes and identify change-related Incidents and Problems;

			
		  		  	 11.     Developing, maintaining, documenting and publishing change schedules; and

			
		  		  	 12.     Reviewing (on a post-implementation basis) change requests and verifying that the change objectives
were met without unexpected adverse impact.    

  

					
	

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	2.7.6	  	 Release
 Management
	  	 The purpose of “Release Management” is to plan, review, approve and coordinate releases.

 
 Release Management includes the following activities:

			
		  		  	 1.     Developing and maintaining the policies, standards and processes to be followed for the lifecycle of
releases and communicating such information to the applicable Process owner(s);

			
		  		  	 2.     Establishing roadmaps for releases and communicating such information to the applicable Process
owner(s);

			
		  		  	 3.     Obtaining and reviewing release packages from the applicable Process owner(s) of Release Management
Execution;

			
		  		  	 4.     Auditing release packages and identifying dependencies or schedule conflicts with other release
packages;

			
		  		  	 5.     Coordinating the testing of releases;

			
		  		  	 6.     Coordinating release schedules;

			
		  		  	 7.     Confirming that the required change approvals have been obtained;

			
		  		  	 8.     Confirming that release packages can be tracked, installed, tested, verified, and/or uninstalled or
backed out as appropriate;

			
		  		  	 9.     Providing feedback to the applicable Process owner(s) of Release Management Execution regarding
proposed release packages;

			
		  		  	 10.   Obtaining approvals from the appropriate personnel designated to approve release packages;

			
		  		  	 11.   Communicating, when warranted, approval of proposed release packages to the applicable Process owner(s) of Release
Management Execution;

			
		  		  	 12.   Developing communication notices regarding releases for publication to Clients and the applicable Process
owner(s); and

			
		  		  	 13.   Archiving release information, including, as applicable, release
images.    

  

					
	

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	2.7.7	  	 Capacity
 Management
	  	 The purpose of “Capacity Management” is to perform the functions necessary to determine the appropriate levels of IT services and
resources to be available and matched to current and anticipated future business needs.
  

Capacity Management includes the following activities:

			
		  		  	 1.     Developing, maintaining and documenting capacity plans;

			
		  		  	 2.     Forecasting the volume of IT services based on the applicable criteria;

			
		  		  	 3.     Developing predictive and ongoing capacity indicators, including obtaining information and feedback
from the applicable Process owner(s) of Client Relations;

			
		  		  	 4.     Analyzing utilization and trend forecasts produced by the owner of Capacity Reporting and proactively
developing recommendations regarding change to the IT environment (e.g., upgrades, downgrades, enhancements, reconfiguration) to correctly align the performance and availability needs with IT service capacity;

			
		  		  	 5.     Responding to capacity-related “threshold” events and initiating the appropriate
activities;

			
		  		  	 6.     Notifying the applicable Process owner(s) of recommended changes to the levels of IT services and
resources to address current and forecasted capacity and capacity-related performance issues;

			
		  		  	 7.     Assisting with the diagnosis and resolution of performance and capacity-related Incidents and
Problems;

			
		  		  	 8.     Obtaining information regarding the short, medium and long term plans for change to the IT environment;
and

			
		  		  	 9.     Assessing the impact of change in the IT environment on capacity plans.

			
	2.7.8	  	 Availability
 Management
	  	 The purpose of “Availability Management” is to understand the availability requirements, develop availability plans, analyze
availability performance and develop recommendations for change to improve availability.
  

Availability Management includes the following activities:

  

					
	

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		  		  	 1.     Understanding the Clients’ requirements for the availability of IT services, including obtaining
information from the applicable Process owner(s) of Client Relations;

			
		  		  	 2.     Developing, maintaining and documenting IT availability plans;

			
		  		  	 3.     Developing and providing availability management reports to the applicable Process
owner(s);

			
		  		  	 4.     Analyzing risks to availability;

			
		  		  	 5.     Analyzing availability information and developing recommendations for improvement; and

			
		  		  	 6.     Assessing the impact of change in the IT environment on availability plans.

			
	 2.7.9
	  	 Service Level

Management
	  	 The purpose of “Service Level Management” is to enact and integrate the performance regime established by Performance
Management.
  
 Service Level Management includes the following activities:

			
		  		  	 1.     Obtaining the performance measurement, reporting and integration requirements;

			
		  		  	 2.     Obtaining, reviewing and monitoring the relevant SLAs;

			
		  		  	 3.     Making the applicable Process owner(s) aware of changes to the performance requirements and
SLAs;

			
		  		  	 4.     Coordinating and integrating the performance reporting activities of Actors so that performance
reporting to the enterprise is consistent;

			
		  		  	 5.     Obtaining Actor-produced performance reports and:

			
		  		  	 (a)    Verifying the reports are consistent with the performance reporting requirements;

			
		  		  	 (b)    Validating the information obtained;

			
		  		  	 (c)    Comparing the performance results with the applicable SLAs;

			
		  		  	 (d)    Determining which, if any, of an Actor’s performance measures require special handling (e.g.,
service level credit, service level bonus);    

  

					
	

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		  		  	 (e)    Validating or determining, as necessary, the correct calculation of incentive and disincentive
payments/credits; and

			
		  		  	 (f)    Tracking the elections and payments of service level credits to and from the applicable
Actors;

			
		  		  	 6.     Discussing performance results and reporting with Actors to understand the underlying issues, problems
and shortfalls and, to the extent applicable, their commitments to resolve such matters;

			
		  		  	 7.     Performing relevant analysis of the performance results (current and historical) to identify trends
that could signal systemic and/or structural issues;

			
		  		  	 8.     Determining, for performance measures that cross the boundaries of multiple Actors, the apportionment
of service level responsibility to the appropriate Actor(s) in cases where service level failure has occurred;

			
		  		  	 9.     Aggregating Actor-specific performance reports into unified reports consistent with the performance
reporting requirements, including those established by the applicable Process owner(s) of Performance Management;

			
		  		  	 10.   Publishing unified performance reports and the associated observations and recommendations to the applicable
Process owner(s);

			
		  		  	 11.   Discussing performance results holistically with the applicable Process owner(s) of Performance Management;
and

			
		  		  	 12.   Observing the underlying service delivery mechanisms and Actor behavior and making recommendations to the
applicable Process owner(s) on ways to provide incentive for Actors to achieve the desired performance outcomes.

			
	2.7.10	  	Service Continuity Management	  	 The purpose of “Service Continuity Management” is to confirm that the service continuity plans developed at the platform, system
and Client levels will collectively meet the continuity requirements.
  
 Service
Continuity Management includes the following activities:

			
		  		  	 1.     Developing and providing service continuity plan guidelines (e.g., objectives, requirements,
timeframes, format, process) to the applicable Process owner(s) of Service Continuity Plan Development;    

  

					
	

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		  		  	 2.     Reviewing service continuity plans;

			
		  		  	 3.     Determining if service continuity plans individually and collectively meet the Client and technical
continuity requirements;

			
		  		  	 4.     Providing advice and guidance regarding adjustments of service continuity plans so that activities
within and across plans are appropriate and compatible;

			
		  		  	 5.     Compiling and publishing finalized service continuity plans into an integrated IT Business Continuity
Plan (“ITBCP”);

			
		  		  	 6.     Obtaining approvals from the appropriate personnel designated to approve ITBCPs;

			
		  		  	 7.     Coordinating, scheduling and monitoring the performance and results of contingency plan testing,
including the development of recommendations for change to the ITBCP;

			
		  		  	 8.     Monitoring Actors to verify that their applicable personnel are appropriately trained in the ITBCP and
are able to successfully implement the plan; and

			
		  		  	 9.     Developing recommendations to improve the system of service continuity.

			
	2.8	  	 Security
 Management
	  	
			
	2.8.1	  	 Security
 Oversight
	  	 The purpose of “Security Oversight” is to oversee Information Security at a high level to ensure appropriate operation of the
security controls with coordination both within the Information Security processes and between the Information Security Actors and other Actors within the IT environment.
  

Security Oversight includes the following activities:

			
		  		  	 1.     Reviewing and approving security policies prepared by the Process Owner of Security Policy
Development.

			
		  		  	 2.     Gaining and maintaining a comprehensive understanding of each delivery Actor’s role as it pertains
to the management of Information Security, relevant methodologies, processes and tools;

  

					
	

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		  		  	 3.     Establishing and maintaining a close working relationship with the applicable Process owner(s) of
Incident Oversight, Incident Management, Security Operations, Security Analysis and Security Incident Response;

			
		  		  	 4.     Acting as an advocate on Information Security issues for the demand side of the IT environment, Clients
and the enterprise, including:

			
		  		  	 (a)    Gaining and maintaining an understanding of the perspectives and preferences of Clients, the enterprise and
IT leadership regarding Information Security;

			
		  		  	 (b)    Establishing and communicating the demand-side Information Security expectations to the applicable Process
owner(s); and

			
		  		  	 (c)    Enforcing accountability among the applicable Information Security Process owner(s) for meeting the
enterprise’s demands for action, quality, cooperation and urgency pertaining to the management of Information Security;

			
		  		  	 5.     Reviewing proposed Security Incident Response solutions and providing input and preferences to the
Process owner(s) of Incident Oversight and Incident Management;

			
		  		  	 6.     Requesting alternative Security Incident Response solutions from the Process owner(s) of Security
Incident Response when proposed solutions do not meet the needs and preferences of Clients, the enterprise or IT leadership;

			
		  		  	 7.     Mandating specific actions and/or solutions to be implemented by the Process owner(s) of Security
Operations and Security Incident Response in response to a security incident;

			
		  		  	 8.     Providing ongoing, operational and tactical day-to-day business and enterprise risk mitigation context
to the Security Operations and Security Analysis Process owners; and

			
		  		  	 9.     Providing strategic business and enterprise risk mitigation context to the Security Requirements
Development Process owner(s).

  

					
	

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	2.8.2	  	 Security Policy

Development
	  	 The purpose of “Security Policy Development” is to develop and document the policies and strategies related to IT security.

 
 Security Policy Development includes the following activities:

			
		  		  	 1.     Identifying the guiding principles and applicable drivers (e.g., risk, legal, industrial,
environmental, corporate) that impact IT security policy;

			
		  		  	 2.     Developing security policies;

			
		  		  	 3.     Obtaining approvals from the appropriate personnel designated to approve IT security policies;
and

			
		  		  	 4.     Documenting the security policies, including:

			
		  		  	 (a)    Maintaining them in an appropriate repository; and

			
		  		  	 (b)    Publishing them to the applicable Process owner(s).

			
	2.9	  	Program Office	  	
			
	2.9.1	  	Program Management Oversight	  	The purpose of “Program Management Oversight” is to oversee, inform and communicate to the applicable Process owner(s) of Program Management and Project Management and other Processes involved in identifying and delivering
Customer needs and requirements including monitoring and evaluating the manner in which Programs are used to achieve Customer objectives.
			
	2.9.2	  	 Program
 Management
	  	 The purpose of “Program Management” is to prioritize the projects to be performed, manage linkages between projects, and oversee
Project Management.
  
 Program Management includes the following
activities:

			
		  		  	 1.     Establishing policies to which projects must conform (e.g., methodology, reporting,
tools);

			
		  		  	 2.     Maintaining awareness of the pipeline of projects, their respective stakeholders, their purpose, and
their expected benefits;

			
		  		  	 3.     Determining the sequence and/or priority of projects;

			
		  		  	 4.     Informing project stakeholders of the prioritization of their projects and re-prioritizing as
appropriate based on feedback;

			
		  		  	 5.     Auditing projects to confirm compliance with the applicable policies and
guidelines;    

  

					
	

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		  		  	 6.     Determining stakeholder satisfaction with the handling of projects;

			
		  		  	 7.     Tracking and analyzing project performance, including:

			
		  		  	 (a)    Monitoring project progress based on major milestones; and

			
		  		  	 (b)    Meeting with project stakeholders and project managers to review project findings and
recommendations;

			
		  		  	 8.     Developing and disseminating stakeholder communications, including:

			
		  		  	 (a)    Determining the information and communications needs of stakeholders (e.g., who needs what information, when
they need it, and how will it be given to them);

			
		  		  	 (b)    Making needed information available to stakeholders; and

			
		  		  	 (c)    Helping Clients and stakeholders understand the implications of programs, projects and other change on their
personnel;

			
		  		  	 9.     Assessing risk on projects of high-importance and on the collection of projects,
including:

			
		  		  	 (a)    Identifying, analyzing, and responding to project risk;

			
		  		  	 (b)    Determining risks likely to affect projects and documenting the characteristics;

			
		  		  	 (c)    Performing a qualitative analysis of risks and conditions to prioritize their effects on project objectives;
and

			
		  		  	 (d)    Tracking identified risks, monitoring residual risks, identifying new risks, executing risk plans and
evaluating their effectiveness in reducing risk; and

			
		  		  	 10.   Integrating projects to provide proper and adequate coordination of the linkages between them.

			
	2.9.3	  	Project Management	  	 The purpose of “Project Management” is to supervise, monitor and manage projects, so that projects are performed in accordance with
established plans, budgets and timelines.
  
 Project Management includes the following
activities:

			
		  		  	 1.     Planning projects, including:

			
		  		  	 (a)    Forming project
teams;    

  

					
	

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		  		  	 (b)    Defining the specific activities that must be performed to produce the various project
deliverables;

			
		  		  	 (c)    Sequencing the activities and documenting dependencies among the activities;

			
		  		  	 (d)    Estimating the time needed to complete individual activities;

			
		  		  	 (e)    Analyzing the activity sequences, activity durations, and resource requirements;

			
		  		  	 (f)    Performing risk management planning;

			
		  		  	 (g)    Determining which resources (e.g., people, hardware, materials) and which quantities of each should be used
to perform project activities;

			
		  		  	 (h)    Working with the applicable Process owner(s) and other personnel as appropriate to identify and assign the
personnel needed to perform project activities;

			
		  		  	 (i)     Developing estimates of the resource costs required to complete projects;

			
		  		  	 (j)     Identifying which quality standards are relevant to projects and how they can be
satisfied;

			
		  		  	 (k)    Identifying, documenting, and assigning project roles, responsibilities, and reporting
relationships;

			
		  		  	 (l)     Determining the information and communications needs of stakeholders;

			
		  		  	 (m)  Identifying quantitative and qualitative risks and documenting the characteristics of each;

			
		  		  	 (n)    Developing procedures and techniques to enhance project success and to reduce threats to
projects;

			
		  		  	 (o)    Determining, in conjunction with the applicable Process owner(s) of Acquisition and other applicable
Processes, and Third Party Contract Managers, what to procure, how much to procure, and when to procure;    

  

					
	

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		  		  	 (p)    Developing project plans by taking the results of the above and incorporating them into consistent, coherent
documents, including planning inputs, historical information, organizational policies, constraints and assumptions, that can be used to guide both project execution and project control;

			
		  		  	 (q)    Submitting draft project plans to the applicable stakeholders and Process owner(s), including those of
Program Management, for approval; and

			
		  		  	 (r)    Revising draft project plans as directed by the applicable stakeholders and Process owner(s), including
those of Program Management;

			
		  		  	 2.     Monitoring and controlling projects, including:

			
		  		  	 (a)    Managing personnel assigned to projects;

			
		  		  	 (b)    Implementing appropriate project management methodology including the use of approved project management
tools;

			
		  		  	 (c)    Preparing performance, financial, utilization and other status reports;

			
		  		  	 (d)    Providing appropriate access to information and project management templates;

			
		  		  	 (e)    Coordinating changes across/within projects;

			
		  		  	 (f)    Controlling changes to project scope;

			
		  		  	 (g)    Controlling changes to project schedules;

			
		  		  	 (h)    Controlling changes to project budgets;

			
		  		  	 (i)     Determining if projects comply with relevant quality standards and identifying ways to eliminate
unsatisfactory performance; and

			
		  		  	 (j)     Tracking identified risks, monitoring residual risks, identifying new risks and executing risk plans
and evaluating their effectiveness in reducing risk; and

			
		  		  	 3.     Executing projects, including:

			
		  		  	 (a)    Executing project plans by causing the assigned personnel, including those associated with other Process
owners, to perform the applicable project activities therein;

  

					
	

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		  		  	 (b)    Evaluating overall project performance on a regular basis to verify that projects will satisfy the relevant
quality standards and causing the applicable Process owner(s) to address deficiencies;

			
		  		  	 (c)    Developing individual and group skills/competencies to enhance project performance;

			
		  		  	 (d)    Verifying performance of project activities, including those performed by other Process owners (e.g.,
Quality Assurance);

			
		  		  	 (e)    Closing out projects and resolving open items; and

			
		  		  	 (f)    Providing administrative closure by generating, gathering, and disseminating information and formalizing
phase or project completion, including evaluating projects and compiling lessons learned for use in planning future projects or phases.

			
	3	  	Service Delivery	  	
			
	3.1	  	 Solution
 Formulation
	  	
			
	3.1.1	  	Technical Requirements Development	  	 The purpose of “Technical Requirements Development” is to analyze business requirements and refine them to a sufficient level of
detail so that solutions can be developed.
  
 Technical Requirements Development includes
the following activities:

			
		  		  	 1.     Obtaining, reviewing and analyzing business requirements from the applicable Process owner(s) of
Business Requirements Documentation and solution requirements from the applicable Process owner(s) of Solution Integration;

			
		  		  	 2.     Establishing and maintaining listings of required capabilities, including:

			
		  		  	 (a)    Analyzing and quantifying functional capabilities required by Clients; and

			
		  		  	 (b)    Analyzing and quantifying non-functional capabilities required by Clients (e.g., availability, performance,
adaptability to change, re-use);

			
		  		  	 3.     Establishing solution requirements,
including:

  

					
	

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		  		  	 (a)    Specifying required alignment with the relevant reference Domain Architecture(s) and approved
standards;

			
		  		  	 (b)    Developing technical requirements for solution design;

			
		  		  	 (c)    Identifying system interface requirements, both internal and external to such solutions;

			
		  		  	 (d)    Developing functional, performance, maintenance, support and disposal concepts, and scenarios;
and

			
		  		  	 (e)    Defining environments in which solutions will operate, including boundaries and constraints;

			
		  		  	 4.     Documenting and providing technical requirements and associated material to the applicable Process
owner(s); and

			
		  		  	 5.     Revising technical requirements based on feedback from the applicable Process owner(s), including the
applicable Process owner(s) of Solution Integration.

			
	3.1.2	  	 Security Solution

Development
	  	 The purpose of “Security Solution Development” is to design solutions that satisfy the business and security requirements (e.g.,
business, integration, technical, risk mitigation) provided by the Security Requirements Development Process owner.
  

Security Solution Development includes the following activities:

			
		  		  	 6.     Analyzing requirements to confirm they are necessary and sufficient, and adequately balance the
objectives and constraints of Clients and IT;

			
		  		  	 7.     Designing solutions that comply with and leverage the Security Architecture(s) and industry best
practice, and that will satisfy the requirements;

			
		  		  	 8.     Developing operational details that define the interaction of solutions, their Clients and the
environment;

			
		  		  	 9.     Identifying ongoing maintenance, support and re-use attributes of solutions;

			
		  		  	 10.   Identifying attributes of solutions that have a significant influence on cost, schedule, timing, functionality,
performance, and risk;

			
		  		  	 11.   Validating that solutions will perform appropriately in their intended-use
environment;    

  

					
	

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		  		  	 12.   Identifying interactivity dependencies and other assumptions related to solutions;

			
		  		  	 13.   Performing risk analysis for the development, implementation, operation and disposal of solutions;

			
		  		  	 14.   Documenting and providing solutions and associated material to the applicable Process owner(s); and

			
		  		  	 15.   Revising solutions based on feedback from the applicable Process owner(s), including the applicable Process owners
of 4.1 Security Management.

			
	3.1.3	  	 Solution
 Development
	  	 The purpose of “Solution Development” is to design solutions that satisfy the requirements (e.g., business, integration,
technical).
  
 Solution Development includes the following activities:

			
		  		  	 1.     Analyzing requirements to confirm they are necessary and sufficient, and adequately balance the needs
and constraints of Clients and IT;

			
		  		  	 2.     Designing solutions that comply with and leverage the relevant Domain Architecture(s) and that will
satisfy the requirements;

			
		  		  	 3.     Developing operational details that define the interaction of solutions, their Clients and the
environment;

			
		  		  	 4.     Identifying ongoing maintenance, support and re-use attributes of solutions;

			
		  		  	 5.      Identifying attributes of solutions that have a significant influence on cost, schedule, timing,
functionality, performance, and risk;

			
		  		  	 6.     Validating that solutions will perform appropriately in their intended-use environment;

			
		  		  	 7.     Identifying interactivity dependencies and other assumptions related to solutions;

			
		  		  	 8.     Performing risk analyses for the development, implementation, operation and disposal of
solutions;

			
		  		  	 9.     Documenting and providing solutions and associated material to the applicable Process owner(s);
and

  

					
	

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		  		  	 10.   Revising solutions based on feedback from the applicable Process owner(s), including the applicable Process
owner(s) of Solution Integration.

			
	3.1.4	  	 Resource
 Estimation
	  	 The purpose of “Resource Estimation” is to develop estimates of the resources and time required to develop, implement, operate and
dispose of solutions.
  
 Resource Estimation includes the following
activities:

			
		  		  	 1.     Identifying the types and estimated quantities and pricing of the resources (e.g., personnel, hardware,
software, services, facilities) required to develop, implement, maintain and support solutions;

			
		  		  	 2.     Estimating the time necessary to build and implement solutions, including obtaining feedback as
applicable from the applicable Process owner(s) of Program Management and Project Management;

			
		  		  	 3.     Documenting and providing estimates of resources and time in the appropriate form required by the
applicable Process owner(s) of Solution Integration; and

			
		  		  	 4.     Revising estimates based on feedback from the applicable Process owner(s) of Solution Integration and
other applicable Processes.

			
	3.2	  	 Infrastructure

Engineering
	  	
			
	3.2.1	  	 Platform
 Engineering
	  	 The purpose of “Platform Engineering” is to design and develop the technology infrastructure platforms in use, or in development,
within the IT environment.
  
 Platform Engineering includes the following
activities:

			
		  		  	 1.     Evaluating, optimizing and specifying hardware, infrastructure software and services CIs;

			
		  		  	 2.     Assessing the feasibility of and risks associated with proposed introduction or changes of CIs to the
IT environment;

			
		  		  	 3.     Performing optimal matching of technical requirements with hardware, infrastructure software and
services CIs available in the marketplace;    

  

					
	

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		  		  	 4.     Testing configured hardware and infrastructure software for satisfaction of the requirements and
compatibility with other CIs;

			
		  		  	 5.     Testing manufacturer’s in-model revisions to hardware and infrastructure software to confirm
proper operation within the IT environment;

			
		  		  	 6.     Evaluating and recommending or developing solution designs that keep the data assets accessible and
recoverable, and meet the requirements for performance, protocol conversion and translation;

			
		  		  	 7.     Tuning and optimizing platform performance, including with respect to changes (i.e., additions,
removals and modifications) of or to software in the IT environment;

			
		  		  	 8.     Developing specifications for physical and logical network addressing in coordination with other
interconnected and third party networks;

			
		  		  	 9.     Developing and maintaining documents describing the physical and logical networks, including security
components and addressing schemes;

			
		  		  	 10.   Developing and documenting configuration parameters in a manner consistent with maximizing the use, performance
and availability of the IT environment within the capabilities of CIs;

			
		  		  	 11.   Developing, documenting and maintaining the configuration parameters and implementation guidelines for the
building of Elements and their sub-components, and providing such information to the applicable Process owner(s);

			
		  		  	 12.   Specifying the type and quantity of hardware, software, facilities and services as required to meet actual and
forecasted business demand;

			
		  		  	 13.   Testing to verify the successful inclusion of availability mechanisms (e.g., redundancy, failover, service
continuity);

			
		  		  	 14.   Developing, testing and documenting architecturally consistent implementations, configurations and
connections;

			
		  		  	 15.   Developing, testing and documenting configuration policy objects that implement the applicable approved
enterprise, IT, security and Client policies;    

  

					
	

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		  		  	 16.   Specifying the environmental (e.g., power, facilities, temperature, humidity) requirements for design, development
and operation;

			
		  		  	 17.   Identifying and reviewing new types of hardware and infrastructure software applicable to the IT environment and
determining compliance with the relevant standards and requirements;

			
		  		  	 18.   Providing input to and assisting with the development of standards; and

			
		  		  	 19.   Performing forward-looking assessments of emerging technology(ies) to assess applicability and potential
benefit.

			
	3.3	  	 Software
 Engineering
	  	
			
		  		  	
			
	3.3.1	  	Software Design	  	 The purpose of “Software Design” is to transform software-based business, solution, technical requirements into complete, detailed
system specifications.
  
 Software Design includes the following
activities:

			
		  		  	 1.     Developing detailed alternative software designs and selection criteria (e.g., cost, technical
performance, complexity, risk), including:

			
		  		  	 (a)    Establishing and maintaining a process or processes for identifying software design alternatives, selection
criteria, and design issues;

			
		  		  	 (b)    Identifying software design alternatives;

			
		  		  	 (c)    Developing criteria for selecting the best software design alternative;

			
		  		  	 (d)    Identifying and characterizing design issues for software design alternatives;

			
		  		  	 (e)    Identifying technologies in the IT environment and other technologies as they relate to software design
alternatives;

			
		  		  	 (f)    Identifying potential risks and developing mitigating design features for software design
alternatives;

			
		  		  	 (g)    Documenting the rationale for using particular software design alternatives;
and    

  

					
	

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		  		  	 (h)    Developing timelines for Client interaction with software development activities;

			
		  		  	 2.     Evolving, to an appropriate degree of detail, operational concepts, scenarios, and environments to
describe conditions, operating modes, and operating states for software designs;

			
		  		  	 3.     Selecting software designs that best satisfy the applicable selection criteria,
including:

			
		  		  	 (a)    Evaluating alternative software design against the applicable selection criteria;

			
		  		  	 (b)    Assessing, based on evaluation of alternatives, the adequacy of the selection criteria and updating these
criteria as necessary;

			
		  		  	 (c)    Identifying and resolving issues with alternative software designs and requirements;

			
		  		  	 (d)    Selecting software design alternatives that best satisfy the established selection criteria;

			
		  		  	 (e)    Establishing requirements for software design alternatives;

			
		  		  	 (f)    Identifying software designs that will be retired, reused or acquired; and

			
		  		  	 (g)    Establishing and maintaining documentation for software designs, evaluations and rationale for
decisions;

			
		  		  	 4.     Developing software designs, including:

			
		  		  	 (a)    Designing the data storage and access for the data layer;

			
		  		  	 (b)    Designing the user interface at the presentation layer;

			
		  		  	 (c)    Designing the business rules layer and the application logic;

			
		  		  	 (d)    Identifying, designing and documenting interfaces associated with other solution components, including those
from application to application, and application to database;

			
		  		  	 (e)    Identifying and designing interfaces associated with external applications or data sources;

			
		  		  	 (f)    Establishing and maintaining criteria against which designs can be evaluated;

			
		  		  	 (g)    Identifying and implementing design methods appropriate for the
solution;    

  

					
	

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		  		  	 (h)    Adhering to the applicable design standards and criteria;

			
		  		  	 (i)     Adhering to the allocated requirements; and

			
		  		  	 (j)     Documenting designs;

			
		  		  	 5.     Establishing and maintaining technical data packages (e.g., solution requirements description,
allocated requirements, solution component descriptions, solution-related life-cycle process descriptions, key solution characteristics, interface requirements, rationale for decisions and characteristics), including:

			
		  		  	 (a)    Determining the number of levels of design and the appropriate level of documentation for each design
level;

			
		  		  	 (b)    Basing detailed design descriptions on the allocated solution requirements, architecture, and higher level
designs;

			
		  		  	 (c)    Documenting the design in the technical data package;

			
		  		  	 (d)    Documenting the rationale for significant decisions affecting cost, schedule, or technical performance;
and

			
		  		  	 (e)    Revising the technical data package as necessary;

			
		  		  	 6.     Developing application design documents that identify the steps used in design of
applications;

			
		  		  	 7.     Developing and documenting design, conversion, migration, and transition strategies; and

			
		  		  	 8.     Evaluating whether solutions should be developed, purchased, or reused based on established criteria,
including:

			
		  		  	 (a)    Developing criteria for the reuse of solution designs;

			
		  		  	 (b)    Analyzing designs to determine if solutions should be developed, reused, or purchased; and

			
		  		  	 (c)    Planning for how maintenance will be performed when purchased or non-developmental (e.g., commercial
off-the-shelf, reuse) solutions are selected.

			
	3.3.2	  	 Software
 Development
	  	 The purpose of “Software Development” is to convert a software design into a complete application program or application
system.
  
 Software Development includes the following activities:

			
		  		  	 1.     Performing software development;

  

					
	

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		  		  	 2.     Selecting, tailoring and using methods, tools, and computer programming languages for performing
software development activities;

			
		  		  	 3.     Developing software, including:

			
		  		  	 (a)    Developing and documenting each unit of the software;

			
		  		  	 (b)    Developing and documenting the data model and database schema associated with the software;

			
		  		  	 (c)    Developing and documenting the test requirements and procedures for testing each unit and
system;

			
		  		  	 (d)    Updating the test requirements;

			
		  		  	 (e)    Evaluating software to confirm internal consistency, feasibility of operation and integration, and
consistency with applicable requirements;

			
		  		  	 (f)    Revising software as necessary; and

			
		  		  	 (g)    Performing unit testing (e.g., statement coverage testing, branch coverage testing, predicate coverage
testing, path coverage testing, boundary value testing, special value testing) of the software as appropriate;

			
		  		  	 4.     Developing plans to install software in the applicable target environments; and

			
		  		  	 5.     Developing and maintaining the applicable software documentation, including:

			
		  		  	 (a)    Reviewing the requirements, design, product, and test results to confirm issues affecting the installation,
operation, and maintenance documentation have been identified and resolved, including creating known error records when software is to be released into production with known errors;

			
		  		  	 (b)    Developing the installation, operation, and maintenance documentation, including development of preliminary
versions of such documentation during the early development phases for review and comment by the relevant stakeholders;

			
		  		  	 (c)    Conducting peer reviews of the installation, operation, and maintenance documentation;
and

  

					
	

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		  		  	 (d)    Revising the installation, operation, and maintenance documentation as necessary.

			
	3.3.3	  	 Software
 Integration
	  	 The purpose of “Software Integration” is to assemble software from software units, confirm the software, as integrated, functions
properly and delivers the solution.
  
 Software Integration includes the following
activities:

			
		  		  	 1.     Determining software integration sequences, including:

			
		  		  	 (a)    Identifying the software to be integrated;

			
		  		  	 (b)    Identifying the methods by which the definition of the interfaces between software units will be
verified;

			
		  		  	 (c)    Identifying alternative software integration sequences;

			
		  		  	 (d)    Selecting the optimal integration sequence; and

			
		  		  	 (e)    Reviewing, periodically, the software integration sequence and revising as appropriate;

			
		  		  	 2.     Determining the environments required for integration of software, including:

			
		  		  	 (a)    Identifying the requirements for the software integration environment;

			
		  		  	 (b)    Identifying the testing criteria and procedures for the software integration environment; and

			
		  		  	 (c)    Deciding whether to make or buy the needed software integration environment;

			
		  		  	 3.     Reviewing interface descriptions for coverage and completeness, including:

			
		  		  	 (a)    Reviewing interface data for completeness and confirming complete coverage of all interfaces;
and

			
		  		  	 (b)    Periodically reviewing the adequacy of interface descriptions;

			
		  		  	 4.     Managing internal and external interface definitions, designs, and changes for software
including:

			
		  		  	 (a)    Maintaining the compatibility of the interfaces throughout the life of the software;

			
		  		  	 (b)    Resolving conflict, noncompliance and change issues;
and

  

					
	

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		  		  	 (c)    Maintaining a repository for interface data;

			
		  		  	 5.     Confirming, prior to assembly, that software units required to assemble the software have been properly
identified, function according to description, and interface in compliance with interface requirements, including:

			
		  		  	 (a)    Tracking the status of the software units as they become available for integration;

			
		  		  	 (b)    Delivering the software units to the integration environment in accordance with the integration sequence and
available procedures;

			
		  		  	 (c)    Confirming the receipt of each software unit and that each meets its description; and

			
		  		  	 (d)    Checking the configuration status against the expected configuration;

			
		  		  	 6.     Assembling software units according to the integration sequence, including:

			
		  		  	 (a)    Confirming the readiness of the integration environment; and

			
		  		  	 (b)    Revising the software integration sequence as appropriate;

			
		  		  	 7.     Evaluating software for interface compatibility, including:

			
		  		  	 (a)    Conducting the evaluation of software following the integration sequence; and

			
		  		  	 (b)    Recording the evaluation results; and

			
		  		  	 8.     Packaging software and delivering it to the applicable Process owner(s), including:

			
		  		  	 (a)    Reviewing the requirements, design, software, verification results, and documentation so that issues
affecting the packaging and delivery of the software or software units are identified and resolved;

			
		  		  	 (b)    Packaging and delivering the software and related documentation to the applicable Process owner(s);
and

			
		  		  	 (c)    Satisfying the applicable requirements and standards (e.g., type of storage and delivery media, required
documentation, copyrights, license provisions, security of the software) for packing and delivering the software.

  

					
	

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	3.3.4	  	Logical Database Administration	  	 The purpose of “Logical Database Administration” is to perform design-related database functions required to support the applicable
Processes.
  
 Logical Database Administration includes the following
activities:

			
		  		  	 1.     Designing, implementing and maintaining database schema;

			
		  		  	 2.     Maintaining design consistency across databases associated with different software and identifying data
redundancies;

			
		  		  	 3.     Designing, developing and maintaining entity relationship diagrams;

			
		  		  	 4.     Reviewing database schema that are the subject of an Incident or Problem and:

			
		  		  	 (a)    Determining the underlying defects; and

			
		  		  	 (b)    Revising database schema to restore full functionality; and

			
		  		  	 5.     Updating existing documentation to record changes to database schema.

			
	3.3.5	  	Peer Review	  	 The purpose of “Peer Review” is to evaluate software and data models so as to maintain or enhance the quality and verify adherence
to the applicable specifications and standards.
  
 Peer Review includes the following
activities:

			
		  		  	 1.     Conducting structured walkthroughs of software and data models;

			
		  		  	 2.     Developing insight into the suitability of software and data models, including:

			
		  		  	 (a)    Obtaining the perspectives of those with applicable backgrounds and experience;

			
		  		  	 (b)    Identifying errors in coding;

			
		  		  	 (c)    Identifying inconsistencies or inefficiencies in how data is managed;

			
		  		  	 (d)    Assessing the degree of compliance with requirements and applicable standards; and

			
		  		  	 (e)    Developing suggestions for improvement; and

  

					
	

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		  		  	 3.     Documenting and sharing the results of peer reviewed software and data models with the applicable
Process owner(s) and other personnel.

			
	3.4	  	 Quality
 Assurance
	  	
			
	3.4.1	  	Testing	  	 The purpose of “Testing” is to confirm that solutions to be added to the IT environment meet their requirements.

 
 Testing includes the following activities:

			
		  		  	 1.     Developing testing methods to test solutions, including:

			
		  		  	 (a)    Identifying the requirements to be satisfied by each solution;

			
		  		  	 (b)    Identifying the testing methods that are available for use; and

			
		  		  	 (c)    Defining the testing methods to be used for each solution;

			
		  		  	 2.     Defining test environments, including:

			
		  		  	 (a)    Identifying the testing environment responsibilities;

			
		  		  	 (b)    Establishing the test team and developing the test files and data;

			
		  		  	 (c)    Identifying the testing resources (e.g., test scripts) that are available for reuse and modification;
and

			
		  		  	 (d)    Identifying the testing hardware and tools;

			
		  		  	 3.     Establishing and maintaining test procedures and criteria, including:

			
		  		  	 (a)    Generating the set of comprehensive, integrated test scripts;

			
		  		  	 (b)    Developing and refining the test criteria when necessary; and

			
		  		  	 (c)    Identifying the expected results, any tolerances allowed in observation, and other criteria for satisfying
the requirements;

			
		  		  	 4.     Testing solutions, including:

			
		  		  	 (a)    Performing testing of solutions or solution components against their
requirements;

  

					
	

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		  		  	 (b)    Recording the results of testing activities;

			
		  		  	 (c)    Identifying action items resulting from testing of solutions or solution components; and

			
		  		  	 (d)    Documenting the “as-run” testing method and the deviations from the available methods and
procedures discovered during its performance; and

			
		  		  	 5.     Analyzing test activity results and identifying corrective actions, including:

			
		  		  	 (a)    Comparing the actual results to expected results;

			
		  		  	 (b)    Identifying, based on the established testing criteria, those portions of the solution and solution
sub-components that have not met their requirements and identifying issues with the methods, procedures, criteria, and verification environment;

			
		  		  	 (c)    Analyzing the testing data related to defects;

			
		  		  	 (d)    Using testing results to compare actual measurements and performance to technical performance parameters;
and

			
		  		  	 (e)    Providing information on how defects may be resolved (e.g., verification methods, criteria, and verification
environment) and preparing a plan for such resolution.

			
	3.4.2	  	Environment Integration Testing	  	 The purpose of “Environment Integration Testing” is to perform those activities necessary to confirm that solutions will perform as
required in the proposed environment.
  
 Environment Integration Testing includes the
following activities:

			
		  		  	 1.     Applying the solutions to the appropriate test environments;

			
		  		  	 2.     Validating, for solutions that are tested in a test environment, that solutions perform as intended
when:

			
		  		  	 (a)    All solution components comprising the required system (e.g., hardware, software) are tested together,
and

			
		  		  	 (b)    Tested in a model production environment; and

			
		  		  	 3.     Validating, for solutions that are tested in the production environment, that solutions perform as
intended when all solution components comprising the required system (e.g., hardware, software) are tested together.

  

					
	

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	 3.4.3
 (a)
	  	User Acceptance Testing (CTS Users)	  	 The purpose of “User Acceptance” is to perform those activities necessary to confirm that solutions will perform as required by the
applicable Clients.
  
 User Acceptance includes the following activities:

			
		  		  	 1.     Confirming that solutions satisfy the applicable test criteria;

			
		  		  	 2.     Confirming that solutions meet the applicable usability requirements (e.g., user interface,
performance, reporting);

			
		  		  	 3.     Confirming that solutions satisfy the applicable business requirements; and

			
		  		  	 4.     Confirming that the introduction of solutions does not adversely impact pre-existing functionality
other than as planned.

			
	 3.4.3
 (b)
	  	User Acceptance Testing (HNT Users)	  	 The purpose of “User Acceptance” is to perform those activities necessary to confirm that solutions will perform as required by the
applicable Clients.
  
 User Acceptance includes the following activities:

			
		  		  	 5.     Confirming that solutions satisfy the applicable test criteria;

			
		  		  	 6.     Confirming that solutions meet the applicable usability requirements (e.g., user interface,
performance, reporting);

			
		  		  	 7.     Confirming that solutions satisfy the applicable business requirements; and

			
		  		  	 8.     Confirming that the introduction of solutions does not adversely impact pre-existing functionality
other than as planned.

			
	3.5	  	Client Support	  	
			
	3.5.1	  	Service Desk	  	 The purpose of “Service Desk” is to provide the primary point of contact related to IT services for Clients, regardless of the
channel (e.g., phone, web, email, software-generated events) used for activities such as requesting information, registering complaints, requesting IT services or reporting IT-related performance issues such as Incidents or Problems (where all such
activities are collectively “Events”). Service Desk acts as an advocate for Clients and provides an information link between and among Clients, the IT environment, other parts of the enterprise, Actors and third parties.

 
 Service Desk includes the following
activities:

  

					
	

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		  		  	 1.     Providing the ability for Clients to:

			
		  		  	 (a)    Submit Events, including complaints regarding the quality of IT services (e.g., non-functioning hardware,
system access needs, other issues with hardware or software) and other inquiries regarding hardware, software and IT services; and

			
		  		  	 (b)    Submit orders for items within either the Service Catalog (e.g., IMACs) or other applicable
mechanisms;

			
		  		  	 2.     Collecting information from the applicable Process owner(s) regarding resolution status and other
activities that may impact or have already impacted Clients;

			
		  		  	 3.     Providing status updates to Clients (or their designees) on matters previously reported;

			
		  		  	 4.     Logging relevant details regarding Events and, as applicable, assigning categorization and
prioritization codes;

			
		  		  	 5.     Making initial assessments of Events to determine whether they can be answered or resolved by the
applicable Process owner(s) of Service Desk;

			
		  		  	 6.     Answering and resolving Events that can be performed by the applicable Process owner(s) of Service
Desk, and transferring responsibility for resolution to the applicable Process owner(s) of other Processes for the remainder;

			
		  		  	 7.     Managing the lifecycle of Events, including opening, closing, verifying, documenting and communicating
with Clients regarding Events, regardless of whether the actions in response to such Events are performed by the applicable Process owner(s) of Service Desk or other Processes;

			
		  		  	 8.     Updating the CMDB as applicable and appropriate;

			
		  		  	 9.     Obtaining approval, where necessary, for Client requests submitted to the applicable Process owner(s)
of Service Desk;

			
		  		  	 10.   Developing and maintaining a repository of applicable knowledge regarding the IT environment so as to maximize the
number of Events that can be handled by the applicable Process owner(s) of Service Desk (i.e., without the need of assistance from other Process owners;

  

					
	

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		  		  	 11.   Publishing approved communication notices, developed by the applicable Process owner(s) of Service Desk and other
applicable Processes, regarding the IT services (e.g., software release schedules, planned outages);

			
		  		  	 12.   Coordinating the handoff of information between and among Clients, the IT environment, other parts of the
enterprise, Actors and third parties to facilitate an effective and efficient delivery of IT services;

			
		  		  	 13.   Obtaining Client feedback regarding the performance of IT services via appropriate and applicable means;
and

			
		  		  	 14.   Developing and producing comprehensive periodic management information packages regarding the delivery of IT
services to Clients, including:

			
		  		  	 (a)    The various operations of Service Desk (e.g., call statistics, call durations, call abandonment, assistance
resolution rates); and

			
		  		  	 (b)    Observations regarding IT service delivery and recommendations for improvement.

			
	3.5.2	  	 Technical
 Support
	  	 The purpose of “Technical Support” is to provide technical input and assistance regarding the IT environment and technology in
general to Clients and the applicable Process owner(s) of Internal Client Relationship Management and External Relationship Management, as directed by the applicable Process owner(s) of Internal Client Relationship Management, External Client
Relationship Management and other Processes.
  
 Technical Support includes the following
activities:

			
		  		  	 1.     Working with Clients to provide technical input to the identification and specification of high-level
IT-related business missions, objectives and concepts;

			
		  		  	 2.     Providing technical input and guidance regarding new business opportunities or requirements that could
affect the IT environment, including general guidance on technical solutions in the pre-business requirements development phase and generating related sourcing and pricing information;

  

					
	

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		  		  	 3.     Attending periodic or ad hoc Client management meetings to provide technical support and feedback
regarding IT technology plans and status; and

			
		  		  	 4.     Providing technical input and guidance into the development of Internal Client responses to requests
for proposals and other similar constructs used by its customers for goods and/or services.

			
	3.5.3	  	Business Systems Support	  	 The purpose of “Business Systems Support” is to provide input and assistance to Clients in their understanding and use of their
business systems.
  
 Business Systems Support includes the following
activities:

			
		  		  	 1.     Maintaining a working knowledge of the business and industry of Clients;

			
		  		  	 2.     Understanding the business processes and systems of Clients, including how they are used collectively
to achieve the desired business outcomes;

			
		  		  	 3.     Understanding the current configuration of the business systems of Clients and maintaining knowledge
regarding the fuller capabilities of such systems;

			
		  		  	 4.     Developing ad hoc reports for Clients, including the provision of softcopy files for direct use and
manipulation by Clients;

			
		  		  	 5.     Assisting Clients with developing strategies for the use of their business systems, including
associated data, configuration options, system upgrade and system replacement;

			
		  		  	 6.     Assisting Clients with articulating their business system requirements and assessing the solutions
developed to achieve such requirements, including those proposed by the applicable Process owner(s) of Solution Integration and other Processes;

			
		  		  	 7.     Assisting Clients with the design of their testing regime and scripts for their business
systems;

			
		  		  	 8.     Identifying opportunities where Client training, change in business process or change in system
configuration would likely improve the efficiency and effectiveness of Client operations and communicating such opportunities to the applicable Clients and Process owner(s);

  

					
	

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		  		  	 9.     Assisting Clients in revising their operational procedures based on change in technology;
and

			
		  		  	 10.   Providing Clients with information and instructions necessary to perform system functions required to handle
infrequently occurring and highly complex business functions.

			
	3.6	  	Acquire	  	
			
	3.6.1	  	 Procurement
 Management
	  	 The purpose of “Procurement Management” is to develop, enter into, and manage purchasing agreements (including master purchasing
agreements and item-specific agreements under existing master purchasing agreements) for Elements and ancillary goods and services (e.g., warranties, Spare Parts, Consumables).

Procurement Management includes the following activities:

			
		  		  	 1.     Serving as the primary point of contact for Internal Actors for the interpretation and modification of
purchase agreements with suppliers for Elements and ancillary goods and services;

			
		  		  	 2.     Obtaining and reviewing properly approved sourcing strategies and requirements for Elements and
ancillary goods and services in the IT environment;

			
		  		  	 3.     Obtaining information regarding procurement standards, objectives and requirements from the applicable
Process owner(s) of Commercial Management;

			
		  		  	 4.     Determining the need to develop or modify purchase agreements for Elements and ancillary goods and
services;

			
		  		  	 5.     Establishing procurement and management strategies for purchase agreements for Elements and ancillary
goods and services;

			
		  		  	 6.     Obtaining approval for procurement strategies from the applicable Process owner(s) of Commercial
Management and, as applicable, other personnel designated to approve procurement strategies;

			
		  		  	 7.     Maintaining a knowledge base of the relevant supplier community (e.g., companies, pricing, procurement
issues and trends, new services and products) for Elements and ancillary goods and services;

  

					
	

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		  		  	 8.     Negotiating purchase agreements with suppliers, including the associated pricing and service levels,
for Elements and ancillary goods and services;

			
		  		  	 9.     Obtaining approvals from the appropriate personnel designated to approve new or modified purchase
agreements for Elements and ancillary goods and services;

			
		  		  	 10.    Converting negotiated deals for Elements and ancillary goods and services into either standalone purchasing
agreements, where an existing agreement is not in force, or contractual amendments to existing purchasing agreements as applicable;

			
		  		  	 11.   Administering the lifecycle of purchase agreements (e.g., renew, modify, renegotiate, terminate, replace) for
Elements and ancillary goods and services, including:

			
		  		  	 (a)    Tracking and providing the requisite notices and other contract-based information to the
suppliers;

			
		  		  	 (b)    Monitoring and verifying the performance of supplier obligations;

			
		  		  	 (c)    Validating the assessment of charges; and

			
		  		  	 (d)    Maintaining ongoing relationships with suppliers, with which purchasing agreements are in place, to
facilitate resolution of issues and implementation of changes; and

			
		  		  	 12.   Reporting instances in which Actors or Clients are found not using the appropriate purchasing agreements for the
purchase of Elements and ancillary goods and services, and advising the applicable Process owner(s) or other personnel as appropriate.

			
	3.6.2	  	Third Party Contract Management	  	The purpose of “Third Party Contract Management” is to manage the contracts of Third Party Vendors as described at [insert reference to Third Party Contract Management in Schedule O]
			
	3.6.3	  	Acquisition	  	 The purpose of “Acquisition” is to use purchasing agreements developed, entered into or managed by Procurement Management to
fulfill the acquisition of Elements and ancillary goods and services.
  
 Acquisition
includes the following activities:

			
		  		  	 1.     Obtaining orders for Elements and ancillary goods and services from the applicable Process owner(s)
and:

  

					
	

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		  		  	 (a)    Validating such orders for correctness and approval from the appropriate personnel;

			
		  		  	 (b)    Determining whether the items requested are already in the IT inventory; and

			
		  		  	 (c)    Acquiring the items through purchasing agreements already in force and, as applicable, other
means;

			
		  		  	 2.     Tracking the status of orders for Elements and ancillary goods and services and escalating delays or
other matters associated with such orders to the applicable Process owner(s) and other personnel as appropriate;

			
		  		  	 3.     Processing appropriately approved order changes for Elements and ancillary goods and
services;

			
		  		  	 4.     Reporting the status of orders for Elements and ancillary goods and services to the applicable Process
owner(s); and

			
		  		  	 5.     Advising the applicable Process owner(s) of Procurement Management of problems or issues with the
purchasing agreements for Elements and ancillary goods and services, and interacting with the underlying suppliers as necessary.

			
	3.7	  	Deploy	  	
			
	3.7.1	  	Configuration	  	 The purpose of “Configuration” is to configure Elements according to the specifications for build and operational function provided
by the applicable Process owner(s).
 Configuration includes the following activities:

			
		  		  	 1.     Building Elements, including the integration of applicable sub-components (e.g., software,
hardware);

			
		  		  	 2.     Performing operational selections, on or with respect to the Element, required to properly implement
the required features, functionality and constraints, including the association of the Element or the user(s) of the Element with the applicable non-security-based policy objects; and

			
		  		  	 3.     Updating the CMDB as applicable and
appropriate.

  

					
	

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	3.7.2	  	Implementation	  	 The purpose of “Implementation” is to coordinate, manage and execute the activities necessary to perform change to Elements in the
IT and Client environments, including adding and removing Elements and sub-components of Elements from such environments.
  

Implementation includes the following activities:

			
		  		  	 1.     Obtaining, from the applicable Process owner(s) (e.g., Service Desk), appropriately approved
implementation requests;

			
		  		  	 2.     Performing those functions necessary to verify that the applicable attributes of the IT and Client
environments can support the implementation requests, including:

			
		  		  	 (a)    Conducting, when applicable, site surveys and informing the applicable Process owner(s), Clients and other
personnel as appropriate of issues (e.g., physical space limitations and requirements, changes to the cabling infrastructure);

			
		  		  	 (b)    Developing implementation plans; and

			
		  		  	 (c)    Coordinating with the applicable Process owner(s), Clients and other personnel as necessary;

			
		  		  	 3.     Optimizing performance from financial, timing and Client-disruption perspectives, including combining
or disaggregating activities when applicable;

			
		  		  	 4.     Proposing, when applicable, implementation windows to, and as necessary obtaining approval for such
windows from, the applicable Process owner(s) of Change Management Execution;

			
		  		  	 5.     Dispatching, when applicable, the appropriate personnel to the applicable location(s);

			
		  		  	 6.     Fulfilling implementation requests, including:

			
		  		  	 (a)    Obtaining, when applicable, items (e.g., Elements, sub-components of Elements, release packages) from the
applicable Process owner(s);

			
		  		  	 (b)    Confirming, when applicable, that obtained items are properly configured;

			
		  		  	 (c)    Installing, moving, adding, changing, removing and releasing, when applicable, obtained items and existing
Elements;

  

					
	

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		  		  	 (d)    Connecting, when applicable, obtained items and existing Elements to the applicable IT and Client
environments;

			
		  		  	 (e)    Performing, or when applicable, requesting to be performed by the applicable Process owner(s), security,
file access, directory and other administrative procedures as applicable;

			
		  		  	 (f)    Activating and deactivating, when applicable, obtained items and existing Elements, including their
underlying services;

			
		  		  	 (g)    Notifying, when applicable, the applicable Process owner(s) of the readiness for supplemental activities to
be performed to complete requests, including notifying the applicable Process owner(s) of Configuration and Security Administration regarding implementation of the associated non-security- and security- based policies and access
rights;

			
		  		  	 (h)    Backing up and copying data when applicable, including, when appropriate, notifying Clients of self-service
data restoration procedures;

			
		  		  	 (i)     Confirming that requests have been implemented as required;

			
		  		  	 (j)     Performing tests to confirm that fulfillment of requests provides the expected functionality,
including, as applicable, with respect to other Elements;

			
		  		  	 (k)    Taking corrective action when necessary, including providing and executing appropriate back-out procedures
for unsuccessful implementations; and

			
		  		  	 (l)     Confirming that Client and IT operational capabilities are not adversely impacted as a consequence of
fulfilling requests;

			
		  		  	 7.     Returning, when applicable, to the applicable Process owner(s), Elements and sub-components of Elements
removed from the IT and Client environments;

			
		  		  	 8.     Advising the applicable Process owner(s) of performance problems or other issues that are unrelated to
the proper fulfillment of implementation requests;

			
		  		  	 9.     Updating the CMDB as applicable and appropriate;
and

  

					
	

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		  		  	 10.   Notifying the applicable Process owner(s), Clients and other personnel of the completion of implementation
requests.

			
	3.8	  	Maintain	  	
			
	3.8.1	  	 Maintenance

Administration
	  	 The purpose of “Maintenance Administration” is to determine the activities necessary to maintain Elements in accordance with the
applicable specifications, including from their manufacturers and applicable standards organizations.
  

Maintenance Administration includes the following activities:

			
		  		  	 1.     Obtaining, throughout the full lifecycle of Elements, the publications (e.g., bulletins, alerts,
manuals, software, firmware) from the applicable organizations (e.g., manufacturers, standards organizations) regarding recommended maintenance activities (e.g., firmware updates, software patches/upgrades, physical cleaning, inspection of parts and
connections, output testing, replacement of Consumables) to be performed (“Recommended Maintenance”);

			
		  		  	 2.     Determining the applicability and appropriateness of implementing Recommended Maintenance, including
requesting the applicable Process owner(s) to review, test and propose recommendations for the modification, use and implementation of Recommended Maintenance;

			
		  		  	 3.     Aggregating and reporting recommendations regarding Recommended Maintenance to the applicable Process
and Element owner(s) and soliciting feedback;

			
		  		  	 4.     Developing and revising maintenance requirements based on the feedback obtained from the applicable
Process and Element owner(s) (“Maintenance Requirements”);

			
		  		  	 5.     Obtaining approvals for implementing recurring and one-time Maintenance Requirements from the
appropriate personnel designated to approve such maintenance;

			
		  		  	 6.     Submitting appropriately approved Maintenance Requirements to the applicable Process owner(s) (e.g.,
Corrective Maintenance, Adaptive Maintenance, Release Management Execution, Local Maintenance & Repair, Remote Maintenance & Repair) to be implemented; and

  

					
	

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		  		  	 7.     Maintaining complete records of Recommended Maintenance and the associated approvals and rejections for
the performance of Maintenance Requirements.

			
	3.8.2	  	Local Maintenance & Repair	  	 The purpose of “Local Maintenance & Repair” is to coordinate, manage and execute the activities requiring physical intervention
to perform approved Maintenance Requirements and correct Incidents and Problems.
  
 Local
Maintenance & Repair includes the following activities:

			
		  		  	 1.     Developing, when applicable, the appropriate mechanisms to provide, as required, for the ready
availability of Spares, Spare Parts and Consumables;

			
		  		  	 2.     Obtaining, from the applicable Process owner(s) (e.g., Maintenance Administration, Service Desk),
appropriately approved maintenance and repair requests;

			
		  		  	 3.     Performing those functions necessary to verify that the applicable attributes of the IT and Client
environments can support the maintenance and repair requests, including:

			
		  		  	 (a)    Conducting, when applicable, site surveys and informing the applicable Process owner(s), Clients and other
personnel as appropriate of issues (e.g., physical space limitations and requirements);

			
		  		  	 (b)    Developing maintenance and repair plans; and

			
		  		  	 (c)    Coordinating with the applicable Process owner(s), Clients and other personnel as necessary;

			
		  		  	 4.     Proposing, when applicable, implementation windows to, and as necessary obtaining approval for such
windows from, the applicable Process owner(s) of Change Management Execution;

			
		  		  	 5.     Dispatching, when applicable, the appropriate personnel to the applicable location(s);

			
		  		  	 6.     Fulfilling maintenance and repair requests, including:

			
		  		  	 (a)    Obtaining, when applicable, items (e.g., Maintenance Requirements, Elements, sub-components of Elements,
Spares, Spare Parts, Consumables, release packages) from the applicable Process owner(s);

  

					
	

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		  		  	 (b)    Confirming, when applicable, that obtained items are properly configured;

			
		  		  	 (c)    Performing, when applicable, the applicable Maintenance Requirements;

			
		  		  	 (d)    Diagnosing, when applicable, Incidents and Problems within the IT and Client environments and formulating
corrective actions designed to restore and/or repair the applicable IT services;

			
		  		  	 (e)    Performing repair activities as required, including, when applicable and appropriate, replacing
malfunctioning sub-components with Spare Parts, replacing Consumables, installing patches and firmware updates, re-installing malfunctioning software, and restoring and reconfiguring the applicable settings;

			
		  		  	 (f)    Replacing Elements with Spares, subject to appropriate approval and prior performance of applicable repair
methods;

			
		  		  	 (g)    Performing, or when applicable, requesting to be performed by the applicable Process owner(s), security,
file access, directory and other administrative procedures as applicable;

			
		  		  	 (h)    Connecting, when applicable, obtained items and existing Elements to the applicable IT and Client
environments;

			
		  		  	 (i)     Activating and deactivating, when applicable, obtained items and existing Elements, including their
underlying services;

			
		  		  	 (j)     Notifying, when applicable, the applicable Process owner(s) of the readiness for supplemental
activities to be performed to complete requests, including notifying the applicable Process owner(s) of Configuration and Security Administration regarding implementation of the associated non-security- and security- based policies and access
rights;

			
		  		  	 (k)    Backing up and copying data when applicable, including, when appropriate, notifying Clients of self-service
data restoration procedures;

			
		  		  	 (l)     Confirming that requests have been implemented as
required;

  

					
	

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		  		  	 (m)  Performing tests to confirm that fulfillment of requests provides the expected functionality, including, as applicable,
with respect to other Elements;

			
		  		  	 (n)    Taking corrective action when necessary, including providing and executing appropriate back-out procedures
for unsuccessful maintenance and repair; and

			
		  		  	 (o)    Confirming that Client and IT operational capabilities are not adversely impacted as a consequence of
fulfilling requests;

			
		  		  	 7.     Returning, when applicable, to the applicable Process owner(s), Elements and sub-components of Elements
removed from the IT and Client environments;

			
		  		  	 8.     Advising the applicable Process owner(s) of performance problems or other issues that are unrelated to
the proper fulfillment of maintenance and repair requests;

			
		  		  	 9.     Updating the CMDB as applicable and appropriate; and

			
		  		  	 10.   Notifying the applicable Process owner(s), Clients and other personnel of the completion of maintenance and repair
requests.

			
	3.8.3	  	Remote Maintenance & Repair	  	 The purpose of “Remote Maintenance & Repair” is to coordinate, manage and execute the activities not requiring physical
intervention to perform approved Maintenance Requirements and correct Incidents and Problems.
  

Remote Maintenance & Repair includes the following activities:

			
		  		  	 1.     Obtaining, from the applicable Process owner(s) (e.g., Maintenance Administration, Service Desk),
appropriately approved maintenance and repair requests;

			
		  		  	 2.     Performing those functions necessary to verify that the applicable attributes of the IT and Client
environments can support the maintenance and repair requests, including:

			
		  		  	 (a)    Validating the availability of required network access and bandwidth;

			
		  		  	 (b)    Developing maintenance and repair plans; and

			
		  		  	 (c)    Coordinating with the applicable Process owner(s), Clients and other personnel as
necessary;

  

					
	

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		  		  	 3.     Proposing, when applicable, implementation windows to, and as necessary obtaining approval for such
windows from, the applicable Process owner(s) of Change Management Execution;

			
		  		  	 4.     Fulfilling maintenance and repair requests, including:

			
		  		  	 (a)    Obtaining, when applicable, items (e.g., Maintenance Requirements, Elements, sub-components of Elements,
release packages) from the applicable Process owner(s);

			
		  		  	 (b)    Confirming, when applicable, that obtained items are properly configured;

			
		  		  	 (c)    Performing, when applicable, the applicable Maintenance Requirements;

			
		  		  	 (d)    Diagnosing, when applicable, Incidents and Problems within the IT and Client environments and formulating
corrective actions designed to restore and/or repair the applicable IT services;

			
		  		  	 (e)    Performing repair activities as required, including, when applicable and appropriate, installing patches and
firmware updates, re-installing malfunctioning software, and restoring and reconfiguring the applicable settings;

			
		  		  	 (f)    Performing, or when applicable, requesting to be performed by the applicable Process owner(s), security,
file access, directory and other administrative procedures as applicable;

			
		  		  	 (g)    Connecting, when applicable, obtained items and existing Elements to the applicable IT and Client
environments;

			
		  		  	 (h)    Activating and deactivating, when applicable, obtained items and existing Elements, including their
underlying services;

			
		  		  	 (i)     Notifying, when applicable, the applicable Process owner(s) of the readiness for supplemental
activities to be performed to complete requests, including notifying the applicable Process owner(s) of Configuration and Security Administration regarding implementation of the associated non-security- and security- based policies and access
rights;

			
		  		  	 (j)     Backing up and copying data when applicable, including, when appropriate, notifying Clients of
self-service data restoration procedures;

  

					
	

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		  		  	 (k)    Confirming that requests have been implemented as required;

			
		  		  	 (l)     Performing tests to confirm that fulfillment of requests provides the expected functionality,
including, as applicable, with respect to other Elements;

			
		  		  	 (m)  Taking corrective action when necessary, including providing and executing appropriate back-out procedures for
unsuccessful maintenance and repair; and

			
		  		  	 (n)    Confirming that Client and IT operational capabilities are not adversely impacted as a consequence of
fulfilling requests;

			
		  		  	 5.     Advising the applicable Process owner(s) of performance problems or other issues that are unrelated to
the proper fulfillment of maintenance and repair requests;

			
		  		  	 6.     Updating the CMDB as applicable and appropriate; and

			
		  		  	 7.     Notifying the applicable Process owner(s), Clients and other personnel of the completion of maintenance
and repair requests or the need for the applicable Process owner(s) of other Processes (e.g., Local Maintenance & Repair, Implementation) to perform activities to resolve matters that cannot be performed remotely.

			
	3.9	  	 Software
 Maintenance
	  	
			
	3.9.1	  	 Corrective
 Maintenance
	  	 The purpose of “Corrective Maintenance” is to (a) modify software (using the applicable Processes and controls of Software
Engineering) and data to correct discovered defects, recover from Incidents, resolve Problems and implement Maintenance Requirements, (b) work with software manufacturers regarding defects they are responsible to correct, and (c) develop
recommendations regarding Recommended Maintenance software designed to address defects (e.g., patches).
  

Corrective Maintenance includes the following activities:

			
		  		  	 1.     Reviewing software that is the subject of an Incident or Problem and determining the underlying
defects, including those:

			
		  		  	 (a)    Resulting from errors in design, logic, coding or other comparable
issues;

  

					
	

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		  		  	 (b)    Resulting in or from errors and inconsistencies in the underlying data being produced or processed;
and

			
		  		  	 (c)    Causing abnormal system performance characteristics;

			
		  		  	 2.     Restoring full functionality prevented by defects, including:

			
		  		  	 (a)    Developing changes to software (e.g., patches, fixes); and

			
		  		  	 (b)    Working, when applicable, with the underlying software manufacturers to cause them to develop and publish
changes to software for which they are responsible;

			
		  		  	 3.     Developing, as required, additional software and other methods to:

			
		  		  	 (a)    Rectify erroneous results (e.g., data, reports) on both a current- and, as applicable, historical-
basis;

			
		  		  	 (b)    Restore system integrity; and

			
		  		  	 (c)    Enable normal use;

			
		  		  	 4.     Documenting and providing to the applicable Process owner(s), detailed actions required to be performed
by such owner(s) in support of the recovery from Incidents and the resolution of Problems with software and data (e.g., rollback of data, re-running of jobs, running of additional software to correct contaminated data);

			
		  		  	 5.     Reviewing, testing and analyzing Recommended Maintenance software and providing recommendations for
use, including modifications to Recommended Maintenance software and, when applicable, other software, to the applicable Process owner(s) of Maintenance Administration;

			
		  		  	 6.     Developing changes, when applicable, to software to implement Maintenance Requirements;

			
		  		  	 7.     Updating supporting documentation to conform with changes to software;

			
		  		  	 8.     Providing the applicable Process owner(s), including those of Business Systems Support, with
information regarding the scope of and potential impact from software changes;

			
		  		  	 9.     Developing and publishing testing schedules to the applicable Process
owner(s);

  

					
	

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		  		  	 10.   Providing changed software to the applicable Process owner(s) for testing, packaging, implementation and use
within the IT and Client environments;

			
		  		  	 11.   Modifying software and associated documentation based on test and implementation results;

			
		  		  	 12.    Submitting changes to the applicable Process owner(s) of Change Management Execution; and

			
		  		  	 13.   Updating the CMDB as applicable and appropriate.

			
	3.9.2	  	 Adaptive
 Maintenance
	  	 The purpose of “Adaptive Maintenance” is to (a) modify software (using the applicable Processes and controls of Software
Engineering) such that it remains operationally useful within the IT and Client environments over time in response to changing circumstances and needs, including implementing Maintenance Requirements, and (b) develop recommendations regarding
Recommended Maintenance software designed to provide changed capabilities (e.g., upgrades).
 Adaptive Maintenance includes the following
activities:

			
		  		  	 1.     Developing changes to software to allow it to adapt over time as necessary, including complying with
ongoing change in:

			
		  		  	 (a)    Client policy, procedure, process, staffing, organization, location, time and other business changes and
requirements;

			
		  		  	 (b)    Client functionality requirements, including those that would (i) modify or remove then-current features and
capabilities, and (ii) add new features and capabilities;

			
		  		  	 (c)    Connectivity requirements with systems both internal and external to the IT environment (i.e.,
interfaces);

			
		  		  	 (d)    Regulatory requirements and applicable industry standards; and

			
		  		  	 (e)    IT policy and technology (e.g., security, architecture, platform, hardware, configuration, tools), including
(i) upgrades and changes to the hardware and infrastructure-based software in which the software must run, and (ii) changes to the interfaces the software must make with hardware or other software (e.g., storage, messaging systems,
databases);

  

					
	

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		  		  	 2.     Reviewing, testing and analyzing Recommended Maintenance software and providing recommendations for
use, including modifications to Recommended Maintenance software and, when applicable, other software, to the applicable Process owner(s) of Maintenance Administration;

			
		  		  	 3.     Developing changes, when applicable, to software to implement Maintenance Requirements;

			
		  		  	 4.     Populating and updating data tables, configuration settings and other adjustment mechanisms associated
with software that are not designed to be performed directly by Clients;

			
		  		  	 5.     Updating supporting documentation to conform with changes to software;

			
		  		  	 6.     Providing the applicable Process owner(s), including those of Business Systems Support, with
information regarding the scope of and potential impact from software changes;

			
		  		  	 7.     Developing and publishing testing schedules to the applicable Process owner(s);

			
		  		  	 8.     Providing changed software to the applicable Process owner(s) for testing, packaging, implementation
and use within the IT and Client environments;

			
		  		  	 9.     Modifying software and associated documentation based on test and implementation results;

			
		  		  	 10.   Submitting changes to the applicable Process owner(s) of Change Management Execution; and

			
		  		  	 11.   Updating the CMDB as applicable and appropriate.

			
	3.9.3	  	 Perfective
 Maintenance
	  	 The purpose of “Perfective Maintenance” is to modify software (using the applicable Processes and controls of Software Engineering)
to improve its efficiency, reliability and maintainability.
  
 Perfective Maintenance
includes the following activities:

			
		  		  	 1.     Monitoring the operation and use of software to gain an understanding of how it performs in the IT and
Client environments;

  

					
	

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		  		  	 2.     Reviewing the underlying code and determining if change from various methods (e.g., programming
language, compiler optimization, code reorganization) could be used to achieve beneficial outcomes;

			
		  		  	 3.     Developing changes to software that will allow it to:

			
		  		  	 (a)    Perform its then-current functions using less IT resources (e.g., compute power, memory, bandwidth,
storage);

			
		  		  	 (b)    Operate at higher levels of availability; and

			
		  		  	 (c)    Require less effort to be maintained, enhanced, adapted or corrected over time;

			
		  		  	 4.     Updating supporting documentation to conform with changes to software;

			
		  		  	 5.     Providing the applicable Process owner(s), including those of Business Systems Support, with
information regarding the scope of and potential impact from software changes;

			
		  		  	 6.     Developing and publishing testing schedules to the applicable Process owner(s);

			
		  		  	 7.     Providing changed software to the applicable Process owner(s) for testing, packaging, implementation
and use within the IT and Client environments;

			
		  		  	 8.     Modifying software and associated documentation based on test and implementation results;

			
		  		  	 9.     Submitting changes to the applicable Process owner(s) of Change Management Execution; and

			
		  		  	 10.   Updating the CMDB as applicable and appropriate.

			
	3.9.4	  	 Preventive
 Maintenance
	  	 The purpose of “Preventive Maintenance” is to modify software (using the applicable Processes and controls of Software Engineering)
to reduce the probability of future failure from defects.
  
 Preventive Maintenance
includes the following activities:

			
		  		  	 1.      Monitoring the operation and performance of software under scenarios designed to provide early
warning signals of potential defects (e.g., memory leaks, maximum number of records to be processed, file size thresholds, input error handling);

			
		  		  	 2.      Developing changes to software
to:

  

					
	

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		  		  	 (a)    Correct latent defects before such defects become Incidents or Problems; and

			
		  		  	 (b)    Improve error identification and error handling;

			
		  		  	 3.     Updating supporting documentation to conform with changes to software;

			
		  		  	 4.     Providing the applicable Process owner(s), including those of Business Systems Support, with
information regarding the scope of and potential impact from software changes;

			
		  		  	 5.     Developing and publishing testing schedules to the applicable Process owner(s);

			
		  		  	 6.     Providing changed software to the applicable Process owner(s) for testing, packaging, implementation
and use within the IT and Client environments;

			
		  		  	 7.     Modifying software and associated documentation based on test and implementation results;

			
		  		  	 8.     Submitting changes to the applicable Process owner(s) of Change Management Execution; and

			
		  		  	 9.     Updating the CMDB as applicable and appropriate.

			
	3.10	  	Operations	  	
			
	3.10.1	  	 Operations
 Scheduling
	  	 The purpose of “Operations Scheduling” is to develop and maintain a schedule for applications and services (e.g., production
control) that meets Client requirements and appropriately takes into consideration dependencies and Client priorities.
  

Operations Scheduling includes the following activities:

			
		  		  	 1.     Resolving scheduling conflicts;

			
		  		  	 2.     Identifying and resolving errors with the execution of jobs, including:

			
		  		  	 (a)    Causing erroneous job activities to be circumvented and jobs to be restarted or rerun; and

			
		  		  	 (b)    Escalating errors that cannot be resolved to the applicable Process owner(s) to remove the underlying
defects in software, hardware and data;

  

					
	

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		  		  	 3.     Assessing the feasibility of and risks associated with proposed changes that could affect processing
schedules or other activities;

			
		  		  	 4.     Implementing changes to processing schedules that are approved by the applicable Process owner(s);
and

			
		  		  	 5.     Proactively preparing for processing deadlines to meet Client requirements.

			
	3.10.2	  	 Computer
 Operations
	  	 The purpose of “Computer Operations” is to perform the functions necessary for operation of computing platforms.

 
 Computer Operations includes the following activities:

			
		  		  	 1.     Providing the required environments (e.g., production, development, quality assurance, training),
including:

			
		  		  	 (a)    Making online systems and applications for such environments available for access during scheduled hours;
and

			
		  		  	 (b)    Maintaining the environments at the required release levels;

			
		  		  	 2.     Assessing the feasibility of and risks associated with proposed changes that affect the systems,
platforms and applications;

			
		  		  	 3.     Implementing changes to systems in a controlled manner, including:

			
		  		  	 (a)    Facilitating the orderly turnover of systems, platforms and applications;

			
		  		  	 (b)    Adhering to documentation standards;

			
		  		  	 (c)    Informing stakeholders of the changes; and

			
		  		  	 (d)    Providing coordination of the implementation, integration, testing and acceptance of new systems, platforms
and applications;

			
		  		  	 4.     Initiating and executing online and batch applications, including scheduled, unscheduled and on-request
applications, as well as Client-initiated processing;

			
		  		  	 5.     Terminating applications as appropriate;

			
		  		  	 6.     Issuing operator commands;

			
		  		  	 7.     Performing back-ups;

  

					
	

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		  		  	 8.     Performing the allocation and placement of files;

			
		  		  	 9.     Monitoring the usage of files;

			
		  		  	 10.   Logging off Clients;

			
		  		  	 11.   Initiating and terminating utilities;

			
		  		  	 12.   Canceling transactions as appropriate;

			
		  		  	 13.   Transmitting and receiving information to and from external organizations;

			
		  		  	 14.   Operating master console functions, including responding to program requests for intervention;

			
		  		  	 15.   Handling abnormal terminations and similar situations resulting from errors and conditions that can be resolved by
correctly performing or re-performing the jobs (e.g., restarts, reruns) in accordance with documented procedures or workarounds, and escalating the errors and conditions that cannot be resolved to the applicable Process owner(s), including those of
Operations Scheduling;

			
		  		  	 16.   Performing computer shutdowns and restarts as required; and

			
		  		  	 17.   Executing utility functions.

			
	3.10.3	  	 Network
 Operations
	  	 The purpose of “Network Operations” is to perform the functions necessary for operation of separate or combined voice and data
networks.
  
 Network Operations includes the following activities:

			
		  		  	 1.     Inventorying and assigning network addresses, and updating naming and other systems;

			
		  		  	 2.     Verifying that network-related software is maintained at the required release levels and causing the
applicable Process owner(s) to address deficiencies;

			
		  		  	 3.     Assessing the feasibility of and risks associated with proposed changes that affect the
network(s);

			
		  		  	 4.     Collecting and analyzing logged network data;

			
		  		  	 5.     Reconfiguring or rerouting network traffic, including by using available alternative routing and
back-up facilities, to:

  

					
	

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		  		  	 (a)    Achieve increased throughput or improved balance among network segments to accommodate unanticipated
demand;

			
		  		  	 (b)    Circumvent a failed component;

			
		  		  	 (c)    Prevent denial of service to legitimate Clients; and

			
		  		  	 (d)    Provide network service to alternate locations in conjunction with disaster recovery tests and actual
disasters;

			
		  		  	 6.     Verifying proper operation of interfaces with affiliated networks, both internal and external to the
enterprise, and causing the applicable Process owner(s) and external network owner(s) to address deficiencies; and

			
		  		  	 7.     Troubleshooting and executing diagnostic tests.

			
	3.10.4	  	 Media
 Operations
	  	 The purpose of “Media Operations” is the management of the media providing input to and producing output from server-based
peripherals.
  
 Media Operations includes the following activities:

			
		  		  	 1.     Checking output queues, changing output priorities, taking media-based Elements in and out of service,
and displaying, starting, spooling and draining output queues;

			
		  		  	 2.     Monitoring print performance and taking remedial action where required to meet the applicable
performance objectives, including control of print queues, queue capacity and print request prioritization;

			
		  		  	 3.     Initiating and completing media mounts, including inserting and ejecting volumes associated with
automated libraries;

			
		  		  	 4.     Executing off-site and on-site media storage processes, including logging and tracking of media on- and
off-site, complying with physical specifications and retention periods, performing required cycling/rotation of media and security, packaging and transportation of media (and/or electronic transmission of information and data) to and from storage
and remote computer recovery centers;

			
		  		  	 5.     Obtaining off-site media when required;

			
		  		  	 6.     Maintaining media library system inventory
information;

  

					
	

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		  		  	 7.     Responding appropriately to media reliability threshold error events, including replacing
media;

			
		  		  	 8.     Archiving data on the applicable media;

			
		  		  	 9.     Executing programs to retrieve data from archived media;

			
		  		  	 10.   Initializing new media and obtaining media inventories as required to fulfill operational needs;

			
		  		  	 11.   Monitoring and reporting media utilization;

			
		  		  	 12.   Testing retrieval and restoration capabilities (e.g., retrieving a randomly selected data file as a test and
verifying that the data can be restored in a usable fashion);

			
		  		  	 13.   Separating, packaging, labeling and tracking printed output;

			
		  		  	 14.   Delivering printed output to required locations; and

			
		  		  	 15.   Finding, tracing or replacing lost printed output.

			
	3.10.5	  	Physical Database Administration	  	 The purpose of “Physical Database Administration” is to manage data, including data contained in files and databases.

 
 Physical Database Administration includes the following activities:

			
		  		  	 1.     Planning for and changing the size of databases as required (e.g., change in business volume, addition
or retirement of new software, software capabilities);

			
		  		  	 2.     Monitoring database and file performance;

			
		  		  	 3.     Monitoring space utilization;

			
		  		  	 4.     Improving database and file access performance;

			
		  		  	 5.     Designing, implementing, reorganizing and maintaining databases and file archives to provide data
integrity and meet applicable business requirements;

			
		  		  	 6.     Recovering damaged or corrupted databases and files;

			
		  		  	 7.     Maintaining physical database definitions;

			
		  		  	 8.     Implementing, testing and promoting into production database structural changes;

			
		  		  	 9.     Updating the CMDB as applicable and
appropriate;

  

					
	

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		  		  	 10.   Copying, moving and updating the information contained within databases and files to meet the appropriately
approved needs of other Process owners and Clients; and

			
		  		  	 11.   Diagnosing and repairing damage to the information contained within databases and files as a result of actions
arising from the storage (i.e., not from use) of such information, and escalating damage that cannot be repaired to the applicable Process owner(s).

			
	3.10.6	  	 Operations
 Monitoring
	  	 The purpose of “Operations Monitoring” is to monitor and report on the operation of Elements and their relevant sub-components.

 
 Operations Monitoring includes the following activities:

			
		  		  	 1.     Monitoring functionality and performance (including monitoring of related manual processes)
to:

			
		  		  	 (a)    Verify compliance with operational design characteristics; and

			
		  		  	 (b)    Identify causes of performance degradation;

			
		  		  	 2.     Monitoring the flow of demand on the IT environment and the achievement of the expected individual and
systemic outcomes;

			
		  		  	 3.     Identifying abnormal circumstances that could be indicative of potential Incidents or Problems and
requesting review, circumvention or repair by the applicable Process owner(s);

			
		  		  	 4.     Reporting Incidents and Problems to the applicable Process owner(s); and

			
		  		  	 5.     Providing reports on the operational status of Elements.

			
	3.11	  	Service Support	  	
			
	3.11.1	  	Incident Management Execution	  	 The purpose of “Incident Management Execution” is to restore normal service following detection of an Incident.

 
 Incident Management Execution includes the following activities:

			
		  		  	 1.     Obtaining Incident information, including the corresponding classification, from Incident
Management;

			
		  		  	 2.     Reviewing Incidents and identifying the applicable Process owner(s) to identify the appropriate
recovery actions;

  

					
	

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		  		  	 3.     Forming teams comprised of personnel from the applicable Processes;

			
		  		  	 4.     Diagnosing Incidents and developing Incident recovery actions, including assessing the impact of
Incidents, and estimating recovery time and costs;

			
		  		  	 5.     Notifying the applicable Process owner(s) of Incident Management of Incident recovery
actions;

			
		  		  	 6.     Notifying the applicable Process owner(s) of their role(s) in performing Incident recovery
actions;

			
		  		  	 7.     Monitoring and directing Incident recovery actions, including coordinating the applicable
Processes;

			
		  		  	 8.     Updating Incident recovery logs as recovery actions are undertaken, including notifying the applicable
Process owner(s);

			
		  		  	 9.     Registering Incidents as closed upon successful recovery, including notifying the applicable Process
owner(s), Clients and other personnel as appropriate;

			
		  		  	 10.   Matching Incidents against known errors and Problems and informing Problem Management of the existence of
unmatched or multiple Incidents;

			
		  		  	 11.   Escalating Incidents and notifying the applicable Process owner(s) and other personnel as
appropriate;

			
		  		  	 12.   Participating in Incident Management review meetings;

			
		  		  	 13.   Developing and maintaining Incident process models and/or workflows for:

			
		  		  	 (a)    Pre-defined Incidents (e.g., recurring Incidents, Incidents requiring special handling);

			
		  		  	 (b)    Major Incidents (often referred to as “severity 1” or “priority 1” Incidents);
and

			
		  		  	 (c)    Preserving Incident evidence; and

			
		  		  	 14.   Establishing and maintaining a close working relationship with the applicable Process owner(s) of Incident
Oversight.

  

					
	

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	3.11.2	  	Problem Identification and Resolution	  	 The purpose of “Problem Identification and Resolution” is to identify Problems, direct the resolution of Problems, proactively and
reactively minimize the adverse impact of Problems on Client operations, and prevent the recurrence of Problems and resulting Incidents.
  

Problem Identification and Resolution includes the following activities:

			
		  		  	 1.     Performing formal root cause analysis of Incidents as appropriate;

			
		  		  	 2.     Determining the existence and nature of workarounds and/or circumventions necessary to eliminate or
reduce the adverse effects of Problems while more permanent solutions are developed;

			
		  		  	 3.     Initiating actions to minimize the adverse impact of Problems;

			
		  		  	 4.     Communicating the identification and assessment of the Problems to
the applicable Process
          owner(s) of Problem Management and
other applicable Processes;

			
		  		  	 5.     Updating records in a database or similar information repository to capture new or changed details
regarding Problems;

			
		  		  	 6.     Identifying actions and/or potential areas of change to prevent the recurrence of Incidents related to
identified Problems (e.g., performing historical Incident trend analysis); and

			
		  		  	 7.     Participating in Problem Management review meetings.

			
	3.11.3	  	Configuration Management Execution	  	 The purpose of “Configuration Management Execution” is to develop the procedures by which the CMDB is updated and maintained
accurate.
  
 Configuration Management Execution includes the following
activities:

			
		  		  	 1.     Developing configuration taxonomies (i.e., the CI information to be maintained);

			
		  		  	 2.     Developing procedures for the applicable Process owner(s) to capture and record CI information in the
CMDB;

			
		  		  	 3.     Monitoring changes made to the CMDB and providing feedback to the
applicable Process
          owner(s);
and

  

					
	

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		  		  	 4.     Verifying the physical existence of items recorded in the CMDB, updating the CMDB as appropriate and
informing the applicable Process owner(s) of such updates.

			
	3.11.4	  	Change Management Execution	  	 The purpose of “Change Management Execution” is to perform tasks supporting the delivery of Change Management.

 
 Change Management Execution includes the following activities:

			
		  		  	 1.     Obtaining requests for changes from Process owners and Clients, including those arising
from:

			
		  		  	 (a)    Incidents or Problems;

			
		  		  	 (b)    Externally imposed requirements (e.g., legislative changes); and

			
		  		  	 (c)    Business initiatives or programs, projects or service improvement initiatives (e.g., initiatives to improve
efficiency or effectiveness);

			
		  		  	 2.     Performing initial classifications of requests for change that take into account the relevant factors
(e.g., risk, cost impact) and are in accordance with the applicable guidelines;

			
		  		  	3.      Performing quality control of change requests, including identification of:
			
		  		  	 (a)    Adequate change testing;

			
		  		  	 (b)    Appropriate back-out and remediation procedures; and

			
		  		  	 (c)    Impractical or unnecessary change requests;

			
		  		  	 4.     Providing feedback and guidance to Process owners that submit unsatisfactory change
requests;

			
		  		  	 5.     Providing properly formed change requests to Change Management;

			
		  		  	 6.     Monitoring the performance of changes and invoking back-out or remediation activities as
applicable;

			
		  		  	 7.     Registering completed changes as closed, including notifying the applicable Process owner(s);
and

			
		  		  	 8.     Performing post-implementation reviews when issues arise during
implementation.

  

					
	

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	3.11.5	  	Release Management Execution	  	 The purpose of “Release Management Execution” is to construct release packages for Elements and provide appropriately approved
release packages to the applicable Process owner(s) to be implemented within the applicable portions of the IT and Client environments.
  

Release Management Execution includes the following activities:

			
		  		  	 1.     Obtaining release components from the applicable Process owner(s);

			
		  		  	 2.     Preparing proposed release implementation plans;

			
		  		  	 3.     Compiling release notification lists;

			
		  		  	 4.     Developing release back-out plans;

			
		  		  	 5.     Submitting requests for change to the applicable Process owner(s) of Change Management Execution for
release packages;

			
		  		  	 6.     Constructing release packages for release components, including, as applicable, appropriate
implementation plans, notification lists, back-out plans and change approvals;

			
		  		  	 7.     Testing release packages and revising such packages as needed, including, if required, obtaining
modified release components from the applicable Process owner(s);

			
		  		  	 8.     Submitting proposed release packages to the applicable Process owner(s) of Release
Management;

			
		  		  	 9.     Modifying proposed release packages based on input from the applicable Process owner(s) of Release
Management;

			
		  		  	 10.   Obtaining approval for release packages from the applicable Process owner(s) of Release Management;

			
		  		  	 11.   Submitting approved release packages to the applicable Process owner(s) (e.g., Implementation) to be deployed in
the IT and Client environments;

			
		  		  	 12.   Modifying release packages to resolve problems encountered during implementation; and

			
		  		  	 13.   Performing post-implementation reviews and closing activities, including cataloging and preparing release
information for archival.

  

					
	

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	3.11.6	  	 Capacity
 Reporting
	  	 The purpose of “Capacity Reporting” is to perform tasks supporting the delivery of Capacity Management.

 
 Capacity Reporting includes the following activities:

			
		  		  	 1.     Obtaining utilization reports from the applicable Process owner(s);

			
		  		  	 2.     Tracking performance, utilization and throughput, including service workloads and transactions, and
confirming that collected data is recorded, analyzed, assessed relative to established limits and thresholds and reported to Capacity Management;

			
		  		  	 3.     Analyzing utilization and trend forecasts, along with the applicable established thresholds, and
proactively developing change recommendations (e.g., upgrades, downgrades, enhancements, reconfiguration), including the associated impact on space, power and personnel to correctly align performance and availability needs with IT service capacity;
and

			
		  		  	 4.     Providing capacity reports and analyses to Capacity Management.

			
	3.11.7	  	 Availability
 Analysis
	  	 The purpose of “Availability Analysis” is to perform tasks supporting the delivery of Availability Management.

 
 Availability Analysis includes the following activities:

			
		  		  	 1.     Obtaining operational reports from the applicable Process owner(s);

			
		  		  	 2.     Measuring availability based on operational information;

			
		  		  	 3.     Performing availability analyses, including:

			
		  		  	 (a)    Monitoring, measuring, analyzing and reporting availability;

			
		  		  	 (b)    Determining availability levels in comparison to established availability-based service levels;
and

			
		  		  	 (c)    Investigating unavailability; and

			
		  		  	 4.     Providing availability reports to Availability
Management.

  

					
	

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	3.11.8	  	Service Continuity Plan Development	  	 The purpose of “Service Continuity Plan Development” is to evaluate potential risks and prepare service continuity plans and
procedures to be integrated into the ITBCP.
  
 Service Continuity Plan Development
includes the following activities:

			
		  		  	 1.     Obtaining and reviewing service continuity plan guidelines from the applicable Process owner(s),
including those of Service Continuity Management;

			
		  		  	 2.     Conducting risk assessments, including collecting input from the applicable Process
owner(s);

			
		  		  	 3.     Conducting Client impact analyses of potential faults;

			
		  		  	 4.     Developing service continuity plans, including the specification of recovery point objectives and
recovery time objectives;

			
		  		  	 5.     Submitting service continuity plans for approval to the applicable Process owner(s) of Service
Continuity Management;

			
		  		  	 6.     Revising service continuity plans based on input from the applicable Process owner(s) of Service
Continuity Management;

			
		  		  	 7.     Developing measures to reduce the chances of the occurrence and impact of disasters, including
providing disaster recovery planning capability and procedures that are consistent with the applicable performance requirements;

			
		  		  	 8.     Reviewing and auditing the performance of the service continuity plan and addressing issues;
and

			
		  		  	 9.     Maintaining recovery plans and options up-to-date.

			
	3.11.9	  	Service Continuity Plan Execution	  	 The purpose of “Service Continuity Plan Execution” is to execute the ITBCP during disaster recovery tests and actual disasters, and
to test and execute contingency plans as requested by the applicable Process owner(s) (e.g., Service Continuity Management, Incident Oversight).
  

Service Continuity Plan Execution includes the following activities:

			
		  		  	 1.     Implementing the applicable processes and procedures described in the ITBCP during disaster recovery
tests and actual disasters;

  

					
	

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		  		  	 2.     Documenting the recovery times, results and issues, if any, encountered and providing such information
to the applicable Process owner(s), including those of Service Continuity Management and Service Continuity Plan Development; and

			
		  		  	 3.     Coordinating with the applicable Process owner(s) to resolve problems, if any, in implementing the
ITBCP.

			
	3.12	  	Security	  	
			
	3.12.1	  	 Security
 Implementation
	  	 The purpose of “Security Implementation” is to develop and implement the methods, mechanisms and devices necessary to comply with
security policies and standards.
  
 Security Implementation includes the following
activities:

			
		  		  	 1.     Developing methods and mechanisms to implement security policies and standards;

			
		  		  	 2.     Developing security rules to be used in conjunction with security hardware and software;

			
		  		  	 3.     Implementing security mechanisms, including the deployment of security rules to be used in conjunction
with security hardware and software; and

			
		  		  	 4.     Implementing, when applicable based on security policy, security devices and software, including the
configuration, installation, maintenance, and disposition of such devices and software in accordance with the applicable activities of the relevant Processes (e.g., Deploy, Maintain, Software Maintenance) and controls appropriate for such
work.

			
	3.12.2	  	 Security
 Operations
	  	 The purpose of “Security Operations” is to implement and operate processes that reduce the likelihood of security threats, reacts
to threats identified, and minimizes the harm caused by security threats.
  
 Security
Operations includes the following activities:

			
		  		  	 5.     Implementing, maintaining and operating a data collection process, including:

			
		  		  	 (a)    Directing the assigned Service Delivery Actor(s) to configure the Element’s data collection tool(s) to
enable proper consolidation, recording and normalization of data in accordance with the security solution; and

  

					
	

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		  		  	 (b)    Collecting data from the identified sources;

			
		  		  	 6.     Implementing, maintaining and operating vulnerability scanning functions, including:

			
		  		  	 (a)    Configuring scanning tool(s) according to the published Client security policy;

			
		  		  	 (b)    Scheduling and executing scans; and

			
		  		  	 (c)    Distributing scan results to the Vulnerability Assessment Process owner;

			
		  		  	 7.     Monitoring and reacting to security alerts, including:

			
		  		  	 (a)    Implementing the alert criteria as defined by the Security Analysis process;

			
		  		  	 (b)    Accepting and processing automated and derived alerts (e.g., rogue device detection, and Distributed Denial
of Service Attack (DDOS) alerts);

			
		  		  	 (c)    Directing, through the Incident Management process, the appropriate assigned Service Delivery Actor(s) to
take event related actions;

			
		  		  	 (d)    Following the alert escalation process; and

			
		  		  	 (e)    Distributing escalated alerts to the Security Analysis, Security Oversight and Incident Management Process
owners; and

			
		  		  	 8.     Operating the security-specific application software, in accordance with established Change Management
Processes, by using the application software user interface, including:

			
		  		  	 (a)    Manipulating rules and data entries;

			
		  		  	 (b)    Designing and ordering reports;

			
		  		  	 (c)    Designing and requesting queries; and

			
		  		  	 (d)    Setting data collection parameters.

			
		  		  	 5.     Reviewing security policies and standards and recommending areas for improvement to Security Policy
Development.

			
		  		  	 6.     Maintaining historical data on security-related matters and Incidents, including performing and
reporting on the applicable analyses (e.g., trends).

  

					
	

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	3.12.3	  	Security Credentials Management	  	 The purpose of “Security Credentials Management” is to manage compliance with the security policy(ies) and standards and to
implement authorized security credentials and access rights.
  
 Security Administration
includes the following activities:

			
		  		  	 1.     Managing the provision of security credentials and access, including issuance, replacement and
revocation of individual access and authentication and authorization credentials, as authorized by the applicable Process owner(s), including those of Credentials Management and Security Enforcement;

			
		  		  	 2.     Implementing security policies and standards, including the association of the Element or the user(s)
of the Element with the applicable security-based policy objects; and

			
		  		  	 3.     Maintaining historical data on security-related access changes.

			
	3.12.4	  	 Credentials

Authorization
	  	The purpose of “Credentials Authorization” is to authorize the granting (including issuance, replacement and revocation) of security credentials and access entitlements, individual access authentication and authorization
credentials to Clients, Actors and other personnel as appropriate.
			
	3.12.5	  	Security Analysis	  	 The purpose of “Security Analysis” is to analyze, disseminate and employ security information to protect against security threats
as described in the security solution.
  
 Security Analysis includes the following
activities:

			
		  		  	 4.     Analyzing data to detect anomalies using rules and parameters established by the Security Oversight
process;

			
		  		  	 5.     Monitoring compliance with the security solution, including:

			
		  		  	 (a)    Monitoring security settings to ensure that they meet or exceed relevant standards; and

			
		  		  	 (b)    Assigning proper remediation activities to the appropriate Service Delivery Actor(s);

			
		  		  	 6.     Monitoring service, system and device access, including:

			
		  		  	 (a)    Detecting misuse of access, with the highest level of scrutiny employed for monitoring misuse of privileged
access;

  

					
	

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		  		  	 (b)    Detecting inappropriately obtained access, with the highest level of scrutiny employed for monitoring
inappropriately obtained privileged access;

			
		  		  	 (c)    Generating and distributing appropriate alerts; and

			
		  		  	 (d)    Following appropriate escalation mechanisms;

			
		  		  	 7.     Detecting and reporting data leakage, including:

			
		  		  	 (a)    Detecting data leakage events;

			
		  		  	 (b)    Reporting data leakage events to Incident Management and Security Incident Response Process
owner(s);

			
		  		  	 (c)    Measuring the effectiveness of the security solutions and/or controls in preventing data leakage;
and

			
		  		  	 (d)    Making recommendations to improve controls through enhancements to the Security Solution Development
Process;

			
		  		  	 8.     Analyzing security events, including:

			
		  		  	 (a)    Analyzing events for potential security incidents; and

			
		  		  	 (b)    Reporting event analysis to Incident Management and Security Incident Response Process owner(s) in
accordance with the security event analysis process;

			
		  		  	 9.     Integrating external threat intelligence into the analysis process, including:

			
		  		  	 (a)    Acquiring and utilizing appropriate external threat intelligence;

			
		  		  	 (b)    Evaluating for technical need and business context; and

			
		  		  	 (c)    Notifying stakeholders of context-normalized external threats; and

			
		  		  	 10.     Analyzing environment resiliency, including:

			
		  		  	 (a)    Evaluating new deployments and technologies for security risks;

			
		  		  	 (b)    Proactively testing the environment for security defects; and

			
		  		  	 (c)    Coordinating with the appropriate Actor(s) to remediate based on the
findings.

  

					
	

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	3.12.6	  	 Security Incident

Response
	  	 The purpose of “Security Incident Response” is to contain and investigate security threats.

 
 Security Incident Response includes the following activities:

			
		  		  	 11.   Containing a security incident, including:

			
		  		  	 (a)    Identifying and recommending mechanisms for limiting the spread of, and exposure to, a security incident;
and

			
		  		  	 (b)    Escalating threat alerts to Incident Management Process owner(s) for execution of threat response;
and

			
		  		  	 12.   Conducting forensic investigation into security event, including:

			
		  		  	 (a)    Analyzing security event to determine impact and appropriate containment approach;

			
		  		  	 (b)    Documenting security event analysis to support root cause analysis (RCA) efforts in accordance with problem
management process; and

			
		  		  	 (c)    Recreating and/or reverse engineering security events, as necessary.

			
	3.12.7	  	 Vulnerability
 Assessment
	  	 The purpose of “Vulnerability Assessment” is to assess the vulnerability of the environment to security threats.

 
 Vulnerability Assessment includes the following activities:

			
		  		  	 13.   Evaluating scans to detect exposure to security threats;

			
		  		  	 14.   Prioritizing remediation tasks;

			
		  		  	 15.   Assigning remediation tasks in accordance with Incident Management Process owner(s);

			
		  		  	 16.   Conducting Penetration Tests and analyzing results; and

			
		  		  	 17.   Assessing and reporting the effectiveness of remediation efforts.

			
	3.13	  	Logistics	  	
			
	3.13.1	  	Disposition	  	 The purpose of “Disposition” is to prepare Elements and their sub-components to be reused, returned to third parties or
disposed.
  
 Disposition includes the following activities:

			
		  		  	 1.     Obtaining Elements and sub-components of Elements that have been de-installed from the IT
environment;

  

					
	

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		  		  	 2.     Removing data and software from the applicable storage media (fixed or removable);

			
		  		  	 3.     Repairing Elements and sub-components of Elements that are operationally and financially worthy of
repair, including:

			
		  		  	 (a)    Determining whether such repair work is covered by a warranty; and

			
		  		  	 (b)    Causing warranty work or the financial equivalent to be performed/obtained when applicable;

			
		  		  	 4.     Upgrading Elements and sub-components of Elements to current standards that are operationally and
financially worthy of upgrade;

			
		  		  	 5.     Returning Elements and sub-components of Elements to the applicable third parties (e.g.,
lessors);

			
		  		  	 6.     Providing repurposed, repaired and appropriately cleaned Elements and sub-components of Elements to be
retained within the IT environment to the applicable Process and Element owner(s);

			
		  		  	 7.     Disposing of Elements and sub-components of Elements that are no longer required within the IT
environment; and

			
		  		  	 8.     Updating the CMDB as applicable and appropriate.

			
	3.13.2	  	 Warehouse
 Management
	  	 The purpose of “Warehouse Management” is to securely store, track and manage the inventories of Elements, Spares, Spare Parts and
Consumables.
  
 Warehouse Management includes the following activities:

			
		  		  	 1.     Maintaining secure physical storage facilities;

			
		  		  	 2.     Performing receiving and shipping functions;

			
		  		  	 3.     Updating the CMDB as applicable and appropriate;

			
		  		  	 4.     Providing inventory reports as requested by other Process owners;

			
		  		  	 5.     Analyzing usage patterns and recommending changes to optimal inventory levels to the applicable Process
owner(s);

			
		  		  	 6.     Developing and maintaining, with input obtained from the applicable Process owner(s), threshold levels
for the replenishment of the various warehouse inventories; and

  

					
	

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		  		  	 7.     Notifying the applicable Process owner(s) when the level of an inventory item reaches its predefined
threshold.

			
	3.13.3	  	Distribution	  	The purpose of “Distribution” is to physically transport Elements, Spares, Spare Parts and Consumables to and from the physical storage locations under the control of Warehouse Management.
			
	4.1	  	 Enterprise
 Security
	  	
			
	4.1.1	  	Enterprise Security Operations	  	 The purpose of “Enterprise Security Operations” is to implement and operate processes that reduce the likelihood of security
threats to the Enterprise and react to threats identified and minimize the harm caused by security threats across the operations of the Enterprise including both business process and IT activities.

 
 Enterprise Security Operations may include the following activities:

			
		  		  	 1.     Implementing, maintaining and operating a data collection process, including:

			
		  		  	 (a)    Directing the assigned Service Delivery Actor(s) to install and configure the Element’s data collection
tool(s) to enable proper consolidation, recording and normalization of data in accordance with the security solution; and

			
		  		  	 (b)    Collecting data from the identified sources;

			
		  		  	 2.     Implementing, maintaining and operating vulnerability scanning functions, including:

			
		  		  	 (a)    Configuring scanning tool(s) according to the published Client security policy;

			
		  		  	 (b)    Scheduling and executing scans; and

			
		  		  	 (c)    Distributing scan results to the Vulnerability Assessment Process owner;

			
		  		  	 3.     Monitoring and reacting to security alerts, including:

			
		  		  	 (a)    Implementing the alert criteria as defined by the Security Analysis process;

			
		  		  	 (b)    Accepting and processing automated and derived alerts (e.g., rogue device detection, and Distributed Denial
of Service Attack (DDOS) alerts);

  

					
	

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		  		  	 (c)    Directing, through the Enterprise Incident Response Team and the appropriate assigned Service Delivery
Actor(s) to take event related actions; and

			
		  		  	 (d)    Following the Enterprise Incident Response Plan (EIRP).

			
		  		  	 4.     Operating security-specific application software, in accordance with established Change Management
Processes including:

			
		  		  	 (a)    Manipulating rules and data entries;

			
		  		  	 (b)    Designing and ordering reports;

			
		  		  	 (c)    Designing and requesting queries; and

			
		  		  	 (d)    Setting data collection parameters.

			
		  		  	 5.     Reviewing security policies and standards and recommending areas for improvement to Security Policy
Development.

			
		  		  	 6.     Maintaining historical data on security-related matters and Incidents, including performing and
reporting on the applicable analyses (e.g., trends).

			
	4.1.2	  	 Enterprise
 Security Analysis
	  	 The purpose of “Enterprise Security Analysis” is to analyze, disseminate and employ security information across the Enterprise to
protect against security threats and adverse events.
  
 Enterprise Security Analysis may
include the following activities:

			
		  		  	 1.     Analyzing information data to detect anomalies;

			
		  		  	 2.     Monitoring compliance with the security solutions, including:

			
		  		  	 (a)    Monitoring security settings to ensure that they meet or exceed relevant standards; and

			
		  		  	 (b)    Assigning proper remediation activities to the appropriate Actor(s);

			
		  		  	 3.     Monitoring service, system and device access, including:

			
		  		  	 (a)    Detecting misuse of access, with the highest level of scrutiny employed for monitoring misuse of privileged
access;

			
		  		  	 (b)    Detecting inappropriately obtained access, with the highest level of scrutiny employed for monitoring
inappropriately obtained privileged access;

			
		  		  	 (c)    Generating and distributing appropriate alerts;
and

  

					
	

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		  		  	 (d)    Following appropriate escalation mechanisms;

			
		  		  	 4.     Detecting and reporting data leakage, including:

			
		  		  	 (a)    Detecting data leakage events;

			
		  		  	 (b)    Reporting data leakage events to Incident Management and Security Incident Response Process
owner(s);

			
		  		  	 (c)    Measuring the effectiveness of the security solutions and/or controls in preventing data leakage;
and

			
		  		  	 (d)    Making recommendations to improve controls through enhancements to the Security Solution Development
Process;

			
		  		  	 5.     Analyzing security events, including:

			
		  		  	 (a)    Analyzing events for potential security incidents; and

			
		  		  	 (b)    Reporting event analysis to Incident Management and Security Incident Response Process owner(s) in
accordance with the security event analysis process;

			
		  		  	 6.     Integrating external threat intelligence into the analysis process, including:

			
		  		  	 (a)    Acquiring and utilizing appropriate external threat intelligence;

			
		  		  	 (b)    Evaluating for technical need and business context; and

			
		  		  	 (c)    Notifying stakeholders of context-normalized external threats; and

			
		  		  	 7.     Analyzing environment resiliency, including:

			
		  		  	 (a)    Evaluating new deployments and technologies for security risks;

			
		  		  	 (b)    Proactively testing the environment for security defects; and

			
		  		  	 (c)    Coordinating with the appropriate Actor(s) to remediate based on the findings.

			
	4.1.3	  	Enterprise Incident Response	  	 The purpose of “Enterprise Incident Response” is to contain and investigate security threats and to coordinate the
Enterprise’s response across all Actors and Enterprise departments in accordance with Health Net’s Enterprise Incident Response Plan (EIRP).
  

Enterprise Incident Response may include the following activities:

  

					
	

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		  		  	 1.     Containing a security incident, including:

			
		  		  	 (a)    Identifying and recommending mechanisms for limiting the spread of, and exposure to, a security incident;
and

			
		  		  	 (b)    Escalating threat alerts to Incident Management Process owner(s) for execution of threat response in the IT
environment; and

			
		  		  	 (c)    Escalating to and coordinating with other Health Net departments and functions in accordance with Health
Het’s EIRP.

			
		  		  	 2.      Conducting forensic investigation into security events, including:

			
		  		  	 (a)    Analyzing security event to determine impact and appropriate containment approach;

			
		  		  	 (b)    Documenting security event analysis to support root cause analysis (RCA) efforts in accordance with problem
management process; and

			
		  		  	 (c)    Recreating and/or reverse engineering security events, as necessary.

			
	4.1.4	  	Enterprise- Wide Vulnerability Assessment	  	 The purpose of “Enterprise-Wide Vulnerability Assessment” is to assess the vulnerability of the Enterprise to security threats.

 
 Enterprise-Wide Vulnerability Assessment may include the following
activities:

			
		  		  	 1.     Evaluating scans to detect exposure to security threats;

			
		  		  	 2.     Prioritizing remediation tasks;

			
		  		  	 3.     Assigning remediation tasks in accordance with Incident Management Process owner(s);

			
		  		  	 4.     Conducting or causing Penetration Tests to be performed and analyzing results; and

			
		  		  	 5.     Assessing and reporting the effectiveness of remediation efforts.

  

					
	

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	II.	Embedded Processes 

 Except to the extent specifically identified elsewhere in the Agreement and formally
assigned to another Actor or entity, the following activities are “embedded” within each of the Processes defined above and are to be performed by each Actor for each Process for which it is responsible: 

 

	 	1.	Developing the procedures underlying the Process, subject to and in compliance with any requirements and constraints dictated by Health Net and in alignment with the approved policies and procedures of other Processes
so as to enable the IT services to function cohesively and in a coordinated manner; 

  

	 	2.	Performing the activities comprising the Process in accordance with approved policies and procedures; 

  

	 	3.	Providing and maintaining the necessary non-human resources (e.g., hardware, property, plant, supplies, software, tools, infrastructure) and human resources (including to provide training) to perform the Process;

  

	 	4.	Retaining all financial, operational and administrative responsibility for the Process, including the resources necessary for its performance; 

 

	 	5.	Performing the required activities necessary to manage the Process, including (i) supervising and reporting, including reporting to other personnel within the Process, (ii) measuring and reporting on the
performance of the Process (or parts thereof) to other Actors, Clients and/or third parties as required, (iii) developing and distributing operational reporting related to the Process, including any reporting related to Service Level
Agreements, (iv) developing and providing budgets and forecasts in accordance with the guidelines and parameters established by the applicable Process owner(s) of Budgeting and Forecasting, and (v) complying with the requests and/or
instructions from the applicable Process owner(s) of Services Management and Incident Oversight; 

  

	 	6.	Managing documents and data (including data acquisition, data entry, data recording and data distribution) related to the Process; 

  

	 	7.	Performing quality control reviews of the Process, including testing the (i) accuracy, reliability and quality of work, (ii) compliance with approved policies and procedures, and (iii) performance and
correction of issues identified during such reviews; 

  

					
	

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	 	8.	Engineering the Process, including performing those actions necessary to maintain or improve the underlying activities based on (i) then-current best practices, and (ii) how it is intended to interact with
other Processes and/or Client processes; 

  

	 	9.	Notifying other Actors as required of output or other findings or information developed or learned through the Process, including notifying the applicable Process owner(s) of the readiness for activities to be performed
by such Process owner(s) that are necessary to either complete or progress a function that spans multiple Processes; 

  

	 	10.	Notifying other Actors as required of detected security incidents or vulnerabilities learned through the Process; 

  

	 	11.	Responding to queries and requests concerning activities associated with the performance of the Process, including making the applicable subject matter experts, documentation and other relevant content available as
necessary to be responsive; 

  

	 	12.	Handling all Events (including, if applicable, directly from Clients) relevant to the Process that cannot be adequately responded to by the applicable Process owner(s) of Service Desk or other Processes due to their
lack of subject matter expertise regarding such Events, including (i) providing the information necessary for such Process owner(s) to respond directly to the Clients, (ii) accepting the transfer of such Events from such Process owner(s)
and responding directly to the Clients, (iii) updating, when applicable, the service management system(s) of record regarding the tracking of such Events, and (iv) providing, to the applicable Process owner(s), information regarding Events
that are likely to be recurring in nature so as to increase such Process owner’s(s’) ability to address such matters in the future without assistance; 

  

	 	13.	Handling all aspects of Incidents and Problems relevant to the Process, including (i) receiving notification of and resolving Incidents and Problems, (ii) providing other applicable Process owner(s), including
those of Incident Management, Problem Management and, to the extent requested, Incident Oversight, and other personnel as appropriate with updated information regarding the status of such Incidents and Problems and the associated resolution efforts,
(iii) escalating Incidents and Problems that cannot be resolved, and (iv) responding to requests and complying with instructions from the applicable Process owner(s) of Incident Management and, to the extent applicable for a given
Incident, Incident Oversight; 

  

	 	14.	Interacting and coordinating as needed with other Process owners that are responsible for related functions, including (i) integrating the Process with the activities of such other Process owners such that the
overall delivery of IT services is optimized (i.e., not sub-optimized within the confines of the Process), and (ii) monitoring the activities performed by other Process owners to mitigate negative impact on the Process; 

  

					
	

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	 	15.	Providing advice and guidance on the Process to other Process owners (e.g., best practices, operational issues, impact from other Processes) so as to enable such other Process owners to optimize the linkages of their
Processes with the Process; 

  

	 	16.	Adhering to the applicable documentation standards; 

  

	 	17.	Managing all aspects of third parties who perform all or part of a Process assigned to the Actor (i.e., as if the Actor performed the Process itself); and 

 

	 	18.	Using the Actor disagreement and dispute forum to resolve issues among Actors and between Actors and Clients, including (i) registering disagreements and disputes with the applicable Process owner(s) of Actor
Integration, (ii) participating, as reasonably requested by the applicable Process owner(s) of Actor Integration, in Actor disagreement and dispute resolution forums, (iii) providing information and resources reasonably requested by the
applicable Process owner(s) of Actor Integration that might be useful to the resolution of disagreements and/or disputes, and (iv) cooperating in the implementation of the final resolution of disagreements and disputes. 

 

	 	19.	Providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group),
including the following: 

  

	 	a.	Providing data and reports requested by the Auditors; 

  

	 	b.	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; and 

  

	 	c.	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function. 

  

					
	

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	III.	Glossary 

  

			
	 Terms
	  	 Definitions

	Actor	  	Means an entity or individual that is responsible for performing or providing part of the IT services.
		
	Application Architecture	  	Means the data and business process models that reflect Applications that: (i) simplify and facilitate the work activities of the business processes and provide automated procedures; (ii) specify the management of information
storage or retrieval required to accommodate the enterprise objectives; and (iii) address location considerations and how information is used.
		
	Client	  	Means an entity or individual that receives or uses IT services.
		
	Configuration Items or CIs	  	Means the configuration records of an Element, hardware, software, IT service or designated item (e.g., personnel, business units, buildings, Client service), including its respective components.
		
	Consumables	  	Means physical items that are designed to work in conjunction with Elements and are intended to be consumed through use (e.g., toner, paper, ink, batteries) rather than subject to repair.
		
	CMDB	  	Means a database that contains all relevant information about the components of the information system used in an organization’s IT environment and the relationships between those components.
		
	Delivery Model	  	Means the allocation of Actors to various levels of Processes and Elements that will be use to deliver the IT services.
		
	Domain Architecture	  	Means the domain-specific architectures that form part of the Enterprise IT Architecture. The Domain Architectures as of the Effective Date consist of Information Architecture, Application Architecture, Infrastructure Architecture,
and Security Architecture.
		
	Element or Elements	  	Means entries on the span axis of a Delivery Model or scope model. Elements may represent a category of components (e.g., Unix Servers), services (e.g., Managed WAN), individual products (e.g., Riverbed WAN Compression Appliance) or
individual applications (e.g., SAP HR Module).

  

					
	

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	 Terms
	  	 Definitions

	Enterprise Architecture	  	Means the underlying IT framework of a business, which defines and describes the applicable characteristics of the IT platforms, information, applications and security required by the enterprise to attain its objectives and achieve
its business vision.
		
	Event or Events	  	Has the meaning provided in Process 3.5.1 (Service Desk).
		
	External Actor	  	Means an Actor that is external to the Health Net organization.
		
	 External Actor Compliance
 Requirements
	  	Means the regulations, directives, recommendations, orders, rulings and other similar requirements that are applicable to an External Actor by virtue of the Services being provided by that Actor from entities legally authorized to
enact or enforce such requirements (including via contract and/or through the External Actor organization’s membership in a trade association with enforcement authority over its members). [Examples include the enforcement of HIPAA
regulations directly onto Business Associates by the Dept. of Health & Human Services, the enforcement of PCI DSS requirements by the Payment Card brands, relevant privacy and data security laws and regulations applicable to data held or
processed by the External Actor.]
		
	External Client	  	Means a Client that is a customer or third party business partner external to the Health Net organization.
		
	 External Compliance
 Requirements
	  	Means the laws, regulations, directives, recommendations, orders, rulings and other similar requirements that are applicable to the Health Net organization from entities legally authorized to enact or enforce such requirements
(including via contract and/or through the Health Net organization’s membership in a trade association with enforcement authority over its members).
		
	IMAC or IMACs	  	Means a request for the installation, movement, addition, change or removal of Elements and sub-components of Elements (e.g., moving physical or virtual Elements from one location to another, “racking and stacking”
Elements, installing physical Elements, adding physical sub- components to Elements, installing software patches, installing software on an Element, performing software configuration changes, establishing logical connections, installing virtual
Elements).

  

					
	

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	 Terms
	  	 Definitions

	Incident	  	Means an event that causes or may cause interruption to or a reduction in the service delivered though or by an Element or Process.
		
	Information Architecture	  	Means the data models and databases that serve all participants in the enterprise business environment, and the strategies, standards and policies required to develop and implement them, which enable the enterprise to develop a
common, shared, distributed, accurate and consistent data resource.
		
	Infrastructure Architecture	  	Means the interoperable technology platforms that link the Information Architecture and the Application Architecture and meet the needs of the various Client roles at identified work locations.
		
	Internal Actor	  	Means an Actor that is internal to the Health Net organization.
		
	Internal Client	  	Means a Client that is within the Health Net organization (i.e., business units or departments such as HR, F&A or Purchasing, including its respective personnel).
		
	ITBCP	  	Has the meaning provided in Process 2.7.10 (Service Continuity Management).
		
	Maintenance Requirements	  	Has the meaning provided in Process 3.8.1 (Maintenance Administration).
		
	Problem	  	Means the underlying cause of one or more Incidents, which may include defects related to or arising from the IT infrastructure, human errors and external events.
		
	Process or Processes	  	Means the groupings of activities identified in this definition document and identified on the process axis of a Delivery Model or scope model. May pertain to an individual (level 3) process (e.g., Infrastructure Architecture
Development, Solution Development) or a group of related (level 2) processes (e.g., Domain Architecture, Solution Formation).
		
	Recommended Maintenance	  	Has the meaning provided in Process 3.8.1 (Maintenance Administration).
		
	Risk Events	  	Means the IT-related events and threats that could negatively impact the enterprise strategically or operationally, including security breaches, system failures, external events, technology investment mistakes, system development
and implementation problems, and capacity shortages.

  

					
	

	  		  	Pillsbury Winthrop Shaw Pittman LLP
	  	Page 127 of 128	  	© 2003 – 2014
	  		  	U.S. Patents 7,308,414 and 7,979,303B2

 

 
 IT Process Definitions 

Version 3.1.0 
  

			
	 Terms
	  	 Definitions

	Security Architecture	  	Means the plan and set of principles that describe: (i) the security services that a system is required to provide to meet the needs of its Clients; (ii) the system elements required to implement the services; and (iii) the
performance levels required in the elements to deal with the threat environment.
		
	Service Catalog	  	Means a repository in which the IT services available to Clients are identified, including a definition of the service, SLAs associated with the service, who is entitled to use or receive the service, the costs or charges for the
service and the procedures for requesting the service.
		
	 Service Level Agreement or
 SLA
	  	Means an agreement describing: (i) the quantitative standards of performance an Actor or entity is required to meet or exceed in providing the IT services (e.g., availability, quality, speed); and (ii) a definition of the terms
controlling various aspects of performance (e.g., measurement definition, priorities, responsibilities, guarantees, changes). SLAs can be between Actors, between Actors and IT, or between IT and Clients.
		
	Spare Parts	  	Means an inventory of hardware-based sub-components of Elements (e.g., memory, motherboard, hard disk) that are currently not in use and are maintained in reserve to replace failed hardware-based sub-components of Elements used to
provide the IT services.
		
	Spares	  	Means an inventory of hardware-based Elements used to provide the IT services that are currently not in use and are maintained in reserve to replace or supplement failed hardware-based Elements used to provide the IT
services.
		
	Third Party Contract	  	Means a contractual arrangement with (i) an External Actor for the provision of IT services, and (ii) suppliers that provide Elements and ancillary goods/services.
		
	Third Party Contract Manager	  	Means an entity that performs contract management functions with respect to Third Party Contracts.

  

					
	

	  		  	Pillsbury Winthrop Shaw Pittman LLP
	  	Page 128 of 128	  	© 2003 – 2014
	  		  	U.S. Patents 7,308,414 and 7,979,303B2

 Final 

 Exhibit A-1-2 

Element Definitions 

  

					
	SOW #4 (IT) Exhibit A-1-2		A-1-2-1		Health Net / Cognizant Confidential

 Final 

 Categories and Element Definitions 

 

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	N/A	  	Definition	  	Commercial Off The Shelf (COTS)	  	“Commercial Off The Shelf” or “COTS” means commercial off-the-shelf software or hardware products that are ready-made and available for sale to the general public.
				
	N/A	  	Definition	  	Internally Developed	  	“Internally Developed” means software developed internally by the customer or at the direction of the customer (i.e., not COTS software).
				
	N/A	  	Definition	  	Appliance	  	“Appliance” means a device attached to the Network with integrated and specially designed software and hardware that provide a narrow range of functions.
				
	N/A	  	Definition	  	Applications Software	  	“Applications Software” shall mean an executable software component or tightly coupled set of executable software components (one or more), deployed together, that deliver some or all of a series of steps
needed to create, update, manage, calculate, or display information for a specific business purpose.
				
	Hardware	  	MER	  	MER Cabling	  	“MER Cabling” means cabling inside a managed equipment room (MER) at Health Net locations.
				
	Hardware	  	MER	  	Building Cabling	  	“Building Cabling” means cabling running inside a Health Net location that is not MER Cabling.
				
	Applications	  	CTS BPaaS	  	HNT Assets Purchase by CTS	  	“HNT Assets Purchased by CTS” means the Applications Software contained in the Heath Net—Cognizant Asset Purchase Agreement purchased by Cognizant or used by Cognizant to provide BPaaS Services to Health
Net including any future enhancements or changes made by Cognizant and the Servers, Storage and Infrastructure Software needed to deliver the HNT Assets Purchased by CTS as part of the CTS BPaaS Services.
				
	Applications	  	CTS BPaaS	  	HNT Custom Enhancements	  	“HNT Custom Enhancements” means enhancements to the HNT Assets Purchased by Cognizant that are funded by Health Net as Discretionary Projects. Includes the Servers, Storage and Infrastructure Software needed
to deliver the HNT Custom Enhancements as part of the CTS BPaaS Services.
				
	Applications	  	CTS BPaaS	  	Interfaces to HNT Systems	  	 “Interfaces to HNT Systems” means all the system interfaces between the Cognizant BPaaS solution and the retained HNT
applications (i.e., AO Applications—COTS and non-COTS and IO Applications,
 as applicable). Includes the Servers, Storage and Infrastructure Software
needed to deliver the Interfaces to HNT Systems as part of the CTS BPaaS Services.

				
	Applications	  	CTS BPaaS	  	Third Party Applications	  	“Third Party Applications” means the additional third party applications required by Cognizant to complete the Cognizant BPaaS IT solution to support Cognizant’s delivery of BPaaS Services to Health Net.
Includes the Servers, Storage and Infrastructure Software needed to deliver the Interfaces to HNT Systems as part of the CTS BPaaS Services.
				
	Applications	  	CTS BPaaS	  	Third Party Services	  	“Third Party Services” means third party data or other electronically delivered services required by Cognizant to provide the BPaaS IT solution to support Cognizant’s delivery of BPaaS Services to Health
Net.
				
	Applications	  	HNT Applications	  	AO Applications (COTS)	  	“AO Applications (COTS)” means the In-Scope Applications defined and listed in the AO Agreement that are COTS.
				
	Applications	  	HNT Applications	  	AO Applications (non-COTS)	  	“AO Applications (non-COTS)” means the In-Scope Applications defined and listed in the AO Agreement that are not COTS.
				
	Applications	  	HNT Applications	  	IO Applications	  	“IO Applications” means software and services designed to provide productivity, communications and collaboration solutions directly to end users. IO Applications include remote access including VDI and VPN,
ITSM software (e.g., Remedy, Service Now), File Shares, e-mail, Good mobile messaging, electronix fax, identity and access management software, etc. IO Applications are not CTS BPaaS Applications or AO Applications. IO Applications includes the
Servers, Storage and Infrastructure Software needed to deliver the IO Applications.
				
	Applications	  	HNT Applications	  	SAAS	  	“SAAS” means third party hosted software delivered “as a Service” by remote connection.
				
	Hardware	  	Collector	  	Collocated Third Party Equipment	  	“Collocated Third Party Equipment” means Appliances and other Servers, Storage or Network hardware, together with associated Software, which Health Net elects to have Cognizant provide Data Center Managed
Service only.
				
	Hardware	  	Collector	  	Network	  	“Network” means a telecommunications network that allows computers to exchange data. The connections (network links) between network points are established using either cable media or wireless media. Network
may include any of the Elements categorized as Network including LAN and WAN.
				
	Hardware	  	Collector	  	Server	  	“Server” means a computing platform utilizing an Operating System (e.g. Unix ,Windows, Linux, AIX, Solaris, etc.), including the CPU, memory, internal hard disk, related peripherals, KVM cabling and the NIC.
A server may perform a specific purpose (e.g., Access Control Server, Applications Server, Data Base Server, eMail Server, Extranet Server, File and Print Server, Infrastructure Server, Replication Server, Web Server, etc.). A Server may be a
physical box, blade or a Virtualized instance.
				
	Hardware	  	Collector	  	Storage	  	 “Storage” means a category of Elements that records and provides access to computing data including

NAS, SAN, DASD, Tape, Virtual Tape System, BUR Appliance, etc.

				
	 Infrastructure

Software
	  	Collector	  	Applications Development	  	“Applications Development” means computer software that is designed to facilitate the designing, building and testing of software.
				
	 Infrastructure

Software
	  	Collector	  	Business Applications	  	“Business Applications” means a category of Infrastructure Software that is designed to provide capability to automate a portion or portions of the enterprise’s operations. They are typically standard
applications that are typically provided across the enterprise to promote productivity and communications rather than support a specific business purpose as defined in Applications
Software.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-2	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	Collector	  	DBMS	  	“DBMS” means software that stores information in a database in an organized manner allowing data to be added, updated, and retrieved as individual items or to be queried in a structured manner. Additionally,
a DBMS maintains metadata, which describe the schema or the organization and relationships between the individual data items.
				
	 Infrastructure

Software
	  	Collector	  	Operations	  	“Operations” means a category of Infrastructure Software that is used to control devices and other software and to facilitate communication, scheduling and execution of computer commands. Operations may
include any of the Elements categorized as Operations Software.
				
	 Infrastructure

Software
	  	Collector	  	Roll Your Own (RYO)	  	“Roll Your Own” or “RYO” means certain types of custom proprietary software components, which include for example, Business Applications and utility applications used by IT, Tools,
Tool Extensions, and Scripts.
				
	 Infrastructure

Software
	  	Collector	  	Security Management	  	“Security Management” means a category of Infrastructure Software that is designed to prevent unauthorized access or manipulation of data including access control as well as monitoring, detecting and managing
viruses and intrusions. Security Management may include any of the Elements categorized as Security Management.
				
	 Infrastructure

Software
	  	Collector	  	Systems Software	  	“System Software” means a category of Infrastructure Software designed to operate the computer hardware and to provide a platform for running application software. Systems Software includes but is not limited
to: (a) the operating system, (b) utility software used to analyze, configure, optimize, maintain, and connect to the system; and (c) middleware which provides additional common services, beyond those of the operating system, to Application
Software. Systems Software may include any of the Elements categorized as Systems Software.
				
	Hardware	  	Data Center	  	Battery	  	“Battery” means a battery used to power equipment.
				
	Hardware	  	Data Center	  	 Cable Management Drop Box to

Server
	  	“Cable Management Drop Box to Server” means the series of physical conduits, hangars, ladder racks, finger brackets, etc. that neatly thread/bundle horizontal copper/fiber cable runs and shorter fiber/copper
cable patch-cords from the end-device connection point (Premise Distribution System (PDS) box) to the active server/end-device.
				
	Hardware	  	Data Center	  	Cable Plant	  	“Cable Plant” means the cable or fiber that carries voice, video, or data signals between computing and communications devices within a building.
				
	Hardware	  	Data Center	  	Cabling	  	“Cabling” means the physical cables in a data center, including voice, video and data LAN cabling and wiring.
				
	Hardware	  	Data Center	  	Electrical Distribution	  	“Electrical Distribution” means a device used to distribute electric current in the IT Environment.
				
	Hardware	  	Data Center	  	Equipment Rack	  	“Equipment Rack” means a cabinet that holds IT equipment (e.g., servers, Routers).
				
	Hardware	  	Data Center	  	Facilities Equipment	  	“Facilities Equipment” means a category of devices that create a suitable computing environment at a data center.
				
	Hardware	  	Data Center	  	Fire Detection	  	“Fire Detection” means a device used to detect fires and includes associated cabling.
				
	Hardware	  	Data Center	  	Fire Suppression	  	“Fire Suppression” refers to a category of devices used to prevent and/or suppress fire outbreak and includes associated cabling.
				
	Hardware	  	Data Center	  	Furniture/Fixture	  	“Furniture/Fixture” means any item of furniture or a fixture used in the data center.
				
	Hardware	  	Data Center	  	Generator	  	“Generator” means a device used to generate and monitor a power supply (e.g., transformer, inverter, uninterruptible power supply device), including associated cabling.
				
	Hardware	  	Data Center	  	 Heating, Ventilation And Cooling

(HVAC)
	  	“Heating, Ventilation And Cooling” or “HVAC” means a device that controls temperature, humidity, air cleanliness and air motion within a physical space.
				
	Hardware	  	Data Center	  	PDU	  	“PDU” means a power distribution unit and includes associated cabling.
				
	Hardware	  	Data Center	  	Physical Access Control	  	“Physical Access Control” means any device used to restrict access to the data center, including locks, card readers, and man traps.
				
	Hardware	  	Data Center	  	 Uninterrupted Power Supply

(UPS)
	  	“Uninterrupted Power Supply” or “UPS” means a device that supplies power to a computer or other electrical equipment on a temporary basis when electricity from a primary power source
is lost or degraded, including all communication cables.
				
	Hardware	  	Definition	  	Collocated Third Party Equipment	  	“Collocated Third Party Equipment” means Appliances and other computing, storage, telecommunications and ancillary hardware, together with associated Software, for which Health Net elects to have Provider provide Data
Center Managed Service only. Health Net shall be responsible for, and bear the costs and expenses associated with data center escort services, installation, testing, implementation, maintenance, upgrade, replacement and enhancement of all Collocated
Third Party Equipment.
				
	Hardware	  	End User	  	Desktop	  	“Desktop” means a computing platform that is not portable and is primarily used directly by an end user, whether networked or standalone, PC or Macintosh. A Desktop includes a central processing unit,
Operating System, video display monitor, modem, related cables (e.g., patch cords), and related peripherals (e.g., keyboard, pointing device).
				
	Hardware	  	End User	  	Desktop Phone	  	“Desktop Phone” means a standard or VOIP handset located at an End User’s workstation.
				
	Hardware	  	End User	  	Mobile Computing Device	  	“Mobile Computing Device” means a small, handheld computing device, typically having a display screen with touch input and/or a miniature keyboard and designed to be carried with little effort. A Mobile
Computing Device has an operating system (OS), and can run various types of application software. Most are equipped with Wi-Fi, Bluetooth, and GPS capabilities that can allow connections to the Internet and other Bluetooth-capable devices. Mobile
computing devices may have the capacity to provide voice communications over a cellular network.
				
	Hardware	  	End User	  	Notebook	  	“Notebook” means a computing platform that is portable, and is primarily used directly by an end user, whether networked or standalone, PC or Macintosh, laptop or tablet PC, desk-based or mobile. A Notebook
includes a central processing unit, operating system, video display monitor, modem, related cables (e.g., patch cords), and related peripherals (e.g., keyboard, pointing device).

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-3	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	Hardware	  	End User	  	Personal Computer (PC)	  	“Personal Computer” or “PC” means a computing platform primarily used directly by an end user, whether networked or standalone, a Desktop or Notebook. A Personal Computer includes a
central processing unit, operating system, video display monitor, network interface card, modem and related cables (e.g., patch cords), and related peripherals (e.g., keyboard, pointing device).
				
	Hardware	  	End User	  	Thick Client	  	“Thick Client” means a Personal Computer that is not portable.
				
	Hardware	  	End User	  	Thin Client	  	“Thin Client” means a device that: (a) enables end users to remotely enter information into one or more computing platforms; (b) displays but does not process data; and (c) includes a web browser.
				
	Hardware	  	End User	  	Workstation Attached Printer	  	“Workstation Attached Printer” means a printer that is directly connected to a Desktop, Notebook or other similar end user device. Workstation Attached Printers may include built in scanning, copying,
facsimile and similar features and functionality.
				
	Hardware	  	Network	  	Access Circuit	  	“Access Circuit” means: (a) a physical (i.e., not logical or virtual) telecommunications connection that is used to carry voice, video and/or data signals between a client location and the telecommunications
backbone; and (b) the logical voice or data communications circuit or path (i.e., PVC) used to carry voice, video and/or data signals across the physical connection.
				
	Hardware	  	Network	  	B2B Connection	  	“B2B Connection” means a connection between the enterprise and a business partner of the enterprise that is provisioned and managed by the business partner.
				
	Hardware	  	Network	  	Certificate Appliance	  	“Certificate Appliance” means an Appliance whose primary purpose is to manage the certificates required by the Public Key Infrastructure (PKI) environment.
				
	Hardware	  	Network	  	Client Extranet	  	“Client Extranet” means a virtual connection between the enterprise and a business partner of the enterprise that is provisioned and managed by the enterprise.
				
	Hardware	  	Network	  	Data Center LAN Service	  	 “Data Center LAN Service” means all networking devices and connectivity required within a Data

Center to support the Server, Storage and Appliance Elements in the Data Center.

				
	Hardware	  	Network	  	 Data Center Switch Port

Aggregation
	  	“Data Center Switch Port Aggregation” means a device that aggregates patches from network switches to allow the use of shared sniffers, probes, network traffic analyzers and other network inspection and
diagnostic devices across a large scale data center network.
				
	Hardware	  	Network	  	Data Leakage Protection (DLP) Appliance	  	“Data Leakage Protection Appliance or DLP Appliance” means an Appliance that is between the trusted and untrusted portions of a network and enables manual and automated inspection of network traffic for
violations of data distribution policies.
				
	Hardware	  	Network	  	Database Encryption Appliance	  	“Database Encryption Appliance” means a device connected to the network that uses purpose-built hardware and software to encrypt full duplex data at multi-gigabit line speeds.
				
	Hardware	  	Network	  	DNS/DHCP	  	 “DNS/DHCP” means a device that provides DNS and DHCP services. Dynamic Host Configuration

Protocol (DHCP) provides network address to the network nodes.

				
	Hardware	  	Network	  	Domain Name Services (DNS)	  	“Domain Name Services” or “DNS” means a software protocol to locate devices on a network and automatically assign and manage their addresses.
				
	Hardware	  	Network	  	Edge Switch	  	“Edge Switch” means a Switch that provides and entry point into an enterprise or service provider core networks (typically into carrier and service provider networks).
				
	Hardware	  	Network	  	Firewall	  	“Firewall” means a device or software, including the network interface, that prevents unauthorized access to a network.
				
	Hardware	  	Network	  	Gateway Appliance	  	“Gateway Appliance” means an Appliance which provides communication to a remote network or an autonomous system that is out of bounds for the host network.
				
	Hardware	  	Network	  	Internet	  	“Internet” means the connection provided by an Internet service provider enabling the enterprise and its employees to access the public Internet.
				
	Hardware	  	Network	  	Intrusion Detection (System)	  	“Intrusion Detection (System)” means a device, including the network interface, that monitors and analyzes user and system configuration and activities to detect unauthorized access to a network or other
attacks designed to adversely affect the performance of the network or systems connected to such network.
				
	Hardware	  	Network	  	Load Balancer	  	“Load Balancer” is an Appliance or device that applies the technique in computer networking of spreading work between two or more computers, network links, CPUs, hard drives, or other resources, in order to
get optimal resource utilization, throughput, or response time. The balancing service is usually provided by a dedicated hardware device or via a functional blade service within a high-end Ethernet switch (e.g., Cisco Content Switch Module (CSM)
Blade).
				
	Hardware	  	Network	  	Local Area Network (LAN)	  	“Local Area Network (LAN)” means computer network that interconnects computers in a limited area. The defining characteristics of LANs, in contrast to wide area networks (WANs), include their usually higher
data-transfer rates, smaller geographic area, and lack of a need for access circuits or telecommunication lines.
				
	Hardware	  	Network	  	Market Data Feed	  	“Market Data Feed” means a connection used to deliver financial market data provided by a data supplier.
				
	Hardware	  	Network	  	 Miscellaneous

Telecommunications Devices
	  	“Miscellaneous Telecommunications Devices” means various items of hardware used to provide telecommunications and call center services, including air cards, PBXs, PDAs, telephones, ACDs, ECDs, VRUs, CTI
equipment, wallboards and headsets.
				
	Hardware	  	Network	  	MPLS Service	  	“MPLS Service” means a telecommunications solution leveraging Multiprotocol Label Switching (MPLS) to provide high-performance telecommunications networks that directs data from one network node to the next
based on short path labels rather than long network addresses, avoiding complex lookups in a routing table. MPLS can encapsulate packets of various network protocols.
				
	Hardware	  	Network	  	Multimedia	  	“Multimedia” means telecommunications services, including all required hardware, systems, and software, that facilitate the audio and video transmissions of two or more people over either dedicated
audio-visual equipment or publicly switched equipment.
				
	Hardware	  	Network	  	Multiplexer	  	“Multiplexer” (MUX) means a device allowing one or more low-speed analog or digital input signals to be selected, combined and transmitted at a higher speed on a single shared medium or within a single shared
device

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-4	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	Hardware	  	Network	  	NAC Appliance	  	“NAC Appliance” means a Network Access Control (NAC) Appliance which provides identity and posture-based network access policy enforcement to prevent vulnerable computers from joining the
network.
				
	Hardware	  	Network	  	Network Edge Router	  	“Network Edge Router” means a Router that routes data between one or more local networks at a physical site and the wide or metropolitan area network serving the site.
				
	Hardware	  	Network	  	Network Intrusion Detection and Prevention System (Network IDPS)	  	“Network Intrusion Detection and Prevention System” or “Network IDPS” means an Appliance that monitors and analyzes user and system configurations and activities to detect unauthorized access to a
network, malicious activities or other attacks designed to adversely affect the performance of the network or systems connected to such network. The functions of intrusion prevention systems include identifying malicious activity, logging
information about said activity, attempting to block/stop activity, and reporting activity.
				
	Hardware	  	Network	  	 Network Performance

Management Platform
	  	“Network Performance Management Platform” means a device that aggregates statistical information from network routing and switching devices for reporting and analysis purposes.
				
	Hardware	  	Network	  	Network Traffic Analyzer	  	“Network Traffic Analyzer” means a device used to examine traffic across a network to aid in the diagnosis of troubles within the network or attached nodes.
				
	Hardware	  	Network	  	OBM Appliance	  	“OBM Appliance” means a device dedicated to providing OBM (out-of-band management) to enable the network operator to establish trust boundaries in accessing the management function to apply it to network
resources. It also can be used to ensure management connectivity (including the ability to determine the status of any network component) independent of the status of other in-band network components.
				
	Hardware	  	Network	  	Office Network	  	“Office Network” means the access service provided by a common telecommunications carrier enabling the enterprise and its employees to access a private IP network.
				
	Hardware	  	Network	  	Private Network Access	  	“Private Network Access” means a dedicated Access Circuit that provides an uninterrupted connection between one location and another.
				
	Hardware	  	Network	  	Public Network Access	  	“Public Network Access” means an Access Circuit that provides connection to a public network.
				
	Hardware	  	Network	  	Router	  	“Router” means a networking device that transmits data to multiple network connected devices, that provides Layer 1, Layer 2, and Layer 3 functionality (as defined by the OSI Reference Model), and that
includes the capability to create VLANs. A Router includes the NIC.
				
	Hardware	  	Network	  	Security Appliance	  	“Security Appliance” means a server or Appliance whose function is to “aggregate” security events within the processing center prior to sending to an off-site SIM portal. The SIM Portal and Security
Appliance may be managed by a third-party provider of Security services. Examples of “aggregation” include but are not limited to parsing of logs, analysis of host-based intrusion detection events, etc.
				
	Hardware	  	Network	  	SIEM Appliance	  	 “SIEM Appliance” means a Security Information and Event Management Appliance which provides

real-time analysis of security alerts generated by network devices and applications as well as log and data reporting and analysis.

				
	Hardware	  	Network	  	Switch	  	“Switch” means an Ethernet network switch that is a computer networking device that connects Ethernet network segments. Ethernet Network Switches are capable of inspecting data packets as they are received,
determining the source and destination device of that packet, and forwarding it appropriately. Most Ethernet switches operate at Layer 2 (as defined by the OSI Reference Model) and are used as the access layer connection point of networked
end-devices. Layer 3 functionality is common in Ethernet Switches deployed as building “core” devices and access layer Switch aggregation points.
				
	Hardware	  	Network	  	Telecom Server	  	“Telecom Server” means any Windows/Unix based server which supports the network services infrastructure. Examples of Telecom servers could contain anything from network monitoring servers to servers that help
manage network routers and switches.
				
	Hardware	  	Network	  	VPN	  	“VPN” means a network Appliance that uses IP protocols to host a secure network for authorized users on either privately or publicly owned equipment and infrastructure.
				
	Hardware	  	Network	  	VPN Concentrator	  	“VPN Concentrator” means a network Appliance that uses IP protocols to host a secure network for authorized users on either privately or publicly owned equipment and infrastructure.
				
	Hardware	  	Network	  	Vulnerability Assessment Scanner	  	“Vulnerability Assessment Scanner” means an Appliance that executes Vulnerability Scanning.
				
	Hardware	  	Network	  	WAN Optimizer	  	“Wan Optimizer” means a physical or virtual appliance that combines monitoring, traffic prioritization, data deduplication, compression, protocol spoofing, transmission blocking and other techniques to
improve the performance of wide area telecommunications facilities.
				
	Hardware	  	Network	  	 Wide Area Application Service

(WAAS)
	  	Wide Area Application Service (WAAS) means a device that accelerates applications, optimizes bandwidth, and reduces latency.
				
	Hardware	  	Network	  	Wide Area Network (WAN)	  	“Wide Area Network (WAN)” means a telecommunication network that covers a broad area (i.e., any network that links across metropolitan, regional, state or national boundaries).
				
	Hardware	  	Network	  	Wireless Access Point (WAP)	  	“Wireless Access Point (WAP)” means a device that is specially configured on wired local area networks that allows individuals to use wireless networking cards in their computers and other electronic
devices.
				
	Hardware	  	Network	  	 Wireless Intrusion Prevention

System (IPS)
	  	“Wireless Intrusion Prevention System (IPS)” means a device that monitors the radio spectrum of a WAP for the presence of unauthorized access points and can automatically take counter measures.
				
	Hardware	  	Network	  	Wireless LAN (WLAN)	  	“Wireless LAN (WLAN)” means a wireless local area network (WLAN) that links two or more devices using some wireless distribution method (typically spread-spectrum or OFDM radio).
				
	Hardware	  	Print	  	High-Speed Printer	  	“High-Speed Print” means a centralized printing device directly attached to a server that prints large volume print jobs, typically associated with batch processing
jobs.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-5	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	Hardware	  	Print	  	 Multi Function

Product/Printer/Peripheral (MFP)
	  	“Multi Function Product/Printer/Peripheral” or “MFP” means a multifunctional, all-in-one (AIO), or Multifunction Device (MFD), office machine which incorporates the functionality of
multiple devices in one, to provide centralized document management, distribution, and production. An MFP typically incorporates the functions of printers, scanners, photocopiers, and facsimile machines and may also provide eMail
capability.
				
	Hardware	  	Print	  	Printer	  	“Printer” means a device that accepts digital output from a queue and transfers the output to paper form.
				
	Hardware	  	Print	  	Sorting / Processing	  	“Sorting / Processing” means a centralized device connected to a High-Speed Printer that sorts and processes large volume print jobs.
				
	Hardware	  	Server	  	Access Control Server (ACS)	  	“Access Control Server (ACS)” means a dedicated server hosting Access Control software.
				
	Hardware	  	Server	  	Alpha Server or Open VMS/Alpha	  	“Alpha Server” or “Open VMS/Alpha” means a Midrange computing platform utilizing the VMS Operating System produced by the Digital Equipment Corporation, including the CPU, memory,
internal hard disk, related peripherals, keyboard/video/mouse (KVM) cabling and the NIC.
				
	Hardware	  	Server	  	Applications Server (HDW)	  	“Applications Server (HDW)” means any computing platform (mainframe, midrange, entry level/blade) the primary purpose of which is to host Applications Software. An Applications Server (HDW) includes the
Central Processing Unit (“CPU” ), memory, related peripherals, internal hard disk, keyboard video mouse (“KVM”) cabling, and the NIC.
				
	Hardware	  	Server	  	Data Base (DB) Server	  	“DB Server” means a real or virtual instance of a server that is designated to be used exclusively to host one or more DBMS instances and that provides access to connected data via the DBMS from applications
and other data consumers executing on other servers.
				
	Hardware	  	Server	  	eMail Server	  	“eMail Server” means a computing platform that manages the distribution of electronic messages, including receipt, delivery, and prioritization.
				
	Hardware	  	Server	  	Extranet Server	  	“Extranet Server” means any Windows/Unix based server which supports the extranet services infrastructure. Examples of Extranet servers could contain anything from network monitoring servers to servers that
help manage firewalls, proxies and other Extranet services.
				
	Hardware	  	Server	  	File & Print Server	  	 “File & Print Server” means a computing platform that performs the functions of a File Server and a

Print Server.

				
	Hardware	  	Server	  	File Server	  	“File Server” means a computing platform (including the CPU, memory, related peripherals, internal hard disk and the NIC) that: (a) centrally stores network files; (b) controls the movement of files and data
between workstations across the network; and (c) enables users to freely access such files.
				
	Hardware	  	Server	  	Infrastructure Server	  	 “Infrastructure Server” means any computing platform (mainframe, midrange, entry level/blade) the primary purpose of
which is to serve traditional infrastructure services. An Infrastructure Server
 includes the Central Processing Unit (“CPU” ),
memory, related peripherals, internal hard disk, keyboard video mouse (“KVM” ) cabling, and the NIC.

				
	Hardware	  	Server	  	POS Controller	  	“POS Controller” means a server that controls POS devices.
				
	Hardware	  	Server	  	Print Server	  	“Print Server” means a computing platform that: (a) provides users or a network with access to a central printer; (b) holds the information to be printed out in memory until the printer is available; (c)
prints jobs in a programmable sequence and queue; and (d) provides notice of a print job completion to the requesting user.
				
	Hardware	  	Server	  	Replication Server	  	“Replication Server” means a server which provides bi-directional, heterogeneous replication, and synchronization between separate servers that support the same application.
				
	Hardware	  	Server	  	Web Accelerator	  	“Web Accelerator” means a proxy server whose purpose is reduce web site access times.
				
	Hardware	  	Server	  	Web Security Proxy	  	“Web Security Proxy” means a device, situated between a client application, such as a web browser, and a real Server, that: (a) intercepts all requests to the real server; (b) authenticates potential users;
and (c) denies access to certain computers, URLs and IP addresses.
				
	Hardware	  	Server	  	Web Server	  	“Web Server” means a computing platform that: (a) stores documents and files for use on one or more Internet or intranet websites; and (b) makes such documents and files accessible to users of such websites
by providing interfaces between different access protocols.
				
	Hardware	  	Server	  	zSeries Server	  	“zSeries Server” means an IBM computing platform utilizing an operating environment that is based on the z/OS, z(VM), or compatible Operating System, including the CPUs, memory, HMCs, service elements and
channel cards.
				
	Hardware	  	Service	  	Active Directory aaService	  	“Active Directory aaService” means the hardware, software and services necessary to run Microsoft Active Directory (AD) for Windows domain networks. AD includes the domain controller function used to
authenticate and authorize all users and computers in a Windows domain type network—assigning and enforcing security policies for all computers and installing or updating software. Service includes PKI based AD Certificate Services.
				
	Hardware	  	Service	  	Data Center Managed Service	  	“Data Center Managed Service” means the delivery as a service of the Data Center Elements for the housing and operation of computing, storage, telecommunications, and ancillary equipment. The service includes
the building and all Data Center Elements including specialized flooring, cabling, access security, fire detection and suppression, primary and backup power provisioning and distribution and heating, ventilation, and air conditioning. Data Center
Managed Service includes the provision of on-site technical support (i.e., “smart hands”) as well as escort services to enable Health Net or Health Net’s Third Party Supplier authorized access to appropriate hardware.
				
	Hardware	  	Service	  	 Disaster Recovery Management

Services
	  	“Disaster Recovery Management Services” means the contracted services for providing Data Center Facility Managed Services and hardware and software to meet specific recovery objectives for a temporary period
in case of a disaster.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-6	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	Hardware	  	Service	  	Network Services	  	“Network Services” means services that provide voice data and video connectivity between the client’s locations and to its business partners. Network Services is comprised of telecommunications
equipment, telecommunications facilities and the people processes and tools required to operate and provide the services. Local, campus, metropolitan and wide area communications facilities are included with the scope of the Network
Services.
				
	Hardware	  	Service	  	VDI / Citrix aaService	  	“VDI / Citrix aaService” means the hardware, software and services necessary to deliver centralized, secure remote access control using the Citrix brand products.
				
	Hardware	  	Storage	  	Attached Disk Array	  	“Attached Disk Array” means a DASD device consisting of two or more disk drives combined in a single unit for increased capacity, speed, and/or fault tolerant operation which may be attached to a
SAN.
				
	Hardware	  	Storage	  	Automated Tape Library	  	“Automated Tape Library” means a device that stores, reads and/or writes magnetic tapes used to store data and utilizes automated tape robots, which are mechanical handlers capable of storing multiple pieces
of removable media and loading and unloading them from one or more drives in arbitrary order in response to electronic commands. An Automated Tape Library includes the media necessary to provide the required storage and recovery functionality. An
Automated Tape Library may be attached to a SAN.
				
	Hardware	  	Storage	  	Backup and Recovery (BUR)	  	“Backup and Recovery” or “BUR” means an Appliance or infrastructure solution that performs data backup onto and recovers data from DASD. BUR may be an Appliance or a solution that
includes servers, silos, and software.
				
	Hardware	  	Storage	  	DASD	  	“DASD” means a Storage device that allows direct access to data: (a) stores, reads and writes data on on-line magnetic media (e.g., disks); and (b) is accessed directly by a server.
				
	Hardware	  	Storage	  	 Data Base Logging and

Compliance
	  	“Data Base Logging and Compliance” means a device that (1) monitors all database changes, including changes to data structures, (2) monitors the activity of privileged users, and (3) provides compliance
reports on all privileged user database activity.
				
	Hardware	  	Storage	  	Data Replication	  	“Data Replication” means the process of sharing data across storage platforms as to ensure consistency between redundant resources. This includes both hardware and software methods.
				
	Hardware	  	Storage	  	Direct Attached Storage	  	“Direct Attached Storage” means digital storage directly attached (i.e., not connected through a network) to a server.
				
	Hardware	  	Storage	  	Disk Subsystem	  	“Disk Subsystem” means DASD that is attached to a LAN instead of directly to a server, has its own network address, is capable of handling multiple network protocols, and is not attached to a SAN.
				
	Hardware	  	Storage	  	Internal or Embedded	  	“Internal” or “Embedded” means a DASD device that is located internally within a computing device.
				
	Hardware	  	Storage	  	Manual Tape Drive	  	“Manual Tape Drive” means a device that stores, reads or writes magnetic tapes used to store data, and that requires manual loading and unloading of removable media from one or more drives. A Manual Tape
Drive includes the media necessary to provide the required storage and recovery functionality.
				
	Hardware	  	Storage	  	Network Attached Storage (NAS)	  	“Network Attached Storage” or “NAS” means a file-level computer data storage connected to a computer network providing data access to heterogeneous network clients.
				
	Hardware	  	Storage	  	SAN	  	 “SAN” means a Storage Area Network which is a system for storing data that is composed of SAN

switches, frames, connection media, disk array cache and processors, disk controllers, and disk drives.

				
	Hardware	  	Storage	  	Tape	  	“Tape” means a Storage device that: (a) stores, reads and writes data on on-line magnetic media (e.g., magnetic tapes); and (b) is sequentially accessed by a server.
				
	Hardware	  	Storage	  	Virtual Tape Appliance	  	“Virtual Tape Appliance” means a device that provides the capability to emulate tape files on a random access storage device.
				
	Hardware	  	Storage	  	Virtual Tape Library (VTL)	  	“Virtual Tape Library” or “VTL” means a server that temporarily stores data, previously residing on tapes for, use in batch processing, onto attached hard disks. Virtual Tape Library includes the
CPU, memory, internal hard disk, related peripherals, KVM cabling and the NIC.
				
	Hardware	  	Voice / Video	  	ACD/IVR	  	 “ACD” (Automate Call Distribution) means a device or system (including applicable software) that distributes incoming
calls to a specific group of phones based on customer need, type, and agent skill set and includes the switches and software for the routing strategy. The routing strategy is a rule-based set of instructions that tells the ACD how calls are handled
inside the system.
  
 “IVR” (Interactive Voice Response) means a
device or system (including applicable software) that allows a caller to interact with a company’s host system via a telephone keypad or by speech recognition, after which they can service their own inquiries by following the IVR dialogue
and/or information can be captured to pass on to the company agent.

				
	Hardware	  	Voice / Video	  	AV Teleconference	  	“AV Teleconference” means the equipment used to provide group audio and visual presentation and teleconferencing to multiple locations in both conference and/or specialized meeting rooms.
				
	Hardware	  	Voice / Video	  	VOIP Solution	  	 “VOIP Solution” means all the hardware and software implemented by Cognizant under Work Order

1217 (VOIP Project) as an Accelerated Project.

				
	Hardware	  	Voice / Video	  	Overhead Paging	  	 “Overhead Paging” means the devices that allow paging through the use of loud speakers within IP

telephones.

				
	Hardware	  	Voice / Video	  	PBX	  	“PBX” means a telecommunications server that manages and operates the switches, internal lines, and pooled external lines of a private branch exchange telephone system.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Application Development Tools	  	“Application Development Tools” means Infrastructure Utility Software the primary purpose of which is to assist in the creation of software programs and programming, such as development environments,
compilers, debuggers, and editors.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	CASE Tool	  	“CASE Tool” means Application Development Computer-aided Software Engineering Tools Software that automates methods for designing, documenting, and producing structured computer code in the desired
programming language.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-7	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	 Applications

Development
	  	Compiler/Interpreter	  	“Compiler/Interpreter” means an Application Development Tool that takes the source code a programmer has written and translates it into object code the computer can understand.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Debugger	  	“Debugger” means an Application Development Tool used to identify and resolve coding errors (i.e., bugs).
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Development Tool	  	“Development Tool” means an Application Development Tool that assists programmers in designing, creating or documenting computer programs.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Load Test	  	“Load Test” means an application development tool used to test and determine total capacity at which applications software can operate without failure.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Program Documentation	  	“Program Documentation” means Infrastructure Utility Software that provides the tools required to develop and maintain documentation, including metadata, about computer programs.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Programming Library	  	“Programming Library” means an Application Development Tool containing a pre-defined set of functions that are accessed and utilized by another program.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	QA	  	“QA” means an Application Development Tool used to facility quality assurance with respect to code development (i.e., testing tools).
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Query/Analysis/OLAP	  	“Query/Analysis/OLAP” means Infrastructure Utility Software that enables a user to selectively extract, view and report data from different points-of-view.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Runtime Libraries	  	“Runtime Libraries” means Infrastructure Utility Software or Application Software housed in a special purpose library the primary purpose of which is used by a compiler, to implement functions built into or
to extend a programming language, during the runtime (execution) of a computer program.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Source Control	  	“Source Control” means an Application Development Tool used to manage applications source code under development by multiple developers.
				
	 Infrastructure

Software
	  	 Applications

Development
	  	Version Control	  	“Version Control” means an Application Development Tool used to manage and control correct versions of applications source code under development by multiple developers.
				
	 Infrastructure

Software
	  	 Business

Applications
	  	Speech Processing	  	“Speech Processing” means Infrastructure Utility Software the primary purpose of which is to provide ability to speech-enable business applications.
				
	 Infrastructure

Software
	  	 Business

Applications
	  	 Standard Collaboration

Applications
	  	“Standard Collaboration Applications” means those applications that are on the standard image and used for End User collaboration (e.g., eMail).
				
	 Infrastructure

Software
	  	 Business

Applications
	  	Standard Productivity Applications	  	“Standard Productivity Applications” means those applications that are on the standard image and used for End User productivity (e.g., MS Office).
				
	 Infrastructure

Software
	  	DBMS	  	Allbase	  	“Allbase” means the proprietary DBMS produced by Hewlett Packard.
				
	 Infrastructure

Software
	  	DBMS	  	Allbase/SQL	  	“Allbase/SQL” means the proprietary relational DBMS that conforms to the SQL specification produced by Hewlett Packard.
				
	 Infrastructure

Software
	  	DBMS	  	Database Administration	  	“Database Administration” means Infrastructure Utility Software that configures and controls databases and restructures, backs-up and restores data contained with the database.
				
	 Infrastructure

Software
	  	DBMS	  	 Database Management Software

(DBMS)
	  	 “Database Management Software” or “DBMS” means software that stores information in a database
in an organized manner allowing data to be added, updated, and retrieved as individual items or to be queried in a structured manner. Additionally, a DBMS maintains metadata, which describe the schema

or the organization and relationships between the individual data items.

				
	 Infrastructure

Software
	  	DBMS	  	Datacom Database	  	“Datacom Database” means proprietary database software produced by the CA Technologies.
				
	 Infrastructure

Software
	  	DBMS	  	DB2 Universal Database (DB2)	  	 “DB2 Universal Database” or “DB2” means the proprietary DB2 Universal Database Management

System produced by IBM.

				
	 Infrastructure

Software
	  	DBMS	  	Informix	  	“Informix” means proprietary database software produced by the Informix Corporation.
				
	 Infrastructure

Software
	  	DBMS	  	 Integrated Database Management

System (IDMS)
	  	“Integrated Database Management System” or “IDMS” means the network DBMS proprietary to CA Technologies.
				
	 Infrastructure

Software
	  	DBMS	  	Oracle	  	“Oracle” means the proprietary DBMS produced by Oracle that implements a relational database management system and that is accessed using the structured query language (SQL).
				
	 Infrastructure

Software
	  	DBMS	  	Sybase Database	  	“Sybase Database” means proprietary database software produced by the Sybase Corporation.
				
	 Infrastructure

Software
	  	DBMS	  	UDB	  	“UDB” means the proprietary IBM UDB (Universal Database) Management System produced by IBM that implements a relational database management system and that is accessed using the structured query language
(SQL).
				
	 Infrastructure

Software
	  	eMail	  	eMail	  	“eMail” means Infrastructure Utility Software that manage the distribution of electronic messages, including receipt, delivery, and prioritization.
				
	 Infrastructure

Software
	  	eMail	  	eMail Scanning	  	“eMail Scanning” means a device or software that searches for and quarantines in-bound eMail messages containing potential Spam and viruses.
				
	 Infrastructure

Software
	  	Operations	  	Application Enabling Services	  	“Application Enabling Services” means the utility functions that provide software solutions, processes, and capabilities allowing business applications to interoperate with the infrastructure hardware and
software. These are shared services leveraged by multiple applications, business units, or affiliates.
				
	 Infrastructure

Software
	  	Operations	  	Application Server (SFTW)	  	“Application Server (SFTW)” means a software framework that provides an environment where applications can run and allows execution of procedures (programs, routines, scripts) for supporting the delivery of
applications. An Application Server behaves like an extended virtual machine for the running of applications, managing connections to the database at one side and connections to a Web client at the other.
				
	 Infrastructure

Software
	  	Operations	  	Audit Tool	  	“Audit Tool” means Infrastructure Utility Software the primary purpose of which is to inspect a computing resource and compare its configuration state to a compliance model and log or report
discrepancies.
				
	 Infrastructure

Software
	  	Operations	  	Automation	  	“Automation” means an Infrastructure Utility Software that enables the unattended operation of a computer or of an Application.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-8	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	Operations	  	Batch Processing Tool	  	“Batch Processing Tool” means Infrastructure Utility Software that manages and executes a series of non-interactive data processing jobs all at one time.
				
	 Infrastructure

Software
	  	Operations	  	Business Process Management	  	 “Business Process Management” means Infrastructure Utility Software the primary purpose of which is to define and
operationalize the flow of work through a network of activities or organized tasks to
 achieve the desired outcome of a business process.

				
	 Infrastructure

Software
	  	Operations	  	Certificate Management	  	“Certificate Management” means Infrastructure Utility Software the primary purpose of which is to manage the certificates required by the Public Key Infrastructure (PKI) environment.
				
	 Infrastructure

Software
	  	Operations	  	Chargeback Utility	  	“Chargeback Utility” means Infrastructure Utility Software the primary purpose of which is to analyze, summarize and allocate resource consumption accounting information for use in recovering the cost of the
resources from the user or customer consuming the resources.
				
	 Infrastructure

Software
	  	Operations	  	Cluster Utility	  	“Cluster Utility” means Infrastructure Utility Software that joins together two or more computers to operate jointly or as a cluster.
				
	 Infrastructure

Software
	  	Operations	  	Clustering	  	“Clustering” means Infrastructure Utility Software that is used to couple multiple computer systems so that they, in many respects, appear and operate as a single computer system.
				
	 Infrastructure

Software
	  	Operations	  	Compression Tool	  	“Compression Tool” means Infrastructure Utility Software that reduces the size data files by means of algorithmic analysis, such that the same file can be restored to its original form without minimal or no
loss of information.
				
	 Infrastructure

Software
	  	Operations	  	 Computer Telephony Integration

(CTI)
	  	“Computer Telephony Integration” or “CTI” means Infrastructure Utility Software that enables increased productivity by utilizing information from the telephone system to automate
certain call center processes.
				
	 Infrastructure

Software
	  	Operations	  	Configuration Management	  	“Configuration Management” means the Infrastructure Utility Software (tools or databases) that facilitates the task of tracking, controlling and storing of changes in Configurable Items.
				
	 Infrastructure

Software
	  	Operations	  	Connectivity	  	“Connectivity” means Infrastructure Utility Software that facilitates the transfer of data between servers and other devices, including verifying that the circuit is operational and the devices are
compatible, monitoring data transmission, sequencing, and receipt, and correcting transmission errors.
				
	 Infrastructure

Software
	  	Operations	  	Content Filter	  	“Content Filter” means Infrastructure Utility Software that screens or filters content to identify certain types of data (e.g., a spam filter).
				
	 Infrastructure

Software
	  	Operations	  	Content Management	  	“Content Management” means Infrastructure Utility Software that collects, catalogs, stores and serves content destined for use in conjunction with web sites.
				
	 Infrastructure

Software
	  	Operations	  	Data Entry	  	“Data Entry” means Infrastructure Utility Software that provides a configurable means of capturing and validating data entered by an operator at a keyboard.
				
	 Infrastructure

Software
	  	Operations	  	Diagnostic Tool	  	“Diagnostic Tool” means Infrastructure Utility Software that assists operations or development personnel to investigate and perform problem determination and isolation.
				
	 Infrastructure

Software
	  	Operations	  	Directory Services	  	“Directory Services” means Infrastructure Utility Software the primary purpose of which is to provide a shared information repository for locating, managing, administering, and organizing common items and
network resources, which may include volumes, folders, files, printers, users, groups, devices, telephone numbers, and other objects.
				
	 Infrastructure

Software
	  	Operations	  	Disaster Recovery	  	 “Disaster Recovery” means Infrastructure Utility Software that is used to build and manage Disaster

Recovery plans.

				
	 Infrastructure

Software
	  	Operations	  	Distributed Computing	  	“Distributed Computing” means Infrastructure Utility Software the primary purpose of which is to provide a framework for the development and operation of business applications using the client/server
model.
				
	 Infrastructure

Software
	  	Operations	  	Document Management	  	“Document Management” means the Infrastructure Utility Software that tracks and stores electronic documents and/or images of paper documents and different versions created by different users (history
tracking).
				
	 Infrastructure

Software
	  	Operations	  	Editor	  	“Editor” means Infrastructure Utility Software that allows the viewing and changing of text files.
				
	 Infrastructure

Software
	  	Operations	  	ETL Tool	  	“ETL Tool” means Infrastructure Utility Software the primary purpose of which is to extract data from is place of residence, transform it to meet the needs of the target data store, and load into the target
data store.
				
	 Infrastructure

Software
	  	Operations	  	Event Management	  	“Event Management” means Infrastructure Utility Software the primary purpose of which is to detect abnormal operational situations (events), notify designed touchpoints and perform event
correlation.
				
	 Infrastructure

Software
	  	Operations	  	Fax Output	  	“Fax Output” means Infrastructure Utility Software that allows facsimile messages to be sent programmatically from a computer.
				
	 Infrastructure

Software
	  	Operations	  	File System	  	“File System” means Infrastructure Utility Software that provides a structure for storing to and retrieving files from direct access storage media.
				
	 Infrastructure

Software
	  	Operations	  	File Transfer	  	“File Transfer” means Infrastructure Utility Software that transmits data files to or from a computer system to one or more other computer systems, generally over telecommunications (e.g., LAN, MAN, WAN)
facilities.
				
	 Infrastructure

Software
	  	Operations	  	File Utility	  	“File Utility” means Infrastructure Utility Software that enables the viewing, back-up, restoration, copying, moving or manipulating of data and files.
				
	 Infrastructure

Software
	  	Operations	  	Fonts	  	“Fonts” means Infrastructure Utility Software the primary purpose of which is to provide outline and raster fonts and associated utility programs for use on certain IBM printers.
				
	 Infrastructure

Software
	  	Operations	  	FTP/SFTP	  	“FTP/ SFTP” means Infrastructure Utility Software that is used to transfer data from one computer to another over the Internet, or through a network, including over an encrypted transport.
				
	 Infrastructure

Software
	  	Operations	  	Global Resource Serialization	  	“Global Resource Serialization” means Infrastructure Utility Software that serializes access between computers to shared resources to protect their integrity.
				
	 Infrastructure

Software
	  	Operations	  	Help Tool	  	“Help Tool” means Infrastructure Utility Software that is used to author, maintain and make available information that allows end users to understand how to utilize computer and software
systems.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-9	  	Health Net / Cognizant Confidential

 Final 

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	Operations	  	Job Entry/Management	  	“Job Entry/Management” means Infrastructure Utility Software the primary purpose of which is to provide supplementary job management, data management, and task management functions such as: scheduling,
control of job flow, and spooling.
				
	 Infrastructure

Software
	  	Operations	  	License Manager	  	“License Manager” means Infrastructure Utility Software the primary purpose of which is to record license information associated with compliance, audits, and proof of ownership.
				
	 Infrastructure

Software
	  	Operations	  	Log Utility	  	“Log Utility” means Infrastructure Utility Software the primary purpose of which is to provide a mechanism for making and analyzing operational log entries.
				
	 Infrastructure

Software
	  	Operations	  	Machine Accounting	  	“Machine Accounting” means Infrastructure Utility Software that accounts for the usage of a computer and its associated peripheral devices.
				
	 Infrastructure

Software
	  	Operations	  	Messaging	  	“Messaging” means Infrastructure Utility Software that provides a communication mechanism to transmit data messages between applications on different platforms. Messaging is intended to connect different
computer systems, diverse geographical locations, and dissimilar IT infrastructures.
				
	 Infrastructure

Software
	  	Operations	  	My SQL	  	“My SQL” means the open source software that implements structured query language (SQL).
				
	 Infrastructure

Software
	  	Operations	  	Network Management	  	“Network Management” means Infrastructure Utility Software that facilitates the monitoring and administration of a computer network including inventory (discovery), configuration, detecting faults, providing
alerts, and performance tracking.
				
	 Infrastructure

Software
	  	Operations	  	Object Cache	  	“Object Cache” means Infrastructure Utility Software the primary purpose of which to is cache frequently accessed Java objects in order to improve the performance of e-business applications.
				
	 Infrastructure

Software
	  	Operations	  	OL Transaction Processing	  	“OL Transaction Processing” means Infrastructure Utility Software that facilitates and manages transaction-oriented applications, typically for data entry and retrieval transactions.
				
	 Infrastructure

Software
	  	Operations	  	Online Survey	  	“Online Survey” means Infrastructure Utility Software that is used to author, maintain, distribute and analyze inquiries intended to obtain end user feedback and opinion.
				
	 Infrastructure

Software
	  	Operations	  	Output Management	  	“Output Management” means Infrastructure Utility Software that controls the packaging and distribution of printed reports or maintains a structured repository of reports in electronic form and controls
viewing access.
				
	 Infrastructure

Software
	  	Operations	  	Password Management	  	“Password Management” means Infrastructure Utility Software that provides for adding, changing and deleting credentials for access to and entitlements within computing and application systems.
				
	 Infrastructure

Software
	  	Operations	  	Patch Management	  	“Patch Management” means Infrastructure Utility Software that applies software changes to and tracks the current state of software products.
				
	 Infrastructure

Software
	  	Operations	  	Performance Management	  	 “Performance Management” means Infrastructure Utility Software that manages (including by

allowing users to observe, monitor, measure and improve) the availability and throughput of components of the infrastructure.

				
	 Infrastructure

Software
	  	Operations	  	Presentation Management	  	“Presentation Management” means System Software that locally executes applications on a server and enables remote access to such applications over telecommunications facilities by end users on suitably
equipped client devices.
				
	 Infrastructure

Software
	  	Operations	  	Presentation Server	  	“Presentation Server” means System Software that locally executes applications and enables remote access to such applications over telecommunications facilities by end users on suitably equipped
devices.
				
	 Infrastructure

Software
	  	Operations	  	Protocol Mediation	  	“Protocol Mediation” means Infrastructure Utility Software that allows two systems employing incompatible data communications protocols to exchange information.
				
	 Infrastructure

Software
	  	Operations	  	Remote Control	  	“Remote Control” means Infrastructure Utility Software that allows one computer system to control the operations of another computer system over a data communications connection.
				
	 Infrastructure

Software
	  	Operations	  	Replication	  	“Replication” means Infrastructure Utility Software that duplicates the data stored in computing platforms.
				
	 Infrastructure

Software
	  	Operations	  	Search Utility	  	“Search Utility” means Infrastructure Utility Software that allows a user to search through an archive of data looking for information with particular contents or characteristics.
				
	 Infrastructure

Software
	  	Operations	  	Session Management	  	“Session Management” means Infrastructure Utility Software that manages and implements the single sign-on of a user to multiple applications on multiple devices.
				
	 Infrastructure

Software
	  	Operations	  	Software Distribution	  	“Software Distribution” means Infrastructure Utility Software that is used to control and transmit software changes to remote computing devices.
				
	 Infrastructure

Software
	  	Operations	  	Sort	  	“Sort” means Infrastructure Utility Software that rearranges the sequence of individual records in data files.
				
	 Infrastructure

Software
	  	Operations	  	Storage Management	  	“Storage Management” means Infrastructure Utility Software that provides monitoring and control of data storage devices, including identification of occupied and available space and its owners.
				
	 Infrastructure

Software
	  	Operations	  	System Administration Tools	  	“System Administration Tools” means Infrastructure Utility Software used by Systems Administrators to install, maintain, monitor and control computer systems or networks.
				
	 Infrastructure

Software
	  	Operations	  	System Log Aggregator	  	“System Log Aggregator” means an Appliance that assembles the logs from diverse devices into a uniform, normalized format so that coherent and correlated reports and statistics can be produced for a complex heterogeneous
computing environment.
				
	 Infrastructure

Software
	  	Operations	  	Systems Management	  	“Systems Management” means Infrastructure Utility Software that provides the ability to monitor, control and report on the computing and network infrastructure. Systems Management includes tools that are used
to automate processes, including problem, incident, change, performance, and capacity management.
				
	 Infrastructure

Software
	  	Operations	  	Tape Encryption	  	“Tape Encryption” means hardware or software that encrypts the data within the recording device. The point at which the encryption occurs is dependent upon the underlying technology capabilities.
				
	 Infrastructure

Software
	  	Operations	  	Tape Management	  	“Tape Management” means Infrastructure Utility Software that keeps track of and controls the inventory of tape media and may catalog the contents of selected units of
media.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-10	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	Operations	  	Terminal Emulation	  	“Terminal Emulation” means Infrastructure Utility Software that allows a computer to perform the functions of keyboard/display device for the purpose of programmatically accessing a computing system with
which the keyboard/display device is compatible.
				
	 Infrastructure

Software
	  	Operations	  	Time Management	  	“Time Management” means Infrastructure Utility Software that is used to capture the correct time and date set those parameters of the computing system.
				
	 Infrastructure

Software
	  	Operations	  	Time Sharing	  	“Time Sharing” means Infrastructure Utility Software that enables multiple remote users to access a shared computer system in a session-oriented manner, typically to perform functions such as file editing,
remote batch job entry, program development and testing, and individual computing.
				
	 Infrastructure

Software
	  	Operations	  	Workload Automation Schedules	  	“Workload Automation Schedules” means the executable output from job scheduler software that defines workflows and/or job dependencies, automates submission of executions, monitor executions and priorities
and/or queues to control the execution order of unrelated jobs.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Access Control	  	“Access Control” means Infrastructure Utility Software that performs authentication of users attempting to access systems and maintains access entitlements to systems.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Access Control (Application Level)	  	“Access Control (Application Level)” means Infrastructure Utility Software that performs authentication of users attempting to access applications and maintains access entitlements to applications.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Access Control (System Level)	  	“Access Control (System Level)” means Infrastructure Utility Software that performs authentication of users attempting to access the O/S and maintains access entitlements to the O/S.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Authentication Server	  	“Authentication Server” means security software that examines and verifies the credentials assigned to network users, servers, and devices prior to allowing access to other network resources.
				
	 Infrastructure

Software
	  	 Security

Management
	  	 Authentication Service

(Application Level)
	  	“Authentication Service (Application Level)” means security software that examines and verifies the credentials assigned to application users, servers, and devices prior to allowing access to other
application resources.
				
	 Infrastructure

Software
	  	 Security

Management
	  	 Authentication Service (System

Level)
	  	“Authentication Service (System Level)” means security software that examines and verifies the credentials assigned to network users, servers, and devices prior to allowing access to other network
resources.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Encryption	  	“Encryption” means Infrastructure Utility Software or Appliance that encodes data so that it systematically scrambled so that it cannot be read without knowing the decoding key.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Encryption (File Level)	  	“Encryption (File Level)” means Infrastructure Utility Software or Appliance that encodes data at rest so that it systematically scrambled so that it cannot be read without knowing the decoding key.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Encryption (Transmission)	  	“Encryption (Transmission)” means Infrastructure Utility Software or Appliance that encodes data in transit so that it systematically scrambled so that it cannot be read without knowing the decoding
key.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Forensics	  	“Forensics” means Infrastructure Software used to conduct network-enabled computer investigations, e-discovery requests, internal investigations, regulatory inquiries, as well as data and compliance
auditing.
				
	 Infrastructure

Software
	  	 Security

Management
	  	 Host Based Intrusion Detection

System (Host Based IDS)
	  	“Host Based Intrusion Detection System” or “Host Based IDS” means Infrastructure Utility Software that monitors and analyzes user and system configuration and activities to detect
unauthorized access attempts to a computer or other attacks designed to adversely affect the performance of the computer.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Identity Management	  	“Identity Management” means the software to provide a broad administrative service that identifies individuals and controls their access to resources by associating their established identity with user
rights, entitlements and privileges.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Intrusion Detection (Software)	  	“Intrusion Detection (Software)” means the Infrastructure Utility Software that monitors and analyzes user and system configuration and activities to detect unauthorized access to a network or other attacks
designed to adversely affect the performance of the network or systems.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Penetration Testing	  	“Penetration Testing” means Infrastructure Utility Software used in penetration testing to simulate an attack from malicious outsiders (who do not have an authorized means of accessing the organization’s
systems) and malicious insiders (who have some level of authorized access).
				
	 Infrastructure

Software
	  	 Security

Management
	  	Security Administration	  	“Security Administration” means Infrastructure Utility Software that allows for the configuration and control of the security apparatus of a computer system or an Application.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Security Exits	  	“Security Exits” mean certain types of Client software that attaches to the security software to allow the behavior of the product to be customized at predefined places or exit points. Exit functions, for
example, include issuing messages, accepting or rejecting various programmatic requests, changing or rerouting the processing flow or modifying the default behavior of the security software.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Security Monitoring	  	“Security Monitoring” means Infrastructure Utility Software that enables the detection, managing, handling, registering and recording of security-related breaches and Incidents including intrusion detection
and hacking.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Virus Detection	  	“Virus Detection” means Infrastructure Utility Software that monitors for, scans, detects, quarantines and removes viruses. Virus Detection includes virus signature files.
				
	 Infrastructure

Software
	  	 Security

Management
	  	Vulnerability Scanning	  	“Vulnerability Scanning” means a process by which you scan operating systems, databases, applications, networks, etc. to assess security weaknesses to enumerate the vulnerabilities present in one or more
targets.
				
	 Infrastructure

Software
	  	System Software	  	Access Methods & Drivers	  	“Access Methods & Drivers” means System Software that supports a particular device (e.g., VTAM, VSAM).
				
	 Infrastructure

Software
	  	System Software	  	AIX	  	“AIX” means the proprietary AIX UNIX Operating System software produced by IBM.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-11	  	Health Net / Cognizant Confidential

 Final 
  

							
	 ScopeModel
	  	 Category
	  	 Element
	  	 Definition

	 Infrastructure

Software
	  	System Software	  	Exits	  	“Exits” mean certain types of Client software that interfaces with the O/S to allow the behavior of the product to be customized at predefined places or exit points. Exit functions, for example, include
issuing messages, accepting or rejecting various programmatic requests, changing or rerouting the processing flow or modifying the default behavior of the O/S.
				
	 Infrastructure

Software
	  	System Software	  	Hypervisor	  	“Hypervisor” means an Operating System that allows the simultaneous operation of multiple instances of the same or different subordinate Operating Systems (e.g., zVM or VMWare).
				
	 Infrastructure

Software
	  	System Software	  	Linux (Unix)	  	“Linux (Unix)” means a computing platform with a central processing unit that implements the instruction sets on various platforms designed to run UNIX and utilizing the Linux or compatible Operating
System.
				
	 Infrastructure

Software
	  	System Software	  	Linux (x86)	  	“Linux (x86)” means a computing platform with a central processing unit that implements the x86 instruction set and utilizing the Linux or compatible Operating System.
				
	 Infrastructure

Software
	  	System Software	  	MPE	  	“MPE” means the proprietary MPE Operating System produced by Hewlett Packard.
				
	 Infrastructure

Software
	  	System Software	  	NonStop O/S	  	“NonStop O/S” means the proprietary NonStop Operating System produced by Hewlett Packard.
				
	 Infrastructure

Software
	  	System Software	  	Operating System (O/S)	  	“Operating System” or “O/S” means software that is the main control program of a computer device and that manages communication between the hardware and other software, including
scheduling tasks, managing storage, and handling communication with peripherals.

  

					
	SOW #4 (IT) Exhibit A-1-2	  	A-1-2-12	  	Health Net / Cognizant Confidential

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EXHIBIT A-1-3 

[RESERVED] 

  

					
	SOW#4 (Information Technology) Exhibit A-1-3		 		Health Net / Cognizant Confidential

 Final 

 EXHIBIT A-1-4 

[RESERVED] 

  

					
	SOW#4 (Information Technology) Exhibit A-1-4		 		Health Net / Cognizant Confidential

 SOW 4 Ex A-1-5 

EXHIBIT A-1-5 
 HNFS
REQUIREMENTS 
 *** 
 [Represents 6
pages of material pursuant to a request for confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 Final 

 EXHIBIT A-3 

INFORMATION TECHNOLOGY 

SOLUTION DESCRIPTION 

  

					
	SOW#4 (Information Technology) Exhibit A-3		 		Health Net / Cognizant Confidential

 Final 

 EXHIBIT A-3 

INFORMATION TECHNOLOGY SOLUTION DESCRIPTION 
  

	1.	ATTACHMENTS 

 This Exhibit A-3 (Solution Description) is comprised of this cover
document and the following Exhibits: 
  

	 	•	 	Exhibit A-3-1 (Solution Description—ITO Phase I) 

  

	 	•	 	Exhibit A-3-2 (Solution Description—ITO Phase II) 

  

	 	•	 	Exhibit A-3-3 (Solution Description—BPaaS) 

  

	 	•	 	Exhibit A-3-4 (Solution Description—People/Process) 

  

	 	•	 	Exhibit A-3-5 [Reserved] 

  

	 	•	 	Exhibit A-3-6 (BPaaS Non-BPaaS Security Solution) 

  

					
	SOW#4 (Information Technology) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

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 EXHIBIT A-3-1 

SOLUTION DESCRIPTION - ITO PHASE I 
  

							
	1.		SCOPE DEFINITION		1
				
			1.1		IN-SCOPE SERVICES		1
				
			1.2		OUT-OF-SCOPE AND SCOPE EXCLUSIONS		8
			
	2.		SOLUTION DESCRIPTION		9
				
			2.1		COGNIZANT’S SOLUTION APPROACH AND STRATEGY		9
				
			2.2		FOUNDATION SERVICES		10
				
			2.3		SERVICE TOWERS		93
				
			2.4		SECURITY COMPLIANCE AND CONTROLS		151
			
	3.		APPENDIX		159
				
	3.1				APPENDIX I – TOOLS FUNCTIONALITY		159
				
	3.1.1				 INTRODUCTION
		159
				
	3.1.2				 OVERVIEW OF TOOLS FUNCTIONALITY
		159
				
	3.2				APPENDIX II – FILE SHARE AND PRINT SERVICES		166
				
	3.3				APPENDIX III – DESKSIDE SERVICES		221
				
	3.3.1				 DESKSIDE RESOURCE MOBILIZATION PLAN
		221
				
	3.3.2				 DESKSIDE LOCATIONS
		222
				
	3.4				APPENDIX VI – DATABASE SERVICES		227
				
	3.4.1				 MS SQL SERVER INVENTORY
		228
				
	3.4.2				 MYSQL SERVER INVENTORY
		231

  

					
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 Final 

 Addendum Summary 

This document have been updated as per the design changes in the Foundation services due to the Impact of BpaaS and ITO requirement 

 

					
	 Section
	  	 Use cases
	  	 Description

	1.1	  	 In-Scope
 Services
	  	 •       Updated Network , Server and Storage scope

			
	2.2.1	  	Datacenter	  	 •       Updated Network Hardware configuration details , Tape library details in Secondary
DC

			
	2.2.2	  	 Network and
 Links
	  	 •       Updated the entire section

			
	2.2.3	  	 Storage &
 Backup
	  	 •       Updated the Solution approach section Storage and backup architecture , connectivity
overview of VSP and HNAS

			
	2.2.4	  	Servers/VMs	  	 •       Updated the Solution Approach Section Server Reference architecture

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-ii	  	Health Net / Cognizant Confidential

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	1.	Scope Definition 

  

	1.1	In-Scope Services 

 Health Net has indicated the scope for the ITO program to include the
foundation services such as Datacenter, Servers/VM, Network and Links, Storage and Backup, and tools at Cognizant Data center and Service Towers such as VDI, File share and print, Deskside, Desktop engineering and Database. 

For detailed in-scope and out of scope Services, please refer to each Foundation and Service Towers scope definition below. 

Foundation Services 
  

			
	 Service Towers
	  	 Scope

	Data center	  	 •       Production Datacenter - Centennial Datacenter
(DC1) would have approximately 5msec latency from the incumbent Boulder Datacenter
  

•       Phoenix, AZ would be the Secondary datacenter (DC2)

 

•       Build Cage for Both Datacenters – type will be decided mutually
with Health Net physical security team
  

•       Robust Tier 3/4 datacenter facility that follows the TIA-942
standard
  

•       SSAE16 certified datacenter

 

•       Enough floor space for initial build to support up to 7500 Sq. ft. to
accommodate growth in DC1.
  

•       Both Datacenters have MPLS connection capability to HN, Health Net
Federal Services (HNFS), and Cognizant Technical Services (CTS)
  

•       DC1 to have P2P connection with Phoenix, AZ (DC2) and Boulder
DC
  

•       Cisco UCS manager will be used for the Datacenter management and
hardware for Cisco blades
  

•       Virtualization monitoring using HP OM VSPI (vSphere)

 

•       Database monitoring using HP OM DB SPI(SQL DC Monitoring related to
VDI)
  

•       Event Flow Integration with HP OMi (MOM)

 

•       Cloud 360 for Virtual management, performance, capacity, and have a
catalog for rapid provisioning

		
	 Service Towers
	  	 Scope

	Network and Links	  	 •       Architecture design for WAN, LAN, Security
(Firewall, IPS), DCI and Network Management
  

•       IP address design and allocation planning

 

•       ITIL process compliance

 

•       Network infrastructure build at Centennial (DC1) and Phoenix (DC2)
Datacenters
  

•       Installation and Configuration of Routers, Core/Access Switches,
Firewalls, IPS, Load balancers and WAN optimizers
  

•       Provisioning and integration of WAN
Links

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-1	  	Health Net / Cognizant Confidential

 Final 

			
		  	 •       Health Net Federal MPLS

 

•       Health Net Non-federal MPLS

 

•       Cognizant MPLS

 

•       P2P links between Centennial and Boulder Datacenters

 

•       P2P links between Centennial and Phoenix Datacenters

 

•       Core and access switch configuration for L3/L2 VLANS, VPC, VDC,
and failover
  

•       Firewall context creation, access rules definition

 

•       IPS filtering, policy configurations and failover configuration.

 

•       Integrate firewall and IPS logs to existing SIEM collector in Boulder
Datacenter
  

•       Load balancer context creation, VIP and failover configurations

 

•       Riverbed WAN optimization services for the Health Net sites as
supported by the remote sites
  

•       High level and low level design

 

•       Design documentation for all the network components.

 

•       Provisioning of Cognizant datacenter network devices, monitoring and
management
  

•       ITIL process compliance

 

•       Network administration services

 

•       Performance monitoring, management and optimization

 

•       IMAC, physical network environment services

 

•       Cabling and wiring services in both Datacenters

 

•       WAN circuit provisioning and administration

 

•       Reporting, analytics and documentation

 

•       Cisco Prime DCNM (Datacenter Network Management) tool

 

•       Cisco NAM tool

 

•       HP Network Node Manager and iSPI for Datacenter network monitoring
tool
  

•       Cisco Security manager tool for firewall monitoring and management

 

•       Riverbed ‘s management tool for monitoring and management

 

•       Load balancer management tool

 

•       HP Operation Manager (Manager of Manager—MOM), tool for event
management
  

•       Service Health Reporter – report overall monitoring of HPOM and
HPNNM

		
	 Service Towers
	  	 Scope

	 Storage and Backup
	  	 Storage
  

•       Build the storage infrastructure in both Datacenters

 

•       Have Data replication capability for Centennial, and Phoenix DC with
VSP and HNAS
  

•       SAN provisioning, monitoring and management for both storage
and

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-2	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Service Towers
	  	 Scope

		  	 backup
  

•       ITIL process compliance

 

•       Support for VSAN/partitioning, NPIV

 

•       Storage array and NAS provisioning, monitoring and management

 

•       Capability for HNAS replication between DC1 and DC2

 

•       Data at rest encryption

 

•       Design documentation for the storage environment

 

•       VSP for VDI and Server storage

 

•       HNAS controllers to manage VDI storage pool

 

•       HCP/HUS storage for File

 

•       Hitachi command suite tools:

 

•       Device manager

 

•       Tuning manager

 

•       Command Director

 

•       Tiered Storage manager

 

•       Dynamic provisioning

 
 Backup
  

•       Support encrypted backups for the following platforms:

 

•       Window, Linux, UNIX, physical and virtual host

 

•       Databases: Oracle, Microsoft SQL Server, MySQL, Rdb, DB2

 

•       NDMP backups of NAS storage

 

•       Backup policy and schedule creation, modification and management

 

•       ITIL process compliance

 

•       Backup monitoring, failure reporting and resolution

 

•       Capacity planning for the backup environment

 

•       Data recovery (ad-hoc and as part of a scheduled DR test)

 

•       Sepaton (Delta View) – monitoring of backup disc library

 

•       Spectra logic – monitoring of backup tape library

 

•       Symantec NetBackup

 

•       Design documentation for the Backup environment

		
	 Service Towers
	  	 Scope

	Server/VM	  	 •       Assets

 

•       Primary Datacenter: 106 Physical Blade servers, 2 Rack Servers

 

•       Secondary Datacenter: 11 Physical blade servers, 1 Rack Server

 

•       Remote Locations: 33 rack servers

 

•       OS licenses for Net-New Servers

 

•       Build services for Net-New servers in the primary and secondary
datacenters
  

•       ITIL process compliance

 

•       Run services

 

•       Server provisioning, monitoring and management for net new servers in
Cognizant Datacenters

  

					
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 Final 
  

			
		  	  

•       Performance and capacity management

 

•       Patching and upgrades management

 

•       Asset refresh and disposal

 

•       Support Non-Disruptive upgrades for UCS

 

•       Support vSphere replication for purpose of DR

 

•       Server provisioning, monitoring and management for new servers in
Datacenter and Health Net remote sites
  

•       Issue resolution

 

•       Security management

 

•       Audit and compliance reporting

 

•       Servers and VMs will be monitored using proposed HP Operations manager
solution and Cloud 360
  

•       Cisco UCS manager tool for hardware monitoring

 

•       HP OMW and VSphere SPI monitoring tools for Servers/VM

 

•       Microsoft OEM tool for image management

 

•       Manage Engine Asset Explorer for asset management

 

•       Cloud 360 will be used for managing the cloud environment

 

•       Service Catalog will be developed in Cloud 360, and will be modified
over time as Health Net needs changes
  

•       Performance Manager tool for OS data collection

 

•       Design documentation for the Server/VM environment

		
	 Service Towers
	  	 Scope

		
	Monitoring Tools	  	 •       Design, Implementation and steady state
support
  

•       HP Operation Manager Window (1 each for Federal and
Non-federal)-servers
  

•       Virtualization monitoring using HP OM VSPI (VSphere)

 

•       Database monitoring using HP OM DB SPI(SQL DC Monitoring related to
VDI)
  

•       Performance Manager tool

 

•       HP Network Node Manager and iSPI

 

•       Service Health Reporter for reporting overall monitoring HPOM and
HPNNM
  

•       HP Operation Manager (Manager of Manager – MOM)

 

•       Manage Engine Asset Explorer for asset management

 

•       Event Flow Integration with HP OMi (MOM)

 

•       HP OMW Federal and Non-federal

 

•       HP NNMi

 

•       Hitachi Tuning Manager

 

•       Sepaton (Delta View manager)

 

•       Spectra logic

 

•       Citrix EdgeSight

 

•       Cisco UCS manager

 

•       Cisco Prime DCNM (Datacenter Network Management)

 

•       Cloud 360

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-4	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Service Towers
	  	 Scope

		
		  	 •       Symantec NetBackup

 

•       Management software for IPS(Intrusion Prevention system)

 

•       Cisco security management tool

 

•       Leverage the exiting tools to support the Health Net hosted database
environment in boulder DC
  

•       Oracle enterprise manager cloud control 12c to monitor database

 

•       MS SQL IDERA and ITcam for SQL monitoring and management

 

•       Lite speed and SSMS tools for MS SQL backup

 

•       RMAN and TSM for Oracle databases

 

•       Oracle utility RMU based backup for Rdb

		
	 Service Towers
	  	 Scope

		
	VDI	  	 •       Citrix XenDesktop-7.5 with PVS

 

•       Planning, design, build and steady state support services for VDI

 

•       Initial build will be 5300 VDIs

 

•       Citrix XenApp 5 for legacy application

 

•       Design , Build and steady state support

 

•       Monitoring and management of VDIs

 

•       DR solution – 5% of 5300 VDI’s (200 Non-persistent and 60
Persistent) Performance Manager tool for VM data collection
  

•       Citrix EdgeSight for Citrix monitoring

 

•       SCCM for software distribution /patching

 

•       MS OEM tools for image management

 

•       Design documentation for VDI

		
	 Service Towers
	  	 Scope

		
	File Share and Print	  	 File share
  

•       Planning, design, build and steady state support

 

•       IMAC and physical environment services

 

•       Centralization of files including MS Access Databases

 

•       Host and support Image backup with both image and file restoration

 

•       Host and support file performance reports

 

•       Migrate about 75000 MS Access Database into the new File/Print
architecture
  

•       Migrate data from each of the remote sites into a local HDI
appliance
  

•       Antivirus scanning

 

•       Provide encryption at rest

 

•       High available design with DR incorporated to support tapeless
backups
  

•       Design documentation for File share

 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-5	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Service Towers
	  	 Scope

		
		  	 •       Utilize HCP/HUS/HDI infrastructure to support
File share
  

•       Hitachi command suite tools for monitoring and management

 

•       Hitachi File Systems Manager tool for HDI event management

 
 Print
  

•       Plan, design, build and steady state support

 

•       IMAC and physical environment services

 

•       Migrate about 941 printers / print queues in the existing
environment
  

•       Design documentation for print

 
 •    Print settings
needs to be retained
  

•       High availability for print servers

 

•       HP OMW tool for monitoring Print service (spooler) and servers

 

		
	 Service Towers
	  	 Scope

		
	Database	  	 •       Support and administration of database (Oracle,
MS SQL, MySQL and Rdb DB2) hosted in all Health Net’s environments
  

•       License compliance

 

•       ITIL process compliance

 

•       Security management

 

•       Patch management

 

•       Performance tuning and configuration management

 

•       Capacity Management

 

•       Maintain and Administration of ASM and its Disk-groups

 

•       Backup and recovery of the databases

 

•       Federal resources will be provided for HNFS activities

 

•       Database design and engineering services

 

•    Database/Instance—creation, validation, testing, support and upgrade

 

•       Database consulting services to the Application team

 

•       Performance Manager tool for Database data collection

 

•       Design documentation on Database

 

•       Leverage the exiting tools to support the Health Net hosted database
environment in boulder DC
  

•       Oracle enterprise manager cloud control 12c to monitor database

 

•       MS SQL IDERA and ITcam for SQL monitoring and management

 

•       Lite speed and SSMS tools for MS SQL backup

 

•       RMAN and TSM for Oracle databases

 

•       Oracle utility RMU based backup for Rdb

		
	 Service Towers
	  	 Scope

	 Desk side
	  	 •       Define services and standards for supporting the desktop/laptop and end user
capabilities

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-6	  	Health Net / Cognizant Confidential

 Final 

			
		
	 Service Towers
	  	 Scope

		
		  	 •       Support for desktop/laptop/Thin Client/VDI
standard configurations
  

•       Installations, removals, decommissions and break –fix of
desktops/laptop
  

•       ITIL process compliance Resources

 

•       Support services for Application Packaging, Software distribution,
Patch Deployment, Image Management
  

•       Resolution of issues connecting/printing or mapping to networked
printers on workstations
  

•       Assist remote access users with accessing a variety of applications at
various locations
  

•       Support and troubleshoot users in manual installation of approved
applications as requested
  

•       Design documentation on Desk side

 

•       Vendor co-ordination

 

•       Lease refresh program

 

•       MS OEM tools for image management

 

•       Flexera Admin Studio for Application packaging

 

•       SCCM 2012 tool for Software distribution/patching

 

•       Symantec Altiris for EUC ( desktop/laptop) asset lifecycle
management
  

•       Facilitating End User computing asset disposal

		
	 Service Towers
	  	 Scope

		
	Desktop Engineering	  	 •       Planning, design, build and Steady state support
of SCCM 2012 environment
  

•       Migration of SCCM 2007 to SCCM 2012

 

•       Perform assessment on SCCM 2007 environment

 

•       Integration of WSUS with SCCM 2012 for Microsoft updates and
synchronization for patching
  

•       Migrate Advertisements, Collections, Packages from SCCM 2007 to SCCM
2012
  

•       Roles and Policy configuration

 

•       Pre-Stage Distribution Points

 

•       Package Conversion and Steady State Support services for Application
packaging, testing, patch deployment and image management
  

•       Software distribution, Patch deployment and Image management for
Desktop , VDI and servers (printer servers and servers)
  

•       Define services and standards for supporting desktops/laptops

 

•       SCCM administration and support

 

•       HP OMW for monitoring availability of SCCM services and
servers

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-7	  	Health Net / Cognizant Confidential

 Final 

Note: Activities not explicitly called out as ‘In Scope’ is considered as out of scope 

Security Controls 
  

			
	 Service Towers
	  	 Scope

		
	 Security Management & Compliance
	  	 •       Training & Security Awareness Sessions for
all associates associated to the Health Net Account
  

•       Cognizant Security Trainings

 

•       Health Net Commercial - Security Trainings

 

•       Health Net Federal Services – Security Trainings

 

•       Defining, Adopting, Monitoring and Reporting all security controls
that relates to
  

•       Desktop , Laptop and VDI

 

•       Database

 

•       Network

 

•       Datacenter & Delivery Centers (Onsite & Offshore)

 

•       Physical Security

 

•       Logical Security

 

•       Servers (Windows & Unix)

 

•       Adopting, Monitoring and Reporting all SOX Compliance Controls

 

•       Supporting Vulnerability Assessment & Remediation’s

 

•       Supporting all Audit Requirements

 

•       Defining Password Vault Policy Services and/or Tools

 

•       Performing Required Security Patching for Operating Systems and COTS
products.

 Note: Detailed Security control design documents will be provided by Cognizant within 60 days of the start
date of transition 
  

	1.2	Out-of-Scope and Scope Exclusions 

 Note: Out of scope items listed are only scope
exclusions for ITO Phase 1. Scope Model document “Ex A-1” defines the Cognizant responsibility for Phase 2 and Phase 3. 
  

	 	•	 	Antivirus support 

 Antivirus file detection, quick patches, vulnerability scanning,
updates for Antivirus software 
  

	 	•	 	Network and Links 

 Implementation, configuration and documentation of network devices
including Riverbeds at Health Net Boulder datacenter and at any Health Net remote branch offices, except 11 locations under new implementation scope for Riverbed, along with Centennial and Phoenix Datacenters 

 

	 	•	 	Incumbent Datacenter services 

  

	 	•	 	Any implementation, configuration and documentation within the Boulder DC and Health Net remote branch offices. 

  

	 	•	 	No Internet connectivity service from Centennial DC and Phoenix DC 

  

	 	•	 	Database (hosted in Boulder DC) 

  

					
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	 	•	 	DB Hardware Provisioning and Support – Infrastructure management service like Server, Storage, backup support in Boulder DC 

  

	 	•	 	Server performance management 

  

	 	•	 	Server capacity management in Boulder DC 

  

	 	•	 	Tape procurement / Tape inventory / Tape management in Boulder DC 

  

	 	•	 	Desk-side Services 

  

	 	•	 	Mobile device management 

  

	 	•	 	End user Computing asset procurement 

  

	 	•	 	End user Computing asset disposal 

  

	 	•	 	McAfee ePO-Antivirus, Encryption, HIPS, DLP Policy update and management 

  

	 	•	 	Desktop engineering 

  

	 	•	 	Support and Management of non-windows devices or windows workstations not part of the Health Net domain 

  

	 	•	 	Server/VM 

  

	 	•	 	vCenter Operations Manager for detailed Virtualization management with the use of Cloud 360Asset 

  

	 	•	 	Software licenses for MS SQL, VDI, Desktop OS Windows 7, Citrix Xen Desktop, Desktop engineering SCCM 2012, VMware enterprise plus, etc. (Licenses will be provided by Health Net) 

 

	 	•	 	All infrastructure assets and licensing will be a cost to Health Net 

  

	 	•	 	Procurement of laptop/desktop/printers/telephones/fax 

  

	 	•	 	Third Party Services 

  

	 	•	 	Offsite Storage of Tapes is not part of the scope. Cognizant will piggy back on existing Health Net’s contract and agreement across both data centers 

 

	2.	Solution Description 

  

	2.1	Cognizant’s solution approach and strategy 

 Cognizant’s services model is
based on the following: 
  

	 	•	 	Leveraging understandings and learning from the ongoing AO services 

  

	 	•	 	Cognizant will provide the monitoring tools defined as part of in-scope 

  

	 	•	 	Right shoring of services to meet Federal and Non-federal requirement 

  

	 	•	 	Cognizant will follow the ITIL v3 processes on end to end ownership of tickets – Periodic, consistent and clear proactive client communications until tickets are closed. 

 

	 	•	 	Cognizant will use the following security practices and processes for Onsite, offshore and on-call support: 

  

	 	•	 	All of the Cognizant resources working offshore will not be provided access to the Cognizant’s customer environments 

  

	 	•	 	As we follow in AO and BPO contracts, all ITO resources that are supporting Health Net will be working out of Health Net approved Offshore Delivery Center (ODC) locations, in a clean room 

 

	 	•	 	All ODCs that are used to support Health Net are audited for Physical security and they undergo Cognizant internal auditing and also go through SSAE 16 audits. 

  

					
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	 	•	 	Onsite Resource Access: All of the onsite resources will access Health Net Environment through Health Net approved devices 

  

	 	•	 	All Cognizant devices are secured by McAfee toolsets for Encryption and for Email/Web access restrictions 

  

	 	•	 	Employee Termination: As per process establish in the account, we submit ISR to delete CID the day associate leave if it is immediate relieving or if it is planned release we submit ISR ahead of time to ensure
successful deletion of the Cognizant resource’s CID 

  

	 	•	 	Under the new agreement Cognizant team will be providing support in managing remediation and incident responses that are required to address any security incident. Security Solution documentation will cover the team
structure along with the roles and responsibilities 

  

	 	•	 	Cognizant will be working with Health Net to define the Security Vault Requirements and such security requirement solution will be implemented within Health Net Environment and at no time will be implemented within
Cognizant Environment. Our resource model for this engagement is dedicated for Health Net, hence our resource will first access the Cognizant/Health Net environment and they will be having access to Password Vault Services. To define the process and
toolset for this, Cognizant team will understand existing policy and procedure from Health Net and/or IBM and will work with Health Net to develop solution and with proper controls that meets SOX compliance and any other compliance needs.

 Cognizant’s engagement partnership will comprise of the following three major pillars: 

 
 

 
  

	2.2	Foundation Services 

 The Foundation services are the core services which include the
complete Greenfield set-up of the Datacenters. Cognizant proposes to build the primary Datacenter at Centennial while the secondary Datacenter will be at Phoenix. 

  

					
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	2.2.1	Datacenter 

 2.2.1.1 Highlights of scope validation workshop 

The table below highlights the scope outlined after the scope validation workshop 

 

					
	 Description
	  	 Pre scope validation workshop
	  	 Post scope validation workshop

			
	Design Considerat ions	  	 •       DC1—96 Cisco UCS (Unified Computing Systems)
manager Blades
  

•       DC2—19 Cisco UCS (Unified Computing Systems) manager Blades

 
	  	 •       DC1 - 106 Cisco UCS (Unified Computing Systems)
manager Blades
  

•       DC2 - 11 Cisco UCS (Unified Computing Systems) manager
Blades

	  	 •       DC1 12 chassis for blade servers, 2 network racks, 2
cable, 4 storage and 2 for tape, 1 for Sepaton
  

•       DC2 2 chassis for blade servers, 2 network racks, 2 storage, 1 for
tape, 1 cable , 1 for Sepaton
	  	 •       DC1-14 chassis for blade servers, 2 network racks, 2
HNAS/HDI, 2 cable, 4 storage and 2 tape, 1 for Sepaton, and built in space for expansion
  

•       DC2 - 2 chassis (1 Rack) for blade servers, 2 network racks, 2 storage
and 1 for tape, 1 for Sepaton, 1 HNAS/HDI, 1 cable, and built in space for expansion

	  		  	
	  	 •       42 Cisco C220 rack servers
	  	 •       36 Cisco C220 rack servers

	  		  	
	  	 •       400 Sq. ft. space in the Datacenter
	  	 •       600 to 700 Sq. ft. space in the Datacenter, to
include reserve space for future expansion of devices like Hitachi VSP Storage and of blade servers.
  

	  	 •       Solution had HUR for Storage replication, and SRM
	  	 •       HUR capable added Sepaton replication license. Will
have HNAS and vSphere replication if needed, will determine during the detail design.
  

	  	 •       No reserved space for expansion
	  	 •       Created reserved space for Sepaton, VSP, and spectra logic for expansion

 2.2.1.2 Solution Approach 

Cognizant will setup two datacenters to meet Health Net’s initiatives. For the Primary Datacenter (DC1), Cognizant will use our Partner
Latisys to deliver the DC1 facility. For the Secondary Datacenter (DC2), Cognizant will utilize space in its Datacenter in Phoenix (Cyrus One facility). 

Primary Datacenter (DC1)—Centennial DC 

DC1 will be located in Centennial at the Latisys facility. This facility has an estimated space of 600 to 700 Sq. ft. This section provides
infrastructure details for DC1 facility. 
 Blade Servers: 
  

			
	 Blade Server Model
	  	 Hardware Configuration

	5108 chassis (x 14)	  	 •       Per Chassis (H x W X D) – 6RU: 10.5 x 17.5 x
32
Power (Per Chassis) - 4 2500 W capacity, 200v -240v, 50 to 60 HZ single-phase
  

	6296 Cisco Switch (x 2)	  	 •       (H X W x D) – 3.44 x 17.3 x29.5

 

•       Power – 750 W

  

					
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The diagram below depicts the rack details for the following UCS blade: 

 

	 	•	 	VDI will have 11 Chassis (3 slots open, and space for another chassis) 

  

	 	•	 	Cloud will have 2 chassis (No open slots, but space for another chassis) 

  

	 	•	 	*Management will use 1 Chassis (4 open slots) 

  

	*Note	- With the flexibility of the Cisco Chassis we can utilize all the slots to accommodate different workloads. (E.g. The 4 open slots in the management chassis could be used for Cloud or VDI if needed. For the open
rack space, the same rule applies but it will be dependent on DC review to make sure we have enough power and the rack can support more weight.) 

  

 
 Figure: Centennial DC 

Rack Components 
  

			
	 Rack Server Model
	  	 Hardware Configuration

	Cisco C220 (x2)	  	 •       (H x W x D) - 1RU: 1.7 x 16.9 x 28.5 in. (4.32 x
43 x 72.4 cm)
  

•       Power – 90 to 264 VAC self-ranging, 100 to 120 VAC nominal and
200 to 240 VAC nominal
  

•       AC input frequency Range: 47 to 63 Hz (single phase, 50 to 60 Hz
nominal)
  

•       Maximum AC input current 6.0 A peak at 100 VAC 3.0 A peak at 208
VAC
  

•       Maximum AC inrush current 11 A

 

•       Maximum output power for each power supply 450 W

 Server - Rack mounted 

The diagram below depicts Network connectivity for the rack server 

  

					
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 Figure: Network Connectivity 

Storage Hitachi VSP/HCP: 
  

			
	 Model
	  	 Hardware Configuration

	 Hitachi VSP
	  	 •       VSP 4 19” racks , will need space on both
the left and right side
  

•       (H x W x D)- 78.9 x 24 x 43.3 (x4, plus 1 space to left and right)

 

•       Power – Each rack requires 4 L6-30 connections 208V for a total
of 16

		
	 HCP/HUS150
	  	 •       HCP 1 19” rack, will need open space to
right for expansion
  

•       (H x W x D)- Universal Rack 600x1200x2010 mm (WxDxH) 42U

 

•       Power - PDU 0RU 22xC13 1Phase 208V 30A NEMA L6- 30P (x4)

  
 

 
 Figure: Hitachi VSP/HCP 

  

					
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Hitachi Storage (HCP) Storage Sepaton: 
  

			
	 Model
	  	 Hardware Configuration

	Sepaton	  	 •       1 rack , standard 19” rack will need 1 space
for expansion
  

•       (W x D) – 24 x 40

 

•       Power - 120/208 VAC - 3 phase, 30A/phase (3P+PE)

  
 

 
 Figure: Storage Sepaton 

Storage Spectra Logic: Hardware Configuration 
 Consists
of a base and an extended rack, not traditional size, will need up to 6 free spaces to the right (facing the product) for future growth 
  

	 	•	 	(W x D) – 29 x 43.25, see page 19 of the document below for details (not standard size) 

  

	 	•	 	Power—NEMA L6-20P, male or NEMA L6-30P, male IEC 60320-C19, female 

  

 
 Figure: Spectra Logic 

  

					
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Storage HNAS/NetBackup/HDI Configuration Details: 2 racks 
  

			
	 Model
	  	 Hardware Configuration

	HNAS (x2), 4080	  	 •       (H x W x D) – 3U:5.1 x 19 x 32.2

 

•       Power - requires 2 110 Power connections Management Switch requires 2
110V

		
	HDI (x4 two sets of 2)	  	 •       Per cluster (H x W x D) - 2U: 3.3 x 19 x 30.3

 

•       Per cluster Power - requires 4 110 Power connections

		
	NetBackup (4 boxes 3- Non-federal , 1 - Federal)	  	 •       Each appliance (W x D) – 2U:17.3 x 27

 

•       Power - 100 to 127, 200 to 240, Amps: 7 (100V to 127V), 3.5 (200V to
240V) L6 -30P

 Network 
 This section
provides configuration details for all the network devices used in the Centennial DC. 
  

			
	 Model
	  	 Hardware Configuration

	 Nexus 5596
	  	 •       (H x W x D) – 2U: 3.47 x 17.3 x 29.5 in

 

•       Power - 100 to 240 VAC and operating power 970 W

		
	 ASR 1004
	  	 •       (H x W x D) – 4U: 7x17.2x18.2 in

 

•       Power - 120 to 240V and operating power 960 W

		
	 ASA 5585
	  	 •       (H x W x D) – 2U: 3.5 x 19 x 26.5 in.

 

•       Power - 120 to 240V, Amps: 12A and operating power 800 W

		
	 F5 5200V
	  	 •       (H x W x D) – 1U:1.75 x 17 x 21 in.

 

•       Power – single supply 120 V and operating power 400
W

		
	 Riverbed 7055
	  	 •       (H x W x D) – 2U:3.43 x 17.2 x 25.4 in.

 

•       Power – dual power supply and operating power 420 W

		
	 McAfee IPS
	  	 •       (H x W x D) – 2U:3.5 x 16.75 x 30 in.

 

•       Power – dual power supply and operating power 450 W

		
	 Nexus 2232
	  	 •       (H x W x D) – 1RU: 1.72 x 17.3 x 17.7
in.
  

•       Power – input operating 270W and output power 400W

		
	 Avocent 6048 console server
	  	 •       (H x W x D) – 1RU : 1.75 x 17.250 x 9.5
in.
  

•       Power – 110 to 240VAC

		
	 ASR 1006
	  	 •       (H x W x D) – 6RU : 10.5 x 17.2 x 18.15
in.
  

•       Power – 110 to 240VAC and operating power 1700W

		
	 NAM2320
	  	 •       (H x W x D) – 2RU : 3.4 x 17.5 x 28.0
in.
  

•       Power – 650 W

		
	 Nexus 7710
	  	 •       (H x W x D) – 14RU: 24.35 x 17.3 x 34
in.
  

•       Power: 110 to 240 VAC and operating power 3-kW

		
	 Cisco 4506-E
	  	 •       (H x W x D) – 10RU: 17.38 x 17.31 x 12.50
in.
  

•       Dual Power -2000 W

		
	 MDS 9513
	  	 •       (H x W x D) - 14RU: 24.5 x 17.37 x 28.0 in.

 

•       Power – 100 to 240VAC , 3.6KW

		
	 MDS 9250i
	  	 •       (H x W x D) - 2RU: 3.84 x 17.22 x 21.4 in.

 

•       Power – 100 to 240VAC , power supply 300W

  

					
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	 Model
	  	 Hardware Configuration

	Riverbed 1555	  	 •       (H x W x D) – 1U: 1.71 x 17.2 x 25.4 in.

 

•       Power – dual power supply and operating power 175 W

 The diagram below depicts the network components in the rack 

 
 

 
 Figure: Updated Rack Details of Network Components 

Overall Layout DC1: 
 This section describes datacenter
floor layout. The space is broken into functional areas consisting of Core Network, Network services, Tape Library, SAN Storage, UCS blade compute and management / SCCM compute. The initial build-out will include the Core Network, Network Services
and a mix of standard compute, Standalone, SAN Storage and tape library functional areas. The remaining space will be reserved for future growth and developed as required. 
  

	 	•	 	Core Network: Contains the core routers, WAN edge, carrier devices, network fibre backbone and network copper cabling infrastructure, etc. 

 

	 	•	 	Network Services: Contains the SAN Switches, and SAN fibre cabling infrastructure 

  

	 	•	 	Tape Library: Contains Automated Tape Library units 

  

	 	•	 	SAN Storage: Contains Storage Arrays (HNAS, SAN), Sepaton , HCP/HDI 

  

	 	•	 	Standard / standalone Compute: Contains standard servers (blades and rack) 

  

					
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	 	•	 	Cage: Physical Cage around racks is as per standard recommended by Industrial security team 

  

	 	•	 	Raise floor to the ceiling cage or standard wall height with cap on top of the cage. As per the Centennial DC setup, there are motion sensors below the raised floor 

 

	 	•	 	Enable security control at cage level instead of rack level 

  

	 	•	 	Security will consist of cameras, notification setup at cage door when someone opens the door. This is the standard recommendation by the industrial security team being used in Health Net MRI rooms. 

 

	 	•	 	Power requirement : 

  

									
	Centennial DC - 700 Sq. ft.	 
			
	 Racks
	  	Power/Rack (Kw)	 	  	Total Power (Kw)	 
	 19
	  	 	8.72	  	  	 	165.7	  

 The following figure depicts DC1 – Rack layout 
  

 
 Figure: Rack Layout-DC1 

Secondary Datacenter (DC2) – Phoenix DC Server Blades: 
  

			
	 Model
	  	 Hardware Configuration

	Cisco - 5108 chassis (x 2)	  	 •       Per Chassis (H x W X D) – 6RU: 10.5 x 17.5 x
32
  

•       Power (Per Chassis) - Four 2500 W output, 200v -240, 50 to 60 HZ
single-phase

		
	6296 Cisco Switch (x 2)	  	 •       (H X W x D) – 3.44 x 17.3 x29.5

 

•       Power – 750 W

  

					
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 Figure: Blade View 

Rack mounted Server Configuration 
  

			
	 Model
	  	 Hardware Configuration

	Cisco C220 (x1)	  	 •       (H x W x D) - 1RU: 1.7 x 16.9 x 28.5 in. (4.32 x
43 x 72.4 cm)
  

•       Power – 90 to 264 VAC self-ranging, 100 to 120 VAC nominal and
200 to 240 VAC nominal
  

•       AC input frequency Range: 47 to 63 Hz (single phase, 50 to 60 Hz
nominal)
  

•       Maximum AC input current 6.0 A peak at 100 VAC 3.0 A peak at 208
VAC
  

•       Maximum AC inrush current 11 A

 

•       Maximum output power for each power supply 450 W

 The diagram below depicts the network connectivity of Rack server 

  

					
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 Figure: Network Connectivity for Rack Server in DC2 

Storage VSP/HCP: 
  

			
	 Model
	  	 Hardware Configuration

	Hitachi VSP	  	 •       VSP 3 19” racks , will need space on both
the left and right side
  

•       (H x W x D)- 78.9 x 24 x 43.3 (x4, plus 1 space to left and right)

 

•       Power – Each rack requires 4 L6-30 connections 208V for a total
of 16

		
	HCP/HUS150	  	 •       HCP 1 19” rack, will need open space to
right for expansion
  

•       (H x W x D)- Minkels Universal Rack 600x1200x2010 mm (WxDxH) 42U

 

•       Power - PDU 0RU 22xC13 1Phase 208V 30A NEMA L6-30P (x4)

  
 

 
 Figure: Hitachi Storage (HCP) 

Storage Sepaton: 
  

			
	 Model
	  	 Hardware Configuration

	Sepaton	  	 •       1 rack, standard 19” rack will need 1 space
for expansion
  

•       (W x D) – 24 x 40

Power - 120/208 VAC—3 phase, 30A/phase (3P+PE)

  

					
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 Figure: Storage Sepaton 

Storage Spectra Logic T950: 
  

			
	 Model
	  	 Hardware Configuration

	Spectra Logic T950	  	 •       Consists of a base and an extended rack, not
traditional size, will need up to 6 free spaces to the right (facing the product) for future growth
  

•       (W x D) – 29 x 43.25, see page 19 of the below document for
details
  

•       Power - NEMA L6-20P, male or NEMA L6-30P, male IEC 60320-C19,
female

  
 

 
 Figure: Spectra Logic Storage Device 

Storage HNAS/NetBackup/HDI: 
  

			
	 Model
	  	 Hardware Configuration

	HNAS (x2), 4060	  	 •       (H x W x D) – 3U:5.1 x 19 x 32.2

 

•       Power - requires 2 110 Power connections management

  

					
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	 Model
	  	 Hardware Configuration

		  	 switch requires 2 110V

		
	HDI (single HDI)	  	 •       (H x W x D) - 2U: 3.3 x 19 x 30.3

 

•       Power - requires 2 110 power connections

		
	NetBackup (3 boxes, 2 - Non-federal and 1 - federal)	  	 •       Each appliance (W x D) – 2U:17.3 x 27

 

•       Power - 100 to 127, 200 to 240, Amps: 7 (100V to 127V), 3.5 (200V to
240V) L6 -30P

 Network Environment 
  

			
	 Model
	  	 Hardware Configuration

	Nexus 5596	  	 •       (H x W x D) – 2U: 3.47 x 17.3 x 29.5
in
  

•       Power—100 to 240 VAC and operating power 970
W

		
	ASR 1004	  	 •       (H x W x D) – 4U: 7x17.2x18.2 in

 

•       Power—120 to 240V and operating power 960 W

		
	ASA 5585	  	 •       (H x W x D) – 2U: 3.5 x 19 x 26.5
in.
  

•       Power—120 to 240V, Amps: 12A and operating power 800
W

		
	F5 5200V	  	 •       (H x W x D) – 1U:1.75 x 17 x 21
in.
  

•       Power – single supply 120 V and operating power 400
W

		
	Riverbed 7055	  	 •       (H x W x D) – 2U:3.43 x 17.2 x 25.4
in.
  

•       Power – dual power supply and operating power 420
W

		
	McAfee IPS	  	 •       (H x W x D) –2U:3.5 x 16.75 x 30
in.
  

•       Power – dual power supply and operating power 450
W

		
	Nexus 2232	  	 •       (H x W x D) – 1RU: 1.72 x 17.3 x 17.7
in.
  

•       Power – input operating 270W and output power
400W

		
	Avocent 6048 console server	  	 •       (H x W x D) – 1RU : 1.75 x 17.250 x 9.5
in.
  

•       Power – 110 to 240VAC

		
	ASR 1006	  	 •       (H x W x D) – 6RU : 10.5 x 17.2 x 18.15
in.
  

•       Power – 110 to 240VAC and operating power
1700W

		
	NAM2320	  	 •       (H x W x D) – 2RU : 3.4 x 17.5 x 28.0
in.
  

•       Power – 650 W

		
	Nexus 7710	  	 •       (H x W x D) – 14RU: 24.35 x 17.3 x 34
in.
  

•       Power: 110 to 240 VAC and operating power 3-kW

		
	Cisco 4506-E	  	 •       (H x W x D) – 10RU: 17.38 x 17.31 x 12.50
in.
  

•       Dual Power -2000 W

		
	MDS 9513	  	 •       (H x W x D)—14RU: 24.5 x 17.37 x 28.0
in.
  

•       Power – 100 to 240VAC , 3.6KW

		
	MDS 9250i	  	 •       (H x W x D)—2RU: 3.84 x 17.22 x 21.4
in.
  

•       Power – 100 to 240VAC , power supply 300W

		
	Riverbed 1555	  	 •       (H x W x D) – 1U: 1.71 x 17.2 x 25.4
in.
  

•       Power – dual power supply and operating power 175
W

 The diagram below depicts the network components in the rack 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-21	  	Health Net / Cognizant Confidential

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 Figure: Rack Details of Network Components in DC2 

DC2 - Overall layout 
 This section describes data center
floor layout. The space is broken into functional areas consisting of Core network, Network services, Tape library, SAN Storage, UCS compute blade, management and SCCM Compute. The initial build-out will include the Core network, Network services
and a mix of standard compute, Standalone SAN Storage, and Tape library functional areas. The remaining space will be reserved for future growth and developed as required. 
  

	 	•	 	Core network: Contains the core routers, WAN edge, carrier devices, network Fiber backbone and network copper cabling infrastructure etc. 

 

	 	•	 	Network services: Contains the SAN Switches, and SAN Fiber cabling infrastructure 

  

	 	•	 	Tape library: Contains Automated Tape Library units 

  

	 	•	 	SAN Storage: Contains Storage Arrays (HNAS, SAN), Sepaton , HCP/HDI 

  

	 	•	 	Standard / Standalone compute: Contains standard servers (blades and rack) 

  

	 	•	 	Cage: Physical Cage around racks is as per standard recommended by Industrial security team. 

  

	 	•	 	Raise floor to ceiling Cage OR standard wall with cap on top of cage to cover from top. As per Centennial DC setup, there are motion sensors below the floor 

 

	 	•	 	Enable security control at cage level instead at rack level 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-22		Health Net / Cognizant Confidential

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	 	•	 	Security will consist of cameras, notification setup at cage door when someone opens the door. This is the standard recommendation by Industrial security team being used in Health Net MRI(Machine Room Instrument) rooms

  

	 	•	 	Power requirement : 

  

									
	Phoenix DC - 500 Sq. ft.	 
			
	 Racks
	  	Power/Rack(KW)	 	  	Total Power (Kw)	 
	 9
	  	 	3.51	  	  	 	31.6	  

 The following figure depicts the DC2 Rack layout 

 
 

 
 Figure: Rack Layout – DC2 

Boulder DC 
 Proposed Cognizant DCs will have redundant 10
Gig Point to Point link towards the incumbent HN DC 2x Nexus 7004 is considered at Boulder to ensure 10 Gig link termination and encryptions services. 
  

			
	 Model
	  	 Hardware Configuration

	Nexus 7004	  	 •       (H x W x D) – 7U : 12.2 x 17.4 x 24.5 in

 

•       Power - 110 to 240 VAC and operating power 3KW

 2.2.1.3 Service deliverables 

VMware infrastructure build 
  

	 	•	 	Build VMware infrastructure for Federal and Non-federal as per design 

  

	 	•	 	Testing Federal and Non-federal to logically separate access restriction 

  

	 	•	 	VMware functionality testing for vMotion, High Availability, VCenter heartbeat, etc. 

 Storage and Backup
infrastructure build 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-23	  	Health Net / Cognizant Confidential

 Final 
  

 

	 	•	 	Build the Storage and backup infrastructure for Federal and Non-federal as per design 

  

	 	•	 	Testing federal and non-federal to logically separate access restriction 

  

	 	•	 	Testing Storage replication across DC for HCP, Zoning, performance and monitoring components 

 Network build
and link Connectivity 
  

	 	•	 	Build the Network infrastructure at DC1 and DC2 as per design 

  

	 	•	 	Testing connectivity over redundant MPLS at Centennial and Single MPLS at Phoenix for Non-federal and Cognizant WAN. 

  

	 	•	 	Testing connectivity over GET-VPN for Federal MPLS at Centennial and Phoenix DC 

  

	 	•	 	Testing connectivity over Redundant P2P Links between Centennial-Boulder and Centennial- Phoenix with encryption over all the P2P links 

 

	 	•	 	Testing Routing reachability between Centennial DC LAN and Boulder DC LAN (server Segment) 

  

	 	•	 	Testing Routing reachability between Centennial DC LAN and Remote Location LAN 

  

	 	•	 	Testing Logical Separation of Federal and non-federal traffic on DC firewall 

  

	 	•	 	Testing firewall filters at Centennial DC, to permit legitimate traffic in-out of Centennial DC over P2P and MPLS Links 

  

	 	•	 	Testing WAN traffic optimization between Centennial DC and remote locations with Riverbed Appliance, for VDI and File/Print traffic 

Info Sec team to validate the hardening of network and security equipment implemented at Centennial and Phoenix 

2.2.1.4 Steady State Support - Deliverables 
 The key
highlights of the proposed solution for the datacenter service towers are described below: 
  

			
	 Solution
	  	 Description

		
	Solution Highlights	  	 •       A dedicated onsite / offshore delivery team performing all in-scope
activities

		
	Support Coverage	  	 •       24x7 dedicated support – Offshore/Onsite
(Non-federal) with on call
  

•       24X7 Onshore support

 

•       8x5 dedicated support – Onsite (Federal) with the rest on
call

		
	Delivery Location	  	 •       Onsite - Health Net Offices

 

•       Offshore – Bangalore ; Coimbatore

		
	  
 DC operation Services
	  	
		
	Support Team	  	 •       24x7 Surveillance of DC room / Infrastructure component

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-24	  	Health Net / Cognizant Confidential

 Final 
  

			
		  	 •    Coordination and tracking of all Datacenter service visits

		
		  	 •    Visual / Physical site inspecting / floor walk in the Datacenter

		
		  	 •    Backup Tape handling - Loading / Unload tape in Tape library

		
		  	 •    Monitor Power / Cooling / Datacenter cleaning

		
		  	 •    Basic observation and reporting on the environment in the Datacenter

		
		  	 •    Develop an annual preventive maintenance schedule

		
		  	 •    Route maintenance of critical infrastructure (UPS and Battery Systems, Power Distribution, Chillers,
Generators, etc.)

 2.2.1.5 Assumptions 
 The
below assumptions have been considered for Datacenter Services. 
 2.2.1.6 Dependency on Health Net 

The below dependencies have been considered for Datacenter services. 
  

	 	•	 	Testing connectivity between DC1 and the incumbent DC 

  

	 	•	 	Dual 10 Gig link termination and service integration with the incumbent DC 

  

	 	•	 	Testing MPLS connectivity/performance between DC and Remote sites Decision on cage type will be determined before DC build out 

2.2.1.7 Risk and Mitigations 
  

									
	 S. No
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	1	  	Support of Key SME’s from incumbent during Implementation	  	High	  	Medium	  	 Involve Health Net to
 facilitate and govern the
Implementation, requiring integration with Boulder DC

					
	2	  	WAN network latency is within the 5 m sec response time between DC1 and the incumbent DC and Performance	  	Low	  	 Low, but
 high for future growth
	  	 Will take a holistic approach
 to mitigate
latency issues by equally looking at the interface layer, Network layer, Transaction layer, and the application layer. For each of these layers we use specific techniques to optimize performance and latency (e.g. for network layer we could do TCP
optimization or QoS policy)

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-25	  	Health Net / Cognizant Confidential

 Final 
  

 2.2.2 Network and Links 

2.2.2.1 ITO Phase 1Modified Scope 
 The table below
highlights the scope outlined after the scope validation workshop: 
  

					
	 Description
	  	 ITO Phase 1
	  	 ITO Phase 1Modified

	Architecture	  	 •    Layer architecture -Access and Core layer
	  	 •    Modular Layer architecture with dedicated Core, Aggregation and Access

			
	 Core and
 Aggregation
	  	 •    2*N5596 at Access and 2*N7004 at Core layer at Centennial DC.

 
 •    2*N5596 at Access
and 2*N7004
	  	 •    2*N5596 at Access and 2*N7710 with VDC support for at Core, Aggregation, WAN Edge and DCI
Edge

			
	Server Farm	  	 •    Cisco UCS manager chassis to connect to the Nexus 5596 with dual 10G
coming through 6296 Fabric interconnect A and B
  

•    Cisco FEX Nexus 2232 for connecting the C-Series Servers

 
 •    F5 Load Balancers
with 2 x virtual context for federal and Non-federal for respective server application load balancing
	  	 •    Cisco UCS manager chassis to connect to the Nexus 5596, UCS Chassis
connects to 6296 Fabric interconnect using dual 10 Gig links
  

•    Cisco FEX Nexus 2232 for connecting the 1 Gig port requirement s

 
 •    F5 Load Balancers
with 2 x virtual context for federal and Non-federal for respective server application load balancing

			
	 Storage Area
 Network
	  	 •    FCoE from UCS Chassis to the Fabric Interconnect (2x FI 6296)

 
 •    FCoE from the FI to
the Nexus 5Ks
	  	 •    FCoE from UCS Chassis to the Fabric Interconnect (2x FI 6296)

 
 •    Dedicated 2x MDS
9513 for SAN
  

•    Dedicated 2x Cisco 9250i for FCIP Replication

 
 •    HBA Interfaces for
the Physical Servers

			
	Services	  	 •    All the network devices Routers, Firewall, IPS, WAN optimizer, L/B
connect to N7004 core switches in both Centennial and Phoenix DCs
  

•    All the UCS Servers, storage (VSP), HNAS (4x10GB only per HNAS) connect to N5596 Access
Switch, while at Centennial the above listed devices connect to N5596 Access Switch.
	  	 •    All the network devices Routers, Firewall, IPS, WAN optimizer, L/B
connect to the respective VDCs on the N7710
  

•    All the HNAS and NetAPP connect to the
N7710

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-26	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Description
	  	 ITO Phase 1
	  	 ITO Phase 1Modified

	Security	  	 •    ASA 5585 SSP 20 with dedicated Security Contexts for providing
Firewall Security
  

•    McAfee 6050 IPS for WAN traffic inspection

 
 •    Logical Separation
of Federal and Non Federal Traffic
	  	 •    ASA 5585 SSP 40 with dedicated Security Contexts for providing
Firewall Security
  

•    McAfee 6050 IPS for WAN traffic inspection

 
 •    Logical Separation
of Federal and Non Federal Traffic
  

•    Cisco ACS for Authentication

			
	WAN MPLS	  	 •    Shared2x ASR 1004 for WAN MPLS

 
 •    Centennial -
Redundant WAN link from ATT providing MPLS Services for Health Net Non- federal, Federal and Cognizant.
  

•    Phoenix - Single MPLS link from ATT for Federal, non-Federal and Cognizant links

 
 •    Existing GET VPN
encryption service from ATT is considered for Federal MPLS
  

•    Redundant McAfee IPS Required for WAN traffic.

 
 •    Riverbed required
for Federal and Non-federal MPLS Traffic Optimization
  

•    Additional 11 Remote Locations require Riverbed Steelhead appliances
	  	 •    Dedicated 2x ASR 1004 for WAN MPLS

 
 •    Centennial -
Redundant WAN link from ATT providing MPLS Services for Health Net Non-federal, Federal and Cognizant.
  

•    Phoenix—Single MPLS link from ATT for Federal, non-Federal and Cognizant links

 
 •    Existing GET VPN
encryption service from ATT is considered for Federal MPLS
  

•    Redundant McAfee IPS Required for WAN traffic.

 
 •    Riverbed required
for Federal and Non-federal MPLS Traffic Optimization
  

•    Additional 11 Remote Locations require Riverbed Steelhead appliances

			
	 Data Center
 Interconnect
	  	 •    Shared ASR 1004 for DCI Link

 
 •    2 x 1Gig Link for
Centennial to Boulder, terminated on the ASR with IPsec Encryption
  

•    2 x 1Gig Link for Centennial to Phoenix, terminated on the ASR with IPsec
Encryption
	  	 •    Dedicated Nexus 7k VDC and 2x ASR 1006 for the DCI Edge

 
 •    2x Nexus 7004 at
Boulder
  
 •    2 x 10
Gig Link for Centennial to Boulder, terminated on the N7k VDC with MACSec Encryption
  

•    2 x 10 Gig Link for Centennial to Phoenix, terminated on the ASR with IPsec
Encryption
  

•    Design to minimize the latency. No Riverbed, Firewall or IPS for the DCI

			
	 Monitoring and
 Management
	  	 •    2x 3750 for Out of Band Management

 
 •    2x Avocent ACS 6032
with Modem
  

•    Cisco Prime Infrastructure

 
 •    HP NNMi
	  	 •    2 x 4506 for Out of Band Management

 
 •    2x Avocent ACS 6048
with Modem
  

•    Cisco Prime Infrastructure

 
 •    HP NNMi

 
 •    Cisco NAM 2320

 

		  		  	 •    Riverbed CMC

 
 •    F5 Enterprise
Manager

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-27	  	Health Net / Cognizant Confidential

 Final 
  

 2.2.2.2 Solution Approach 

Network infrastructure will be built at Centennial and Phoenix Datacenters to host about 5300 VDI client infrastructure, File and print solution and Virtual
machines for future use. Centennial is the preferred choice for the primary Datacenter due to the requirement for a high speed connection with the incumbent DC, (i.e. Boulder DC over 2 x 10G fiber redundant links to achieve latency less than 5ms for
any application and database access from Centennial VDI environment to Boulder DC). Phoenix DC is the proposed DR site for critical VDI users hosted at Centennial DC, for now it is expected to host about (200 

Non-persistent and 60 persistent) VDI users (about 5% of total build) in cold standby mode. 2x10 Gig redundant link considered between Centennial and Phoenix
with less than 60 ms link level latency. 
 All network components shared between HNFS and Health Net Non-federal with transiting Federal data would be
managed by onsite Federal network support team. 
 Incumbent – AT&T, a Health Net network service provider, would configure MPLS, Federal GET VPN,
and routing schema at DC1 and DC2 WAN devices to cohesively interoperate with remainder of Health Net Enterprise network. Riverbed design will follow the current Health Net WAN Acceleration architecture managed by ATT. 

Centennial DC is proposed with redundant MPLS links from ATT for Health Net Federal, Health Net Non-federal, and Cognizant. Phoenix DC is proposed with single
MPLS link for Health Net Federal, Health Net Non-federal, and Cognizant. Redundant 10G P2P links between Centennial and Boulder DC, Centennial and Phoenix DC, and the links will be encrypted using MACSec/IPSEC, for the purpose of Federal compliance.
Health Net Federal MPLS links will be encrypted with GETVPN encryption, managed by AT&T. Health Net Federal and Non-federal users are spread across the country connecting over existing MPLS networks respectively (Federal and Non-federal are
separate MPLS networks over AT&T). Health Net Non-federal Internet users shall access the VDI infrastructure at Centennial via Boulder DC, using the 10G P2P redundant links between Centennial and Boulder DC. Redundant router, Core switch, Access
switch, firewalls, Network IPS, Load Balancer, WAN optimizers will be positioned to support the VDI, File / Print, VM infrastructure, with 10G Ethernet connectivity across the DC LAN. For Cognizant’s management and monitoring of DC1 and DC2
infrastructure, a separate In-Band management switch will be deployed with management VLAN and traffic will be routed through Firewall context. The firewall will have three virtual contexts to separate traffic among Federal, Non-Federal and
Cognizant. MacAfee IPS will be placed in line between ASR router and ASA firewalls to inspect Federal, Non-Federal and Cognizant data traffic. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-28		Health Net / Cognizant Confidential

 Final 
  

 Logical Architecture-DCl and DC2 

The overall Network architectural design for Proposed DC1 and DC2 is shown below 
  

 
 Figure: Logical Architecture DCl and DC2 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-29		Health Net / Cognizant Confidential

 Final 
  

 DC Network Infrastructure (Phoenix and Centennial) 

DC LAN architecture follows a modular design with layered Access, Aggregation and Core Networks. A pair of Cisco Nexus 7710 with Virtual Device Context (VDC)
will be set up in Centennial and Phoenix. Additional VDC is considered for WAN Edge and DCI Edge. Dedicated pair ASR 1004 is considered for WAN edge to provide MPLS termination and GET VPN encryption. Dedicated pair of ASR 1006 is considered for DCI
edge. DCI link will use MACSec or IPSec encryption as appropriate. 
 Dedicated Pair of Nexus 7004 is proposed at Boulder for 10 Gig Link termination and
DCI link encryption support. 
 A pair of Cisco ASA 5585 will be configured with multiple contexts and *McAfee IPS M-6050 for protecting the network
segments Storage Area Network (SAN) will have a dedicated pair of MDS9513. A pair of 9250i is considered for Storage Replication using FCIP technology. 

Cisco UCS Chassis and C-Series Servers will be connected to the Fabric Interconnect (FI 6296) for both Ethernet and Storage access. No FCoE is considered
North bound from FIs. Multi Chassis Ether Channel considered providing efficient link utilization and redundancy. FIs will be directly connected to the san switches (MDS 9513) for Storage Access. A pair Cisco FEX 2232 considered for 1 Gig port
requirements. 
 Health Net Federal and Non-Federal traffic flow will be logically segregated using appropriate technologies like VRFs, VLANs and Virtual
Contexts. Cisco 5585 will support virtual firewall with multiple contexts for Federal, Non-Federal and Cognizant network segments. F5 Load balancers will be deployed in virtual appliance mode to segregate Federal and Non-Federal traffic load
balancing. Nexus VDC is considered for maintaining the layered architecture with device consolidation approach. Nexus will use VRFs and VLANs to main the logical segregation of Federal and Non Federal Traffic. 

Isolated Management Infrastructure with both IP level and console level access to all the network devices. PSTN (modem) is considered for Out of band
management access. Management infrastructure access will be secured and controlled meeting industry best practices. Federal segment of the management zone will be managed from the Onshore location at Rancho Cordova office by the Federal approved
Cognizant onshore users. Access from Rancho Cordova office to the Centennial DC will be through the Federal MPLS cloud 
  

	*	All McAfee IPS appliances at DC1 and DC2 will be managed /monitored by Health Net SOC service provider: Leidos 

Cisco Prime DCNM for DC Network Management 
 Cisco DCNM
will be used for managing Cisco Datacenter network (SAN and LAN infrastructure) equipment at Centennial and Phoenix DC. The Cisco DCNM will be used to operate and manage a virtualized environment, which simplifies operational management of the
virtualized environment. Apart from the above DCNM offers multiple advantages such as: flexibility in management by proactive monitoring and problem diagnosis, less time needed to troubleshoot problems, performance and capacity monitoring and
trending of the SAN and LAN infrastructure, VMpath analytics and troubleshooting, simplified deployment of innovative Cisco NX-OS features, easy-to-use provisioning capabilities for technologies such as virtual PortChannel (vPC), VDC, Cisco
FabricPath, Fiber Channel over Ethernet (FCoE), zoning, and virtual SANs (VSANs), and template-based configuration capabilities for efficient rollout of new technologies. 

Cisco DCNM provides outstanding visibility into dependencies that exist between virtualized computing, networking, and storage infrastructures through
features such as VMpath and virtual machine–aware topology views. Cisco DCNM streamlines the provisioning of the unified fabric and proactively monitors the LAN and SAN components. Offering an exceptional level of visibility and control through
a single management pane for the Cisco Nexus®, Cisco Unified Computing System. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-30		Health Net / Cognizant Confidential

 Final 
  

 Cisco Prime NAM 2320 is considered for future network troubleshooting and traffic analysis. 

Security Infrastructure 
 ASA 5585 security appliance with
multi context mode will be used for traffic filtering; ASA will be deployed between ASR WAN edge and Nexus Core layer 7710 VDC. ASA will be deployed in HA mode with multiple contexts: WAN, Federal, Non-federal and Cognizant, Management etc. Traffic
between the VRFs will be strictly controlled through appropriate firewall context to maintain the required isolation. 
 MacAfee IPS M6050 will be
positioned in line between ASR router and ASA 5585-x firewalls to inspect and prevent the Federal, Non-Federal and Cognizant data traffic. McAfee IPS will send logs to existing Health Net’s Nitro SIEM tool. Appropriate log collector will need
be discussed and agreed with the SoC team to ensure all the logs are consolidated and compressed. 
 All in-band, and out of band network access will be
secured by Cisco Access Control Server (ACS). Two factor authentication requirements can be achieved by service integration with Health Net’s Active Directory and 2-factor systems at Boulder datacenter. Accounting logs will be sent to Health
Net’s security logging service for retention purpose. 
 Local database authentication will be configured as the fall back mechanism to authenticate,
in case the centralized Authentication servers are not reachable. Local database accounts will be created and maintained per Health Net’s password security policy 

Network Management 
 OOB (Out-of-Band) 

Out of Band Management solution will be built at Centennial and Phoenix datacenters using Avocent ACS 6048, this solution would be used for both Network and
Security Device console access. 
 Each console server comes with built-in dial-up modems and would be connected to the POTs line and Ethernet port would be
connected to the management switch (4506). 
 All OOB, network access will be secured by the use of Cisco ACS. Devices will be configured to forward the
authentication request to ACS using TACACS+ or RADIUS protocol. Two factor authentication requirements can be achieved by service integration with Health Net’s 2-factor (RSA/McAfee) systems at Boulder datacenter. Accounting logs will be sent to
logging service for retention purpose. Local database authentication will be configured as the fall back mechanism to authenticate, in case the centralized Authentication servers are not reachable. Local database accounts will be created and
maintained per Health Net’s password security policy 
 Appropriate security measurement will be in place to restrict access between devices. 

Centennial and Phoenix datacenters, Cognizant onsite (Rancho Cordova office) & offshore team will require POTs line and modems, as shown in the
diagram through which they would be able to gain secure access to the network devices in DC & DR, in the event of the IP network failure. 
 If ISP
requires OOB access to the Managed Routers/ASR, Avocent can be leveraged to gain access to the routers and will use an agreed approach meeting the security guide lines. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-31		Health Net / Cognizant Confidential

 Final 
  

  
 

 
 Figure: OOB Architecture 

INB (IN-Band) 
 In Band Management solution will be built
at Centennial and Phoenix datacenters, this solution would be used for both Network and Security Device MGMT interface access. The 4506 switches serves as a single point for access and administration of connected devices via management interface.
These Switches will have connectivity to dedicated MGMT context to separate the MGMT traffic from other traffic. 
 All Inband network management access will
be secured by the use of Cisco ACS. Devices will be configured to forward the authentication request to ACS using TACACS+ or RADIUS protocol. Two factor authentication requirements can be achieved by service integration with Health Net’s
2-factor (RSA/McAfee) systems at Boulder datacenter. Accounting logs will be sent to logging service for retention purpose. Local database authentication will be configured as the fall back mechanism to authenticate, in case the centralized
Authentication servers are not reachable. Local database accounts will be created and maintained per Health Net’s password security policy 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-32		Health Net / Cognizant Confidential

 Final 
  

 DCI Infrastructure 

Dedicated P2P 10G redundant fiber links will be established between Centennial and Boulder DC for application and Database access for VDI functionality, over
MACsec encryption for federal compliance. Redundant P2P 10G Redundant Fiber links will be established between Centennial and Phoenix DC with IPSEC VPN encryption for federal compliance. FCIP based SAN replication will utilize the DCI links. DCI
environment at Centennial and Phoenix consists of dedicated Nexus 7K VDCs and ASR 1006s with 10 gig encryption throughput. Currently there is no requirement of layer 2 extension across the data centers. DCI link will traverse all the Federal and Non
Federal traffic and there is no segregation considered. As this is just transit traffic there will not be any cross talk and appropriate traffic segregation will happen at the source and destination vicinity. Minimal latency is one of the main
considerations for the DCI links and high throughput traffic (eg: FCIP Replication) path will not have any Firewall, IPS or Riverbed. 
 WAN
Infrastructure 
 WAN infrastructure will be provisioned with dual MPLS Links with different local access carriers for Secondary MPLS WAN circuits for
each MPLS cloud. The local access carrier for the primary link is Century Link, followed by a Secondary Local Access Carrier. 
 WAN Infrastructure includes
two ASR 1004s configured with device and link level redundancy. The existing MPLS will be extended to the Cognizant Datacenter at Centennial and Phoenix using two 150Mbps circuits over 1G links for Non-Federal, and 50Mbps AVPN over 1G links for
Federal, and 45Mb AVPN over 1G links for Cognizant MPLS connectivity. All the MPLS AVPN links are scalable to 1g, with soft upgrades with a lead time of 2-3 weeks. 

Once the Centennial DC becomes fully operational, all existing Cognizant traffic (towards Boulder) will be re-routed through Centennial DC via P2P links.
Existing Cognizant MPLS links to Boulder and Rancho Cordova office will be de-commissioned in the future (as shown in the diagram). Federal MPLS cloud will be secured by extending the current GET VPN for the traffic encryption. 

3VRF named Federal, Non-federal and Cognizant will be configured on the both ASR to isolate Federal and Non-Federal traffic and also keep Cognizant traffic
separate, while the internal 10G link will be shared among the 3 VRF with logical separation. 
 Traffic isolation between Federal, Non-Federal and
Cognizant will be maintained end-to-end by the logical separation of each layer. Then the WAN edge ASA firewalls and Nexus WAN edge VDC will be configured with similar 3 Contexts/VRFs and at the access layer and the logical separation will be
achieved by configuring separate layer 2 VLANs for each zone. All traffic and routing (end-to-end) between the security zones (Contexts) will be denied by default until permitted by the super user. 

NOTE: Cognizant for now will assume the ownership of the ASR routers & the links and we assume Incumbent Health Net network service provider
(AT&T) will own the ASR routers & links at the later stage and also will manage MPLS, Federal GET VPN, and routing schema at DC1 & DC2 WAN devices to cohesively interoperate with the remaining HN Enterprise network 

Riverbed Steelhead 7055-L is considered with redundancy for bandwidth optimization across WAN links for Remote site traffic optimization at Centennial and
Phoenix DC. Steelhead will be deployed in in-line mode between the ASA 5585 and Nexus 7710. Steelhead will optimize all or any specific traffic (based on policy) between Steelhead peers placed at remote branch offices. Steelhead pair at Centennial
and Phoenix DC will peer with Branch SH to optimize VDI, File and print traffic. Steelhead INPATH will be connected using 10G connections (LAN and WAN both). 

McAfee IPS will be configured to provide Intrusion Prevention Service for the WAN Edge. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-33		Health Net / Cognizant Confidential

 Final 

 NOTE: Cognizant for now will assume the ownership of the Riverbed boxes in DC1 & DC2 including 11
HN branches and we assume Incumbent Health Net network service provider (AT&T) will own the Riverbed boxes (DC1 & Dc2 including 11 branches) at the later stage. Riverbed Steelhead WAAS appliances at DC1 & DC2 including 11
branches will be configured to cohesively interoperate with the remaining HN Enterprise network 
 The table below has the Bill of Materials for the
network components in both Centennial and Phoenix DCs: 
 Network BOM for DC & DR 

 

									
	 Device
	  	DC1 Count	 	  	DC2 Count	 
	 Nexus 7710
	  	 	2	  	  	 	2	  
	 Nexus 5596
	  	 	2	  	  	 	2	  
	 N2K-C2232PP
	  	 	2	  	  	 	2	  
	 Cisco Prime Infrastructure
	  	 	1	  	  	 	1	  
	 Cisco ASR1006
	  	 	2	  	  	 	2	  
	 Cisco Prime NAM 2320
	  	 	1	  	  	 	1	  
	 ASA 5585-X
	  	 	2	  	  	 	2	  
	 Cat4500 E-Series 6-Slot
	  	 	2	  	  	 	2	  
	 ASR 1004
	  	 	2	  	  	 	2	  
	 F5 LTM 5200V
	  	 	2	  	  	 	2	  
	 Riverbed 7055
	  	 	2	  	  	 	2	  
	 MCAFEE M-6050
	  	 	2	  	  	 	2	  
	 Avocent ACS6048
	  	 	2	  	  	 	2	  
	 Cisco ACS (virtual edition)
	  	 	1	  	  	 	1	  
	 Riverbed CMC (virtual edition)
	  	 	1	  	  	 	0	  
	 F5 Enterprise Manager (virtual edition)
	  	 	1	  	  	 	1	  
	 MDS 9513
	  	 	2	  	  	 	2	  
	 MDS 9250i
	  	 	2	  	  	 	2	  

 Boulder DC: 
  

					
	 Device
	  	 Count
	 
	 Nexus 7004
	  	 	2	  

 WAN Link Connectivity Locations / Link speed / Handoff / Service Provider Details 

The table below maps the connectivity between the datacenters: 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-34	  	Health Net / Cognizant Confidential

 Final 

															
	 Source
	 	 Source Location
	 	 Target
	 	 Target

location
	 	 Access/port
	 	 Service

Provider
	 	*Local
Access
Carrier	 	Handoff
	IBM DC	 	Boulder, CO	 	 Primary
 DC
	 	Centennial, CO	 	10G P-to-P Link	 	Level3	 	Level3	 	SMF
	 	 	 	 	 	 Time
 Warner
	 	Time
 Warner
	 	SMF
								
	 Cognizant
 Primary MPLS
	 	 Englewood, CO
 80112, Englewood, CO
80112
	 		 		 	 100M
 access
	 	AT&T	 	Time
 Warner
	 	SMF
	 	 	 	 	45M Port	 	 	 
								
	 Cognizant
 Secondary

MPLS
	 	 335 Inverness Drive
 South,
Englewood, CO 80112
	 		 		 	 100M
 access
	 	AT&T	 	Level3	 	SMF
	 	 	 	 	45M Port	 	 	 
								
	 Health net
 primary MPLS
	 	 335 Inverness Drive
 South,
Englewood, CO 80112
	 		 		 	1G access	 	AT&T	 	Century
 Link
	 	SMF
	 	 	 	 	200M Port	 	 	 
								
	 Health net
 Secondary

MPLS
	 	 335 Inverness Drive
 South,
Englewood, CO 80112
	 		 		 	1G access	 	AT&T	 	Level3	 	SMF
	 	 	 	 	200M Port	 	 	 
								
	 Health net
 Primary MPLS
(Federal)
	 	 335 Inverness Drive
 South
Englewood, CO 80112
	 		 		 	 100M
 access
	 	AT&T	 	Century
 Link
	 	SMF
	 	 	 	 	50M Port	 	 	 
								
	 Health net
 Secondary

MPLS (Federal)
	 	 335 Inverness Drive
 South
Englewood, CO 80112
	 		 		 	 100M
 access
	 	AT&T	 		 	SMF
	 	 	 	 	50M Port	 	 	 
								
	 Cognizant
 Primary MPLS
	 	 2335 S Ellis St,
 Chandler, AZ
85286
	 		 		 	 100M
 access
	 	AT&T	 	Integra	 	SMF
	 	 	 	 	45M Port	 	 	 
								
	 Health net
 primary MPLS
	 	 2335 S Ellis St,
 Chandler, AZ
85286
	 		 		 	1G access	 	AT&T	 	Integra	 	SMF
	 	 	 	 	200M Port	 	 	 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-35	  	Health Net / Cognizant Confidential

 Final 

															
	 Source
	 	 Source Location
	 	 Target
	 	 Target

location
	 	 Access/port
	 	 Service

Provider
	 	*Local
Access
Carrier	 	Handoff
	Health net	 	2335 S Ellis St,	 		 		 	100 access	 	AT&T	 		 	SMF
	 Primary MPLS
 (Federal)
	 	Chandler, AZ 85286	 		 		 	50M Port	 		 		 	
								
	Primary DC	 	Centennial, CO	 	Secondary DC	 	Phoenix	 	 10G P-to-P
 Link
	 	Level3	 	Level3	 	SMF
	 	 	 	 	 	 Time
 Warner
	 	Time
 Warner
	 	SMF

  

	*	Note -The links will have LEC and POP diversity built into the solution as supported by the Telco. As shown in the above table, the LECs we are using are Time Warner Telecom, Integra and Level 3.

 Latency of P2P Links 
  

					
	 From
	  	 To
	  	 Latency

	Boulder DC	  	Centennial DC	  	5 m sec
	Centennial DC	  	Phoenix DC	  	60 m sec

 Network and Security component Scalability at DC1 and DC2 

DC Switch (Access/Aggregation and Core) 
 Proposed Nexus
7710 has two slots for the Supervisor Engines and the remaining 8 slots for the line card modules. Only 3 x F3 line card modules are considered at this time, which provides ample scope for the future expansion. Currently one pair of Nexus 5596 pod
is considered and the modular design support infrastructure scalability by introducing additional Nexus 5k pods. Nexus 7710 has 8 +1 VDC license and only 4 VDC will be consumed for ITO Phase 1project. Nexus 2k acts as remote line card for the Nexus
switches and currently one pair of nexus 2232 is considered for 1 Gig access 
 Load Balancer – The Load Balancer considered for this
requirement is F5 5200v. This is a mid-range appliance from the F5 Big IP range; however is an entry range appliance for Virtual appliance purposes. 5200v is capable of 4 VCMP (virtual Appliance), however the current requirement is only for 2
(Federal and Non-Federal), with the additional 2 virtual appliances for future use. The B/w supported by 5200v is 15 Gbps. 
 Riverbed WAN Optimizer
– The Riverbed Steelhead WAN optimizer chosen is 7055L, with capability of 622 Mbps of optimized b/w, scalable to 1.5Gbps. This model support software license upgrade (e.g.: 7055H) providing higher optimization throughput. 

  

					
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 Final 

 Physical 10 Gig connectivity 

 

															
	 Access Switch connectivity 2 x 5596 @ DC1
and DC2
	 	 	 Core Switch connectivity 2 x 7710 @ DC1 and
DC2
	 
	 	 	 10G

Ethernet
	 	 	 Device
	  	 10G Ethernet

ports
	 
	 Device
	 	 DC1
	 	    DC2    	 	 	  	 DC1
	  	DC2	 
	 Nexus 5k Cross connects
	 	12	 	 	12	  	 	 Nexus 7k VDC cross connects
	  	40	  	 	40	  
	 Nexus 5k to 7K
	 	32	 	 	32	  	 	 ASA firewall
	  	24	  	 	24	  
	 Nexus 2232
	 	8	 	 	8	  	 	 McAfee IPS
	  	4	  	 	4	  
	 Nexus 5k to FI
	 	32	 	 	32	  	 	 F5 L/B
	  	8	  	 	8	  
	 Spare for implementation

Contingency
	 	16	 	 	16	  	 	 HNAS (2)
	  	8	  	 	8	  
		 		 				 	 NetBackup (4)
	  	8	  	 	8	  
		 		 				 	 MDS 9250 FCIP
	  	4	  	 	4	  
		 		 				 	 HCP (1)
	  	8	  	 	8	  
		 		 				 	 HDI (1)
	  	4	  	 	4	  
		 		 				 	 Sepaton
	  	4	  	 	4	  
		 		 				 	 Spectralogic
	  	2	  	 	2	  
		 		 				 	 ASR-WAN
	  	4	  	 	4	  
		 		 				 	 ASR -DCI
	  	6	  	 	6	  
		 		 				 	 Nexus 5K to N7k Agg
	  	32	  	 	32	  
		 		 				 	 Spare for implementation

Contingency
	  	16	  	 	16	  
	 Ports per Access Switch
	 	50	 	 	50	  	 		  	86	  	 	86	  
	 Total Ports per Access Switch
	 	100	 	 	100	  	 		  	172	  	 	172	  

  

									
	 SAN Switch connectivity 2 x MDS9513 @ DC1
and DC2
	 
	 Device
	  	FC	 
	  	DC1	 	  	DC2	 
	 FI 6296
	  	 	32	  	  	 	32	  
	 VSP (1)
	  	 	16	  	  	 	16	  
	 NetBackup (4)
	  	 	16	  	  	 	12	  
	 MDS 9250 FCIP
	  	 	8	  	  	 	8	  
	 Sepaton
	  	 	8	  	  	 	8	  
	 Spectralogic
	  	 	16	  	  	 	7	  
	 Spare for implementation Contingency
	  	 	16	  	  	 	16	  
	 Ports per Access Switch
	  	 	56	  	  	 	50	  
	 Total Ports per Access Switch
	  	 	112	  	  	 	99	  

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-37	  	Health Net / Cognizant Confidential

 Final 

 2.2.2.3 Network Monitoring Tools 

This section describes the proposed monitoring tools solution for network service towers. The functionality benefits and reporting for this tool is described
in detail in the Appendix. 
  

	 	•	 	HP Network Node Manager and SPI for Datacenter network availability and performance monitoring 

  

	 	•	 	Cisco Prime DCNM (Datacenter Network Management) tool for Event management, performance and capacity management 

  

	 	•	 	Cisco Security Manager event management and performance monitoring 

  

	 	•	 	Riverbed’s Central Management Console (CMC) for availability, event management and log management 

  

	 	•	 	F5 Enterprise Manager 

  

	 	•	 	Cisco Prime Infrastructure and NAM 2320 

  

	 	•	 	Cisco UCS manager will be used for the Datacenter management and hardware health monitoring 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

  

	 	•	 	HP Service Health Reporter – report overall monitoring of HP OMi and HP NNMi 

 2.2.2.4 Service
deliverables 
  

	 	•	 	Successful Reachability and Security: 

  

	 	•	 	Testing connectivity over redundant MPLS Link at Centennial and Single MPLS Links at Phoenix for Non-federal, and Cognizant WAN 

  

	 	•	 	Testing connectivity over GET-VPN for Federal MPLS at Centennial and Phoenix DCs 

  

	 	•	 	Testing connectivity over Redundant P2P Links between Centennial-Boulder and Centennial- Phoenix encryption over all the P2P links 

  

	 	•	 	Testing Routing reachability between Centennial DC LAN and Boulder DC LAN (server Segment) 

  

	 	•	 	Testing Routing reachability between Centennial DC LAN and Remote Location LAN 

  

	 	•	 	Testing Logical Separation of Federal and Non-Federal traffic on the DC firewall. 

  

	 	•	 	Testing firewall filters at the Centennial DC, to permit legitimate traffic in and out of Centennial DC over P2P and MPLS Links 

  

	 	•	 	Testing WAN traffic optimization between Centennial DC and Remote locations with Riverbed Appliance, for VDI and File/Print traffic 

  

	 	•	 	Health Net Info Sec team to validate the hardening of network and security equipment implemented at Centennial and Phoenix DCs 

  

					
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 2.2.2.5 Steady state support – Deliverables 

The key highlights of the proposed solution for network service towers are described below: 

In Scope Services 
  

			
	 Solution
	  	 Description

	 Solution Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore ; Coimbatore

 The high level activities for network services are mentioned below: 

Level 1 Services 
 L1 Services will be provided in
accordance with the procedures documented in the SOPs and will include the following: 
  

			
		
	L1 Team	  	 •    Basic incident management—incident logging and tracking

 

	  	 •    Monitoring link UP and DOWN times

 

	  	 •    Monitoring routers and switches for CPU and memory utilization

 

	  	 •    Monitoring - performance and capacity of network devices

 

	  	 •    Monitoring bandwidth utilization

 

	  	 •    LAN/TCP/IP configuration

 

	  	 •    Pre designed Link re-routing

 

	  	 •    Performing health check as per defined procedure

 

	  	 •    Vendor management

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

			
		
	L2 Team	  	 •    Configuration management and change control

 

	  	 •    Performance and availability management

 

	  	 •    Working with service providers to implement new or upgraded data
network
  

	  	 •    Managing router tables and IP addresses

 

	  	 •    Network device configuration

 

	  	 •    Perform hardware diagnostics

 

	  	 •    Implement firmware and software upgrades and patch installation and management

  

					
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			 •    Problem management and troubleshooting

 

		
			 •    Handling escalated routing issues and routing changes

 

		
			 •    Performing network integration tests

 

		
			 •    Bandwidth management

 

		
			 •    IMAC of Network devices

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 Network Support group. This team will work with Vendors when required. 
  

			
	L3 Team    		 •    Performing operational planning for capacity and performance
purposes
  

		 •    Conducting feasibility studies for implementation of new
technologies
  

		 •    Performing project management and project estimation

 

		 •    Reviewing efficiency and effectiveness of problem control
process
  

		 •    Network design and architecture

 

		 •    Root Cause Analysis

 2.2.2.6 Dependency on Health Net 
  

	 	•	 	Details of IP schema information used across Health Net (Boulder DC, branches, etc.) 

  

	 	•	 	New IP Schema requirement for Centennial and Phoenix DCs, and VDI IP range from Health Net existing Private IP Schema pool, and required configurations on Existing DHCP / IP management Server in Boulder DC

  

	 	•	 	Understanding of Health Net naming conventions, VLAN tag’s, etc., to retain the same in new DC and DR. 

  

	 	•	 	Detail understanding of existing Health Net routing architecture (LAN/WAN) at Boulder DC and Remote Locations 

  

	 	•	 	Detail understanding of health Net Firewall and IPS policies to design the Centennial and Phoenix DC inline to Health Net Security standards 

 

	 	•	 	DCI 10 Gig link termination and Service integration at Boulder 

  

	 	•	 	Routing configuration on P2P 10G links at Boulder DC side to ensure successful routes are configured for servers / applications to be reachable from Centennial DC and vice-versa 

 

	 	•	 	Implementation and Integration of Health Net MPLS circuits on Centennial and Phoenix DC Routers to be performed by Health Net/ATT 

  

	 	•	 	Configuration of GETVPN on federal MPLS circuits on Centennial and Phoenix Routers to be performed by Health Net/ATT 

  

	 	•	 	Health Net will extend their current services for NTP,IPAM and external DNS 

  

	 	•	 	Health Net SoC to provide local SIEM log connector at the proposed Cognizant Data Center to conserve the bandwidth consumption 

  

					
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	 	•	 	Incumbent Health Net network service provider, AT&T, must configure MPLS, Federal GET VPN, and routing schema at DC1 and DC2 WAN devices to seamlessly interoperate with remainder of Health Net Enterprise network

  

	 	•	 	Understanding of existing Riverbed Architecture and remote site Riverbed Details 

  

	 	•	 	Understanding of Remote Site Network Infrastructure to integrate new Riverbed Steelhead appliance 

  

	 	•	 	Availability of IP Address range, VLAN, Rack space, switch ports, etc. at each site for Riverbed implementation and integration 

  

	 	•	 	Configuration and Integration at Remote side existing riverbed appliance for peering with New DC/DR Riverbed steelhead appliance 

  

	 	•	 	Configuration and Integration of Riverbed appliances at target DC1 and DC2 including all remote sites’ existing and new to cohesively interoperate with the rest of Health Net’s Enterprise network

  

	 	•	 	Firewall configuration on Boulder DC (perimeter and Core) to allow access to / from Centennial DC for application access, Network Services Access, and necessary access for Application, Infrastructure at Centennial DC to
reach Boulder DC Server Farm. Access policies to be provided by Health Net team 

  

	 	•	 	Firewall Configuration at Boulder DC (perimeter and Core) to allow Centennial / Phoenix DC firewall and IPS logs to be sent to Health Net Log collector in Boulder DC and also to the SOC at San Diego using existing IPSEC
VPN tunnel over internet from Boulder DC 

  

	 	•	 	Copy of the requirements document for information security compliance, to complete the hardening of network and security equipment for Health Net information security team approvals. 

 

	 	•	 	Availability of Health Net SMEs to understand the details of the existing network and security setup in Health Net hosted DC at Boulder 

Availability of Health Net SMEs to understand the details of required security policies at proposed Centennial and Phoenix DCs 

2.2.2.7 Risk and Mitigations 
  

									
	 S. No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	1	  	Access and support from key SME’s from incumbent during implementation	  	High	  	Medium	  	Involve Health Net to facilitate and govern the implementation requiring integration with the Boulder DC
					
	2	  	 Based on discussions with
 Health Net team, task
such as, GET VPN configuration at Centennial and Phoenix DC on Federal MPLS Links, IPSEC VPN configuration at Boulder DC on P2P Link, and are considered as project by IBM and lead time to execute could be between 1 to 3 months.
	  	High	  	High	  	 Health Net to govern the incumbent to
 expedite
planning and execution of said activities to establish routable and secure connectivity between the two Datacenters. Cognizant will provide these requirements in advance.

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-41	  	Health Net / Cognizant Confidential

 Final 

									
	 S. No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	3	  	 Change management at Boulder
 firewall, DHCP,
DNS, VLAN, IP schema, may cause delay of 3-5 days
	  	High	  	High	  	Health Net to govern the incumbent for expedite change management especially during go-live time, to avoid delays in go-live schedule. Cognizant will provide detailed list of firewall ports to be opened, and other service
requirements in advance for change management activities at Boulder, however this is subject to Cognizant’s limited knowledge and understanding of the Boulder DC Setup. Requires expedited change management at Boulder DC for Centennial/ Phoenix
integration.
					
	4	  	 Understanding of existing
 Boulder Datacenter
firewall rules, load balancers policies, VLAN L2/L3, routing details, for specific environments being accessed from Centennial
	  	High	  	High	  	Engage with Health Net SMEs to understand the details of existing DC networks and security that will be integrated with the new DCs
					
	5	  	 WAN Link commissioning timelines at Centennial / Phoenix DC for P2P, and MPLS

circuits
	  	High	  	High	  	Early initiation of link ordering and alignment of project plan in line with link availability. High level of dependencies across all WAN links.

 2.2.3 Storage and Backup 

2.2.3.1 Highlights of Scope Validation Workshop 
 This
table below highlights the scope outlined after the scope validation workshop: 
  

					
	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

	The number of ports on the VSP	  	 •    There were 64 ports that were initially configured on the VSP
	  	 •    Now there would be an initial configuration of 32 ports on the VSP with 16 ports wired for
use

			
	 The HDS HNAS
 model
	  	 •    HDS HNAS 3080 will be used
	  	 •    Now HNAS 4080 will be used in the Centennial DC and HNAS 4060 will be used in the Phoenix
DC

			
	 Replication
 between Centennial
and Phoenix DC
	  	 •    HDS HUR to be used for the storage level replication between the VSP from Centennial and Phoenix
DCs
	  	 •    HDS HUR will be available solution. There can be storage level replication from the VSP. Also,
replication would be from HNAS and the replication will be enabled at later phase

  

					
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	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

			
	Tape slots in the Spectra Logic Tape Library	  	 •    In the Spectra Logic Tape library it was 1810 tape slots in the Centennial and 380 tape slots in Phoenix
DC
	  	 •    In the Spectra Logic tape library there will be 700 tape slots in the Centennial DC and 100 tape slots in
the Phoenix DC

 2.2.3.2 Solution Approach 
  

	 	•	 	Design and Build Approach 

  

	 	•	 	Designing the target environment 

  

	 	•	 	Installation of infrastructure in the Datacenter 

  

	 	•	 	Dedicated VLAN for backup traffic 

  

	 	•	 	LAN Free (SAN-based) backups to be used for servers exceeding a defined storage capacity threshold > 600GB 

  

	 	•	 	Build infrastructure for Storage ( VSP , HNAS , Sepaton) and Backup 

  

	 	•	 	Logical separation and restricted Access for Federal data 

  

	 	•	 	Scalable and redundant Storage Area Network (SAN) 

  

	 	•	 	Multipath load balancing 

  

	 	•	 	Support port aggregation of inter-switch links 

  

	 	•	 	VSP Storage for all tiers of SAN storage, Thin Provisioning, Automatic Tiering 

  

	 	•	 	262 TB usable capacity in the primary Datacenter and about 55 TB usable capacity in secondary Datacenter 

  

	 	•	 	Out of the 262 TB we will use 188.7 TB for VDI in primary DC 

  

	 	•	 	Out of the 52 TB we will use about 12.6 TB for VDI in DR DC 

  

	 	•	 	Storage model – HDS VSP and HNAS (to increase VDI capability) 

  

	 	•	 	HNAS will use EVS (Enterprise Virtual Servers) to separate Federal and Non- Federal data 

  

	 	•	 	Installation of management tool for managing Storage and Backup environment 

  

	 	•	 	Manage the Storage and Backup environments in the Centennial and Phoenix DCs. 

 Storage and Backup 

 

	 	•	 	Design and Build Approach 

  

	 	•	 	Dedicated Backup VLAN 

  

	 	•	 	Designing the target environment 

  

	 	•	 	Creating implementation Plan 

  

	 	•	 	Procurement of required infrastructure 

  

					
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 Final 

	 	•	 	Installation of infrastructure in our DC 

  

	 	•	 	Build infrastructure for Storage and Backup 

  

	 	•	 	Build different pools support Federal and Non-Federal separation 

  

	 	•	 	Encryption will be enabled for data at rest 

  

	 	•	 	Installation of management tools for managing Storage and Backup environment 

  

	 	•	 	Manage the Storage and Backup environments in the Centennial and Phoenix DCs. 

 Backup and VSP Storage
Architecture 
 Primary Data Center (DC1)—Centennial 

The diagram below depicts the High Level Storage and Backup architecture at DC1 

  

					
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 Figure: Storage and Backup architecture at DC1 

Phoenix DC 
 The diagram below depicts the High Level
Storage and Backup architecture at DC2 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-45		Health Net / Cognizant Confidential

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 Figure: Storage and Backup architecture at DC2 

  

					
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 VSP Architecture 
  

 
 Figure: VSP architecture in DC1 and DC2 

Storage Overview—Primary DC 
 The diagram below
details the Connectivity overview of VSP, HNAS 
  

	 	•	 	Each HNAS 4080 node will have 4 direct fiber channel connections (FC-AL) to the VSP 

  

	 	•	 	Each HNAS 4080 node will have 4 10G LAN connection to the 5596 

  

	 	•	 	The VDI traffic will use NFS 

  

	 	•	 	The server traffic will use ISCSI or FCOE. Currently it will support both, during the LLD (low level design) we will determine the method 

 
 

 
 Figure: VSP, HNAS connectivity 

Summary of Storage VSP Build 
  

  

					
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	 	•	 	The LUN details that would be configured in both DC and DR for storage 

  

	 	•	 	At initial install, the HDS team will create a single HDP pool for all Non-HNAS LUN 

  

	 	•	 	Once the Pools are created, HDS will work the Cognizant team to pre-determine the V-Volume size 

  

	 	•	 	HNAS devices will be presented raw 2.6 TB LUNS from the VSP 

  

	 	•	 	Configured VSP Storage for Federal, Non-Federal and VDI 

  

	 	•	 	Configured general capacity 80 TB 

  

	 	•	 	Configured HNAS capacity 160 TB+ 

  

	 	•	 	Separate Federal and Non-Federal pools with EVS (Enterprise Virtual Servers), which is Hitachi multi-tenant feature that allows own file systems and separate disk on the storage arrays 

 

	 	•	 	HNAS capacity for VDI Infrastructure 

  

	 	•	 	188 TB 900GB 10K Raid 10(4+4) 

  

	 	•	 	General Pool capacity 

  

	 	•	 	Tier1 – 4.8 TB FMD 1.6 TB RAID5 (3D+1P) 

  

	 	•	 	Tier2 – 37.7TB SAS 900GBx10k RAID6 (6D+2P) 

  

	 	•	 	Tier3 – 32.1TB 3TB NL-SAS RAID6 (6D+2P) 

  

	 	•	 	BOS License configured—230TB+(Unlimited) 

 Storage Tiering Details for DC1 

 

																			
	 Storage Model-VSP
	 	 	 	 Y1 configuration

	 Tier 1
	 	 Disk Type
	 	 RA ID
	 	 RAID

Type
	 	 Usable (TB)

Ask
	 	 Tier

(%)
	 	 RAID

Groups

Required
	 	 Usable (TB)

Configured
	 	 Disks
	 	 HS

	 Disk Tier1
	 	 1.6 TB Flash

module Drive
	 	5	 	3D+1P	 		 	6.43%	 	1	 	4.80	 	4	 	1
										
	 Disk Tier2
	 	 900GB 10K

rpm SAS 2.5” Drive
	 	6	 	6D+2P	 	74.60	 	50.54%	 	8	 	37.70	 	64	 	2
										
	 Disk Tier 3
	 	 3TB 7.2Krpm

NL-SAS 3.5” Drive
	 	6	 	6D+2P	 		 	43.03%	 	2	 	32.10	 	16	 	2
										
	 HNAS VDI Disk
	 	 900GB 10K

rpm SAS 2.5” Drive
	 	1	 	2D+2D	 	188.7	 	N/A	 	60	 	188.7	 	480	 	8
		 		 		 		 		 	Total	 	71	 	263.30	 	564	 	13

 The Raid and Pool Configurations: Primary pool will be single HDT pool containing all of the 1.6TB FMD, 900GB HDD and the 3TB
HDD. The underlying devices will be configured with Raid 5 for the 

  

					
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 FMD’s and Raid 6 for all other devices. 

VSP Encryption – the VSP storage system uses the Encryption License key feature to set up the data encryption license keys to encrypt and decrypt
data. We will use encryption license key feature to backup data encryption license keys. The VSP storage system automatically creates a primary backup of the data encryption license key, and stores this backup on each MP package. Cognizant will
create Secondary backup data encryption license key to restore the key if the primary backup is unavailable. The lists below are the VSP encryption details: 
  

	 	•	 	Encryption algorithm – Advanced Encryption standard (AES) 256 bit. 

  

	 	•	 	Encryption mode – XTS mode 

  

	 	•	 	Creating data encryption license keys – Use Storage Navigator (SN) to create the data encryption license key 

  

	 	•	 	Deleting data encryption license key – Use SN to delete data encryption license keys 

  

	 	•	 	Scope of encryption license keys – 32 data encryption license keys per storage system 

  

	 	•	 	Unit of encryption/decryption – Parity group 

 Note: For more details please refer to the PDF:
http://www.hds.com/assets/pdf/vsp-hitachi-encryption-license-key-user-guide.pdf 
 Storage Overview — Secondary DC 

The diagram below details the Connectivity overview of VSP, HNAS 
  

	 	•	 	Each HNAS 4060 node will have 4 direct fiber channel connections (FC-AL) to the VSP 

  

	 	•	 	The VDI traffic will use NFS 

  

	 	•	 	The server traffic will use ISCSI or FCOE. Currently it will support both but during the LLD (low level design) will determine the method. 

 
 

 
 Figure: Connectivity Overview 

  

					
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 Final 

 Summary of VSP Build 
  

	 	•	 	LUN details that would be configured in both DCs and DR for storage 

  

	 	•	 	At initial install, the HDS team will create a single HDP pool for all Non-HNAS LUN 

  

	 	•	 	Once the Pools are created, HDS will ask the Cognizant team to pre-determine the V-Volume size 

  

	 	•	 	HNAS devices will be presented raw 2.6TB LUNS from the VSP 

  

	 	•	 	Configured VSP Storage for Federal, Non-federal and VDI 

  

	 	•	 	Configured General Capacity 39.40TB 

  

	 	•	 	Configured HNAS Capacity 12.6TB 

  

	 	•	 	Separate Federal and Non-federal pools with EVS (Enterprise Virtual Servers), which is Hitachi multi-tenant feature that allows own file systems and separate disk on the storage arrays 

 

	 	•	 	HNAS Capacity for VDI Infrastructure 

  

	 	•	 	12.6TB 900GB 10K Raid 10(4+4) 

  

	 	•	 	General pool capacity 

  

	 	•	 	Tier1 – 4.80TB FMD 1.6TB RAID5 (3D+1P) 

  

	 	•	 	Tier2 – 18.9TB SAS 900GBx10k RAID6(6D+2P) 

  

	 	•	 	Tier3 – 15.70TB 3TB NL-SAS RAID6(6D+2P) 

  

	 	•	 	BOS license configured—60TB 

 Storage Tiering Details for DC2 

 

																			
	 Storage Model-VSP
	 	 Y1 configuration

	 Tier 1
	 	 Disk Type
	 	 RAID
	 	 RAID

Type
	 	 Usable

(TB) Ask
	 	 Tier

(%)
	 	 RAID

Groups
 Required
	 	 Usable (TB)

Configured
	 	 Disks
	 	 HS

										
	 Disk

Tier1
	 	 1.6 TB Flash

module
 Drive
	 	5	 	3D+1P	 		 	12%	 	1	 	4.80	 	4	 	1
										
	 Disk

Tier2
	 	 900GB 10K

rpm SAS

2.5” Drive
	 	6	 	6D+2P	 	39.40	 	48%	 	4	 	18.90	 	32	 	1
										
	 Disk

Tier 3
	 	 3TB

7.2Krpm
 NL-SAS

3.5” Drive
	 	6	 	6D+2P	 		 	40%	 	1	 	15.70	 	8	 	2
										
	 HNAS
	 	900GB 10K	 	1	 	4D+4D	 	12.6	 	N/A	 	4	 	12.60	 	16	 	1
										
	 VDI Disk
	 	 rpm SAS

2.5” Drive
	 		 		 		 		 		 		 		 	
		 		 		 		 		 	 Total
	 	10	 	52.00	 	60	 	5

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-50	  	Health Net / Cognizant Confidential

 Final 

 Raid and pool configurations: Primary pool will be single HDT pool containing all of the 1.6TB FMD, 

900GB HDD and the 3TB HDD. The underlying devices will be configured with Raid 5 for the FMD’s and Raid 6 for all other devices. 

VSP Encryption – the VSP storage system uses the Encryption License key feature to set up the data encryption license keys to encrypt and decrypt
data. We will use encryption license key feature to backup data encryption license keys. The VSP storage system automatically creates a primary backup of the data encryption license key, and stores this backup on each MP package. Cognizant will
create Secondary backup data encryption license key to restore the key if the primary backup is unavailable. The lists below are the VSP encryption details: 
  

	 	•	 	Encryption algorithm – Advanced Encryption standard (AES) 256 bit. 

  

	 	•	 	Encryption mode – XTS mode 

  

	 	•	 	Creating data encryption license keys – Use Storage Navigator (SN) to create the data encryption license key 

  

	 	•	 	Deleting data encryption license key – Use SN to delete data encryption license keys 

  

	 	•	 	Scope of encryption license keys – 32 data encryption license keys per storage system 

  

	 	•	 	Unit of encryption/decryption – Parity group 

 Note: For more details please refer to the PDF
http://www.hds.com/assets/pdf/vsp-hitachi-encryption-license-key-user-guide.pdf 
 Hitachi management tools 

Cognizant uses the native capabilities of the device, vendor provided element managers and call home systems to manage and support the Storage environment.
Some of these tools require servers to be installed with the equipment. Some of the base management elements include: 
  

	 	•	 	Hitachi command suite: Simplify management to streamline application availability, performance and access to critical data. Unify management across all Hitachi storage systems and data types. It is comprised of
the following integrated Hitachi software: 

  

	 	•	 	Device Manager: Manages one or many Hitachi storage systems from a single console. Increases productivity with consolidated views of physical, logical, host, and virtual server. Aligns storage assets, pools and
provisioning with business applications and entities using logical views. 

  

	 	•	 	Tuning Manager: Applies intelligent, path-aware monitoring, analysis and reporting from application to storage devices. Identify, isolate and diagnose storage performance bottlenecks. Uses predictive capacity
planning, proactive monitoring, integrated alerts and historical trending. 

  

	 	•	 	Command Director: Monitor, analyze and meet application-specific service level objectives by capacity, performance and tier. Improve capacity utilization and planning by monitoring key metrics. Manage across
block, file and unified Hitachi storage. 

  

					
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	 	•	 	Tiered Storage Manager: Lower costs by moving infrequently accessed and less demanding applications’ data to economical storage tiers. Improve performance by moving I/O intensive data to higher performing
storage tiers. 

  

	 	•	 	Dynamic provisioning: The thin provisioning software that provides virtual storage capacity. Adds physical storage non-disruptively by allowing it to draw from a central pool when an application requires
additional capacity rather than add physical disks. Improves storage performance and cuts time to provision new storage 

 Backup
environment 
 The backup environment (NetBackup) would be built in the Cognizant DC adhering to Health Net’s backup policy guidelines. There will
be no migration of backup data from the existing Boulder DC. 
 There will be a logical separation between Federal and Non-federal at the EVS (Electronic
vaulting service) level. 
 Backup data flow diagram 
  

 
 Figure: Backup Data Flow Diagram 

Backup Software 
 Cognizant would implement Symantec
NetBackup as the datacenter backup and recovery technology. Symantec NetBackup 7.5 provides a comprehensive yet integrated approach to protecting data for next generation data centers. 

  

					
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 Backup to Tape 

The disk-to-disk-to-tape (D2D2T) combination allows backup administrators to have the following: keeping off-site backups in Iron Mountain location, while
retaining fresh backups on disk for ultrafast restores. The D2D2T model uses a two-tiered architecture that can effectively handle both near-line and archival data. Dual-stage disks and automated tape backup effectively address the data protection
gaps and performance limitations that result when either technology is used individually, enhancing a Health Net’s existing tape backup process. All the backups to tape and disk will be encrypted. 

Note: Health net will own the Iron Mountain relationship. 

NDMP Backup 
 Symantec NetBackup for NDMP helps provide
reliable, high-performing backup and recovery services for NDMP enabled Network Attached Storage (NAS). To streamline operations, NetBackup for NDMP extends its advanced media management and virtually unlimited scalability via the Network Data
Management Protocol (NDMP). 
 NDMP facilitates communication between Symantec NetBackup for NDMP and a NDMP server application to initiate backup and
restore tasks. This communication integrates the protection of NAS into a consolidated, Datacenter- strength backup solution. 
 Backup policy 

 

	 	•	 	Production Systems 

  

	 	•	 	Daily (incremental)—4 weeks 

  

	 	•	 	Weekly (full / synthetic full)—2 months 

  

	 	•	 	Monthly (full / synthetic full)— 7 years 

  

	 	•	 	Non-Production Systems (DEV / QA / UAT / STG) 

  

	 	•	 	Daily (incremental)—4 weeks 

  

	 	•	 	Weekly (full /synthetic full)—2 months 

  

	 	•	 	Monthly – None 

  

	 	•	 	Backup methods 

  

	 	•	 	LAN Free (SAN-based) backup to be used for servers exceeding a defined storage capacity threshold of >600GB 

  

	 	•	 	Dedicated VLAN for network based backups 

 Backup Overview—Primary DC 

The backup solution will be supporting Multi-Master server architecture to support several capabilities. First, we will need two different Master servers in
DC1; this is to support splitting backup data to either a Federal Master server or a Non- Federal Master server. The Non-Federal architecture will have a Master server and two physical media servers (see below) and the Federal Master server will act
as both Master server and media server. A similar architecture will be in DC2 but at a smaller scale. Secondly, this 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-53		Health Net / Cognizant Confidential

 Final 

 
architecture prepares (future capability) Cognizant to implement A.I.R (auto image replication) with the Sepaton device, which allows DC1 Sepaton to replicate to DC2 Sepaton . For now, the design
will have the data moved from source via dedicated backup VLAN or LAN-Free to the Sepaton device where it utilize tools like de-duplication and compression. Once it has arrived in the Sepaton the data will be laid out in a pre-defined structure (LLD
– low level design phase). After the data meets pre-defined qualification (LLD – Low level design phase) the data then will be moved to the Spectra logic to either a Federal pool or Non-Federal pool. Lastly, in the Spectra Logic device
will have pre-defined qualification (during LLD) to move the tape to a remote location using Iron Mountain. 
  
 

 
 Figure: Backup Server Architecture and Connectivity – Commercial 

 
  
 

 
 Figure: Backup Server Architecture and Connectivity – Federal 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-54		Health Net / Cognizant Confidential

 Final 

  
 

 
 Figure: Spectra Logic architecture and connectivity details for Federal and Commercial 

 

	 	•	 	Slots 

  

	 	•	 	700 Slots that are licensed 

  

	 	•	 	Federal is 20% and Non-federal is 80% 

  

	 	•	 	Tape Drives 

  

	 	•	 	12 LTO-6 Tape drives for Non-Federal 

  

	 	•	 	2 LTO-6 Tape drives for Federal 

  

	 	•	 	Encryption 

 Spectra logic will be using Spectra BlueScale encryption key management.
Spectra Logic BlueScale encryption key management provides an easy-to-use interface that lets Cognizant to quickly implement Spectra Logic encryption. The key is automatically handled in multiple software layers, as well, so it is not apparent to
the end user. LTO tape drives use AES-256 bit encryption keys generated within BlueScale to encrypt data. This data cannot be read until it is decrypted, which requires the use of the same key that was used during data encryption. This kind of
encryption requires creation, tracking and protection of the encryption keys. The life cycle of a BlueScale encryption key includes the following stages: 
  

	 	•	 	Encryption User Definition 

  

	 	•	 	Key Creation/Deletion 

  

	 	•	 	Key Escrow 

  

	 	•	 	Key Use in Data Encryption/Decryption 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-55		Health Net / Cognizant Confidential

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 The following encryption type will be used: 

 

	 	•	 	Professional (32 keys) 

 Note: See the following link for more details on Spectra logic
encryption: 
 ( https://www.spectralogic.com/index.cfm?fuseaction=home.displayFile&DocID=1902) 

 

	 	•	 	Ports 

  

	 	•	 	14 FC ports are required for Spectra logic 

  

	 	•	 	2 Ethernet ports are required for management and camera 

  

	 	•	 	Power 

  

	 	•	 	2 L6/20 outlets power connections are required for Spectra Logic 

  
 

 
 Figure: Sepaton architecture and connectivity details for Federal and Commercial 

Features and Benefits: 
  

	 	•	 	The world’s fastest enterprise backup and recovery solution 

  

	 	•	 	The Sepaton backs up data at an industry-leading ingest rate of up to 80 TB per hour, regardless of data type, data change rate or system capacity 

 

	 	•	 	The Sepaton’s patented Content AwareTM de-duplication technology delivers the fastest time to safety and most efficient capacity reduction of any solution available today 

 

	 	•	 	The only data protection solution that can effectively de-duplicate separate parallel backup streams (multi stream) and across multiplexed data volumes, as required for large database environments such as Oracle, DB2
and SQL 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-56		Health Net / Cognizant Confidential

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	 	•	 	Delta ScaleTM architecture makes it easy to increase storage capacity and maintain performance as your needs grow 

  

	 	•	 	Enables fast and secure replication and transmission of massive backup volumes to remote disaster recovery sites over a wide area network. Replication is performed automatically 

 

	 	•	 	Byte differential Content AwareTM de-duplication reclaims storage space continuously as it operates, freeing capacity sooner and saving administration time 

 

	 	•	 	Symantec NetBackup OST features such as Auto Image Replication (A.I.R.), Optimized Synthetic Backups, GRT and Symantec NetBackup Accelerator, which we have purchased the licenses but it will be implemented in later
projects 

  

	 	•	 	Delta ScaleTM architecture’s secure multi-tenancy capability allows data managers to allocate performance, capacity bandwidth and quality of service as needed by their enterprise’s various segments,
departments and business units 

  

	 	•	 	Encrypts data at rest while maintaining its blazing fast time to safety and industry-leading backup performance (Sepaton S2100-ES3’s encryption of data at rest capability integrates with industry standard
interoperability protocols for encryption key managers (EKM) that are compliant with industry-standards) 

 Sepaton Management tools

  

	 	•	 	VPN access / WebEx access 

  

	 	•	 	SFTP access from the S2100 to the Sepaton support infrastructure 

  

	 	•	 	Automation of daily SFTP uploads of the S2100 support ticket 

  

	 	•	 	Delta View portal provides 

  

	 	•	 	Case management, Capacity planning 

  

	 	•	 	Backup reporting analytics 

  

	 	•	 	Email configuration 

  

	 	•	 	Email Notification for Alerting 

  

	 	•	 	Email Distribution for DeltaStor Reporting 

 2 – SRE Nodes 

We would be creating 2—S2100 Storage pools to breakout Federal and Non-Federal. 4 trays of HUS110 

 

					
	•		1 Controller tray		27TBs Usable – 9/2/1 hot spare
			
	•		1 Jbod		30TBs usable – 10/2
			
	•		1 Jbod		27TBs usable – 9/2/1 hot spare
			
	•		1 Jbod		30TBs usable – 10/2

 Storage Pool Breakout 

The smallest storage pool can be 1 LUN = 1 tray 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-57		Health Net / Cognizant Confidential

 Final 

	 	•	 	1 tray allocated for Federal 

  

	 	•	 	3 trays allocated for Non-Federal 

 Sepaton Encryption 

 

	 	•	 	Hardware-accelerated compression and encryption 

  

	 	•	 	Leverages high-performance HiFn DX 1845 to do compression and encryption in unified pipeline 

  

	 	•	 	Massive bandwidth provides compression and encryption throughput for 2 x 8Gbps Fibre Channel ports ingesting data with 100% change rate per SRE node 

 

	 	•	 	Key management is external to VTL using an OASIS KMIP-compatible key manager (or the HP proprietary Enterprise Key Manger or the SafeNet Enterprise Key Manager which are both supported by our architectural approach)

  

	 	•	 	Communication with the Key Manager is via the CryptSoft KMIP SDK 

  

	 	•	 	Provides linear scalability as SRE nodes are added to the system 

  

	 	•	 	Performs predictably—no CPU performance impact on ingest or de-duplication processing 

  

	 	•	 	All customer data is encrypted before landing on disk 

  

	 	•	 	Encryption keys never stored on disk 

 Sepaton Key Management 

Key Management Availability: The VTL only needs to access the key manager at startup. The key is cached in memory (not on disk) while the VTL is
running. At boot time the system interrogates the list of key managers (up to nine of them) to get the key. If no key manager responds, the system goes into maintenance mode. You can safely take key managers down for system maintenance once the
Sepaton system has retrieved the key. 
 For security reasons, the VTL never stores the key on disk. It always checks for a key on reboot so that IT can
revoke the key (or more commonly) disable the key manager in the event of a data center-wide security intrusion. If this were to happen, shut down the key manager and reboot the VTL to prevent access to live data on the VTL. 

Backup Overview—Secondary DC 
 The backup solution
will be supporting multi-Master server architecture to support several capabilities. First, we will need two different Master servers in DC2; this is to support splitting backup data to either a Federal Master server or a Non- Federal Master server.
The Non-Federal architecture will have a Master server and one physical media servers (see below) and the Federal Master server will act as both Master server and media server. A similar architecture will be in DC1 but at a larger scale. Secondly,
this architecture prepares (future capability) Cognizant to implement A.I.R (auto image replication) with the Sepaton device, which allows DC1 Sepaton to replicate to DC2 Sepaton. For now, the design will have the data moved from source via
dedicated Backup VLAN or LAN-Free to the Sepaton device where it utilize tools like de-duplication and compression. Once it has arrived in the Sepaton the data will be laid out in a pre-defined structure (LLD – low level design phase). After
the data meets pre-defined qualification (LLD – Low level design phase) the data then will be moved to the Spectra logic to either a Federal pool or Non-Federal pool. Lastly, in the Spectra Logic device will have pre-defined qualification
(during LLD) to move the tape to a remote location using Iron Mountain. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-58		Health Net / Cognizant Confidential

 Final 

 For future growth needs, we have adjusted the Phoenix Data Center Tape library from Spectra logic T380 to a
Spectral logic T950. This will give us the ability to expand the tape environment with more tape slots and tape drives as needed. 
 Additionally, we moved
all fiber connection from the 5596 to a multi domain SAN using MDS 9513. This will make Health net tape environment agile and cost effective by creating a TAN environment. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-59		Health Net / Cognizant Confidential

 Final 

  
 

 
 Figure: Backup Server architecture and connectivity (DC2)—Commercial 

 
  
 

 
 Figure: Backup Server architecture and connectivity (DC2)—Federal 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-60		Health Net / Cognizant Confidential

 Final 

  
 

 
 Figure: Spectra Logic architecture and connectivity (DC2) – Commercial and Federal 

 

	 	•	 	Switched T380 to a T950 to support future growth 

  

	 	•	 	Slots 

  

	 	•	 	100 Slots that are licensed 

  

	 	•	 	Federal is 20% and Non-federal is 80% 

 Tape Drives 

 

	 	•	 	3 LTO-6 Tape drive for Non-federal 

  

	 	•	 	2 LTO-6 tape drives for Federal 

  

	 	•	 	Encryption 

 Spectra logic will be using Spectra BlueScale encryption key management.
Spectra Logic BlueScale Encryption key management provides an easy-to-use interface that lets Cognizant to quickly implement Spectra Logic encryption. The key is automatically handled in multiple software layers, as well, so it is not apparent to
the end user. LTO tape drives use AES-256 bit encryption keys generated within BlueScale to encrypt data. This data cannot be read until it is decrypted, which requires the use of the same key that was used during data encryption. This kind of
encryption requires creation, tracking and protection of the encryption keys. The life cycle of a BlueScale encryption key includes the following stages: 
  

	 	•	 	Encryption User Definition 

  

	 	•	 	Key Creation/Deletion 

  

	 	•	 	Key Escrow 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-61		Health Net / Cognizant Confidential

 Final 

  

	 	•	 	Key Use in Data Encryption/Decryption. 

 The following encryption type will be used: 

 

	 	•	 	Professional (32 keys) 

 Note: For more details on Spectra logic encryption refer to the
link below: 
 (https://www.spectralogic.com/index.cfm?fuseaction=home.displayFile&DocID=1902) 

 

	 	•	 	Ports 

  

	 	•	 	6 FC ports are required for Spectra logic 

  

	 	•	 	2 Ethernet ports are required for management and camera 

  

	 	•	 	Power 

  

	 	•	 	2 L6/20 outlets power connections are required for Spectra Logic 

 The figure below depicts Sepaton
architecture for Federal and Commercial 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-62		Health Net / Cognizant Confidential

 Final 

  
 

 
 Figure: Sepaton architecture for Federal and Commercial 

Features and Benefits: 
  

	 	•	 	The world’s fastest enterprise backup and recovery solution 

  

	 	•	 	The Sepaton backs up data at an industry-leading ingest rate of up to 80 TB per hour, regardless of data type, data change rate or system capacity 

 

	 	•	 	The Sepaton’s patented Content AwareTM de-duplication technology delivers the fastest time to safety and most efficient capacity reduction of any solution available today 

 

	 	•	 	The only data protection solution that can effectively de-duplicate separate parallel backup streams (multi stream) and across multiplexed data volumes, as required for large database environments such as Oracle, DB2
and SQL 

  

	 	•	 	Delta ScaleTM architecture makes it easy to increase storage capacity and maintain performance as your needs grow 

  

	 	•	 	Enables fast and secure replication and transmission of massive backup volumes to remote disaster recovery sites over a wide area network. Replication is performed automatically 

 

	 	•	 	Byte differential Content AwareTM de-duplication reclaims storage space continuously as it operates, freeing capacity sooner and saving administration time 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-63		Health Net / Cognizant Confidential

 Final 

  

	 	•	 	Symantec NetBackup OST features such as Auto Image Replication (A.I.R.), Optimized Synthetic Backups, GRT and Symantec NetBackup Accelerator, which we have purchased the License but it will be implemented in later
projects. 

  

	 	•	 	Delta ScaleTM architecture’s secure multi-tenancy capability allows data managers to allocate performance, capacity bandwidth and quality of service as needed by their enterprise’s various segments,
departments and business units 

  

	 	•	 	Encrypts data at rest while maintaining its blazing fast time to safety and industry-leading backup performance (Sepaton S2100-ES3’s encryption of data at rest capability integrates with industry standard
interoperability protocols for encryption key managers (EKM) that are compliant with industry-standards) 

 Sepaton Management tools

  

	 	•	 	VPN access / WebEx access 

  

	 	•	 	SFTP access from the S2100 to the Sepaton support infrastructure 

  

	 	•	 	Automation of daily SFTP uploads of the S2100 support ticket 

  

	 	•	 	Delta View portal provides 

  

	 	•	 	Case management, Capacity planning 

  

	 	•	 	Backup reporting analytics 

  

	 	•	 	Email configuration 

  

	 	•	 	Email Notification for Alerting 

  

	 	•	 	Email Distribution for DeltaStor Reporting 

 2—SRE Nodes 

We would be creating 2—S2100 Storage pools to breakout Federal and Commercial. 2 trays of HUS110 

 

			
	 •    1 Controller tray
		27TBs Usable – 9/2/1 hot spare
	 •    1 Jbod
		30TBs usable – 10/2

 Storage Pool Breakout 

The smallest storage pool can be 1 LUN = 1 tray 
  

	 	•	 	1 tray allocated for Federal 

  

	 	•	 	1 tray allocated for Non-Federal 

 Sepaton Encryption 

Hardware-accelerated compression & encryption 
  

	 	•	 	Leverages high-performance HiFn DX 1845 to do compression and encryption in unified pipeline 

  

	 	•	 	Massive bandwidth provides compression and encryption throughput for 2 x 8Gbps Fibre Channel ports ingesting data with 100% change rate per SRE node 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-64		Health Net / Cognizant Confidential

 Final 

  

	 	•	 	Key management is external to VTL using an OASIS KMIP-compatible key manager (or the HP proprietary Enterprise Key Manger or the SafeNet Enterprise Key Manager which are both supported by our architectural approach)

  

	 	•	 	Communication with the Key Manager is via the CryptSoft KMIP SDK 

  

	 	•	 	Provides linear scalability as SRE nodes are added to the system 

  

	 	•	 	Performs predictably—no CPU performance impact on ingest or deduplication processing 

  

	 	•	 	All customer data is encrypted before landing on disk 

  

	 	•	 	Encryption keys never stored on disk 

 Sepaton Key Management 

Key Management Availability: The VTL only needs to access the key manager at startup. The key is cached in memory (not on disk) while the VTL is
running. At boot time the system interrogates the list of key managers (up to nine of them) to get the key. If no key manager responds, the system goes into maintenance mode. You can safely take key managers down for system maintenance once the
Sepaton system has retrieved the key. 
 For security reasons, the VTL never stores the key on disk. It always checks for a key on reboot so that IT can
revoke the key (or more commonly) disable the key manager in the event of a data center-wide security intrusion. If this were to happen, shut down the key manager and reboot the VTL to prevent access to live data on the VTL. 

The key manager is essential infrastructure, like power or cooling. Once you decide to implement encryption, you have to maintain the infrastructure to enable
encryption and decryption. It’s like putting locks on your doors and locking the doors. You must keep a key in your pocket (your key manager) to be able to operate the lock. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-65		Health Net / Cognizant Confidential

 Final 

 The figure below depicts backend of the HP DL380p 

 
  
 

 
 Figure: Backend of HP DL380p 

Iron Mountain Open Media and Closed Media Containers Procedures 
  

	 	•	 	Closed Container Program: Iron Mountain rotates the container by its retention date. Iron Mountain picks up the locked container from the Health Net and stores it unopened at its vaulting facility. Iron Mountain
does not interact with the media inside the closed container. The container has a single retention date; hence, the entire contents have the same retention date. Iron Mountain can provide information on which containers you have stored at their
facility. Detail of the contents is Health Net’s responsibility. 

  

	 	•	 	Open Container Program: Iron Mountain rotates individual tapes by their retention date. Iron Mountain picks up the locked container from the Health Net, unlocks the container at its facility, and the media is
slotted inside the Health Net’s designated vault space. This interaction with the media is called an open container environment. Each tape within the transport container can have its own retention date. Iron Mountain can provide exact
information on the media you have stored at their facility. 

 2.2.3.3 Monitoring tools 

This section describes the proposed monitoring tools solution for storage and backup service towers: 

 

	 	•	 	Hitachi command suite tools—centralized management for Hitachi storage system , availability , capacity and performance monitoring 

 

	 	•	 	Sepaton (Delta View manager) – monitoring, Event management, reporting, capacity and performance management 

  

	 	•	 	Spectra logic (Blue scale)– manage tape library (Media lifecycle management), media health monitoring 

  

	 	•	 	Symantec NetBackup for backup management and integrating SNMP traps to HP OMi for alerts 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

  

					
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 Final 

 2.2.3.4 Service Deliverables 

 

	 	•	 	Design , build and manage scalable, reliable online and offline storage environment in the primary and secondary DCs 

  

	 	•	 	Logical separate storage setup for Federal and Non-federal applications and data 

  

	 	•	 	Deploy Disk-to-Disk backup and Disk-to-Tape data vaulting 

  

	 	•	 	To meet the VDI capacity requirements of approximately 5300 users (including about 3600 concurrent users) 

  

	 	•	 	Primary and DR Storage Solutions will have high availability, resilience, performance and scalability. 

2.2.3.5 Steady state support—Deliverables 
 The key
highlights of the proposed solution for storage and backup service towers are described below: 
  

			
	 Solution
	  	 Description

	 Solution
 Highlights

 
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

	 Support
 Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24x7
Onshore support:
  

•    8x5 dedicated support – (Federal onsite) with the rest on call

 

	 Delivery
 Location
	  	 •    Onsite—Health Net offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 The high level activities of storage and backup services are described below: 

Level 1 Services: Storage 
 L1 Services will be provided
in accordance with the procedures documented in the SOPs and will include the following: 
  

			
	L1 Team    	 	 •    FC / director port monitoring

 

	 	 •    Array event monitoring

 

	 	 •    Storage array performance monitoring

 

	 	 •    Disk drives health monitoring

 

	 	 •    Array disk space capacity monitoring and reporting

 

	 	 •    Event monitoring

 

	 	 •    Storage controller Monitoring (CPU) and reporting

 

	 	 •    Where applicable, keep Health Net informed and notified on the status and progress

 Level 2 Services: Storage 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include: 

  

					
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	 	•	 	Incident management services 

  

	 	•	 	Change management services 

  

			
	L2 Team    		 •    LUN/Meta device configuration (creation, deletion, allocation)

 

		 •    Host systems configuration in the array manager (addition,
modification)
  

		 •    Array event analysis

 

		 •    FC / HBA configuration in the host server

 

		 •    Multi-path configuration

 

		 •    Port configuration

 

		 •    Zone configuration

 

		 •    Event analysis

 Types of incidents include following: 
  

			
	 Server Monitoring

	L2 Team    		 •    Storage availability

 

		 •    Space, Memory and Cache

 

		 •    Unauthorized / Inactive User Access

 

		 •    Backup

 

		 •    Disk space utilization

 

		 •    Security and configuration exception alerts

  

			
	 Basic Administration

	 L2 Team    
		 •    Startup/shutdowns of Storage and Backup

 

		 •    Additional Space allocation

 

		 •    Initial troubleshooting and incident management

 

		 •    Set up storage and backup auditing

 Level 3 Services: Storage 

All unknown / new errors and problems will be resolved by L3 Storage Support group. This team will work with Vendors when required. 

 

			
	L3 Team    		 •    Storage array performance analysis

 

		 •    Hardware modification (replacement/ expansion)

 

		 •    FC / HBA hardware modification (replacement/ expansion)

 

		 •    Device parameter configuration

 

		 •    Fabric firmware upgrade / management

 

		 •    Switch port performance analysis

 

		 •    FC cable connectivity modification (new/changes)

  

					
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 Level 1 Services: Backup and Recovery 

L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
	L1 Team    		 •    Proactive monitoring and management of the backup environment (Client
/ Catalog Backup Jobs)
  

		 •    Troubleshooting and preliminary investigations of problem tickets

 

		 •    Unresolved tickets escalating to L2 team ( whenever necessary )

 

		 •    Updating the problem tickets as per the observations and preliminary
investigations
  

		 •    Monitoring backup server logs, OS logs, alert logs, event logs.

 

		 •    Maintaining and updating the log register

 

		 •    Monitoring of Scratch Pools

 Level 2 Services: Backup and Recovery 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
	L2 Team    		 •    Updating operation handbook / Runbooks.

 

		 •    Automation of backup jobs through scripting

 

		 •    Updating the design documents with respect to changes implemented

 

		 •    Troubleshooting, configuration management, Implementing changes

 

		 •    Restarting of failed backup jobs or running the jobs manually
(whenever required)
  

		 •    Client configuration or de-configuration support

 

		 •    Coordinate hardware and software vendor technical support

 

		 •    Master / Media server configuration

 Level 3 Services: Backup and recovery 

L3 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
	L3 Team    		 •    Hardware configurations (Tape, Drive, VTL, etc.)

 

		 •    Handle backup / Restore requests

 

		 •    Create / delete / modify storage pools

 

		 •    Diagnosing, analyzing, performance management and capacity
planning
  

		 •    Configuring backup/Recovery policies and maintaining record of changes
to policies
  

		 •    Implementing best practices and recommendations (Data Depute)

 

		 •    Resolving escalated issue and creating the K.E.D.B. Conducting Root Cause Analysis (RCA) on Severity 1/2
issues

 2.2.3.6 Dependency on Health Net 
  

	 	•	 	Health Net to perform acceptance testing and sign-off on the following: 

  

	 	•	 	Backup Performance (LAN and LAN-Free) 

  

	 	•	 	RTO and RPO 

  

	 	•	 	Testing the VDI environment 

  

					
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 2.2.3.7 Risk and Mitigation 
  

									
	 No    
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	1	  	 Availability of VM, Database
 and Application
team resources for testing VDI and File shares
	  	Medium	  	Medium	  	 Resource requirements and schedules will
 be
developed during the planning phase and will be communicated to the concerned teams

 2.2.4 Servers/VMs 

2.2.4.1 Highlights of Scope Validation Workshop 
  

					
	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

	        Scope        	  	 DC1 - 98 Cisco UCS (Unified
 Computing Systems)
manager Blades
  
 •  11 ESX
Blades for service towers VM 25% and 2 blades for HA
  

•  70 ESX Blades for VDI distribution and 4 blades for HA

 
 •  1 SCCM on Microsoft Hyper-V

 
 •  7 ESX blades for VDI
infrastructure
  
 •  3 ESX blades
for Citrix XenApp
  
	  	 DC1 - 106 Cisco UCS (Unified Computing
 Systems)
manager Blades
  
 •  84 - B200 M3
2 socket 10 core 384GB memory
  

•  84 ESX Blades for VDI
  

•  22 - B200 M3 2 socket 10 core 256GB memory

 
 •  1 bare-metal Blade for SCCM

 
 •  16 ESX Blade for Private
cloud
  
 •  5 ESX Blade for -
Management

	  	 DC2 - 16 Cisco UCS (Unified
 Computing Systems)
manager Blades
  
 •  14 ESX
blades for service towers VM25% (includes HA and Federal)
  

•  1 ESX Blades for VDI distribution

 
 •  1 ESX blades for Citrix
XenServer
  
	  	 DC2 - 11 Cisco UCS (Unified Computing Systems) manager Blades
  

•  5 - B200 M3 2 socket 10 core 384GB memory

 
 •  6 - B200 M3 2 socket 10 core
256GB memory
  
 •  6 ESX Blades
for Private cloud

	  	 •  42 Cisco C220 M3 rack servers

 
	  	 •  36 Cisco C220 M3 rack servers

	  	 •  C220 M3 racks servers configured with single physical server to support SCCM , print service and Antivirus
scan
	  	 Servers will be configured to run two guest windows OS on Microsoft Hyper-V

 
 •  VM1 - server to support SCCM ,
print service and Antivirus scan
  

•  VM2 - Domain controller (future requirement)

 
 VMware architecture change

 

		  		  	 •  4 VMware clusters for resource grouping and access restriction between Federal ,
Non-federal, VDI, and Cognizant management tools
  

		  		  	 •  3 vCenter with heart beat 1 for VDI, 1 Federal, and 1 for Non-federal

  

					
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 2.2.4.2 Solution Approach 

Cognizant will deliver WAN connected highly virtualized production and test environments utilizing current generation Hypervisors including Microsoft Hyper-V
and VMware ESXi. The delivered open systems environments will consist of the following: Wintel (with current Microsoft versions through Windows 2012 Standard), Red Hat Enterprise Linux and virtual Appliances (Symantec NetBackup and others). The
environment split consists of the following Non-federal and Federal breakdown to meet the capacity consistent with 25% service towers. All VM’s and Servers will utilize SCCM for patch management and software distribution. 

 

	 	•	 	VM Non-federal 25% 

  

	 	•	 	Prod - 75 VM’s with 4vCPU and 16GB vRAM 

  

	 	•	 	Non-Prod 20 VM’s with 2 vCPU and 12GB vRAM 

  

	 	•	 	Storage 15TB 

  

	 	•	 	VM Federal 25% 

  

	 	•	 	Prod – 40 VM’s with 4vCPU and 16GB vRAM 

  

	 	•	 	Non-Prod 20 VM’s with 2 vCPU and 12GB vRAM 

  

	 	•	 	Storage 10TB 

  

	 	•	 	Enterprise class availability, scalability and robust infrastructure 

  

	 	•	 	Standardization of server architecture to reduce cost of maintenance 

  

	 	•	 	Will utilize a Reference Architecture approach with UCS B200 M3 blades (Cisco Unified Computing Systems) and Cisco C220 M3 1 RU servers 

 

	 	•	 	Utilize 4x10Gbps ports for Networking and Storage 

  

	 	•	 	Currently using 15:1 ratio for virtual servers 

  

	 	•	 	About 10% white space for future growth 

  

	 	•	 	Cognizant chose UCS because of its agile and flexible capabilities and its wide range acceptance by many storage vendors. Cisco UCS manager is the industry leader in scalable virtualized environments on converged
networks 

  

	 	•	 	Federal VM’s will be isolated from Non-federal VM’s by residing on designated Federal B200 M3 blades which will be in the same Chassis as Non-federal Blades. This configuration needs to meet NIST requirements.
Once all servers are in place Cognizant will start the certification process. These efforts will consist of security scans, reporting and remediation in support of audit/compliance activities. 

 

	 	•	 	Rapid provisioning and management with Cognizant proprietary provisioning tool—Cloud36. 

  

					
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 C220 M3 Servers: 

36 Cisco C220 M3 servers would be built and deployed at the remote Health Net offices to support services like SCCM 2012, Print service and Antivirus scan
servers. The Cisco C220 M3 will be used to meet future requirement like Active Directory Domain Controllers 
 Connectivity Details for C220 M3 

 

	 	•	 	2 Network interface – 1Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	1 Management Interface – 1Gbps for Management 

  

	 	•	 	33 Servers will be deployed in this configuration for connectivity to Health Net remote LAN 

  

	 	•	 	3 Servers will be deployed to Datacenter 

  

	 	•	 	2 servers in DC1 and 1 Server will be deployed in DC2 

  

	 	•	 	2 Network interface – 10Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	1 Management interface - 1Gbps for management 

 C220 M3 server connectivity in Health Net remote sites

 Diagram below depicts the connectivity of C220 M3 server in Health Net remote sites: 

 
 

 
 Figure: Connectivity C220 M3 Server – Remote Site 

C220 M3 server connectivity in DC1 and DC2 
 Diagram below
depicts the C220 M3 server connectivity in DC1 and DC2: 
  

  

					
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 Figure: Connectivity C220 M3 Server – DC1 and DC2 

C220 M3 server - Virtualization Details 
  

	 	•	 	Servers will be configure to run two guest Windows OS on Microsoft Hyper-V 

  

	 	•	 	If a C220 M3 requires more than 2 VM’s the Hypervisor will be changed to VMware ESXi 

  

	 	•	 	VM1 - would be installed and configured with SCCM 2012 distribution point, print service and Antivirus scan servers 

  

	 	•	 	VM1 would be installed with SCCM 2012 to support 1 secondary site along with 28 distribution points for branch offices across CA location. For the remaining locations 5 dedicated distribution points are considered

  

	 	•	 	VM1 will also be configured as print servers by adding the necessary print queues applicable to that respective site/ users 

  

	 	•	 	VM1 deployed in 26 smaller sites will also be configured to provide File Share and Antivirus scan. The 8 larger sites will have 2 C220 M3 physical servers and both the servers will be configured as antivirus scan
servers 

  

	 	•	 	VM 2 - Active directory domain controller (future requirement) 

 Server Distribution details 

The following locations (22) will be installed with 1 Cisco C220 M3 Rack server 
  

									
	 Server Distribution
details

	Chatsworth	  	Oakland DDP	  	International/
 Prospect Park
	  	San Diego	  	Tigard
					
	Fresno	  	Oakland Grand	  	Whiterock 2	  	San Marcos	  	Tucson
					
	Huntington Beach	  	Glendale	  	San Bernardino	  	San Mateo	  	Arlington
					
	Concord	  	Modesto	  	Tempe	  	Mercantile	  	Johnstown
					
	Hampton	  	DC1	  	*ElCerrito	  	*Mountain
 view
	  	*San Jose
					
		  	Visalia	  	Califa	  		  	

  

					
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 The following locations (7) will be installed with 2 Cisco C220 M3 Rack servers 

 

							
	 Server Distribution
details

	Irving	  	Sun Center	  	San Rafael	  	Aerojet
				
	DC1	  	Woodland Hills	  	GoldPoint	  	*Boulder FS
				
		  	*Boulder Corp	  		  	

  

	*	Note – Red boxes are sites that been determined to small or incumbent DC location and where not putting equipment in those sites. 

Connectivity details for UCS with B200 M3 blades 

Connectivity to the Cisco UCS manager chassis consists of a 2 X 10Gbps Ethernet connection to each of the converged fabrics for 4 10GBps connection. This
ensures that there is no single point of failure in the design. Virtual Connectivity to each B200 M3 blade is policy based. Traffic over the links is well defined to allow adequate bandwidth to all required services. Services bandwidth can be
adjusted on demand to meet the needs of vMotion and Backup. The remaining bandwidth is for data traffic. Reference Architecture, Logical flow and Physical connectivity for UCS demonstrating end to end connectivity is represented in the illustration
below. 
 Replication between DC1 and DC2 can be done using vCenter replication or HNAS 

  

					
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 Figure: Reference Architecture Commercial 

  

					
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 Figure: Reference Architecture - Federal 

UCS Infrastructure for VDI 
 The diagram below depicts UCS
blade server and Storage SAN connectivity: 
 (The red line shows the Data flow for VDI object storage, it will be using NFS via the 10G network to the HNAS.
The HNAS will be the mechanism to control the VDI storage pool on the VSP via 4 FC connections per controller.) 

  

					
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 Figure: UCS Blade Server and Storage San Connectivity - VDI 

UCS Infrastructure for Cloud 
 The diagram below depicts
UCS blade sever and Storage SAN connectivity: 
 The red line shows the data flow for block storage, it will be connecting from the USC chassis via 6296
(DC1) or 6296 (DC2) to a set of 5596 via 10G network. The set of 6296 will connect Cisco MDS 9513 to the VSP via 8GB fiber channel (16 8Gbps to switch 1 and switch 2). The environment is currently setup for FC and the final protocol will be
determined during the LLD. 

  

					
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 Figure: UCS Blade Server and Storage San Connectivity - Cloud 

Primary Datacenter DC1 
 UCS blade server / Hardware
details 
  

	 	•	 	106 Cisco UCS (Unified Computing Systems) manager Blades with 8 Blades per Chassis 

  

	 	•	 	84 Blades - B200 M3 w/ 2 socket 10 Core and 384 GB Memory 

  

	 	•	 	22 Blades DR - B200 M3 w/ 2 socket 10 Core and 256 GB Memory 

  

	 	•	 	2 Chassis for Private Cloud 

  

	 	•	 	Break out of Blade Servers 

  

	 	•	 	14 ESX Blades for service towers VM 25% (private cloud) with 2 blades for HA 

  

	 	•	 	2 blades + 1HA for Federal and 5 blades free 

  

	 	•	 	2 blades + 1HA for Non-federal and 5 blades free 

  

	 	•	 	70 ESX Blades for VDI distribution with 4 blades for HA 

  

	 	•	 	1 SCCM bare metal 

  

	 	•	 	3 ESX blades for Citrix XenApp 

  

	 	•	 	7 B200 M3 VDI Infrastructure 

  

	 	•	 	5 Blades for management 

  

					
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 The diagram below depicts Centennial Datacenter (DC1) - Physical rack layout 

 
  
 

 
 Figure: Physical Rack Layout – DC1 

Secondary Datacenter DC2 
 UCS blade server / Hardware
details 
  

	 	•	 	11 Cisco UCS (Unified Computing Systems) manager Blades with 8 blades per chassis 

  

	 	•	 	5 Blades (VDI) - B200 M3 w/ 2 socket 10 Core and 384 GB Memory 

  

	 	•	 	6 Blades - B200 M3 w/ 2 socket 10 Core and 256 GB Memory 

  

	 	•	 	Break out of Blade servers in Secondary DC 

  

	 	•	 	6 ESX blades for service towers VM 25% (includes HA and Federal) 

  

	 	•	 	1 Blades + 1 HA for Federal and 1 open blade 

  

	 	•	 	1 Blades + 1 HA Non-federal and 1 open blade 

  

	 	•	 	5 ESX Blades for VDI distribution 

 The diagram below depicts Secondary Datacenter (DC2) - Physical rack layout

  

					
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 Figure: Physical Rack Layout – DC2 

 

			
	Software Details
		
	Virtual Desktop Broker		Citrix Xen Desktop
	VDI Desktop Provisioning		Citrix Provisioning Services 7.1
	User Profile Management		Citrix User Profile Manager
	VDI Personalization		Citrix Personal vDisks
	Licensing		Citrix License Server 11.11
	Virtual Desktop OS		Microsoft Windows 7
	Windows Server 2012		Standard version
	Database		Server Microsoft SQL Server 2012
	Hypervisor Management		VMware vCenter Server 5 standard
	HA monitoring		VMware vCenter Hearbeat 5.5
	VDI Hypervisor		VMware vSphere Desktop Edition
	Hypervisor		VMware VSphere Enterprise Plus
	Private cloud		Cognizant Cloud 360

 DC1 Licensing 
  

	 	•	 	DC1 software licensing requirements comments 

  

	 	•	 	VMware is licensed by the CPU physical socket while Windows is license per computer 

  

	 	•	 	81 of the blades will use VS5-dt100vm-c Qty 53. VS5-dt100vm-c are 100 count pool licenses for VDI 

  

					
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	 	•	 	3 blades w/ 2cpu x = 6 CPU with VMware Enterprise Plus 

  

	 	•	 	16 blades for cloud infrastructure – In this phase there will be 3 (2+1HA) Non-federal, 3 (2+1HA) Federal (12CPU of VMware Enterprise Plus) 

 

	 	•	 	1 blade x 2CPU SCCM – dedicated 

  

	 	•	 	5 blades x2 (10cpu will have VMware Enterprise Plus ) 

 DC2 Licensing 

 

	 	•	 	DC2 software licensing requirements comments 

  

	 	•	 	5 blades will use the VS5-DT100VM-C Qty 3 from the existing pool at DC1 during DR exercises 

  

	 	•	 	6 blades for cloud but will start out with 2 (1+1HA) Non-federal, and 2 (1+1HA) for Federal (8CPU Cloud 360) 

Software Licensing Totals 
  

											
	 Server / VM Licensing

Requirements
	  	 DC1 C220

M3
	  	 DC1 B200

M3
	  	 DC2 C220

M3
	  	 DC2 B200

M3
	  	 Total

	 Microsoft
	  		  		  		  		  	
						
	 Windows 2012 Data Center Edition
	  		  		  		  		  	
						
	 Windows 2012 Standard Edition
	  	 5Mgmt 1
 SCCM
	  		  		  		  	6
						
	 Cognizant Cloud 360
	  		  	TBD	  		  	TBD	  	TBD
						
	 VMware
	  		  		  		  		  	
						
	 VS5-dt100vm-c
	  		  	53	  		  	 In DR 3
 reassigned
	  	53
						
	 Enterprise Plus
	  		  	28	  		  	8	  	36
						
	 Red Hat Enterprise
	  	TBD	  		  	TBD	  		  	

 Security considerations 

Health Net Federal Information systems (IS) are currently following HN defined NIST requirements and will require recertification due to the state change.
Health Net has indicated that IS going forward will be Certified and Accredited (C&A) on NIST. The NIST process is illustrated below: 

  

					
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 Figure: NIST Process 

2.2.4.3 Monitoring Tools 
 This section
describes the proposed tools solution for Server/VM service towers: 
  

	 	•	 	Cisco UCS manager for monitoring hardware components, fault detection, auditing, and statistics collection 

  

	 	•	 	Cisco UCS manager will be used for the Datacenter management 

  

	 	•	 	HP OMW for Windows server monitoring 

  

	 	•	 	Virtualization monitoring using HP OM VSphere SPI 

  

	 	•	 	Database monitoring using HP OM DB SPI (SQL server Monitoring) 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

  

	 	•	 	Cloud 360 for Virtual management, monitor Hypervisor and rapid VM provisioning 

  

	 	•	 	SCCM for Software distribution/patching 

  

	 	•	 	OEM tools like Microsoft Deployment tool for image management 

  

	 	•	 	Manage Engine Asset Explorer for asset management 

 2.2.4.4 Service deliverables 

 

	 	•	 	Design , Build and Manage scalable, reliable server environment in DC1 and DC2 to meet Federal and Non-federal requirement for service towers like VDI , SCCM , VM and management server 

  

					
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	 	•	 	Integration with Cloud 360 into VMware for VM management and support VM provisioning 

  

	 	•	 	Create initial Service catalog for rapid provisioning, this will be a living catalog and will evolve over time. 

  

	 	•	 	Create initial customer reports based of detail design 

  

	 	•	 	Test the server environment VMware HA functionality 

  

	 	•	 	Health Net standard monitoring tools will be installed on the server as part of standard build. For ex: McAfee TPE, Titanium client, and Quest Intrust 

 

	 	•	 	Create and maintain Build and Runbook documents 

 2.2.4.5 Steady state support—Deliverables 

 

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated Onsite / Offshore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24x7
Onshore support:
  

•    8x5 dedicated support – (Federal onsite) with the rest on call

 

	 Delivery
 Location
	  	 •    Onsite—Health Net Offices

 
 •    Offshore –
Bangalore; Coimbatore

 Level 1 Services 

“Level1” Services will be provided for the servers. L1 Services will be provided in accordance with the procedures documented in the SOPs and will
include the following: 
  

			
	L1 Team	  	 •    Servers status Monitoring

 

	  	 •    Monitor server logs and do initial troubleshooting steps define in
Runbook
  

	  	 •    Escalate to L2 team when necessary

 

	  	 •    Carry out daily, weekly and other regular reporting activities as
defined in the SOPs
  

	  	 •    User / group account management, access permissions

 

	  	 •    Act as the central point of contact between Health Net and
Cognizant for tickets
  

	  	 •    Broadcast communications authorized by the Health Net to users.

 

	  	 •    Where applicable, keep Health Net informed and notified on the service status and
progress

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

	 	•	 	Maintenance of server configuration documentation in the CMDB (Configuration Management Database) 

  

	 	•	 	Managing and configuring Cloud360 

  

					
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	 	•	 	Managing and configuring VMware Enterprise Plus 

  

			
	L2 Team		 •    Security Management – OS hardening / Password management

 

		 •    Carry out scheduled server maintenance / reboot activities

 

		 •    Administration of Physical and Logical server Partitions

 

		 •    Administering clusters ( Adding packages , modifications to package
configuration, startup/shutdown of packages)
  

		 •    Installation of patch bundles / firmware upgrades

 

		 •    Configuration of new hardware

 

		 •    Disk space management

 

		 •    Performance management like Kernel Tuning

 

		 •    Installation of packages / applications

 

		 •    Volumes / File system management

 

		 •    Escalate any technical problem to L3 team when necessary

 

		 •    Implementation of Service improvement plan / Best practices

 

		 •    Maintain Incident information in the KEDB (Known error
Database)
  

		 •    Carry out daily, weekly and other regular reporting activities for Incidents.

 Types of incidents include following: 

Server Monitoring 
  

			
	 L2 Team
		 •    Server availability

 

		 •    Space, Memory and Cache

 

		 •    Replication / Stand by monitoring

 

		 •    Unauthorized / Inactive User Access

 

		 •    Backup status

 

		 •    Disk space / Table space utilization

 

		 •    Security and configuration exception alerts

 Basic Administration 
  

			
	 L2 Team
		 •    Startup/shutdowns of Servers

 

		 •    Additional Space allocation

 

		 •    Initial troubleshooting

 

		 •    Set up server auditing

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 server Support group. This team will work with Vendors when required. 
  

			
	L3 Team		 •    Server planning and Design services

 

		 •    Design any special application or security requirements.

 

		 •    Setup redundant / load balanced servers for application requiring high availability – Server
clustering / network /Server load balancing

  

					
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			 •    Administration / handling issues related to clusters.

 

			 •    Provide technical escalation support to L1 and L2 team when
required
  

			 •    Troubleshoot installation

 

			 •    Validate the new servers before releasing to production

 

			 •    Work closely with Problem Management organization on the remediation
of all problems directly or indirectly related to server engineering
  

			 •    Capacity Management

 

			 •    Troubleshoot major server issues on virtual and physical servers

 

			 •    Conduct Root Cause Analysis (RCA) on Severity 1 issues

 

			 •    Monitor for patches and test

 

			 •    Prepare work plan for major maintenance activity

 

			 •    Deploy patch

 

			 •    Confirm patch efficacy, no adverse effects

 

			 •    Disaster recovery solution design, benchmarking, load testing, implementation, configuration, monitoring
and troubleshooting, both internal and external

 2.2.4.6 Assumptions 
 The
following are the assumptions considered under Servers/VMs 
  

	 	•	 	Cognizant will provide the VM and OS licenses if they are not available with Health Net 

  

	 	•	 	Cognizant will purchase Microsoft Windows Datacenter licenses and Redhat Enterprise subscriptions if needed to accomplish the design objectives of the solution architecture 

 

	 	•	 	Cognizant will work with Health Net to ensure License compliance 

  

	 	•	 	Cognizant will not use unlicensed software in the performance of this contract 

  

	 	•	 	Advance notice for any large project with space requirement above the 10% additional capacity 

  

	 	•	 	Cognizant to have prebuilt small, medium, and large VM profiles in our Service catalog within cloud 360 to help with rapid provisioning, but Cognizant will refine this during the detail design workshops with Health Net

  

	 	•	 	Federal and non- Federal servers may be physically co-located with spares in the chassis 

 2.2.4.7
Dependency on Health Net 
 The following are the dependencies considered under Servers/VMs 

 

	 	•	 	Health Net will provide standard security tools which needs to be installed as part of the standard builds. 

2.2.4.8 Risk and Mitigations 
  

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-85		Health Net / Cognizant Confidential

 Final 

									
	 S. No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	1	  	Licensing to ensure DC failover	  	Medium	  	Medium	  	 Cognizant will review licensing with
 vendors to
address gaps

					
	2	  	 Multiple Hypervisor solutions
 complicate
management and require subject matter experts to possess deep knowledge of multiple competitive products
	  	Medium	  	Medium	  	 Cognizant will ensure that all subject
 matter
experts possess the required knowledge to administrate deployed virtualization solutions

					
	3	  	 Blade based solutions draw more
 power than the
typical rack infrastructure
	  	Low	  	Low	  	 Cognizant will work with DC
 managers to ensure
that implemented
 UCS have adequate power and cooling

					
	4	  	 Vendor licensing changes during the
 life of
UCS
	  	Medium	  	Medium	  	 Cognizant will work with solution
 providers to
identify potential EOL and availability issues to ensure that UCS as deployed will not be impacted

					
	5	  	IS NIST certification	  	High	  	High	  	 Cognizant will work with Health Net to deployed IS meet NIST C&A

requirements

					
	6	  	 Access to Key SME’s from
 incumbent during
Implementation
	  	Medium	  	Medium	  	 Cognizant will work with system
 owners to
define escalation and support criteria that ensure timely access to SME’s

 2.2.5 Monitoring Tools 

2.2.5.1 Highlights of Scope Validation Workshop 
  

					
	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

			
	 Scope
	  	 •    Common OS Monitoring Solution for both Federal and Non-federal

 
	  	 •    Dedicated Federal OS monitoring solution

 

	  	 •    Basic out of box performance reports which will be used for Capacity Management
	  	 •    Enhanced Service Health reporter with historical data storage
capability for OS and Network performance analysis (Additional effort has been considered to build HP SHR)
  

	  	 •    VMware Monitoring was considered through vCenter and planned only
for OS monitoring using HP OM
  
	  	 •    In depth Virtualization monitoring has been added in the solution
along with HP OM
  

	  	 •    No Development and Test environment considered
	  	 •    Added development and Test environment as part of new solution

  

					
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 Final 

 2.2.5.2 Solution Approach 

Cognizant’s enterprise monitoring tools solution which has immense flexible and scalable architecture to support strategic requirement. The following are
the key services achieved using our tools solution. 
  

							
	 Technology
	  	 Environment
	  	 Availability

Monitoring
	  	 Performance Monitoring

(Used for Capacity Mgmt.)

	Operating System	  	Federal	  	HP OMW-1	  	HP Service Health Reporter
				
	Operation System	  	Non-Federal	  	HP OMW-2	  	HP Service Health Reporter
				
	Network Device	  	Federal and Non-Federal	  	HP NNMi	  	HP Service Health Reporter
				
	Physical Server	  	Federal and Non-federal	  	Cisco UCS manager	  	
				
	vSphere	  	Federal and Non-federal	  	vCenter	  	HP OM VSPI and vCenter
				
	Storage	  	Federal and Non-federal	  	 Hitachi Tuning
 Manager
	  	Hitachi Tuning Manager
				
	NetBackup	  	Federal and Non-federal	  	Symantec NetBackup	  	Symantec NetBackup
				
	 Virtual Disk
 Libraries
	  	Federal and Non-federal	  	Sepaton	  	Sepaton
				
	 Tape Disk
 Libraries
	  	Federal and Non-federal	  	Spectra logic	  	Spectra logic
				
	VCloud Enterprise	  	Federal and Non-federal	  	Cloud 360	  	Cloud 360

 High level ESA Tools Solution 

The figure below depicts the representation of the overall tools functionality, integration and IT user’s operation model 

 
 

 
 Figure: Operation Model 

  

					
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	 	•	 	HP tools will be integrated with HP OMi using built-in adaptors and other monitoring tools will be integrated with HP OMi through SNMP traps 

 

	 	•	 	All the events from individual monitoring tools will be directed to HP OMi (MoM) 

  

	 	•	 	Performance data from HP OMW and HP NNM will be directed to HP Service Health Reports (includes DB and Virtualization SPI performance report) 

 

	 	•	 	BMC remedy will be integrated with HP OMi for auto ticketing 

  

	 	•	 	Cognizant’s L1 team will monitor incidents in the BMC remedy tool 

  

	 	•	 	Asset information will be tracked in Manage Engine Asset Explorer 

  

	 	•	 	Cognizant’s IT operations team will leverage HP Service Health Reporter to analyze Operating System, Database, Virtualization and Network performance 

 

	 	•	 	HP Service Health report has a capability to capture historical data for a year to perform trend analysis 

Proposed Tools Architecture in Production 
  

 
 Figure: Commercial Network 

Proposed tools architecture in development 

  

					
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 Figure: Development Environment 

2.2.5.3 Service Deliverables 
  

	 	•	 	Implementation of HP Operation Manager Windows ( 1 – Federal and 2 – Non-federal) 

  

	 	•	 	Implementation of Database monitoring using HP OM DB SPI(SQL DC Monitoring related to VDI) 

  

	 	•	 	Implementation of Virtualization monitoring using HP OM VSPI (vSphere) 

  

	 	•	 	Implementation of Performance Manager 

  

	 	•	 	Implementation of HP Network Node Manager and iSPI 

  

	 	•	 	Implementation of Service Health Reporter 

  

	 	•	 	Implementation of HP Operation Manager (Manager of Manager – MOM) 

  

	 	•	 	Centralized Event Integration using HP Omi for 9 individual Monitoring tools ( 2 – HP OMW, HP NNMi, Citrix Edge sight, Hitachi Tuning Manager, Sepaton, Spectra logic, Symantec NetBackup, Cloud360, Cisco UCS manager
and vCenter) 

  

	 	•	 	Operating system and Networks performance reports using HP Service Health Reporter 

  

	 	•	 	Implementation of Manage Engine Asset Explorer and import asset inventory into Asset Explorer 

 Service
availability tools mapping 
 The figure below depicts the mapping of tools with their functionality for various infrastructure elements in Health
Net’s environment: 

  

					
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 Management Tools Mapping 
  

 

  

					
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 IT Service Management Mapping 

 
 

 
  

	*	BMC Remedy will be replaced with Service Now or HP tools set like HP UCMDB (Universal Configuration Management Database) or HP SAW in the future 

	**	Future tools are only for reference; will not be included in this service engagement Modules with in Hitachi Command Suite are, 

  

	 	•	 	Command Director 

  

	 	•	 	Device Manager 

  

	 	•	 	Dynamic Link Manager Advanced 

  

	 	•	 	Dynamic Provisioning 

  

	 	•	 	Dynamic Tiering 

  

	 	•	 	Replication Manager 

  

	 	•	 	Tiered Storage Manager 

  

	 	•	 	Tuning Manager 

  

	 	•	 	Itrack 

 Modules with in Oracle Enterprise Manager 12c Cloud Control 

 

	 	•	 	Oracle Diagnostics Pack 

  

	 	•	 	Oracle Tuning Pack 

 2.2.5.4 Steady state support – Deliverables 

Key highlights of the proposed solution for Monitoring tools are described below: 
  

			
	 Solution
	  	 Description

	 Solution

Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

  

					
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	 Solution
	  	 Description

	 Support
 Coverage
	  	 •    24x7 dedicated monitoring support—Offshore

 
 •    24X7 Onshore
support
  

                8x5 dedicated support – Onsite (Federal) with the rest on
call
  

	 Delivery
 Location
	  	 •    Onsite—Health Net Offices

 
 •    Offshore –
Bangalore ; Coimbatore

 Tools Support Services 

Tools support services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
	Tools Support Team	  	 •    Support tools environment

 

	  	 •    Configure and troubleshooting agents in new environment

 

	  	 •    Monitoring and tuning the alert parameters

 

	  	 •    Analysis, reduction event correlation, suppress duplicate
alerts
  

	  	 •    Report preparation and analysis

 

	  	 •    Automatic trouble ticket generation for error conditions

 2.2.5.5 Assumptions 
  

	 	•	 	Proposed effort are limited to out of box implementation and no customization 

  

	 	•	 	Monitoring and management tools for the foundation and service towers will be installed on the management servers in standalone mode and HP OMI will be installed and configured with high availability 

 

	 	•	 	All authorized support Health Net staff will have read access to any tools approved through Health Net’s approval processes 

2.2.5.6 Dependency on Health Net 
  

	 	•	 	Health Net would facilitate HP OMi integration with BMC Remedy tool for auto ticket creation 

  

	 	•	 	Health Net Support is required to accomplish prerequisites like domain group creation AD, domain account creation, firewall access, etc. 

  

					
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 2.3 Service Towers 

2.3.1 VDI 
 2.3.1.1 Highlights of Scope Validation

  

					
	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

	Scope	  	 •    A total of 5000 hosted virtual desktops are required. There are
three waves or phases to this implementation.
  

•    Initial wave wise VDI requirement

 
 •    Non-Persistent

 
 •    300 (Wave 1)

 
 •    3000(Wave 2 )

 
 •    Persistent = 1700 (
Wave 3 )
  
 •    Xen
Desktop 7 with provisioning services
  

•    Citrix UPM will be used for user profiles

 
 •    Citrix EdgeSight
will be used for monitoring
  

•    Non-persisting VDI configuration details -2Gb RAM, 1 VCPU, 60 Gb, 10Gb Write cache, 12
IOPS
  
 •    Persistent
VDI configuration details - 8Gb RAM, 2 VCPU, Cache disc - 80 GB for provisioning—PVS + (persistent disc—40Gb additional for storing data), 10Gb Write cache, 20 IOPS
  

•    Image—Win 7 64Bit( 2-3 images)
	  	 •    A total of 5300 hosted virtual desktops are required. The
implementation is going to spread across 2 phases
  

•    Updated wave wise VDI requirement

 
 •    Non-Persistent=
3300 (Wave 1)
  

•    Persistent = 2000 ( Wave 2 )

 
 •    Xen Desktop 7.5
with provisioning services
  

•    Citrix UPM will be used for user profiles

 
 •    Citrix EdgeSight
will be used for monitoring
  

•    Non-persisting VDI configuration details -2Gb RAM, 1 VCPU, 60 Gb, 10Gb Write cache, 12
IOPS
  
 •    Persistent
VDI configuration details - 8Gb RAM, 2 VCPU, Cache disc—80 GB for provisioning—PVS + (persistent disc—40Gb additional for storing data), 10Gb Write cache, 20 IOPS

 
 •    Image—Win 7
64Bit( 2-3 images)
  

•    Non-persistent( Federal – 300, Non- federal – 3000)

 
 •    Persistent (
Federal – 30 and Non- federal – 1970 )
  

•    Test/UAT environment will be built and would be in use for all patch testing and other
application update testing ( DC2 )

 NOTE: Design Decision: 

PVS v/s MCS: Cognizant has designed based on best practices, and will be using Xen Desktop 7.5 with PVS for 2000 persistent VDI Users, based on consultation
with Citrix and WWT. Per Health Net’s request, if PVS does not work as advertised, Cognizant will revert to MCS, and an additional storage of 150 TB will need be procured at that time, and cost will be charged to Health Net. 

  

					
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 2.3.1.2 Solution Approach 
  

	 	•	 	The solution provided for Health Net uses Citrix Xen Desktop 7.5 with provisioning server over VMware vSphere platform. 

  

	 	•	 	The Xen Desktop environment is a two-farm two site (Centennial and Phoenix) architecture. 

  

	 	•	 	Citrix components like NetScaler servers, AD authentication and license servers would be common for both XenApp and Xen Desktop environment. 

 

	 	•	 	Intranet Users with in the LAN (Health Net) would directly hit the web interface placed in Centennial DC. 

  

	 	•	 	Internet Users would hit the NetScaler Access Gateway placed in Boulder DC and would be routed to Web interface in Centennial DC 

  

	 	•	 	The vDisks base image would have about 40-50 Health Net approved applications 

  

	 	•	 	Citrix User profile management would be used for user profile solution 

  

	 	•	 	The current VDI platform is designed for 5300 VDIs and can accommodate an additional 50- 100 VDIs 

  

	 	•	 	DR site would be the Phoenix DC and would cater to 200 Non-persistent and 60 Persistent virtual desktops which is 5% of 5300 VDI’s. 

 

	 	•	 	There would be no storage replication / SRM configuration for VDI Images, standard build of persistent and non-persistent VDI images will be maintained in DR site 

 

	 	•	 	Dedicated Microsoft DHCP/DNS would be built in Centennial DC for VDI. 

  

	 	•	 	Citrix XenApp 5.0 will be built for the legacy applications. 

  

	 	•	 	A limited Citrix Xen App 5.0 environment will be built to host a small number of legacy applications that are not compatible with the Windows 7 VDI images. (Examples—IE 6, Hyperion, Access 97). This pool of servers
will be used by a small number of clients and phased out as application requirements permit. 

  

	 	•	 	For non-persistent VDI users will be able to save data only on their home drive (Network drives) 

  

	 	•	 	Persistent VDI users will have Personal vDisks where users can store and install software. 

  

					
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 Components of the Xen Desktop 7.5 environment: 

 

									
	 S No.
	  	 Components
	  	 Physical/VM
	  	 No. of server
	  	 Configuration

	1	  	 NetScaler Access
 Gateway
	  	Physical device	  	2	  	In Bolder DC not in scope
					
	2	  	Storefront server	  	VM	  	10 Prod/test/DR	  	 Win2012 r2, 8Gb ram,
 4vpcu, 80gb.

					
	3	  	License server	  	VM	  	3 Prod/test/DR	  	 Win2012 r2, 8Gb ram,
 4vpcu, 80gb.

					
	4	  	 SQL Database Server-
 Instances

For XD and Xen App
	  	VM	  	10 Prod/test/DR	  	60Gb/Instance
					
	5	  	 Desktop Delivery
 Controller

(DDC)/Studio
	  	VM	  	8 Prod/test/DR	  	 Win2012 r2, 16Gb ram,
 4vpcu,
120gb.

					
	6	  	Desktop Director	  	VM	  	4 Prod/test/DR	  	 Win2012 r2, 8Gb ram,
 4vpcu,
120gb.

					
	7	  	 Provisioning Services
 server
	  	VM	  	10 Prod/test/DR	  	 Win2012 r2, 16Gb ram,
 4vpcu, C: 120gb. D:
240gb

					
	8	  	 Virtual Desktop Agent
 (VDA)
	  	VM	  		  	To be installed on images
					
	9	  	Virtualization host infrastructure (vSphere )	  	ESX/vSphere	  	5300VDI	  	 XD/Xen App infrastructure and VDI

execution

					
	10	  	Citrix XenApp 5 for legacy application	  	VM	  	20 Prod	  	 Xen App member server and infra servers (Win2k8r2, 16Gb ram, 4vpcu,

120gb.)

					
	11	  	File server	  	appliance	  		  	Network drives
					
	12	  	User profile Manager	  	appliance	  	30 Tb	  	Storage/Fileserver ( For 5300 users)
					
	13	  	Active Directory	  	VM	  	2	  	Domain controller
					
	14	  	DHCP /DNS	  	VM	  	3 Prod/DR	  	 DC1 – 2 VM, active and passive, DC2 -
 1
VM
 Win2012 r2, 16Gb ram,
 4vpcu, C: 120gb.

					
	15	  	Hitachi Storage	  	NAS	  	 161TB
 +15Tb

+10TB =
 186Tb
	  	 161 Tb is for VDI, 15 TB is for
 infrastructure
servers, UPM,
 10 TB = Buffer.

 Note: These are approximate figures and might changes during LLD phase. 

  

					
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 Final 

 VDI logical architectural design 

 
 

 

  

					
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 UCS Infrastructure for VDI 

The diagram below depicts UCS blade server and Storage SAN connectivity: 

(The red line shows the data flow for VDI object storage, it will be using NFS via the 10G network to the HNAS. The HNAS will be the mechanism to control the
VDI storage pool on the VSP via 4 FC connections per controller.) 
  

	*	Note - Please refer to section 2.2.4 Servers/VM’s for detailed information 

  

 
 Note: Refer Storage, Server/VM’s section for detailed integration of VDI with vSphere and storage 

Sizing calculation done based on the VDI requirement: 

Non-Persistent Image 
  

	 	•	 	Windows 7 64bit, 1vCPU, 2GB RAM, 60GB Disk, (approx. <10 GB write cache required). 

  

	 	•	 	12 IOPS estimated per Virtual desktop 

 Persistent Image 

  

					
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	 	•	 	Windows 7 64bit, 2vCPU, 8GB RAM, 80GB Disk 

  

	 	•	 	20 IOPS estimated per Virtual Desktop 

 VDI –BOM calculation in DC1 to cater for 5300 VDI’s

  

															
	 	  	 VCPU
	  	 RAM-

Gb
	  	 Storage-Gb
	  	 Write

Cache
	  	 IOP’s
	  	 Assumption
	  	 Cores

required

	 Wave 1 – 3300
 VDI
	  	3300	  	6600	  	240-Image	  	33000	  	49500	  	8 vcpu /Core Normal users	  	413
								
	 Wave 2 – 2000
 VDI
	  	4000	  	16000	  	 240 for

Image
 /80000 for

PVD
	  		  	40000	  	4 vcpu /Core Heavy users	  	1000

 VDI – BOM calculation in DC2 to cater to 260 VDI’s 

 

															
	 	  	 VCPU
	  	 RAM-

Gb
	  	 Storage-Gb
	  	 Write

Cache
	  	 IOP’s
	  	 Assumption
	  	 Cores

required

	 Non-
 persistent -200
	  	200	  	400	  	480 GB	  	2000	  	2000	  	8 vcpu /Core	  	25
								
	Persistent -60	  	120	  	480	  	 240 for Image

2400 for PVD
	  		  	1200	  	4 vcpu /Core Heavy users	  	30

 Capacity Management 

Please refer to the process document shared with Health Net for detailed understanding of the Capacity Management process flow. Typical high level activity to
meet increase capacity of VDI requirements beyond 5300 users (e.g. to add additional 400 users) 
  

	 	•	 	Assessments of the new VDI requirement like persistent and non-persistent, new application, image build requirement, etc. 

  

	 	•	 	Follow the service request process 

  

	 	•	 	Assess the current infrastructure capacity like server, storage space availability, network device capacity 

  

	 	•	 	Assess the Network bandwidth i.e., Boulder to DC1, Health Net office link etc. 

  

	 	•	 	Based on the assessment, if required procure new hardware like blade server, disk space, network module, software license etc. 

  

	 	•	 	Design, build, test and deliver the VDI to users 

  

	 	•	 	Document the build activity 

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-98	  	Health Net / Cognizant Confidential

 Final 

 2.3.1.3 Monitoring Tools 

The section below describes the proposed tools solution for VDI service towers: 
  

	 	•	 	Citrix EdgeSight for monitoring the citrix environment and real-time alerting 

  

	 	•	 	Citrix EdgeSight for event management, performance management , trend usage and capacity planning 

  

	 	•	 	Citrix EdgeSight reports will be shared with Infosec team 

  

	 	•	 	SCCM for Software distribution/patching 

  

	 	•	 	OEM tools like Microsoft Deployment tool for image management 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

 2.3.1.4 Service Deliverables 

 

	 	•	 	Build of Citrix Xen Desktop and XenApp infrastructure 

  

	 	•	 	Creation of Low level design document 

  

	 	•	 	Creation and maintenance of build documents/ runbook 

  

	 	•	 	Pilot testing before releasing to production 

  

	 	•	 	Test and validation by end users 

  

	 	•	 	Transition and handover to steady state support team 

  

	 	•	 	Documentation of build and processes / runbooks for steady state team 

 2.3.1.5 Steady State Support –
Deliverables 
  

			
	 Solution
	  	 Description

		
	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 Level 1 Services 
 L1
Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 
  

			
		  	 •    Perform incident analysis

		
		  	 •    Perform initial troubleshooting to determine the nature of the issue

		
		  	 •    Collect basic user and session information

		
	L1 Team	  	 •    Update ticket and log all troubleshooting steps performed

		
		  	 •    Resolve basic Citrix related issues, connectivity problems and application related issues using
existing KEDB articles

		
		  	 •    Escalate unsolved issue to Level -2

  

					
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			 •    If the issue is related to particular applications or other technologies and not the Citrix
infrastructure, escalate the issue to the appropriate application or technology support units

		
			 •    Generate requests for additional issue resolution guides as necessary

		
			 •    Assign user permission for Virtual Desktops

		
			 •    Citrix ICA/HDX Connectivity Issues

		
			 •    ICA settings / configurations

		
			 •    First level incident tickets from Citrix Edge Sight

		
			 •    Direct call handling from Health Net – Service request

		
			 •    Daily check list monitoring for Xen Desktop Site

		
			 •    Virtual desktop profile issues and login problems

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

			
			 •    Perform intermediate issue analysis and resolution

		
			 •    Respond to VDI infrastructure alerts and system outages

		
			 •    Respond to critical monitoring alerts

		
			 •    Generate articles and issue resolution scripts

		
			 •    Perform basic server maintenance and operational procedures

		
			 •    Manage user profiles

		
			 •    Escalate unsolved ticket to L3 team or appropriate technology owner

		
	L2 Team		 •    Create periodic reports of server health, resource usage, user experience, and overall environment
performance

		
			 •    Configuration compliance reporting

		
			 •    Manage Desktop Catalog

		
			 •    Assign Desktops to end users

		
			 •    Manage Provisioning Server and Storage

		
			 •    License Management / Monitoring

		
			 •    Customize Desktop Group

		
			 •    Manage Desktop Delivery Controller

		
			 •    Update and Maintain Incident information in the KEDB

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 VDI Support group. This team will work with Vendors when required. 
  

			
			 •    Create Desktop Catalog

		
			 •    Perform advanced issue analysis and resolution

		
	L3 Team		 •    Perform maintenance and environment upgrades

		
			 •    Address high severity issues and service outages

		
			 •    Review periodic reports of server health, resource usage, user experience, and overall environment
performance

  

					
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			 •    Perform policy-level changes

		
			 •    Review change control requests that impact the Xen Desktop environment

		
			 •    Create new image templates based on the project requirements

		
			 •    Perform image updates on the configured images.

		
			 •    Adding or updating applications to Xen Desktop environment will be managed from SCCM 2012

		
			 •    Load balancing troubleshooting

		
			 •    HA and DR Support

		
			 •    Storage Awareness and Support

		
			 •    SQL Awareness and Support

		
			 •    Manage VMware ESX and Xen Desktop Delivery

		
			 •    Manage provisioning of Server and Storage

		
			 •    Update and Maintain Incident information in the KEDB

 2.3.1.6 Assumptions 
  

	 	•	 	Non persistent - User data does not change, image remains the same. 

  

	 	•	 	Persistent - User data will not be up to date as agreed with HN, and normal base image will be available and user’s data can be stored on the network drives, this is specific to the DR site only. 

 

	 	•	 	Netscaler would be transitioned to Cognizant delivery team at a later stage and will be supported 

  

	 	•	 	Additional VDI requirements provided by Health Net will be implemented and Change Request will be submitted to Health Net 

2.3.1.7 Dependency on Health Net 
 The following are the
dependencies which are required to be in place for successful implementation of this VDI environment. 
  

	 	•	 	Network Connectivity, bandwidth and configuration 

  

	 	•	 	Health Net to provide installation and configuration guide for applications in the Virtual desktop base images, Xen App member servers 

 

	 	•	 	Netscaler Access Gateway configuration in Boulder DC 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-101		Health Net / Cognizant Confidential

 Final 

 2.3.1.8 Risks and Mitigations 

 

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	1	  	Bandwidth between Datacenter hosting virtual desktops and branch office	  	Medium	  	Medium	  	 Review the bandwidth requirement with
 Health
Net and upgrade the link

					
	2	  	Netscaler Access gateway is in Bolder DC and supported by incumbent vendor	  	Medium	  	Medium	  	 Co-ordinate with incumbent vendor for

configuration / support

 2.3.2 File Share and Print 

2.3.2.1 Highlights of Scope Validation 
  

					
	 Description
	  	 Pre Scope Validation

Workshop
	  	 Post Scope Validation Workshop

	Remote Location sites for File Shares	  	 •    There were 8 large remote sites and 26 small remote sites for a total of 34 remote sites.
	  	 •    There are now 7 large sites including DC1 and 21 small remote sites for the file shares. Now there are
total of 28 remote sites.

			
	Failover solution for large remote sites	  	 •    There was no failover solution
	  	 •    The proposed solution for “Failover Solution for Large Sites” is to take advantage of
HDI’s “Roaming Home Directories” feature. This feature takes advantage of Windows DFS capability of assigning network shares based on logon details (such as location). When a user is in a “failover” situation, they will
launch a VDI session (located in Centennial) and DFS will dynamically determine that the HDI cluster in Centennial is now the “active” home directory for that session (and not their local HDI home directory) and will allow the user to read
and write files to their directory in Centennial. The standby HDI server in Centennial is continuously populating its file system (each of the user’s home directories) from the HCP so when a VDI session is launched in Centennial, the
users’ directories have been pre-populated with metadata and stubs of their files.

  

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-102	  	Health Net / Cognizant Confidential

 Final 

 2.3.2.2 Solution Approach 

File Share Services 
 Design and Build Approach 

 

	 	•	 	Design the target environment 

  

	 	•	 	Install and configure HCP/HUS/HDI in the DC1 and DC2 

  

	 	•	 	Setup HTTPS replication between DC1 HCP to DC2 HCP 

  

	 	•	 	Build HDI infrastructure for File share in remote location in a phased approach 

  

	 	•	 	Build C220 servers with hyper-V, with SCCM distribution point, print services and AV offload server. (refer to C220 server virtualization details) 

 

	 	•	 	User / Shared data migration to new environment if required 

  

	 	•	 	Manage the environments (HCP/HUS) for File Share in the Centennial and Phoenix DCs. 

  

	 	•	 	Cognizant will utilize a client /server architecture with an appliance on the premises. The architecture is designed to move data back to the central location for both File and WAN optimization 

 

	 	•	 	HDI (Hitachi Data Ingestor) cluster appliance would be placed in both the DCs 

  

	 	•	 	The HCP/HUS (Hitachi Unified Storage) solution will reside in both ( Centennial and Phoenix ) DCs with storage capacity of 100TB for each DC, but depending on our design consideration during the LLD this number could be
50T. For example if we keep one copy local and the second copy in DC2 then the total usable will be 100TB, but if we do a local copy (two copies on a HCP before sending to DC2 (which will keep two copies as well) the useable will be 50TB. The reason
it’s half the size in option 1; a file that takes 1TB will need only 1TB , but in option2 if a file is 1TB and we make a local copy, then you will need a second TB and we have less risk but it comes at a price. Final design will be determined
during the LLD. 

  

	 	•	 	The HCP solution utilizes a non-tape archiving method and will be mitigated by configuring DC1 HCP to replicate to DC2 HCP environment. 

 

	 	•	 	Primary and secondary DC will have one spare HDI appliance in case one HDI (Hitachi Data Ingestor) goes down and the remote site has a backup appliance 

 

	 	•	 	HDI provides virus protection by working with scan server 

  

	 	•	 	7 HDI (Hitachi Data Ingestor) cluster appliances and 21 HDI (Hitachi Data Ingestor) single nodes in remote offices 

  

	 	•	 	For the smaller 21 sites HDI appliance would leverage the existing SCCM server for AV scanning. 

  

	 	•	 	The 7 large sites ( includes DC1 ) having clustered HDI appliance requires two scan servers out of which one would be the existing SCCM server and other would be new server for scanning 

 

	 	•	 	MS Access and Data will be local to the remote site for performance but when file changes, the changed data gets synced up to the central repository over IP connectivity 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-103		Health Net / Cognizant Confidential

 Final 

 Remote Location details 
  

															
	 	  	 	  	 	  	 	  	Site Meets	  	Configuration	  	 N= No

Riverbed

	 Current Site
	  	 New Site (if

applicable)
	  	Configuration	  	virtual
HDI	  	Req.
Yes	  	No	  	Needs
updated	  	*=
Riverbed
	 Sun Center
	  		  	1	  		  		  		  		  	N
								
	 Irving
	  		  	1	  		  		  		  		  	*
								
	 San Rafael
	  		  	1	  		  		  		  		  	*
								
	 Aerojet
	  		  	1	  		  		  		  		  	*
								
	 Woodland Hills
	  		  	1A	  		  		  		  		  	**
								
	 GoldPoint
	  		  	1A	  		  		  		  		  	***
								
	 Boulder Corporate
	  	DC1 (Centennial)	  	1A	  	1	  	x	  		  		  	
								
	 Boulder FS
	  	 DC1

(Centennial)
	  	3	  		  	x	  		  		  	
								
		  	 DC2
	  	1	  	1	  	x	  		  		  	
								
	 Concord
	  		  	3	  		  		  		  		  	N
								
	 Chatsworth
	  		  	3	  		  		  		  		  	N
								
	 ElCerrito
	  		  		  		  		  		  		  	
								
	 Fresno
	  		  	4	  		  		  		  		  	*
								
	 Huntington Beach
	  		  	4	  		  		  		  		  	*
								
	 Modesto
	  		  	3	  		  		  		  		  	N
								
	 Mountain View
	  		  		  		  		  		  		  	
								
	 Oakland DDP
	  		  	3	  		  		  		  		  	N
								
	 Oakland Grand
	  		  	4	  		  		  		  		  	*
								
	 Glendale
	  		  	4	  		  		  		  		  	*
								
	 Tempe
	  		  	4	  		  		  		  		  	*
								
	 International/Prospect

Park
	  		  	3	  		  		  		  		  	N
								
	 Whiterock2
	  		  	3	  		  		  		  		  	N
								
	 Mercantile
	  		  	3	  		  		  		  		  	N

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-104	  	Health Net / Cognizant Confidential

 Final 
  

															
	 	  	 	  	 	  	 	  	Site Meets	  	Configuration	  	 N= No

Riverbed

	 Current Site
	  	 New Site
(if applicable)
	  	Configuration	  	virtual
HDI	  	Req.
Yes	  	No	  	Needs
updated	  	*=
Riverbed
								
	 San Bernardino
	  		  	3	  		  		  		  		  	N
								
	 San Diego
	  		  	4	  		  		  		  		  	**
								
	 San Jose
	  		  		  		  		  		  		  	
								
	 San Marcos
	  		  	3	  		  		  		  		  	N
								
	 San Mateo
	  		  	3	  		  		  		  		  	N
								
	 Tigard
	  		  	4	  		  		  		  		  	*
								
	 Tucson
	  		  	4	  		  		  		  		  	*
								
	 Visalia
	  		  		  		  		  		  		  	
								
	 Califa
	  		  		  		  		  		  		  	
								
	 Arlington
	  		  	4	  		  		  		  		  	*
								
	 Johnstown
	  		  	4	  		  		  		  		  	*
								
	 Hampton
	  		  	4	  		  		  		  		  	*

 Configuration: 
  

													
	 Configuration
	  	 Equipment
	  	 Requirement
	  	 Weight
	  	 Power WATTS
	  	 # of ports

1 GBE
	  	 # of

Sites

	Configuration 1	  	 HDI
 Cluster (2 HDI nodes)
	  	5	  	 Server - 39.4Kg
 HUS - 43kg

IP Switch-
 2.5Kg
	  	 Server - 240
 HUS - 500

IP Switch - 28
	  	12	  	4
							
		  	 Cisco
 C220 1
	  	1	  	37.1 Kg	  		  	 3 (2 for public 1
 for Management)
	  	
							
		  	 Cisco
 C220 2
	  	1	  	37.1 Kg	  		  	 3 (2 for public 1
 for Management)
	  	
							
	 Configuration
 1a
	  	 2 HDI
 Cluster (4 HDI Nodes)
	  	10	  	 Server - 39.4Kg
 HUS - 43kg

IP Switch-
 2.5Kg
	  	 Server - 240
 HUS - 500

IP Switch - 28
	  	24	  	3

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-105	  	Health Net / Cognizant Confidential

 Final 
  

													
			 Cisco
 C220 1
		1		37.1 Kg				3 (2 for public 1 for Management)		
			 Cisco
 C220 2
		1		37.1 Kg				3 (2 for public 1 for Management)		
							
	Configuration 2		 HDI
 Cluster (2 HDI nodes)
		5		 Server - 39.4Kg
 HUS - 43kg

IP Switch-
 2.5Kg
		 Server - 240
 HUS - 500

IP Switch - 28
		12		1
			 Cisco
 C220 1
		1		37.1 Kg				3 (2 for public 1 for Management)		
			 Cisco
 C220 2
		1		37.1 Kg				3 (2 for public 1 for Management)		
			Riverbed		2								
							
	Configuration 3		 Single
 HDI
		2		32.7Kg		461.5		4		11
			 Cisco
 C220 1
		1		32.7Kg				3 (2 for public 1 for Management)		
			Riverbed		2								
							
	Configuration 4		 Single
 HDI
		2		32.7Kg		461.5		4		11
			 Cisco
 C220 1
		1		32.7Kg				3 (2 for public 1 for Management)		
	Total												*30

  

	*	Note – the total number is 28, but we made it more granular and counted DC1 and DC2 multiple times. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-106		Health Net / Cognizant Confidential

 Final 

 High Level File share architecture 

 
 

 
 Hardware Overview 

HCP Overview: 
 The Hitachi Content Platform, as a
general-purpose object store, allows unstructured data files to be stored as objects. An object is essentially a container that includes both file data and associated metadata that describes the data. 

Multi tenancy support allows the repository in a single physical HCP instance to be partitioned into multiple namespaces. A namespace is a logical partition
that contains a collection of objects particular to one or more applications. 
 Data access to HCP namespaces would authenticated and configuration of the
access protocol. Authentication can be performed using Microsoft Active Directory® groups. 
 HCP
supports encryption at rest capability that allows seamless encryption of data to the physical device. This ensures data privacy by preventing unauthorized access to the stored data. 

Hitachi Content Platform Services 
  

			
	 Policy
	  	 Description

		
	 Protection
	  	Enforces DPL policy compliance by ensuring that the proper number of copies of each object exists in the system, and that damaged or lost objects can be recovered.
		
	 Content Verification
	  	Guarantees data integrity of repository objects by ensuring that the content of a file matches its digital signature. Repairs the object if the hash does not match. SHA- 256 hash algorithm is used by
default.

  

					
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 Final 

			
		
	 Scavenging
		Ensures that all objects in the repository have valid metadata, and reconstructs metadata in case the metadata is lost or corrupted, but data files exist.
		
	 Garbage Collection
		Reclaims storage space by purging hidden data and metadata for objects marked for deletion, or left behind by incomplete transactions.
		
	 Duplicate

Elimination
		Identifies and eliminates redundant objects in the repository, and merges duplicate data to free space.
		
	 Shredding
		Overwrites storage locations where copies of the deleted object were stored in such a way that none of its data or metadata can be reconstructed, for security reasons. Also called secure deletion. The default HCP shredding algorithm
uses 3 passes to overwrite an object and is DoD 5220.22-M standard compliant.
		
	 Disposition
		Automatic cleanup of expired objects. All HCP namespaces can be configured to automatically delete objects after their retention period expires.
		
	 Compression
		Compresses object data to make more efficient use of system storage space. The space reclaimed by compression can be used for additional storage. A number of configurable parameters are provided via System Management Console (i.e.
Scheduled service)
		
	 Capacity Balancing
		Attempts to keep the usable storage capacity balanced across all storage nodes in the system. If storage utilization for the nodes differs by a wide margin, the service moves objects around to bring the nodes closer to a balanced
state.
		
	 Storage Tiering
		Determines which storage tiering strategy applies to an object, evaluates where the copies of the object should reside based on the rules in the applied service plan, and moves objects between running and spin-down storage as
needed.

 HDI Overview: 
 Integrated
Edge-to-core Storage Solution 
 Hitachi Data Ingestor (HDI) is an elastic and backup-free cloud on-ramp and filer. HDI with Hitachi Content Platform (HCP)
is an integrated storage solution that is seamlessly scalable and backup-free for distributed consumers of IT, such as remote offices, branch offices (ROBO) and cloud storage users. Hitachi Data Ingestor provides a standard connection, or on-ramp,
into the core data center without requiring application recoding and without changing the way users interact with storage today. Because HDI acts as a caching device, it gives users and applications seemingly endless storage and a host of newly
available capabilities. These features reduce management time and cost by eliminating the need to constantly manage capacity, utilization and performance of the system. 
  

	 	•	 	Content sharing and roaming home directories enable simplified access and management across different sites. 

  

	 	•	 	Deploy a wide area content distribution framework. 

  

					
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 Final 

	 	•	 	Data protection and file restore. 

  

	 	•	 	No need for tape backup. 

  

	 	•	 	Data security and encryption. 

  

	 	•	 	Retrieve previous versions of a file as well as deleted files. 

  

	 	•	 	Maintain file and directory access control. 

  

	 	•	 	Automated migration. 

  

	 	•	 	Easily transition from NAS and Windows Servers to HDI. 

 HCP and HDI Encryption: 

HDI and HCP uses DARE (Data at rest encrypted) encryption and Key management it installed when the system is initially installed, and can be done in several
ways. 
  

	 	•	 	HDI only 

  

	 	•	 	HCP only 

  

	 	•	 	HDI and HCP ( our planned configuration, will be revisited during LLD) 

 Once installed the key Blob is moved
from the HDI to the central HCP during the first save, then removed from the HDI. Once on the HCP the key is partition over the nodes (4 currently for HN) and no on node will have the full key for protecting the Key. Currently will have 3 keys: 

 

	 	•	 	DEK – Used to encrypt/decrypt data at rest in HDI 

  

	 	•	 	KEK – Used to encrypt/decrypt the DEK embedded in the OS 

  

	 	•	 	KEY Blob – created by encrypting the DEK with KEK and stored in the HCP 

 Note : For more details please
refer to the PDF:  
 https://hcpanywhere.hds.com/mobile/links/public/file/HDI%204.1%20DARE%20Details.pdf?token=Tm5
aBSFdQMOgh3YXOVTO9sRpmCo8qWsd0WfLMb0i4yr8cjGMgIzCIUcKD56alZd7mPml0Inz9VKyEh tS_CidwI6x15Suzcm5qISPhsGStY0S9aDrGPX76Cc-KJXugvgJ 
 HCP Replication

 Replication, an HCP service, is the process of keeping selected tenants and namespaces in two HCP systems in sync with each other. This entails
copying object creations, object deletions, metadata changes, and other information between the two systems. The HCP system in which the objects are initially created is called the primary system. The second system is called the
replica. Typically, the two systems are in separate geographic locations and are connected by a high-speed wide area network. 
 To start the
replication service, you create a replication link between the primary system and the replica. A replication link is a secure trust relationship between the two systems. It determines what is replicated and how data is transmitted between the
primary system and the replica. 
 A link created on a primary system must be accepted by the replica before replication can begin. To the primary system,
this link is an outbound link and to the replica, it’s an inbound link. 

  

					
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 Final 
  

 You can also create a link remotely on the replica. When you do this, replication from the primary system to
the replica begins right away, without the primary system having to accept the link. To the primary system, the link is still an outbound link and to the replica, it’s still an inbound link. 

Replication relies on SSL to ensure the integrity and security of transmitted data. Before you can create a replication link, the primary system and the
replica must each have a valid SSL server certificate. Each system must also have the server certificate from the other system installed as a trusted replication server certificate. 

Replication is asynchronous with other tenant and namespace activity on both the primary system and the replica. An HCP system can, therefore, develop a
backlog of objects to be replicated. 
 You can choose to have the replication service work on objects with the oldest changes first, regardless of which
namespaces they’re in. Alternatively, you can have the service balance its processing time evenly across the namespaces being replicated. In this case, the service may replicate recent changes in some namespaces before older changes in others.

 Note : For more details please refer to the PDF- 

https://hcpanywhere.hds.com/mobile/links/public/file/HCP%20Replicating%20Tenants%20and%20Nam
espaces%206.0.pdf?token=sYZO4aYyIkbr7LX1o645Xgy5g4TTnu3817rtdj-5Rv6- I19UVmKRRNnQPOt2zttkcOnsTnRHPC6VdDC3qSjU6dHWJPxaRIFRdEn9cBKah7C2Ox7lVCNJdxdJ_GYgBGR_ 

Datacenter 
 The diagram below depicts the HDI integration
with UCS/storage for VDI user. This details the UCS/HNAS/HCP connectivity and HDI/HCP connectivity: 
  

	 	•	 	UCS g HNAS: NFS 8 x 1GbE 

  

	 	•	 	UCS g HDI: NFS 8 x 1GbE 

  

	 	•	 	HNAS g HCP: HTTPS 8 x 1GbE 

  

	 	•	 	HDI g HCP: HTTPS 8 x 1GbE 

  

					
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 Final 

  
 

 
 Remote Sites – Health Net branch offices 

There are 7 large sites including a new one in DC1 and 21 small remote sites for the file shares. The 7 large sites will have clustered HDI appliance and
smaller site will be configured with single node HDI. The diagram below illustrates the HDI architecture for remote offices. Users at Small Sites will connect to the single node HDIs via 2 x 1GbE connections on board the HDI. Users at Large Sites
will connect to the clustered HDI via (up to) 8 x 1GbE connections (4 available on each HDI node). Each HDI cluster is backed by an HUS block storage system. The same 1GbE ports on the HDIs will be used to replicate/retrieve files to/from HCP at the
Datacenter (through a Riverbed device). Each HCP node has 2 x 1GbE ports (both can be active) for a total of 8 x 1GbE ports available for receiving/retrieving files. 
  

 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-111		Health Net / Cognizant Confidential

 Final 

 HDI - Hardware details 
  

	 	•	 	Single node HDI – 4 ports of 1 GbE each for data total of 4 ports 

  

	 	•	 	1GbE port for maintenance port segregated from the data ports 

  

	 	•	 	The single node HDI will have a maximum cache size of 4 TB 

  

	 	•	 	Cluster Node HDI – 4 ports of 1GbE each for data total of 8 ports 

  

	 	•	 	1GbE for maintenance and management ports segregated from the data ports 

  

	 	•	 	The clustered node HDI will have a maximum cache size of 7TB. 

  

	 	•	 	The HDI cluster will be directly connected to the HUS 110. 

 Replication: the replication between the
Centennial and Phoenix DC’s will be through HCP via HTTPS over the WAN. The replication policies are configured at the HCP namespace level. 
 Note:

  

	 	•	 	For the read/write failover from a single node HDI there has be a single node HDI in the Centennial DC and for the read/write failover from a cluster node HDI there has to be clustered node HDI in the Centennial DC

  

	 	•	 	For read only failover from a single / clustered node HDI the HDI model does not matter whether it’s a cluster or single node at the Centennial DC 

Tools for managing the HCP and HDI Storage Management Unit (SMU) for the HDI SMU features: 

 

	 	•	 	Data movement from distributed environments into centralized core infrastructures and maintains a local link to the content for fast retrieval 

 

	 	•	 	Wide range of advanced storage features for simplified, automated and centralized management. 

  

	 	•	 	Content sharing across a network of HDI systems 

  

	 	•	 	File restore 

  

	 	•	 	NAS migration 

 Hitachi content platform tool for HCP 

HCP features: 
  

	 	•	 	Multi tenancy and scalability 

  

	 	•	 	High-density, high-efficiency storage 

  

	 	•	 	Reliable, utility-grade architecture 

  

	 	•	 	Active data protection 

  

	 	•	 	Easy to set up, manage and adapt 

  

	 	•	 	Unique metadata gathering and intelligence tools 

  

	 	•	 	Support for legacy, contemporary and emerging storage protocols and media types 

  

	 	•	 	Safe, secure file synchronization and sharing with Hitachi Content Platform Anywhere 

  

	 	•	 	Integrated with Hitachi Data Ingestor to connect remote and branch offices 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-112		Health Net / Cognizant Confidential

 Final 

 Failover Solution for Large Remote Sites 

The proposed solution for “Failover Solution for Large Sites” is to take advantage of HDI’s “Roaming Home Directories” feature. This
feature takes advantage of Windows DFS capability of assigning network shares based on logon details (such as location). When a user is in a “failover” situation, they will launch a VDI session (located in Centennial) and DFS will
dynamically determine that the HDI cluster in Centennial is now the “active” home directory for that session (and not their local HDI home directory) and will allow the user to read and write files to their directory in Centennial. The
standby HDI server in Centennial is continuously populating its file system (each of the user’s home directories) from the HCP so when a VDI session is launched in Centennial, the users’ directories have been pre-populated with metadata
and stubs of their files. The UCS/VDI solution will use CIFS shares on the HDI (backed by HUS block storage) for all user data files and use NFS/CIFS shares on HNAS (backed by VSP) to store all other information. The connections shown in the diagram
are from UCS to HDI and HCP (not to HUS/VSP). 
  

	 	•	 	UCS g HNAS: NFS 8 x 1GbE 

  

	 	•	 	UCS g HDI: NFS 8 x 1GbE 

 HNAS g HCP: HTTPS 8 x 1GbEHDI g HCP: HTTPS 8 x 1GbE 
  

 
 2.3.2.3 Monitoring Tools 

The section below describes the proposed tools solution for File Share service towers: 

 

	 	•	 	Hitachi command suite tools—centralized management for Hitachi storage system, availability, capacity and performance monitoring 

 

	 	•	 	Hitachi File systems Manager ( HFSM) – for managing HDI and integrating SNMP traps to HP OMi for alerts 

  

	 	•	 	HDI single nodes are managed by GUI connected via browser 

  

	 	•	 	HCP has Admin GUI built in to the solution (connect via browser) for management 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

 2.3.2.4 Service Deliverables 

 

	 	•	 	Design and build File share HDI solution 

  

	 	•	 	Testing the Failover of Single node and clustered HDI access from remote office 

  

					
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 Final 

	 	•	 	Testing the failover of VDI users for file share 

 2.3.2.5 Steady State Support – Deliverables 

 

			
	 Solution
	  	 Description

		
	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24x7
Onshore support:
  
 8x5 dedicated support – (Federal onsite)
with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore ; Coimbatore

 Level 1 Services 
 L1
Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 
  

			
		  	 •    Monitoring of File share for alert

		
	 L1

Team
	  	 •    Assist in user permission and rights assignment

 

	  	 •    Fix level 1 issue and incident response

		
		  	 •    Co-ordinate with vendor for hardware failures/replacements

		
		  	 •    Update and Maintain Incident information in the KEDB

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

			
		  	 •    CIFS share configuration/Administration

		
		  	 •    File System Administration

		
		  	 •    Quota Management

		
		  	 •    Replication configuration and administration

		
	 L2

Team
	  	 •    NDMP backup/recovery co-ordination with backup team

 

	  	 •    Checkpoint Administration

		
		  	 •    DFS namespace configuration

		
		  	 •    HDI, HCP, HUS, and HNAS Configuration

		
		  	 •    Antivirus scanning integration with AV team.

		
		  	 •    Update and Maintain Incident information in the KEDB

  

					
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 Final 

 Level 3 Services 

All unknown / new errors and problems will be resolved by L3 file and print Support group. This team will work with Vendors when required. 

 

			
		  	 •    Co-ordinate with vendor for code level updates

		
	L3
 Team
	  	 •    Plan and co-ordinate during DR exercises

 

	  	 •    Plan and design file services architectural changes

		
		  	 •    Performance management and capacity planning

		
		  	 •    Update and Maintain Incident information in the KEDB

 2.3.2.6 Dependency on Health Net 
  

	 	•	 	Testing File Shares after they are moved to Cognizant DC 

  

	 	•	 	Availability of Knowledge Management 

  

	 	•	 	Access to servers to move data to the HDI appliance in the remote sites. 

  

	 	•	 	Detail session on health net guidelines for configuring the HCP policies 

 2.3.2.7 Risk and Mitigation

 None 
 Print Services 

2.3.2.8 Highlights of Scope Validation 
  

					
	 Description
	  	 Pre Scope Validation

Workshop
	  	 Post Scope Validation Workshop

			
	Scope	  	 •    Migrate print queues from existing print servers to new servers

 
 •    There are 941
Printers / Print queues in the existing environment which has to be migrated
  

•    Printers are spread across in 32 different locations

 
 •    All the print
settings has to be retained
  

•    High availability has to be configured if a print Server fails at branch
location
	  	 •    Migrate print queues from existing print servers to new servers which
will be on the SCCM distribution server in the branch locations
  

•    There are 941 Printers / Print queues in the existing environment which has to be
migrated
  

•    Printers are spread across in 32 different locations for 30 branch location the print
queues will be configured on the SCCM distribution points and other 6 location where there is no SCCM DP servers were the print queues needs to configured will be configured on the central print servers in the Centennial datacenter and the fail back
of those will be in servers in the phoenix datacenter. And the same server will host the backup queues for the 26 locations as well.

			
		  		  	 •    All the print settings has to be retained

 
 •    High availability
has to be configured if a print Server fails at branch location that will in the respective data centers.

  

					
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 Final 

 2.3.2.9 Solution Approach 

Health Net currently has 941printers spread across 32 locations and there are 30 locations there are print servers which is also configured on the existing
SCCM 2007 servers. There is a backup print server in the IBM owned Boulder datacenter in which the backup queues for some of the major sites configure. There are AD domain controllers in Boulder Datacenter. The user send’s the print request and
gets it authenticated from the respective Domain controller and the request after authentication goes to print server, the print job gets spooled in the print server and is then send to the respective printer for printing that job. 

The diagram below gives the current environment overview. 
  

	 	•	 	Design Deploy and migrate the Print service from the existing print server to the new Printer server which would be hosted on the SCCM 2012. 

 

	 	•	 	There will be a Print Servers installed and configured at Primary datacenter with 30 print queues. All the 30 print queues will be configured on the Primary datacenter, backup will be in the secondary datacenter as a
part of DR. 

  

					
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 Final 

 Print Service High Level Architecture 

 
 

 
  

	 	•	 	Design and Build Approach 

  

	 	•	 	Designing the target environment 

  

	 	•	 	Creating implementation Plan 

  

	 	•	 	Procurement of required infrastructure 

  

	 	•	 	Installation of infrastructure in our DC 

  

	 	•	 	Build infrastructure for print service server on the new SCCM 2012 servers 

  

	 	•	 	Manage the environments for print servers as backup for the branch location in the Centennial and Phoenix DCs. 

  

	 	•	 	Design Consideration and approach 

  

	 	•	 	SCCM Distribution point Servers will be deployed onto 30 locations; same Servers will be configured as Print Servers by adding the necessary print queues applicable to that respective location users 

 

	 	•	 	Print Servers will be loaded with 32 bit and 64 bit drivers to cater both types of end users 

  

	 	•	 	Print management Export / Import utility will be used to migrate the print queues from existing Print Servers to new ones 

  

	 	•	 	All the existing printer settings will be retained as it is 

  

	 	•	 	New Print queues will be published in Active Directory so that Users can add the print queues 

  

	 	•	 	Print queues can be deployed through group policy as well if that is feasible in Health Net environment 

  

					
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	 	•	 	High availability 

  

	 	•	 	There will be Print Servers installed and configured at the Primary datacenter with 30 print queues for the DR and will be using the Secondary Datacenter and vCenter replication technology to copy the print queues into
the secondary Datacenter Servers 

  

	 	•	 	All the 30 print queues will be configured on the Primary datacenter backup will be in the secondary datacenter as a part of the DR 

  

	 	•	 	If any local print Server fails then backup print queue from Datacenter will be published so that users can access the print queue and print jobs can be continue (failover is manual operation) 

 

	 	•	 	Print Servers will be configured for high availability to address the DR scenario 

 Hardware Overview

 Datacenters and Branch locations 
  

					
	 S No
	  	 Specification
	  	 Configuration

	 1
	  	 Print server in Centennial DC (utilizing
 the
SCCM server)
	  	 Processor: 4 x Quad Core
 RAM: 16 GB

Disk Space: 72 GB

			
	 2
	  	 Print server in phoenix DC(utilizing the
 SCCM
server)
	  	 Processor: 4 x Quad Core
 RAM: 8 GB e

Disk Space: 72 GB

			
	 3
	  	 Print server in the Branch site (utilizing
 the
SCCM server)
	  	 Processor: 4 x Quad Core
 RAM: 4 GB

Disk Space: 72 GB

 Aspect that impact this design 

There will be no impact on the current environment because the existing printers will be exported from the existing servers and will be imported on the target
server 
 Test 
 One machine should be provided with
Windows 2003 Standard edition installed. This machine would be used for testing purposes, since we will install 64 bit driver’s for existing printers and then check if the printer’s functionality has been affected, if the test result are
positive then we would proceed with the migration of existing printers on windows 2008 R2 OS. 
 If installation of 64 bit drivers affect any functionality
of existing printing environment then we will not be able to proceed (export the settings and import it to the target) with migration of print servers on Windows 2008R2 OS. This way we can keep the existing environment unaffected as well as check
the 64 bit driver compatibility issues if any. 

  

					
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 Final 

 This test virtual server will be built using VMware virtual machine software. This server will be configured
with: 
  

	 	•	 	2003 standard edition 

  

	 	•	 	Print spooler 

  

	 	•	 	Printer drivers.(32bit and 64bit) 

  

	 	•	 	Network printers 

 2.3.2.10 Monitoring Tools 

The list below describes the proposed tools solution for print services: 
  

	 	•	 	HP OMW to monitor the availability of Print service ( spooler ) and servers 

  

	 	•	 	Event Flow Integration with HP OMi (MOM) 

 2.3.2.11 Service Deliverables 

This list below describes the service deliverables for print services: 
  

	 	•	 	Cognizant will utilize a client /server architecture and SCCM distribution point as the print server for the branch location. 

  

	 	•	 	There will be a Print Servers installed and configured at Primary datacenter with 30 print queues 

  

	 	•	 	All the 30 print queues will be configured on the Primary datacenter backup 

 2.3.2.12 Steady State Support
- Deliverables 
  

			
	 Solution
	  	 Description

		
	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 The high level activities for Print services are mentioned below: 

 

	 	•	 	Support Services will be provided in accordance with the procedures documented in the SOPs and will include the following : 

  

			
		
		  	 •    Monitoring and ensuring availability of print servers

		
		  	 •    Perform incident analysis

		
		  	 •    Perform initial troubleshooting to determine the nature of the issue

		
	Support services (L1, L2 and L3 )	  	 •    Update ticket and log all troubleshooting steps performed

 

	  	 •    Co-ordinate with vendor for hardware failures/replacements

		
		  	 •    Reload the printer drivers

		
		  	 •    Print queue management

		
		  	 •    Perform print server configuration and administration

		
		  	 •    Install and configure new printers

		
		  	 •    Capacity planning

		
		  	 •    Review and update documentation

  

					
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 2.3.2.13 Assumptions 
  

	 	•	 	Access to all the existing print servers 

  

	 	•	 	Printers are compatible with 64/32 bit drivers and Windows 2008 / 2012 

  

	 	•	 	Availability of Local IT for testing the printers post migration 

  

	 	•	 	Technical information about product should be shared before migration begins 

 2.3.2.14 Risk and Mitigation

  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	1	  	Impacts Design and Migration Plan Impacts High Availability Design and Failover	  	High	  	High	  	Prepare Inventory List using Manual and Discovery Tools ( HP) which would result in reduced cost and timelines
					
	2	  		  		  		  	
					
	3	  		  		  		  	
					
	4	  	 Migrating print data to
 Cognizant DC
	  	Medium	  	Medium	  	Before migrating print data the details will be collected and tested on the test machine then it will rolled out to the production network

  

					
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 Final 

 2.3.3 Deskside 

2.3.3.1 Highlights of Scope Validation Workshop 
  

					
	 Description
	  	 Pre Scope Validation

Workshop
	  	 Post Scope Validation Workshop

			
	Scope	  	 •    Field support

 
 •    Managed print
services support
  

•    Asset provisioning (Including tagging and labeling)

 
 •    Asset
decommissioning
	  	 •    Field Support

 
 •    Hardware break
fix
  
 •    IMAC for
Desktop and Laptop
  

•    Dispatch support to remote sites

 
 •    Refresh of Laptops
and Desktops based on refresh cycle
  

•    Lease refresh program

 
 •    Asset provisioning
( Including tagging and labeling)
  

•    Asset decommissioning

 
 •    Provide remote
resolution for non-hardware related problems
  

•    Install custom software per request

 
 •    Support Windows
Desktop operating system related issues on End User devices
  

•    Reconfigure applications based on Service requests

 
 •    Reinstall approved
applications based on service requests
  

•    Support devices connected to end users devices like scanners and printers

 
 •    Support remote and
VPN users through remote support
  

•    Managed print services support

 
 •    Printer queues are
managed by Desk-side team while Physical printers are managed by IKON. Refer the list of all published printers (Appendix section)
  

•    Resolution of issues connecting, printing or mapping to networked printers on
workstations

 2.3.3.2 Solution Approach 

The Deskside support design is specific to Health Net’s environment across multiple locations. 

Solution considerations 
 Cognizant will take over desk
side services from Incumbent and post transition, begin steady state operation and fix the critical issue via turn key projects in parallel. 

  

					
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 Final 

 The diagram below depicts the Deskside solution approach: 

 
 

 
 The details of turnkey projects are depicted below: 

 
 

 
  

	 	•	 	Dedicated Service Model, VIP Support Requirement 

  

	 	•	 	Provide hands-and-feet support at Health Net locations for hardware break/fix, IMAC and any other Desk-side support requests 

  

	 	•	 	On call Support for critical incidents and VIP users 

  

	 	•	 	Deskside support through Campus Site, Depot Model and Dispatch Model 

  

					
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	 	•	 	Deskside support is further categorised as offshore remote support and onsite remote Deskside support, 

  

	 	•	 	For Commercial (Health Net environment) both offshore remote support & onsite remote Deskside support are available, 

  

	 	•	 	For federal (Health Net environment) due to regulations only onsite remote Deskside support is available 

  

	 	•	 	Asset Refresh – ( Desktop/Laptop) 

  

	 	•	 	Cognizant understands that Health Net has an asset refresh policy of 36 months for desktop/Laptop. Asset refresh activity is executed in batches over a period of 36 months and the cycle continues. 

 

	 	•	 	Asset Refresh service includes provisioning a new desktop /laptop to users including: 

  

	 	•	 	Create and maintain planning/tracker of the refresh activity 

  

	 	•	 	Single point of contact for refresh co-ordination and status reporting to Health Net 

  

	 	•	 	Inventory management of Hardware at the warehouse 

  

	 	•	 	Verifying the build of the new system as per the Health Net build requirement and ship to Health Net office location 

  

	 	•	 	Cognizant shall co-ordinate and manage the receipt of new hardware at warehouse 

  

	 	•	 	Upon delivery of new hardware at warehouse, Cognizant would verify delivery content and report any discrepancies to Health Net and will work with vendor to remediate it. 

 

	 	•	 	Managing return of damaged item to the vendor 

  

	 	•	 	All equipment will be received with asset tag and if asset tags are missing Cognizant will add asset tag to the equipment. 

  

	 	•	 	Validate and report purchase order V/s actual system/equipment delivered across location for business property tax payment 

  

	 	•	 	Report to Health Net regarding equipment that is stolen/lost/untraceable. 

  

	 	•	 	Populate and update the asset information in the Symantec Altiris tools for new, upgraded and decommissioned hardware 

  

	 	•	 	During transition phase, Cognizant would work with Health Net and incumbent vendor to understand the asset refresh process and depot service process. 

Site locations are classified into Depot site, Campus site, Dispatch site and Depot support site 

 

			
	 Site classification
	  	 Description

	Depot site	  	 •    Dedicated Onsite Support

 
 •    Number of users
> 350
  

•    Provisioning / De-provisioning of hardware

 
 •    Spares /
Inventory

		
	Campus site	  	 •    Dedicated Onsite Support

 
 •    Number of users
> 150 outside California
  

•    Number of users > 250 inside
California

  

					
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	Dispatch site		 •    No dedicated Onsite Support

		
			 •    Dispatch model if onsite support is required

 
 •    # of users between
5 and 250 in California

		
	Depot support site		 •    No dedicated Onsite or dispatch Support model

 
 •    Hardware shipped to
nearest depot location for support
  

•    Number of users less than 5

 
 •    Small/Home
Office

 Target Operating Model for various locations 
  

 
 The table below details out the activities and responsibilities for all inbound new/Leased hardware to depot (ware house),
dispatching installed system to other Health Net location and decommissioned equipment 

  

					
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 Final 

  

					
	 Deskside / Depot Responsibility
	  	Cognizant	  	Health Net
	 Cognizant to provide rolling three month forecast report to HN
	  	X	  	
			
	 Cognizant to provide monthly procurement forecast
	  	X	  	
			
	 Cognizant to provide monthly end of lease report
	  	X	  	
			
	 Hardware procurement
	  		  	X
			
	 Receiving New Hardware at Depot location
	  	X	  	
			
	 Upon delivery of new hardware at warehouse , cognizant would verify delivery content and reporting any discrepancies to Health
Net
	  	X	  	
			
	 Managing return of damaged item to the vendor
	  	X	  	
			
	 Inventory management of Hardware at the depot
	  	X	  	
			
	 Identify and allocation of new system to Health Net users
	  		  	X
			
	 Co-ordinate with Health Net for asset tagging all the new hardware received at warehouse and updating the asset management
system
	  	X	  	
			
	 Report to Health Net regarding equipment’s that is Stolen/lost/untraceable
	  	X	  	
			
	 Dispatch the system to Other location
	  	X	  	
			
	 Dispatch of hardware (Monitor, keyboard, etc.) to other location
	  	X	  	
			
	 Co-ordinate for transportation and distribution on system to the health net location as needed by end users
	  	X	  	
			
	 Shipping responsibility , insurance and charges
	  	X	  	X
			
	 Identify and approval to decommission hardware
	  		  	X
			
	 Cognizant to provide asset management report identifying the equipment that has been removed
	  	X	  	
			
	 Degauss all decommissioned equipment
	  		  	X
			
	 Shipping decommission equipment from remote location to Depot location
	  	X	  	X
			
	 Packaging and shipping the equipment to Vendor
	  	X	  	
			
	 Asset update in Altiris for decommissioned hardware
	  	X	  	X
			
	 Health Net owned ( Decommissioned ) equipment disposal for recycling
	  		  	X
			
	 Cognizant would return HealthNet leased hardware to the lessor as per the Health Net process
	  	X	  	
			
	 Cognizant would relocate Health Net owned assets (Decommissioned , removed , not used ) in a secured area as designated by health
net
	  	X	  	

 2.3.3.3 Monitoring Tools 

This section describes the proposed tools solution for Deskside service towers: 
  

	 	•	 	OEM tools like Microsoft Deployment tool for image management 

  

	 	•	 	Flexera Admin Studio for Application packing 

  

	 	•	 	SCCM 2012 for Software distribution/patching 

  

	 	•	 	Symantec Altiris for EUC ( desktop/laptop) asset lifecycle management 

  

	 	•	 	Manage Engine Asset Explorer for asset management 

  

					
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 Final 

 2.3.3.4 Service Deliverables 
  

	 	•	 	Deskside service transition and support 

 2.3.3.5 Steady State Support - Deliverables 

 

			
	 Solution
	  	 Description

		
	Solution
 Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support
 Coverage
	  	 •    24x7 dedicated support – Offshore (Non-federal) with on call

 
 •    24X7 Onshore
support
  
 •    8x5
dedicated support – Onsite (Non-federal) with the rest on call
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery
 Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 Support Services will be provided in accordance with the procedures documented in the SOPs and will include the following:

  

			
		
	Support services (L1, L2 and L3 )	  	 •    End to end remote desktop support

 

	  	 •    Resolution of issues connecting/printing or mapping to networked
printers on workstations
  

	  	 •    Define services and standards for supporting the desktop/laptop and
End User capabilities
  

	  	 •    Deskside support (Local) for unmanaged application installation and
troubleshooting
  

	  	 •    Support for desktop, laptop, thin client and VDI standard
configurations
  

	  	 •    Assist remote access users with accessing a variety of applications at
various locations
  

	  	 •    L1 Remote Desktop Support Team

 
 •    Ticket triaging

 
 •    Level 1 incident
determination and resolution
  

	  	 •    L2/L3 Remote Desktop Support Team o End to end remote desktop support
o Asset tracking and update
  

•    Print Queue Management

 
 •    Print driver update
on print servers
  

•    Setup and configuration of local printers

 
 •    Install and
configure custom software’s based on service requests
  

•    Setup of new print queues for new printers in network

 
 •    Decommission of
print queues for retired printers
  

•    Trouble shoot operating and application related issues on end user devices

 

	  	 •    Provide installations, removals, decommissions and break-fix for all
End User Resources
  

	  	 •    Vendor coordination

  

					
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			 •    Provide personal productivity services (e.g. PDA support) and office automation services, including
setup, proper use, troubleshooting and RMAs for devices

		
			 •    Perform installation and support services for user telecommunication devices

		
			 •    Image, configure and set up workstations and VDI’s

		
			 •    Remotely diagnose equipment

		
			 •    Configure End User workstation/VDI’s to utilize printer

		
			 •    Adjust and resolve issues with display properties, including screen resolution and color
depth

		
			 •    Assist remote access users with accessing a variety of applications at various locations in different
environments

		
			 •    Provide end user operating instructions and guidance

		
			 •    Support/troubleshoot issues with locally installed applications (standard and non-standard)

		
			 •    Managed print services support

		
			 •    Update and Maintain Incident information in the KEDB

 2.3.3.6 Assumptions 
  

	 	•	 	PDA device installation at new facilities or locations will be considered as a separate project 

  

	 	•	 	Overall, Cognizant does not envisage more than 10 new communication instrument installations per month 

  

	 	•	 	For all locations with less than 5 devices, a new device will be dispatched in case of hardware repair and office location staff will dispatch the faulty machine to depot location 

 

	 	•	 	Hardware maintenance will be supported by the respective support teams 

  

	 	•	 	Any migration activity will need to be handled as a separate project 

  

	 	•	 	Solution is based on the current infrastructure and scope 

  

	 	•	 	Support of applications issues and configuration on best effort basis which doesn’t have any support groups or documentation 

  

	 	•	 	Health Net to provide standard and supported application catalog to Cognizant during knowledge transfer sessions 

Turn Key Project assumptions: 
  

	 	•	 	Identify, review, fix the common issues and build the Known Error Database 

  

	 	•	 	10% of 14,000 desktop/Laptop does not connect to SCCM 

  

	 	•	 	70% of above issue are in Rancho Cordova and Woodland hills office 

  

	 	•	 	30% of above issue are in small office 

  

	 	•	 	Desktop refresh activity - XP migration for the remaining system having dependency on applications will be done over a period of time 

Steady State Assumptions: 
  

	 	•	 	Locations with less than 5 – 10 devices: 

  

	 	•	 	New device will be dispatched in case of hardware repair 

  

	 	•	 	Office location staff will dispatch the faulty machine to depot location 

  

	 	•	 	Health Net will provide the required infrastructure and access to perform the services in scope 

  

	 	•	 	Cognizant will use Health Net facility for desktop/laptop staging and build 

  

	 	•	 	Health Net will share the existing knowledge base 

  

					
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 Final 

  

	 	•	 	Asset procurement (desktop, laptop, spares, consumables) and asset disposal are not considered as part of scope however, will be facilitated by Cognizant and managed by Health Net contracted Vendor 

2.3.3.7 Dependency on Health Net 
  

	 	•	 	Health Net will provide the required infrastructure and access to perform the services in scope 

  

	 	•	 	Cognizant will use Health Net facility for desktop/laptop staging and build 

  

	 	•	 	Health Net will share the existing knowledge base 

  

	 	•	 	Asset procurement (desktop, laptop, spares, consumables) and asset disposal are not considered as part of scope however, will be facilitated by Cognizant and managed by Health Net contracted Vendor 

 

	 	•	 	UAT testing for the application package and images 

  

	 	•	 	Pilot tester identification for Image, Application package, Software and Patch testing 

 2.3.3.8 Risks and
Mitigations 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	1	  	Infrastructure and access readiness for transition	  	High	  	High	  	Cognizant to work with Health Net POCs to receive and verify required infra and access for transition
					
	2	  	Non-availability of SME’s Stakeholders for Transition	  	High	  	High	  	 Health Net to allocate SMEs for driving
 the
transition plan

					
	3	  	Any scope change because of in-flight projects like Win 7 Migration etc.	  	Medium	  	Medium	  	 Cognizant SME participation in current

in-flight Projects

					
	4	  	Missing or unclear documentation/definition of Process, SOP, Roles and Responsibilities	  	Medium	  	Medium	  	Verify, create and manage required process docs based on Cognizant. If required Cognizant SME has to create documents during KT using Cognizant standard Runbook
					
	5	  	Involvement and support from different support teams	  	Medium	  	Medium	  	Metrics and support requirements dependent on other support teams to be clearly defined as part of the each process and scope activities
					
	6	  	Any migration support requirements/activities impacting managed service support activities.	  	Medium	  	Medium	  	Migration activities to be discussed and taken up as separate projects to be taken up in parallel whenever required

  

					
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 Final 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	7	  	Any scope changes by new activities identified during transition will require revisiting the resource count. (e.g. In case the number of users and computers increased from the earlier proposed counts)	  	Medium	  	Medium	  	Buffer resources to be identified and need revisit the head counts

 2.3.4 Desktop Engineering 

2.3.4.1 Highlights of Scope Validation Workshop 
  

					
	 Phases
	  	 Pre Scope Validation workshop
	  	 Post Scope Validation Workshop

			
	Assessment Phase	  	 •    Assessment document highlighting current state of SCCM 2007 and supporting infrastructure
	  	 •    No Change

			
	Design Phase	  	 •    Design document

 
 •    Target SCCM 2012
Architecture with Roles and Features
  

•    Steps for SCCM 2012 Upgrade Process

 
 •    Phased Migration
Approach for existing SCCM roles, objects, clients, security and delegation
	  	 •    No Change

			
	Test Phase	  	 •    Build the SCCM 2012 design in a test environment

 
 •    Document
highlighting results on proposed Design, SCCM 2012 features, migration approach and test results
	  	 •    There are changes in proposed design and most recently validated resource count

			
	Production Phase	  	 •    Upgrade to SCCM 2012

 
 •    Migrate
workstations, collections, packages
  

•    Migration of SCCM 2007 environment which consists of two SCCM v2007sp3 R2 servers in
Boulder location to SCCM 2012
  

•    Migration of 14,000 workstation SCCM 2007 clients (Mix of 1450 Corporate and 150 Federal
Services virtual desktops)
	  	 •    No change in the resource count for SCCM 2012 Migration post scope clarification
workshop

  

					
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 Final 
  

					
	 Phases
	  	 Pre Scope Validation workshop
	  	 Post Scope Validation Workshop

			
		  	 •    Provide detailed analysis of packages active in SCCM 2007 to Health
Net
  
 •    Migration
of 500 Packages from SCCM 2007 to SCCM 2012 based on inputs from Health Net
  

•    Migration of OS Imaging packages from SCCM 2007 to SCCM 2012

 
 •    WSUS, MDT
integration for OS deployment and Patch Management Migrate Packages to Applications in SCCM 2012
	  	
			
	 Implementation of

SCCM 2012 Features
	  	 •    Patch Management

 
 •    Patch Management
for workstations will be done through SCCM
  

•    Application Deployment

 
 •    Leverage new
Application Distribution model to target users and types of applications (virtual and non-virtual)
  

•    App-V integration will be discussed and implemented as a proposed phase II
	  	 •    Application Catalogue is one feature which Health Net is very
interested in implementing
  

•    Health net would also like to see the Internet based management feature turned on

 
 •    Health Net would
also like to manage remote and DC servers (maintained by Cognizant) through SCCM. This will also be implemented in the BAU process for SCCM

			
	 Production Desktop
 Engineering
Support
	  	 •    Application packaging

 
 •    Software
distribution
  

•    Patch management

 
 •    Image
Management
  

•    Software metering

 
 •    SCCM administration
and support
  

•    Asset Management
	  	 •    Application packaging

 
 •    MSI/Vendor
setup
  
 •    10-20 is
average volume per month
  

•    Packaging process uniform across various regions and business units

 
 •    Manual installation
check of applications in standard Windows 7 32bit and 64bit images for compatibility
  

•    Application packaging requests are categorized as either steady state work or project
Work
  
 •    Microsoft
best practices and existing naming convention needs to be followed for all the packaging requests
  

•    UAT Coordination support post packaging

 
 •    Image
Management
  

•    Image refresh - Rebuilding the Gold Image based on Health Net requirements

 
 •    Adding Device
drivers, Software updates, Hot Fixes, Applications to Gold Image

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-130	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Phases
	  	 Pre Scope Validation workshop
	  	 Post Scope Validation Workshop

			
		  		  	 •    Image deployment environment setup and OSD configuration

 
 •    Image deployment
issues trouble shooting
  

•    Define Image Management Process

 
 •    Manage Windows 7
x86 and Windows 7 x64 Image
  

•    Software distribution

 
 •    Deployment
compliance rate 95%
  

•    Software deployment is part of the packaging lifecycle

 
 •    Define process for
Application Software testing environment
  

•    Application complexity and SLA are defined

 
 •    Application
packaging process flow to be designed
  

•    Support and troubleshoot users in manual installation of approved applications as
requested
  

•    Provide support services for standard desktop applications, including assisting in
installation per standard configuration as well as troubleshooting
  

•    Patch Management

 
 •    Patch deployment
applicable for Workstation, Laptops and VDI
  

•    Pilot test deployment for approved monthly security patches to pilot group

 
 •    Production
deployment of patches post pilot testing (based on CMR approval)
  

•    Goal is to complete cycle within 30 days. Typical compliance rate is around 95%.
Detailed process attached
  

•    Non-Microsoft application (Example: Adobe, JRE) patches are deployed as application
deployment and Software deployment and process followed via SCCM

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-131	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Phases
	  	 Pre Scope Validation workshop
	  	 Post Scope Validation Workshop

		  		  	 •    All patching for COTS product will be handled by Cognizant team. As
part of the support model Cognizant will keep Health Net apprised about the patches availability and associated documentation that are delivered with it. Cognizant expectation is that HN Security and/or CTO team will review the patches list and will
provide approval to Cognizant IO team to implement any patches. Our solution includes patching all the COTS application and is considered in our pricing
  

•    Cognizant will work with all the stakeholders to review the patches

 
 •    SCCM Administration
and support
  

•    Asset Management with SCCM 2012

 
 •    Software metering
and reporting on requested software from Health Net
  

•    Hardware asset reporting based on request from Health Net

 
 •    Ad-hoc asset
reports from SCCM 2012
  

•    Cleanup of AD computer objects to maintain a clean environment

 
 •    Manage Desktop
Operating System GPO
  

•    Update GPO based on requirements

 
 •    Create new GPO
based on service requests

 2.3.4.2 Solution Approach 

Cognizant will adapt a phased approach for this engagement, assessment, design, testing and production rollout. The table below depicts the activities and the
associated deliverables across the different phases of the engagement. 
  

							
	 Phase
	  	 Activities –Cognizant
	  	 Activities-Health Net
	  	 Deliverables

	Assessment Phase	  	 •    Review Current SCCM 2007 architecture (Central Sites, Primary Sites, Secondary Sites, Distribution
Points, Collections, packages, queries, reports, etc.)
	  	 •    Arrange for meeting with key stake holders to conduct interviews and understand their requirements and
expectation from IT
	  	 •    SCCM 2007 and supporting Infrastructure
Assessment

  

					
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			 •    Network Topology - Network bandwidth between sites

 
 •    SCCM Client
environment -
  

•    Workstation SCCM client deployment,

 
 •    SCCM Client
settings,
  
 •    SCCM
client enabled
  

•    features
  

•    SCCM Security - SCCM delegation

 
 •    Active Directory
(AD Sites , AD replication, AD Schema for SCCM, PKI Solution)
  

•    Documentation of the complete assessment
		 •    Appoint single point of contact for Cognizant team to execute the
engagement
  

•    Provide access to the environments and all relevant documentation for analysis
purposes
  

•    Availability of key SMEs for validation of data collection and analysis results

 
 •    Medium involvement
of SME, typically 4 hours per week
  

•    Low involvement of Senior Management and technical staff, typically 2 hours per
week
		 •    Current state – SCCM

 
 •    High level
assessment of AD and Network
  

•    Prioritized findings

				
	 Design Phase
		 •    Review of assessment findings

 
 •    Design sessions
with Health Net
  

•    SCCM 2012 Design—Upgrade planning, prerequisites, security design, discovery
design, client installation\deployment \Upgrade—client agent settings, site design, role placement (Primary, Distribution Points, Branch DPs), Boundary planning
  

•    SCCM 2012 Feature (OSD, DCM, NAP, etc...)

 
 •    SCCM 2012 Backup
and Recovery and Failover
  

•    SCCM 2012 Upgrade Project Plan
		 •    Medium involvement of SME, typically 4 hours per week

 
 •    Low involvement of
Senior Management and technical staff, typically 2 hours per week
		 •    Target SCCM 2012 Architecture

 
 •    SCCM 2012 roles and
features design—role placement
  

•    SCCM 2007 to 2012 upgrade process

 
 •    Migration/Upgrade
Approach
  

•    Develop phased migration for SCCM roles

 
 •    Develop phased
migration for SCCM object (collections, packages, queries, reports, etc.)
  

•    Develop phased migration for SCCM
clients

  

					
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			 •    Documentation of the complete design phase with target SCCM 2012 architecture
				 •    Develop Security/Delegation approach

 
 •    Develop scheduling
for migration/upgrade

				
	Testing / Pilot Phase		 •    Build proposed SCCM 2012 environment based on Design

 
 •    Implement SCCM 2012
Design features
  

•    Implement migration/ upgrade process

 
 •    Upgrade Pilot users
to SCCM Client 2012 infrastructure set up in test environment
  

•    Create Validation Document

 
 •    Document
findings
  

•    Identify next steps
		 •    High involvement of SME’s , typically 12 hours per week

 
 •    Low involvement of
Senior Management and technical staff, typically 2 hours per week
		 •    Setup Lab environment similar to production

 
 •    Test proposed
Design in lab
  

•    Test SCCM 2012 features in lab

 
 •    Validate lab
results and report on findings
  

•    Test Documentation

				
	Production Migration Phase		 •    Build SCCM 2012 production environment in Centennial Datacenter

 
 •    Build out SCCM 2012
roles and sites
  

•    Primary site(s) Distribution points, Branch Distribution points

 
 •    Implement SCCM 2012
features (Applications, Patch Management, OSD Deployment)
  

•    Implement SCCM 2007 upgrade plan

 
 •    Upgrade Pilot users
to SCCM Client 2012
  

•    Scheduling and Coordination
		 •    High involvement of senior management, SME’s , and technical staff, typically 12 hours per
week
		 •    Implementation of SCCM 2012 Design into Production

 
 •    Installation of
SCCM servers
  

•    Enable SCCM roles

 
 •    Migrate packages,
collections etc.
  

•    Migrate all users/workstations (Pilot users will be 1% of users/workstations)

 
 •    Scheduling and
coordination of upgrade process

  

					
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	Documentation and Sign-off		 •    Create SCCM 2012 Build Document

 
 •    Project completion
report documentation
		 •    High involvement of Senior Management and SME’s to sign off on the project completion
report
		 •    Documentation of SCCM 2012 Build Process

 
 •    Project completion
report.

  

					
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 Final 

 SCCM Architecture 

Given below is the reference design architecture for SCCM implementation which submitted during proposal stage: 

 
 

 

  

					
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 Given below is the reference design architecture for SCCM implementation which includes the changes suggested
by Health Net during scope verification workshops: 
  
 

 
 Major changes to design: 
  

	 	•	 	Changes suggested to SCCM Design 

  

	 	•	 	Currently there is only one DP for Tucson and Tempe. This is because both these sites fall in the state of Arizona with combined user count not more than 310. Health Net suggested that each of these sites should have
its own DP 

  

	 	•	 	Arlington and Hampton – similar to above, should have separate DPs 

  

	 	•	 	Following sites are going to be decommissioned, as such no requirement to place a DP at these sites: 

  

	 	•	 	Visalia 

  

	 	•	 	El Cerrito 

  

	 	•	 	Mountain View 

  

					
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	 	•	 	San Jose 

  

	 	•	 	Califa 

  

	 	•	 	New York 

  

	 	•	 	Only the sites with DPs in south California should report to secondary server proposed in Woodland Hills. These sites are: 

  

	 	•	 	Woodland Hills 

  

	 	•	 	Huntington Beach 

  

	 	•	 	Pasadena now also known as Glendale 

  

	 	•	 	Chatsworth 

  

	 	•	 	San Diego 

  

	 	•	 	San Bernardino 

 The list below are the sites and distribution points for SCCM implementation: 

 

							
	 Site
	  	 State
	  	 Site/DP
	  	 Platform

	Centennial Datacenter	  	Colorado	  	Primary SCCM Server	  	Server OS
				
	Woodland Hills	  	CA(California)	  	Secondary With DP	  	Server OS
				
	Gold Pointe	  	CA(California)	  	Distribution Point	  	Server OS
	Aero Jet	  	CA(California)	  	  	Server OS
	Rancho Cordova-Sun Center	  	CA(California)	  	  	Server OS
	Huntington Beach	  	CA(California)	  	  	Server OS
	San Rafael	  	CA(California)	  	  	Server OS
	Rancho Cordova-White Rock	  	CA(California)	  	  	Server OS
	Pasadena(Glendale)	  	CA(California)	  	  	Server OS
	Oakland	  	CA(California)	  	  	Server OS
	San Marcos	  	CA(California)	  	  	Server OS
	Chatsworth	  	CA(California)	  	  	Server OS
	Rancho Cordova-International/Prospect Park	  	CA(California)	  	  	Server OS
	San Diego	  	CA(California)	  	  	Server OS
	Fresno	  	CA(California)	  	  	Server OS
	San Bernardino	  	CA(California)	  	  	Server OS
	Oakland-MHN	  	CA(California)	  	  	Server OS
	Modesto	  	CA(California)	  	  	Server OS
	Concord	  	CA(California)	  	  	Server OS
	San Mateo	  	CA(California)	  	  	Server OS
				
	Irving	  	TX	  	Site with DP	  	Server OS
				
	Phoenix	  	AZ(Arizona)	  	Site with DP	  	Server OS
				
	Tucson	  	AZ(Arizona)	  	Site with DP	  	Server OS
				
	Tempe	  	AZ(Arizona)	  	Site with DP	  	Server OS

  

					
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	Johnston		PA		Site with DP		Server OS
				
	Tigard		OR		Site with DP		Server OS
				
	Arlington-Washington DC		VA		Site with DP		Server OS
				
	Hampton		VA		Site with DP		Server OS
				
	Boulder DC ( in DMZ)		CO(Colorado)		Site with DP		Server OS

  

	 	•	 	Additional DP suggested to be placed in Boulder DC. An important consideration should be to place a DP in DMZ in Boulder to enable internet based management. Health Net would facilitate for the required server in the
Boulder DC 

  

	 	•	 	Health Net would like to see Software catalogue feature to be implemented along with SCCM implementation. This implementation should account for the time taken for software distribution process which needs to change

 Software Distribution Management 

Cognizant would perform the Software distribution management services for Servers, Desktop/Laptop and VDI which includes operating system updates,
software/security patches, other software and application releases through SCCM 2012 platform 
  

	 	•	 	Software distribution activities would be executed in line with change and release management obligations 

  

	 	•	 	Desktop engineering team would work in collaboration with Server/VDI/Desktop team for deployment requirement , testing plan and deployment requirement 

 

	 	•	 	Create and Perform application packaging , testing & deployment 

  

	 	•	 	Co-ordination for UAT testing post application packaging and testing 

  

	 	•	 	Creating and maintaining standard images for Health Net End User desktop/laptop 

  

	 	•	 	Develop Software deployment/management policies and procedures 

  

	 	•	 	Performing installations, changes for the new Software components, including commercial and custom developed Applications 

  

	2.3.4.3	 Monitoring Tools 

 This section describes the proposed tools solution for Desktop
engineering service towers: 
  

	 	•	 	HP OMW for monitoring availability of SCCM services and servers 

  

	 	•	 	OEM tools like Microsoft Deployment tool for image management 

  

	 	•	 	Flexera Admin Studio for Application packing 

  

	2.3.4.4	 Service Deliverables 

  

	 	•	 	Design SCCM 2012 target architecture 

  

	 	•	 	Implementation of SCCM 2012 Design into Production 

  

	 	•	 	Installation of SCCM Servers and enable SCCM Roles 

  

	 	•	 	Migrate packages, collections, etc. 

  

	 	•	 	Migrate all users\workstations (Pilot users will be 1% of users\workstations) 

  

	 	•	 	Software distribution, Patch deployment and Image management for Desktop, VDI and servers 

  

	 	•	 	Application packaging 

  

					
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	2.3.4.5	 Steady State Support - Deliverables 

  

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support - Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support - Onsite (Federal) with the rest on call

		
	 Delivery
 Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore -
Bangalore (India) ; Coimbatore (India)

  

					
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 Solution Approach Desktop Engineering- Steady State 

Application Packaging 
 Day in the Life
of a Packaging Request 
  
 

 
 Steady State Support Activities: 

Level 1 Services 
 “Level1” Services will be
provided for the desktop engineering activities. L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 
  

			
			 •    Validate and categorize tickets

		
			 •    Monitor all tickets related to the desktop engineering in the Service Management System

		
			 •    Ensuring availability of SCCM site servers

		
			 •    Monitoring and Controlling SCCM site health status

		
			 •    Monitoring and Controlling client health status

		
			 •    Defragment all SCCM site systems

		
			 •    Where applicable, keep Health Net informed and notified on the status and progress of all
tickets

		
	L1 Team		 •    Monitoring long running queries

		
			 •    Monitoring Audit messages

		
			 •    Delete unnecessary workstation objects from AD and SCCM DB

		
			 •    Delete unnecessary files from site systems

		
			 •    Check disk space on all site systems

		
			 •    Check advertisement status

		
			 •    Review Package status

		
			 •    Review sync between SCCM (Parent-Child) sites

		
			 •    Clean out old machines and user accounts

  

					
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			 •    Carry out daily, weekly and other regular reporting activities as defined in the SOPs

		
			 •    Update and Maintain Incident information in the KEDB

 Level 2 Services 

“Level 2” (“L2”) Services will be provided by L2 support group. L2 Services will be provided in accordance with the procedures documented
in the SOPs and will include: 
  

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

			
			 •    Break-fix and provide workarounds acceptable to the User that reported the Incident which do not require
database changes

		
			 •    Perform Database Maintenance

		
			 •    Review advertisement success/failure rate

		
			 •    As applicable, escalate incidents requiring immediate attention by using Health Net’s current
escalation guidelines

		
			 •    Review SCCM updates and SQL updates on all SCCM servers

		
			 •    Reviewing AD and SMS objects

		
			 •    Review SCCM site settings on all SCCM servers

		
			 •    Review SCCM Site boundaries

		
	L2 Team		 •    Review SCCM-OU mapping

		
			 •    Application packaging , testing

		
			 •    Co-ordinate for UAT post packaging

		
			 •    Image management (maintain image, update driver, software, patches to gold image)

		
			 •    Provide support service for desktop application and troubleshooting

		
			 •    Perform software deployment on servers ,VDI and desktops through SCCM 2012

		
			 •    Patch deployment Servers , VDI and desktops

		
			 •    Carry out daily, weekly and other regular reporting activities for Incidents

		
			 •    Maintain documentation for Incidents

		
			 •    Update and Maintain Incident information in the KEDB

 Level 3 Services 

“Level3” (“L3”) Services will be provided by the L3 Support Group. All unknown / new errors and problems will be resolved by this group.

  

			
			 •    Performance review and tuning

		
			 •    For new software components determine how to deploy and support

		
			 •    Troubleshoot installation

		
			 •    Work closely with Problem Management organization on the remediation of all problems directly or
indirectly related to desktop engineering.

		
			 •    Patch Deployment Process Determination

		
			 •    Capacity planning

  

					
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			 •    Package Archival

		
			 •    SCCM hierarchy review

		
			 •    Review SCCM security / reports

		
			 •    Identify patch effects like reboots to calculate deployment time

		
			 •    Deploy Patch on Servers , VDI and Desktop

		
			 •    Work with Vendors when required

		
			 •    Perform root cause analysis

		
			 •    Update and Maintain Incident information in the KEDB

 2.3.4.6 Assumptions 
  

	 	•	 	SCCM 2012 implementation is a onetime project which includes design, implementation and migration from SCCM 2007 to SCCM 2012 

  

	 	•	 	Post SCCM 2012 implementation project, Cognizant resources will take over steady state operations for SCCM 

  

	 	•	 	Health Net will allow Cognizant (with notification) to leverage discovery tools on the network where necessary to supplement existing documentation and meeting information. 

 

	 	•	 	Cognizant assumes that at least one SME and technical staff from incumbent vendor will be available for each scope service towers – SCCM, Network (LAN/WAN), Security/Policy 

 

	 	•	 	Current SCCM 2007 is in a healthy state 

  

	 	•	 	Enabled SCCM 2007 features are performing as intended 

  

	 	•	 	SCCM 2007 is reporting minimal to zero critical/severe errors 

  

	 	•	 	The current network and support infrastructure environments are all healthy and able to support 

  

	 	•	 	SCCM 2012 upgrade goals 

  

	 	•	 	Database consistent without corruption 

  

	 	•	 	No network or latency issues affecting SCCM environment 

  

	 	•	 	Travel to Health Net remote sites will be as per project needs 

  

	 	•	 	During the Production Phase, packages, custom collections, custom reports and custom queries will be migrated to SCCM 2012 

  

	 	•	 	All users\workstations will be migrated during this project 

  

	 	•	 	Existing Distribution points will be retained as Windows 7 rollout is in progress. It can be migrated to SCCM 2012 

  

	 	•	 	Print services would be run on SCCM distribution points 

  

	 	•	 	Images update frequency – biannually for hardware changes, security and software updates. Two core images/OS (One basic build and one with Health Net standard productive applications (email and Office).) Maintain
one XP sp3. Support Windows 7x64 sp1 post migration 

  

	 	•	 	Post Migration to SCCM 2012 applications will be deployed via SCCM 2012 for environments in-scope 

  

	 	•	 	Application Packaging process flow will be designed during the KT phase and receive approval from Health Net 

2.3.4.7 Dependency on Health Net 
  

	 	•	 	Access to existing SCCM 2007 environment and its Data(Inventory, Packages, Image Data, Collections) 

  

					
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	 	•	 	Existing process documents and process relates to SCCM 

  

	 	•	 	Health Net SCCM SME availability for design review and Approvals 

  

	 	•	 	Project Plan review and approvals from Health Net 

  

	 	•	 	Appropriate rights access to existing SCCM 2007 servers 

  

	 	•	 	AD,DHCP,DNS availability 

  

	 	•	 	Access to existing SCCM 2007 Data ( App and Pack , Configurations ) 

  

	 	•	 	DOMAIN ADMIN in Active Directory access to ‘SCCM account ‘ 

  

	 	•	 	SPOC from existing SCCM 2007 team During SCCM 2012 Migration and Cutover 

  

	 	•	 	Health Net to facilitate for provisioning server in Boulder DC –DMZ to install SCCM Distribution Point 

2.3.4.8 Risks and Mitigations 
  

									
	 S

No.
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	1	  	Not enough clarification for resource restrictions for Federated Environment and limited access from offshore.	  	Medium	  	Medium	  	Federal requirement would be discussed and documents in design phase
					
	2	  	We have estimated 500 packages will be migrated to SCCM 2012 and any major changes in volumetric of these Packages will have on effect on project timelines.	  	Low	  	Low	  	Any new changes would be considered as new project
					
	3	  	Access restriction to existing SCCM 2007 will result in manual migration of SCCM data like packages collections etc. which has effect on Project timelines	  	Low	  	Low	  	SCCM 2007 access and document requirement will be discussed with Health Net team during transition phase

 2.3.5 Database 

2.3.5.1 Highlights of Scope Validation Workshop 
  

					
	 Description
	  	 Pre Scope Validation Workshop
	  	 Post Scope Validation Workshop

	 Scope
 (Database

Migration)
	  	 •    Migrate approximately 1600 databases of the SQL Server in the Health Net environment
	  	 •    Support services for all Databases across Health
Net

  

					
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			 •    Only databases that are SQL 7.0/SQL 2000 and SQL 2005 server.

		
			 •    Migrate about 105 instances of the SQL Server.

		
			 •    Federal databases should be migrated by Federal resource only

 2.3.5.2 Solution Approach 

This sections details Database managed services for all databases hosted in the Health Net environment (regardless of server type/location) (Refer to appendix
for MS SQL database inventory). 
 Database Managed Services 

Database managed services includes : maintenance and steady state support of existing and future databases (MS SQL , MYSQL , Oracle , Rdb) hosted in Health Net
environment. 
 Cognizant will provide the Database steady state operation after a successful transition. Transition is the first and one of the most
crucial phases of any sourcing engagement. Effective transition of knowledge and services are essential for the success of subsequent phases of steady state support and transformation. Cognizant will follow a unique Transition model to address
Health Net requirement to implement a timely managed transition for database services while ensuring that the risk of sub-optimal knowledge and services transition is minimized. For MS SQL Databases, Health Net will pay for user databases, and not
for the standard system databases (e.g. master, msdb, model, resource and tempdb) that are basic requirements to run the systems 
 2.3.5.3 Monitoring
Tools 
  

	 	•	 	Boulder DC- 

  

	 	•	 	Leverage the existing tools for performance, availability, server monitoring and capacity monitoring for all databases 

  

	 	•	 	SQL IDERA management and ITCam for SQL Monitoring 

  

	 	•	 	Oracle Enterprise Manager Cloud Control 12c, with plug-ins installed to monitor other database technologies and to implement Oracle 12c as standard 

 

	 	•	 	Lite Speed and SSMS ( SQL server management studio ) tool for MS SQL database backup and upgrade 

  

	 	•	 	RMAN and TSM backup tool for Oracle database 

  

	 	•	 	Oracle utility RMU based backup for Rdb 

  

	 	•	 	Cognizant DC 

  

	 	•	 	HP OMW to be used for monitoring, availability and performance for MS SQL databases 

 2.3.5.4 Service
Deliverables 
  

	 	•	 	Service Improvement initiatives to be identified and implemented for frequent issues. (E.g. SQL Job optimization, space issues and long running Jobs.) 

 

	 	•	 	Long running issues to be identified for Permanent fixes and root cause analysis. Those issues can be candidates for problem investigation. 

 

	 	•	 	SQL Migration documentation for In-place and Side by Side Upgrade on all versions 

  

					
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	 	•	 	Run books and Work instructions of all processes which was handed over to Cognizant team during KT phase 

  

	 	•	 	Shadow support / Guided phase will be supported by documents created 

 2.3.5.5 Steady state support –
Deliverables 
  

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Supported
 Technologies
	  	 •    Oracle

 
 •    Microsoft SQL

 
 •    MY SQL

 
 •    Rdb

		
	 Database
 Inventory
	  	 •    Oracle 272 databases

 
 •    SQL Server 2129
databases / 105 instances
  

•    My SQL 33 databases

 
 •    Rdb 150
databases
  
 Note: Database count are approximate and count will be updated during
transition

		
	 Support
 Coverage
	  	 •    24x7 dedicated support - Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  
 8x5 dedicated support - Onsite
(Federal) with the rest on call

		
	 Delivery
 Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore -
Bangalore ; Coimbatore

 Level 1 Services 

“Level1” Services will be provided for the Databases. L1 Services will be provided in accordance with the procedures documented in the SOPs and will
include the following: 
  

			
		  	 •    Validate, categorize tickets

		
		  	 •    Monitor all tickets related to the databases in the Service Management System

		
		  	 •    Report downtimes and uncommon system behavior to Health Net

		
		  	 •    Carry out daily, weekly and other regular reporting activities as defined in the SOPs

		
		  	 •    Act as the central point of contact between Health Net and Cognizant for tickets

		
	L1 Team	  	 •    Broadcast communications authorized by the Health Net to Users

		
		  	 •    Where applicable, keep Health Net informed and notified on the status and progress of all
tickets

		
		  	 •    Database Instance availability

		
		  	 •    L1 Database monitoring (Query / Transaction/ Alert log / Trace file/Space etc.)

		
		  	 •    Job Monitoring

		
		  	 •    Replication / stand by monitoring

		
		  	 •    Object monitoring

  

					
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			 •    Unauthorized / Inactive User Access

		
			 •    Backup status monitoring

		
			 •    Disk space / Table space utilization

		
			 •    Security and Configuration exception alerts

		
			 •    Listener Availability

		
			 •    Update and Maintain Incident information in the KEDB

 Level 2 Services 

“Level 2” (“L2”) Services will be provided for the Databases receiving L2 as listed above. L2 Services will be provided in accordance with
the procedures documented in the SOPs and will include: 
  

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

 “Incident Management Services” mean the Services to resolve (or
break-fix, as applicable). An Incident which has no known resolution will include the following: 
  

			
			 •    Resolve and document Incidents

		
			 •    Break-fix and provide workarounds acceptable to the User that reported the Incident which do not require
database changes

		
			 •    As applicable, escalate incidents requiring immediate attention by using Health Net’s current
escalation guidelines

		
	L2 Team		 •    Maintain Incident information in the Service Management System

		
			 •    Carry out daily, weekly and other regular reporting activities for Incidents

		
			 •    Maintain documentation for Incidents

		
			 •    Update and Maintain Incident information in the KEDB and will responsible for maintaining & updating
operation handbook / Runbooks as well

  

			
	Database Monitoring:
		
			 •    Database Instance Availability

		
			 •    L2 Database monitoring (Query / Transaction/ Alert log / Trace file/Space etc. )

		
			 •    Job monitoring

		
			 •    Replication / stand by monitoring

		
			 •    Object monitoring

		
	L2 Team		 •    Unauthorized / Inactive User Access

		
			 •    Backup status monitoring

		
			 •    Disk space / Table space utilization

		
			 •    Security and configuration exception alerts

		
			 •    Listener Availability

		
			 •    HA (RAC, Cluster, ASM etc.,) services Availability

		
			 •    Update and Maintain Incident information in the KEDB and will responsible for maintaining & updating
operation handbook / Runbooks as well

  

					
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	Basic Administration:
		
			 •    Startups/Shutdowns of database servers

		
			 •    Additional Space allocation

		
			 •    Object maintenance

		
			 •    Job Purging/reruns

		
	L2 Team		 •    Initial troubleshooting

		
			 •    Cluster ware troubleshooting

		
			 •    Set up database auditing

		
			 •    Database refresh

		
			 •    Standby/Mirror database re-instantiation

		
			 •    Update and Maintain Incident information in the KEDB and will responsible for maintaining & updating
operation handbook / Runbooks as well

	
	DB User Management:
		
			 •    End User account requests (create, delete, reset password, roles)

		
			 •    Elevated privileges requests for existing or new roles

		
	L2 Team		 •    Elevated privilege challenge process

		
			 •    Non-expiry profile requests

		
			 •    Update and Maintain Incident information in the KEDB and will responsible for maintaining & updating
operation handbook / Runbooks as well

	
	Database Lifecycle Management:
		
			 •    Vendor software installation; includes RDBMS and related add-on products

		
			 •    Database creation, clones, copies and moves

		
			 •    Database upgrades as defined by the Refresh Report, Schema maintenance

		
	L2 Team		 •    Patch planning scheduling and installations

		
			 •    Database decommissioning

		
			 •    Database reorganization

		
			 •    Update and Maintain Incident information in the KEDB and will responsible for maintaining & updating
operation handbook / Runbooks as well

	
	Backup and Recovery:
		
			 •    Implementing backup solutions

		
			 •    Scripts/tool based backup

		
			 •    Disaster recovery testing

		
	L2 Team		 •    Backup and recovery via various tools(e.g. – RMAN/Oracle, TSM, SQL Server Native tools/SQL Server,
O/S utilities, Business copy, Ad-hoc backup and restore)

		
			 •    Quality: for integration testing and User Acceptance Tests.

		
			 •    Update and Maintain Incident information in the KEDB and will be responsible for maintaining &
updating operation handbook / Runbooks as well

  

					
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 Level 3 Services 

“Level3” (“L3”) Services will be provided by the L3 Support Group for Database Management services. All unknown / new errors and problems
will be resolved by this group. 
  

			
			 •    Database planning and Design services

		
			 •    Design any special application or security requirements.

		
			 •    For new software components determine how to deploy and support

		
			 •    Design database objects

		
			 •    Determine database parameters

		
			 •    Troubleshoot installation

		
			 •    Performance tuning of database parameters

		
			 •    Work closely with Problem Management organization on the remediation of all problems directly or
indirectly related to database engineering.

		
			 •    Patch Deployment Process Determination

		
			 •    Identify vulnerable systems and determine severity

		
			 •    Determine Response until patch is available

		
	L3 Team		 •    Implement response until patch is available

		
			 •    Monitor for Patches and test

		
			 •    Identify patch effects like reboots to calculate deployment time

		
			 •    Deploy Patch

		
			 •    Confirm Patch Efficacy, no adverse effects

		
			 •    Recommend Server Placement/ Hardware Migration

		
			 •    Disaster recovery solution design, benchmarking, load testing, implementation, configuration, monitoring
and troubleshooting, both internal and external.

		
			 •    Injection of HA (RAC, Data Guard, Clustering etc.,) Services assessment for new
deployments/enhancements

		
			 •    Work with Vendors when required

		
			 •    Perform root cause analysis

		
			 •    Update and Maintain Incident information in the KEDB (Known error Database) and will responsible for
maintaining & updating operation handbook / Runbooks as well

 2.3.5.6 Assumptions 

Database Managed Services 
  

	 	•	 	Monitoring and alerting process and tools are in place 

  

	 	•	 	All PHI, PCI, PII data in databases are encrypted at disk level for compliance and security 

  

	 	•	 	Documented procedures exist for DB deployment qualification and validation processes 

  

	 	•	 	DB refresh activities occur on a frequent basis (at least 4 refreshes per week) 

  

	 	•	 	At the time of this agreement, User access/management is a manual activity, no automated tools are used 

  

	 	•	 	Current infrastructure support team performs backups and reports on “failed backups” on a daily basis to the DB team 

  

					
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	 	•	 	At the time of this agreement DB provisioning is a manual process and qualification is done via a checklist 

  

	 	•	 	Cognizant team will actively participate in audit activities 

  

	 	•	 	Database backups will be scheduled through backup software and are managed and administered by backup administrators. For Oracle Databases, the RMAN backup are scheduled in CRONTAB 

 

	 	•	 	All middleware related issues will be handled by the incumbent delivery team in Boulder DC 

  

	 	•	 	DB Connection String on the application side will be changed appropriately so that the application can talk to the newly migrated Instances 

 

	 	•	 	Database upgrades are performed by incumbent and considered to be completed before services transition to Cognizant 

2.3.5.7 Dependency on Health Net 
 2.3.5.8 Risk and
Mitigations 
 Database Managed Services 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	1	  	Legacy system support from Cognizant and Partners need to be identified and documented for every CI/Device in the list. Especially production and business critical systems	  	High	  	High	  	Cognizant requires separate SLA and waivers as required. Also those systems should be migrated to the latest platforms to avoid /mitigate this risk
					
	2	  	Any change in scope might impact delivery (e.g. Increase Delivery cycle time, Attrition)	  	Low	  	Low	  	Contractual scope should be adhered by Cognizant and Health Net.
					
	3	  	Tool capability in tracking SLA’s proactively, assignment of right priorities, supporting escalation process, reporting capability not known. If not available, manual tracking of SLA’s, timely escalation will require
additional efforts	  	Medium	  	Medium	  	Need to validated during Transition Phase

  

					
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 Final 

 2.4 Security Compliance and Controls 

Security Controls: Entire Security requirements of Health Net and Cognizant GIS (Global Information Security) team will be defined and documented as Controls.
For establishing the controls, Cognizant Security team will follow the direction of Health Net Info Security team to enforce the HIPAA, SOX and TRICARE contract security requirements. For every defined control, acceptance criteria will be
established working with Health Net Information Security team. Any changes required to the security controls time to time as required by the Law /Legislation Enforcement will be supported by Cognizant Security team. To enforce security compliance,
controls will be defined for following support areas under the ITO services 
  

	1.	Physical Security – Applies to Primary and Secondary Datacenters and Cognizant Delivery Location with in United States and Cognizant Offshore Delivery Centres (ODC) 

 

	2.	Logical Security – Applies to all associates equipment working for Health Net Account 

  

	3.	Database 

  

	4.	Servers 

  

	5.	Desktop, VDI and Laptops 

  

	6.	Networks 

  

	7.	Security Patching Requirements for OS and COTS products. 

  

	8.	SOX Compliance 

  

	9.	Internal and External Audit Requirements 

  

	10.	Support of security agents 

 All the security controls that are to be defined will be documented during the
transition period and will be enforced from the Day-1 of the steady state. (Please refer Transition Schedule for detailed plan.) 
 Associate Training

 Cognizant associates working for the Health Net account will be trained on all the required Security courses as defined by Health Net Inc and
Health Net Federal Services. Yearly compliance of such training will be enforced. Cognizant will ensure all associates are trained within 3 weeks after gaining necessary access to Health Net environments. Following are the list of Health Net Inc and
Health Net Federal Services training that will be enforced by Cognizant. If any of the new courses introduced or any modification done to the existing training courses, Cognizant will enforce its associate to get trained in the new training courses
within a month of written/e-mail notification from Health Net. 
 Health Net Inc – Security Training Courses 

 

	 	1.	Getting the Records Straight – Disposition Procedures (1.0) 

  

	 	2.	HIPAA Basic – Privacy and Security (1.0) 

  

	 	3.	Painful Price of Healthcare Fraud and Pharmaceutical Fraud (1.0) 

  

	 	4.	Health Net Code of Business Conduct and Ethics 

  

	 	5.	Health Net General Compliance 

  

	 	6.	Medicare Part D: Fraud, Waste and Abuse (for all associates whose job functions cover or may cover Medicare Part D) 

  

					
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	 	7.	Other training courses that Health Net requires its employees or contractors to take, as reasonably requested by Health Net, or updated version of the training courses listed above. 

Health Net Federal Services – Security Training Courses 
  

	 	8.	G&SS HIPPAA Privacy Training 

  

	 	9.	GSS Security Awareness 

  

	 	10.	GSS Records Management Training 

  

	 	11.	Security Baseline Training 

  

	 	12.	ISO 101-2009 

  

	 	13.	HNFS URAC CORE V3.0 (TRICARE ONLY) 

  

	 	14.	URAC Applied Training (TRICARE ONLY) 

  

	 	15.	HNFS Reporting Quality of Care and Serious Reportable Events 

 2.4.1 Information System Security 

McAfee antivirus and IDS units will be managed by HN’s McAfee EPO instance and HN’s SOC. Cognizant will work with HN INFOSEC team to apply McAfee AV
in server & desktop equipment. 
 2.4.2 Vulnerability Risk Assessment & Management 

Cognizant understands Health Net Info security team performs Vulnerability Risk assessment and prepares plan to remediate them as per the governing rules,
Cognizant associates will support such assessment and will work with Health Net security team for remediation and to prevent such incidents in the future. 

Incident Reporting 
 All of the security incidents
will be reported to Health Net within reasonable time frame and with detailed incident reports. Cognizant Management will ensure all of its associate provides complete cooperation to ensure the required remedy for such incident are derived quickly
and per Health Net direction. The incident reporting will be filed to Privacy Officer of Health Net Inc. / Health Net Federal Services as deemed applicable. 

Security Controls Definition and Password Services Build Timeline 

All of the security services will be aligned based on the services delivery dates 
  

					
	 HN ITO Security
	  	 Start Date
	  	 End Date

	 Password Vault Services
	  	3-Feb-2014	  	2-May-2014
			
	 Requirement Gathering
	  	3-Feb-2014	  	7-Feb-2014
			
	 Requirement Analysis
	  	3-Feb-2014	  	7-Feb-2014
			
	 Solution Designing
	  	10-Feb-2014	  	14-Feb-2014
			
	 Construction/Configuration
	  	17-Feb-2014	  	28-Mar-2014
			
	 Testing - SIT
	  	31-Mar-2014	  	18-Apr-2014
			
	 UAT
	  	21-Apr-2014	  	25-Apr-2014
			
	 Implementation
	  	28-Apr-2014	  	2-May-2014

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-152	  	Health Net / Cognizant Confidential

 Final 
  

					
	HN ITO Security Controls Definition		3-Feb-2014		25-Apr-2014
			
	 Group 1
		3-Feb-2014		21-Feb-2014
			
	 Requirements & Definition
		3-Feb-2014		7-Feb-2014
			
	 Physical Security - Health Net DC & ODC
		3-Feb-2014		7-Feb-2014
			
	 Logical Security - Cognizant DC and Cognizant ODC
		3-Feb-2014		7-Feb-2014
			
	 Training - Health Net & Health Net Federal Services
		3-Feb-2014		7-Feb-2014
			
	 Desktop/VDI/Laptop Controls
		3-Feb-2014		7-Feb-2014
			
	 Documentation
		10-Feb-2014		14-Feb-2014
			
	 Review Walkthrough
		17-Feb-2014		17-Feb-2014
			
	 Final Review and Sign Off
		18-Feb-2014		21-Feb-2014
			
	 Group 2
		24-Feb-2014		21-Mar-2014
			
	 Database Security Controls
		24-Feb-2014		28-Feb-2014
			
	 DB SOX Compliance Controls
		3-Mar-2014		7-Mar-2014
			
	 Documentation
		10-Mar-2014		14-Mar-2014
			
	 Review Walkthrough
		17-Mar-2013		17-Mar-2014
			
	 Final Review and Sign Off
		18-Mar-2014		21-Mar-2014
			
	 Group 3
		24-Mar-2014		25-Apr-2014
			
	 Server Controls
		24-Mar-2014		4-Apr-2014
			
	 Windows
		24-Mar-2014		28-Mar-2014
			
	 Unix /AIX/Solaris
		31-Mar-2014		4-Apr-2014
			
	 Vulnerability Assessment Support Process
		7-Apr-2014		9-Apr-2014
			
	 Audit Process Definition
		10-Apr-2014		11-Apr-2014
			
	 Documentation
		14-Apr-2014		18-Apr-2014
			
	 Review Walkthrough
		21-Apr-2014		21-Apr-2014
			
	 Final Review and Sign Off
		22-Apr-2014		25-Apr-2014

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-153		Health Net / Cognizant Confidential

 Final 

 2.4.3 Password Vault Assessment 

 

	2.4.3.1	Print and File services 

 Provisioning/De-provisioning 

 

	 	•	 	Discuss Provisioning and De-provisioning process at high level 

  

	 	•	 	Access to Print and File services to follow existing ISR process 

  

	 	•	 	Cognizant Admin’s will create file share (if it’s a new share request) and provide appropriate rights (read/write) to user groups. 

 

	 	•	 	IBM will create/modify user groups and also add/remove users to groups 

 Process for
provisioning/De-provisioning 
  

	 	•	 	User creates ISR for print and file share 

  

	 	•	 	SR created for CTS team for provisioning (if request is for a new share) / De-provisioning files share 

  

	 	•	 	CTS creates print/file share as needed and control’s access to print and file services using group’s 

  

	 	•	 	Approval process for user access will be derived in design phase 

  

	 	•	 	ISR to add/remove user’s to existing file share group’s will not trigger a SR to CTS admin 

Issues/Concerns 
  

	 	•	 	In current scenario file system privileges is not tightly controlled 

  

	 	•	 	Users and privileges to different print and file services change over time 

  

	 	•	 	Configuration drift on access modifications 

  

	 	•	 	Delay in processing by Access Admin may delay CTS processing time for ISR 

 Proposed Remediation

  

	 	•	 	Setup process and monitoring utilities in place to report on users and access level’s 

  

	 	•	 	Create audit report on a periodic basis and share with HN audit team to review/approve 

  

	 	•	 	Details on type of monitoring utility and reporting will be derived during design phase 

  

	 	•	 	Setup automated De-provisioning of CID accounts using feed from CTS ESA system 

  

	 	•	 	Cognizant model will have dedicated administrator’s instead of shared admin’s in IBM model 

  

	2.4.3.2	Citrix and VDI services 

 Provisioning/De-provisioning 

 

	 	•	 	Discuss Provisioning and De-provisioning process at high level 

  

	 	•	 	Access to Citrix services to follow existing ISR process 

  

	 	•	 	Access admin team to control ISR’s process 

  

					
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	 	•	 	Cognizant Admin’s will create Citrix VDI/application access and manage Citrix/VDI policies 

 Process
for provisioning/De-provisioning 
  

	 	•	 	User creates ISR for Citrix/VDI 

  

	 	•	 	ISR follows existing approval process and access admin governs the process 

  

	 	•	 	A SR is created for CTS team for provisioning/De-provisioning Citrix/VDI access 

  

	 	•	 	CTS admin team creates or modifies Citrix profile/rules to indicate Secure/Remote Citrix, Persistent/Non-Persistent VDI, manage advanced configurations such as USB, File/Print share 

 

	 	•	 	Adding/Removing users to groups is performed by IBM 

 Issues/Concerns 

 

	 	•	 	In current scenario user’s access is not tightly controlled 

  

	 	•	 	User’s moving between Secure and Remote access without right documentation 

  

	 	•	 	Configuration drift within Citrix profile /policies 

  

	 	•	 	Delay in access admin process could delay CTS turn-around time 

 Proposed Remediation 

 

	 	•	 	Setup process and monitoring utilities in place to report when user profile changes 

  

	 	•	 	Create audit report periodically and share with HN audit team to review/approve 

  

	 	•	 	Details on type of monitoring utility and reporting will be derived during design phase 

  

	 	•	 	CTS to monitor and manage capacity planning for Citrix/ Persistent VDI 

  

	 	•	 	Cognizant model to have dedicated administrator’s instead of shared admin’s in IBM model 

  

	2.4.3.3	Database Services 

 Provisioning/De-provisioning 

 

	 	•	 	MYSQL, Oracle DB’s and RDB are not integrated with AD 

  

	 	•	 	Majority of SQL Server DB’s are integrated with AD 

  

	 	•	 	Elevated privileges for admin’s are controlled by having 2 AD accounts for administrators 

  

	 	•	 	Elevated privileges are provided for 72 hours using the existing vault process where credentials need to be checked in/out for the duration of access needed 

 

	 	•	 	Manual process involved in resetting password and check in credential for elevated accounts 

  

	 	•	 	Discuss Provisioning and De-provisioning process access at high level 

  

	 	•	 	Follow existing ISR process to gain access. ISR process managed by access admin 

  

	 	•	 	CTS DBA to provide access to DB’s and create DB roles and assign users to roles 

  

					
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 Final 

 Process for provisioning/De-provisioning 

 

	 	•	 	CTS DB admin’s will have three accounts 

  

	 	•	 	CID for regular access 

  

	 	•	 	ID with administrative access on non-SOX Compliance systems 

  

	 	•	 	ID with elevated privileges for SOX Compliance systems. Privilege valid for 72 hours 

  

	 	•	 	Elevated privilege is not needed to “Monitor” SOX Compliance systems 

  

	 	•	 	Regular Access 

  

	 	•	 	User creates ISR for DB access 

  

	 	•	 	A SR is created for CTS DB team for provisioning/De-provisioning access 

  

	 	•	 	Administrative access – for non-SOX Compliant systems 

  

	 	•	 	CTS DB admin’s create ISR for DB access for non-SOX compliance system administration 

  

	 	•	 	For non-SOX Compliant systems CTS admin team creates or modifies user accounts in DB and creates DB roles to control privileges and assign roles to users 

 

	 	•	 	Elevated Privilege’s Access – for SOX compliant systems 

  

	 	•	 	Create ISR for elevated access & EPSS approves it 

  

	 	•	 	Elevated access account is enabled and credential is checked out from password vault 

  

	 	•	 	User makes use of elevated privilege account for <= 72 hours (Renews as needed) 

  

	 	•	 	Use Password vault system to checks-in credential after 72 hours and reset elevated account password 

Issues/Concerns 
  

	 	•	 	In addition to developers and system account’s, users have access to database 

  

	 	•	 	AD based authentication not in use for lot of DB’s 

  

	 	•	 	Delete privileges are not removed by default 

  

	 	•	 	Need to have 72 hour elevated privileges for SOX compliant systems access which is not a industry practice for standard operating procedure 

 

	 	•	 	IBM unable to provide audit report on elevated privilege users and access which calls for existence of Password Vault Service 

  

	 	•	 	Lot of manual process involved in access admin and password reset 

  

	 	•	 	No process/system is in place to ensure users do not use elevated privileges and credentials are checked into the vault after 72 hours 

 

	 	•	 	Automation of process to remove 72 hour elevated privileges access and password vault needs to be approved by KPMG, Deloitte audit team 

  

					
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 Final 

 Proposed Remediation 
  

	 	•	 	One ISR process to create accounts for regular access, admin access to non-SOX systems and elevated access to SOX compliant systems 

  

	 	•	 	Setup process and monitoring utilities in place to report elevated privilege and regular access 

  

	 	•	 	Create audit report periodically and share with HN audit team to review/approve 

  

	 	•	 	Look at possibility of Integrating MYSQL, SQL Server and Oracle DB with LDAP 

  

	 	•	 	Documentation to be derived to follow process for user account provisioning 

  

	 	•	 	Detailed process and steps to be derived in low level design phase 

  

	 	•	 	Follow current 72 hour elevated privilege process 

  

	 	•	 	No new password vault system to be developed for CTS. Follow existing process for elevated privilege access on SOX compliant systems 

Note: Cognizant has used NIST as general terminology, where it is required to define HN custom defined security controls that are built on top of NIST
security controls. 

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-157		Health Net / Cognizant Confidential

 Final 

 Data Center Build - Resource Model 

The table below highlights the resources that will be used in the datacenter to build/implement the service towers: 

 

											
	 Sl No
	 	 Use Case
	 	 Phases
	 	 Non Federal
	 	 Federal
	 	 Comments

	1	 	Data Center	 	Build/Implement	 	ü	 	ü	 	Federal Links would be terminated by Federal resource
	 	 	DC Operations	 	ü	 	ü	 	NIST operational compliance by Federal resource
						
	2	 	Network & Security	 	Build/Implement	 	ü	 		 	Design & build of network infrastructure would be executed by non federal resource till its not connected to Fed data
	 	 	Steady state /Operations	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
						
	3	 	Server/VM	 	Build/Implement	 	ü	 		 	Design & build of virtual infrastructure would be executed by non federal resource till its not connected to Fed data
	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
	 	 	Project	 	ü	 	ü	 	
						
	4	 	Storage & Backup	 	Build/Implement	 	ü	 		 	Design & build of storage infrastructure would be executed by non federal resource till its not connected to Fed data
	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
						
	5	 	File Share service	 	Build/Implement	 	ü	 		 	Design & build of file share infrastructure would be executed by non federal resource till its not connected to Fed data
	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non FedResources
						
	6	 	Print Service	 	Build/Implement	 	ü	 		 	Design & build of print infrastructure would be executed by non federal resource till its not connected to Fed data
	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
	 	 	Hardware breakfix	 	ü	 	ü	 	
						
	7	 	VDI	 	Build/Implement	 	ü	 		 	Build OS image & testing would be exected by non federal resource till its not connected to Fed data
	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
	 	 	OS image build	 	ü	 		 	 Build OS image & testing would be exected by non federal

resource till its not connected to Fed data

						
	8	 	Desktop Engineering	 	Build/Implement	 	ü	 		 	 Design & build of desktop engineering infrastructure would be executed by non federal resource till its not connected to Fed

data

	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
	 	 	Application Packaging	 	ü	 		 	Application packaging / test would be executed by non federal resource
						
	9	 	Tools	 	Build/Implement	 	ü	 		 	 Design & build of tools infrastructure would be executed by

non federal resource till its not connected to Fed data

	 	 	Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources
						
	10	 	Desk side support	 	Deskside support	 	ü	 	ü	 	Federal resources to support HN Federal users as per location demarcation
	 	 	Remote support	 	ü	 		 	
						
	11	 	Database	 	Upgrade and Steady state	 	ü	 	ü	 	Logical Access for Fed and Non Fed Resources

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-158	  	Health Net / Cognizant Confidential

 Final 

 3. Appendix 

3.1 Appendix I – Tools Functionality 

3.1.1 Introduction 
 As a follow-through of
the Monitoring Tools solution described in Section 2, this section further details the over-all capability of the major tools that have been proposed for this engagement along with their features and snapshots of their reporting capabilities.

 3.1.2 Overview of Tools Functionality 

HP NNMi (Network Node Manager i) + iSPI 
 HP NNMi (Network
Node Manager i) 9.x is foundation of Network Fault and Performance Management. This tool, in Health Net environment, will be primarily used for availability and traffic performance monitoring of entire network components. It will be integrated with
HP OMi for centralized event aggregation. The following are the additional benefits that will be leveraged by using this tool: 
  

	 	•	 	Automatic discovery feature to simplify the complex Network architecture and also provide Map based views 

  

	 	•	 	Automated action and notification support for quick remediation and reduction in MTTR 

  

	 	•	 	Dynamic RCA and Service impact support to assess impact to network survivability, recovery and reductions in redundancy 

  

	 	•	 	Real time graphs to enable Network expert to view the Network performance in real time 

 The HP NNMI (Network
Node Manager i) iSmart Plug-ins (iSPI’s) for performance is an add-on module that extends the capabilities of HP NNMi software to enable unified fault, availability, and performance management. The iSPIs add performance management capability to
HP NNMi by analysing, processing, and aggregating a range of standard and advanced metrics collected by HP NNMi. 

  

					
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 Benefits of HP NNMi 
  

	 	•	 	Maximizing network availability and performance 

  

	 	•	 	Continuous spiral discovery 

  

	 	•	 	Event pipeline for multi-phased conditioning and correlation 

  

	 	•	 	Deterministic root-cause analysis that adapts to changing topology 

  

	 	•	 	Unified fault and performance management 

  

	 	•	 	Maximizing operator efficiency and productivity 

  

	 	•	 	Exception-based management 

  

	 	•	 	Quick start configuration wizard and configuration graphical user interface (GUI) forms 

  

	 	•	 	Integrated solution 

  

	 	•	 	Minimizing total cost of ownership (TCO) 

  

	 	•	 	Extreme scalability 

  

	 	•	 	Flexible n-tier architecture 

  

	 	•	 	Web-based application accessibility 

  

					
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 HP Operations Manager (OMW) 

HP OMW (Operation Manager for Windows) 9.x is one of the leading enterprise monitoring tools in the IT industry. This will provide out-of-box functionality to
monitor heterogeneous operating systems components like CPU, memory, disk, event log, services, etc. This product also has ready-to-use smart plugins to perform deep dive monitoring for enterprise applications which will enable the monitoring
process swift. Cognizant’s proposed solution also includes SQL DB smart plug-ins to enable deep dive monitoring of the database environment. 
 The
Smart Plug-in for Databases (DB SPI) integrates with HP Operations Manager (HPOM) and provides database availability, performance and services reports from a central, easy-to-use dashboard through the HPOM console. Our DB monitoring solution will
provide deeper visibility of database availability and performance and improve capacity management and planning for database use. 
  

 
 The HP OM Smart Plug-in for Virtualization Infrastructure (VI SPI) enables management and monitoring of virtual
infrastructure on various technologies from an HP Operations Manager (HPOM) console. The VI SPI monitors the performance, capacity, utilization, availability, and resource consumption of the host machines, virtual machines, and resource pools. 

  

					
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 The image below represents the structural view of Health Net’s virtualization infrastructure hierarchy in the
environment. 
  
 

 
 The HP Virtualization SPI, along with HP Operations Agents, consolidates performance metrics to generate preconfigured
reports, including: 
  

	 	•	 	Configuration information, CPU and memory utilization of datacenter, host servers, and guest virtual machines configured on them 

  

	 	•	 	List of top 10 CPUs according to usage 

  

	 	•	 	List of top 10 host machines according to disk space consumed 

  

	 	•	 	List of top 10 virtual machines reaching thresholds in terms of memory usage 

  

					
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 Benefits of HM OM 
  

	 	•	 	Reduce costs and duplication of effort by consolidating events from disparate IT domains into a single enterprise console 

  

	 	•	 	Speed the resolution of issues with improved visibility across the entire enterprise IT infrastructure 

  

	 	•	 	Decrease the number of costly escalations by empowering Operations Bridge staff to resolve incidents on their own 

  

	 	•	 	In-depth monitoring of physical and virtual environment and provide advance visualization of resource utilization 

Manager of Manager – HP OMi 
 Cognizant proposes HP
OMi (Operations Manager i) as a centralized event management console to aggregate events from all the monitoring tools and perform Event correlation, Event Filtering and Event de-duplication. In the Health Net environment, the element managers like
HP OMW, NNMi and other third party tools like Hitachi Tuning Manager, Sepaton, Spectra logic, Citrix EdgeSight, Cisco UCS manager and vCenter will be integrated with HP OMi to help minimize the gaps in operations. 

  

					
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 Sample Event Browser View 
  

 
 Benefits of HP OMi 
  

	 	•	 	Operations Bridge event-management improvement 

  

	 	•	 	Accelerate time to repair by focusing operators on causal events with topology-based event correlation 

  

					
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	 	•	 	Reduce outages proactively by linking business services to the underlying IT infrastructure, enabling operators to prioritize their activities 

 

	 	•	 	Visualize application and service health 

  

	 	•	 	Performance management 

  

	 	•	 	Identify resource problems in OS and Databases to reduce business risks associated with downtime or slow performance 

  

	 	•	 	Analyze historical performance trends to identify bottlenecks and drive infrastructure optimization 

  

	 	•	 	Provide immediate performance-issue identification with real-time diagnostic capabilities to lower business service impact 

  

	 	•	 	Reporting 

  

	 	•	 	Identify issues using reports that unify performance, system, and availability information on a single graph 

  

	 	•	 	Clarify performance and usage trends based on historical application and system data to enable capacity management 

Spectralogic tape library 
 Data Integrity Verification

 PreScan ensures that tapes are usable and can accept data. PreScan checks each imported tape and verifies that the tape can be written
to, scanning the tape for potential issues including broken or dislodged leader, poor media health and write-protected status. 
 QuickScan
confirms that a single track (one direction) can be read. QuickScan scans a tape unidirectionally by reading the length of one track of the tape to provide a rapid indicator of integrity of data written. 

PostScan checks an entire tape to ensure that all sectors can be read. PostScan confirms that there are no media errors on the tape by reading
the entire length of the tape up to the end of the recorded data. 
 Media Lifecycle Management (MLM) 

When you use Spectra Certified Media, BlueScale Media Lifecycle Management (MLM) non-intrusively tracks more than 40 criteria about each tape
throughout its usable life. This reporting helps you identify tapes that require retries to complete an operation, tapes with high error rates, and tapes with other problems so that you can evaluate whether the tape health is poor or the drive
writing to the tape is the cause of the problem. 
 Drive Lifecycle Management (DLM) 

Drive Lifecycle Management provides data about drives that you can use to identify drives with issues before those drives affect ongoing
library operations. Used in conjunction with Spectra Logic’s Certified Media, DLM, MLM, and LLM help you comprehensively manage your library and its drives and media across the life of each. 

  

					
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 Final 

 Library Lifecycle Management (LLM) 

BlueScale Library Lifecycle Management (LLM) tracks the library and its components across the library’s lifecycle. Hardware Health
Monitoring (HHM) tracks maintenance thresholds for key library components and notifies you when maintenance tasks are required to keep your library in optimum operating condition. 

BlueScale Management 
 The BlueScale
management interface offers you unparalleled operator efficiency, giving you the ability to manage all library features including: 
  

	 	•	 	Tape media with Media Lifecycle Management (MLM) 

  

	 	•	 	Drives, robotics and other hardware components with Library Lifecycle Monitoring (LLM) 

  

	 	•	 	Encryption and encryption keys with BlueScale Encryption 

  

	 	•	 	Integrity of data with Data Integrity Verification (DIV) 

 Encryption 

Spectra T-series libraries support BlueScale Encryption and key management, with data encrypted through LTO drives. This is the only
library-integrated encryption and key management available— no external hardware, appliance, or applications required. In a single step, you both encrypt and back up data. Because encryption is hardware-based, it minimally affects backup
windows, and it doesn’t burden the network. Managing encryption and the keys used to encrypt data is simple, because it’s all handled through the library’s graphic interface—on the Web and on the front panel. 

3.2 Appendix II – File Share and Print Services 

This appendix lists-out the printer names along with their locations, servers on which they are hosted and the drivers which are installed over these servers.

  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-YORKTOWN-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-WRIGHTP-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-WOMACK-06	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-WOMACK-05	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-WOMACK-04	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-WOMACK-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-WOMACK-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-166	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-WOMACK-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-VIRGINIAB-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-VIRGINIAB-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-VIRGINIAB-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-SURFSIDE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-SEYMOURJ-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-SELFRIDGE-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-SCOTT-04	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet P4010_P4510 Series PCL 6
	P-SCOTT-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-SCOTT-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-RADER-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-QUANTICO-04	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4350 PCL 6
	P-QUANTICO-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-QUANTICO-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-PORTSMOUTH-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-PORTSMOUTH-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-PORTSMOUTH-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-PITTSBURG-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-PEASE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-PATUXTENTR-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-PATUXTENTR-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-167	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-PATUXENTR-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-PATTERSON-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-NYSTATEN-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-NEWPORTNEWS-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-NEWPORT-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-NEWL-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-MD01H43A	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-MCGUIRE-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-MCGUIRE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-MCDONALD-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-MALCOLMG-02	 	Remote Office-TSC	 	bld-fsvs01.fs.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-LEJEUNE-05	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-LEJEUNE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-LANGLEY-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-KNOX-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-KNOX-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-KIRK-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-KIRK-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR3570/iR4570 PCL6
	P-KIMBROUGH-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-KIMBROUGH-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)

  

					
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	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-KIMBROUGH-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Xerox Global Print Driver PCL6
	P-KENNER-02	 	Remote Office-TSC	 	BLD-FSVS01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-KELLER-02	 	Remote Office-TSC	 	BLD-FSVS01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-KELLER-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-HANSCOM-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-HANSCOM-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-HAMILTON-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-GUTHERIE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GROTON-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GREATL-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GREATL-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-FAIRFAX-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-Evansmill-02	 	Remote Office-TSC	 	bld-fsvs01.fs.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-ELIZABETH-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-DOVER-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-DILORENZO-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-DILORENZO-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-DEWITT-04	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-DEWITT-03	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-DEWITT-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-DETROIT-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)

  

					
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	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-DCWASH-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR3570/iR4570 PCL6
	P-DCWASH-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-DAYTON-05	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-DAYTON-04	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-DAYTON-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-DAYTON-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-COLUMBUS-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-CHERRYP-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-CHERRYP-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR2200-3300 PCL6
	P-CARLISLE-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BOSTON-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-BOLLING-02	 	Remote Office-TSC	 	bld-fsvs01.fs.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-BOLLING-01	 	Bolling—TSC	 	bld-fsvs01.FS.healthnet.com	 	Canon iR3570/iR4570 PCL6
	P-BETHESDA-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-Barquist-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-BALTIMORE-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-ANNAPOLIS-02	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-ANNAPOLIS-01	 	Remote Office-TSC	 	bld-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.4)
	P-CC02R40A	 	CA/Concord	 	ccr-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-CC02H42A	 	CA/CONCORD	 	ccr-fs01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e

  

					
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 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-CC02H38A	 	CA/CONCORD	 	ccr-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-MC01R40A	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-MC01R40B	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-MC01R70A	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-MC01R75A	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-MC01R30A	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-MC02R30A	 	CA/Chatsworth	 	cw-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-DC09R70B	 	VA/Arlington	 	DC-FSVS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-DC09R70A	 	VA/Arlington	 	DC-FSVS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-DC09H55E	 	VA/Arlington	 	dc-fsvs01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-DC09H47A	 	VA/Arlington	 	DC-FSVS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-DC02R70B	 	VA/Arlington	 	dc-fsvs01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-DC02R70A	 	VA/Arlington	 	DC-FSVS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-DC01H47C	 	VA/Arlington	 	dc-fsvs01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-DC01H47B	 	VA/Arlington	 	dc-fsvs01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-DC01H47A	 	VA/Arlington	 	DC-FSVS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-ARLINGTON943	 	VA/Arlington	 	DC-FSVS01.fs.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-ARLINGTON904	 	VA/Arlington	 	DC-FSVS01.fs.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-ARLINGTON933	 	VA/Arlington	 	DC-FSVS01.fs.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-ARLINGTON129	 	VA/Arlington	 	DC-FSVS01.fs.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-ARLINGTON215A	 	VA/Arlington	 	DC-FSVS01.fs.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-171	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-EC01R40A	 	CA/ElCerrito	 	ELC-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-EC01R40A	 	CA/ElCerrito	 	ELC-FS02.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-FR01H5SA	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si/5Si MX PS
	P-FR01H47A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-FR01H42A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-FR01H41A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e
	P-FR01R71A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 171 PCL 5e
	P-FR02R40A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-FR01R40B	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-FR01R40A	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-FR01R40C	 	CA/FRESNO	 	fat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GL15R75A	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-GL15R50D	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GL15R50C	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GL15R50B	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PS
	P-GL15R50A	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GL15R35B	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP C3502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-172	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GL15R35A	 	CA/Glendale	 	GLE-FS01.hncorp.healthnet.com	 	RICOH Aficio MP C3502 PCL 6
	P-HAMWH46A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6
	P-HAMEI13A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6
	P-HAMEH47A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-HAMEH41B	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6
	P-HAMEH23A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-HAMEC35A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	Canon iR3570/iR4570 PCL 6
	P-HAMEC33C	 		 	HAM-FS01.FS.healthnet.com	 	Canon iR2200-3300 PCL 5e
	P-HAMEC33A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	Canon iR2200-3300 PCL 5e
	P-HAME02H90A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6
	P-HAM02WR70A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-HAM02WH47A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-HAM02ER40A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HAM02EH27B	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-HAM02EH27A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-HAM01WR75C	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HAM01WR75B	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HAM01WR75A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HAM01ER75C	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HAM01ER30A	 	VA/Hampton	 	HAM-FS01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 5e

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-173	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-HB08R70B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-HB08R70A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-HB08H47A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-HB08H46X	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-HB08H46D	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 6
	P-HB08H46C	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 6
	P-HB08H46B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 6
	P-HB08H46A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 6
	P-HB06R40A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4000 PCL 6
	P-HB06R75A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 5e
	P-HB06R40B	 	CA/Huntington Beach	 	hb-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-HB08R50A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-HB08R50B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-HB08R40B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-174	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-HB07R70B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-HB07R50B	 	CA/Huntington Beach	 	hb-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-HB07R50A	 	CA/Huntington Beach	 	hb-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-HB07R40B	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-HB07R40A	 	CA/Huntington Beach	 	HB-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	HP LaserJet 4350 PCL 5e	 		 	ivg-fscl04.hncorp.healthnet.com	 	HP LaserJet 4350 PCL 5e
	 HP LaserJet P4010_P4510
 Series PCL
6
	 		 	ivg-fscl04.hncorp.healthnet.com	 	HP LaserJet P4010_P4510 Series PCL 6
	P-IV08H25B	 		 	IVG-FSVS01.hncorp.healthnet.com	 	HP 2000C
	P-IV08H45B	 		 	IVG-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500 PCL 6
	P-IV09R75B	 	TX/Irving/Floor 9	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-IV09R75A	 	TX/Irving/Floor 9	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-IV09R70A	 	TX/Irving/Floor 9	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-IV09R50A	 	TX/Irving/Floor 9	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 5e
	P-IV09H36A	 	TX/Irving/Floor 9	 	IVG-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-175	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-IV08R40D	 	TX/Irving/Floor 8	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 5e
	P-IV08R40C	 	TX/Irving/Floor 8	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 5e
	P-IV08R40B	 	TX/Irving/Floor 8	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 5e
	P-IV08R40A	 	TX/Irving/Floor 8	 	IVG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 5e
	P-IV08H25A	 	TX/Irving/Floor 8	 	IVG-FSVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 6
	P-JT04H46C	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6
	P-JT04H-T8	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-JT04H-S19	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-JT03H-G2	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-JT03H-A5	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-JT03H-P22	 	PA/Johnstown	 	JST-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-MO01R30A	 	CA/Modesto	 	mod-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-MO01R40A	 	CA/Modesto	 	mod-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-MV01R30A	 	CA/Mountain view	 	mv-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-MV01R40A	 	CA/Mountain view	 	mv-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-NY26H43C	 	NY/NYC-E42St	 	nyc2-fs01.hncorp.healthnet.com	 	HP LaserJet 4345 mfp PCL 6
	P-NY26H43A	 	NY/NYC-E42St	 	nyc2-fs01.hncorp.healthnet.com	 	HP LaserJet 4345 mfp PCL 6
	P-NY26H43B	 	NY/NYC-E42St	 	nyc2-fs01.hncorp.healthnet.com	 	HP LaserJet 4345 mfp PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-176	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-NY26H47B	 	NY/NYC-E42St	 	nyc2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-OAK01H4PB	 	CA/OAKLAND-DDP	 	oak4-fs01.hncorp.healthnet.com	 	HP LaserJet 4 Plus
	P-OAK01H47A	 	CA/OAKLAND-DDP	 	oak4-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-OAK01H40A	 	CA/OAKLAND-DDP	 	oak4-fs01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL 5e
	P-OAK01R70A	 	CA/OAKLAND-DDP	 	oak4-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-OAK01C50B	 	CA/OAKLAND-DDP	 	oak4-fs01.hncorp.healthnet.com	 	Canon iR5055/iR5065 PCL5e
	P-OK06R50A	 	CA/Oakland/Floor 6	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5000 PCL 6
	P-OK05R50A	 	CA/Oakland/Floor 5	 	OAK-FSVS01.hncorp.healthnet.com	 	GelSprinter GX 5050N PCL 6
	P-OK06R50D	 	CA/Oakland/Floor 6	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-OK06R50C	 	CA/Oakland/Floor 6	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-OK06H90C	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 9000 PCL 5e
	P-OK06H90B	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 9000 PCL 5e
	P-OK06H90A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 9000 PCL 5e
	P-OK07R40A	 	CA/Oakland/Floor 7	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-OK06R70A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-OK06H81A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 8150 Series PCL6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-177	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-OK06H80A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 8000 Series PCL 5e
	P-OK06H5SC	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 5Si/5Si MX PS
	P-OK06H47A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-OK06H46E	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-OK06H46D	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-OK06H46C	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-OK06H46B	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-OK06H46A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-OK06H45B	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-OK06H45A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-OK06H42B	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4200 PCL 5e
	P-OK06H41A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e
	P-OK06H40A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-OK06R40A	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-178	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-OK06R50E	 	CA/Oakland/Floor 6	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-OK06R40B	 	CA/Oakland/Floor 6	 	oak-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-OK06H5SD	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-OK06H5SA	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-OK06H42D	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-OK06H40B	 	CA/Oakland/Floor 6	 	OAK-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4050 Series PCL 6
	P-TE01H55B	 	AZ/Tempe/Floor 1	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PS
	P-TE01H55A	 	AZ/Tempe/Floor 1	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PS
	P-TE04H45A	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 6
	P-TE04H55B	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL 6
	P-TE04H55A	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL 6
	P-TE04H46B	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 6
	P-TE04H46A	 	AZ/Tempe/Floor 4	 	phx1-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PS
	P-TE04H38A	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PS

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-179	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-TE03R70A	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-TE03R40A	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-TE04R70C	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-TE04R70B	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-TE04R70A	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TE04R40A	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-TE03H55A	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5550 PS
	P-TE03H47A	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PS
	P-TE03H38A	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PS
	P-TE01R70A	 	AZ/Tempe/Floor 1	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TE04R40C	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-TE04R40B	 	AZ/Tempe/Floor 4	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-TE03R40B	 	AZ/Tempe/Floor 3	 	PHX1-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R40B	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R40A	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-180	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ252H45A	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet CP4520 Series PCL6
	P-AJ252H43A	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet 4350 PCL 6
	P-AJ252H42G	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-AJ252H41B	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-AJ251R70A	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-AJ251R50B	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R50A	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R40A	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-AJ251R30A	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP C305 PCL 6
	P-AJ251H90B	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet 9000 PCL 6
	P-AJ251H47B	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-AJ251H47A	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-AJ251H42D	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet 4250 PCL 6
	P-AJ192R50A	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ192R40B	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-AJ192H47A	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-AJ191H61A	 	CA/Aerojet 2019/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP Designjet Z6100ps 42in Photo PS3
	P-AJ15BR40C	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15BR40B	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-AJ15BR40A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-181	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ15BR30A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-AJ15BR20A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-AJ15BH95A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 9500 PCL 6
	P-AJ15BH55A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Designjet 5500 42 by HP
	P-AJ15BH47C	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-AJ15BH47B	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-AJ15BH46D	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Color LaserJet 4600 PCL 6
	P-AJ15BH45A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-AJ15BH33A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-AJ15BH10A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP DesignJet 1050C by HP
	P-AJ15AR70A	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-AJ15BR50B	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ15AR50B	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ15AR50A	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ15AR40A	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-AJ15BH45B	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-AJ15AR40B	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15AR50C	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ15AR40C	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15AR40D	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15BR40F	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-182	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ15BR40I	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15BR40H	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15BR40G	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15BR40E	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R50A	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ252R40F	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R40E	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R40D	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R40C	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ252R50B	 	CA/Aerojet 2025/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R50E	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R50D	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R50C	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ251R40C	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ251R40B	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ192R50C	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ192R50B	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ192R40C	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ192R40E	 	CA/Aerojet 2019/Floor 2	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-AJ15AH43B	 	CA/Aerojet 2015A	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 mfp PCL6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-183	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ15BH43A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 mfp PCL6
	P-AJ15BH43C	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 mfp PCL6
	P-AJ15BH43B	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 MFP PCL 6
	P-AJ251H43C	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 mfp PCL6
	P-AJ251H43B	 	CA/Aerojet 2025/Floor 1	 	RC1-FS01.FS.healthnet.com	 	HP LaserJet M4345 mfp PCL6
	P-AJ15BR50A	 	CA/Aerojet 2015B	 	RC1-FS01.FS.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-ID02H46A	 	CA/International	 	rc2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-ID02R70A	 	CA/International	 	rc2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-ID02R40A	 	CA/International	 	rc2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-ID02R70B	 	CA/International	 	rc2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-ID02R40B	 	CA/International	 	rc2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-WR02H47A	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WR02R70A	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WR02R70B	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WR02R50A	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-WR02H90B	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-WR02R75A	 	CA/Whiterock2	 	rc3-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-MR01H5MA	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP LaserJet 5M
	P-MR01H46A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-MR01R50A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-MR01R40A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-184	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-MR01H42A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP LaserJet 4200 PCL 6
	P-MR01H41A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e
	P-MR01H40B	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP LaserJet 4050 Series PCL
	P-MR01H40A	 	CA/Mercantile	 	rc4-fs01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL 5e
	Test 5775 PCL6	 		 	rc5-fscl03.hncorp.healthnet.com	 	Xerox WorkCentre 5775 PCL6
	P-SC02H36B	 	Executive 2nd floor	 	rc5-fscl04.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SC02H5SI	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02H5SG	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02H5SD	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02H5SC	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02H5SB	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02H4SA	 	CA/Sun Center/Floor2	 	rc5-fscl04.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-SC02R40D	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SC02R40C	 	CA/Sun Center/Floor 2	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PS
	P-SC02R40B	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-185	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SC02R40A	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SC02H46C	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-SC02H46B	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-SC02H46A	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-SC02H36C	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SC02H36B	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SC02H36A	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SC02H27A	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP LaserJet M2727 MFP Series PCL 6
	P-SC01R70D	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC01R70C	 	CA/Sun Center/Floor 1	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC01R70B	 	CA/Sun Center/Floor 1	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC01R50B	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SC01R40F	 	CA/Sun Center/Floor1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SC01R40E	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-186	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SC01R40D	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SC01R40C	 	CA/Sun Center/Floor 1	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SC01R40B	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SC01R40A	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SC01R16B	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 161 PCL 5e
	P-SC01H47A	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-SC01H46A	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-SC01H36A	 	CA/Sun Center/Floor 1	 	RC5-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SC02R70D	 	CA/Sun Center/Floor 2	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC02R70B	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC02R70A	 	CA/Sun Center/Floor 2	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-SC01R16A	 	CA/Sun Center/Floor 1	 	rc5-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 161 PCL 5e
	P-SC02H40F	 	CA/Sun Center/Floor 2	 	RC5-FSVS01.hncorp.healthnet.com	 	HP LaserJet 4050 Series PCL
	Test 5775 PCL6	 		 	RC-PRTCL01.hncorp.healthnet.com	 	Xerox WorkCentre 5775 PCL6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-187	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	test 5745 PCL6	 		 	RC-PRTCL01.hncorp.healthnet.com	 	Xerox WorkCentre 5745 PCL6
	P-UNIVERSAL03	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-TURLOCK-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 3390 Series PCL 5e
	P-REDWOODCITY-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 161 PCL 5e
	P-GD01H47A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-GD01H36A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC03H90C	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-GC03H90B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-GC03H90A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-GC03H85A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 8550 PCL 5c
	P-GC03H81E	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e
	P-GC03H81D	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e
	P-GC03H81C	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e
	P-GC03H81A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-188	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC03H80A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8000 Series PCL 5e
	P-GC03H4PC	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4 Plus
	P-GC03H36B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC03H36A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC03H12A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 1200 Series PCL 6
	P-GC02T56A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	Tektronix Phaser 560
	P-GC02HD5A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Designjet 500 24+HPGL2 Card
	P-GC02H46B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-GC02H46A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-GC02H45F	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-GC02H45C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL
	P-GC02H45B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-GC02H36C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC02H36A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-189	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC01L23A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 6
	P-GC01H36A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC01H20B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet P2015 Series PCL 5e
	P-GC01H20A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP 2500C Series Printer
	P-GA02H55A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-GA02H46C	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-GA02H46B	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-GA02H46A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-GA02H36A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-DECATUR-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e
	P-AJ15BH4MB	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4M Plus
	P-AJ15BH46C	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-GC01H46A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-GC01H45B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-190	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC02H36B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GC03H81G	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 Series PCL
	P-GC01R35A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP C3501 PCL 6
	P-BAKERSFIELD-03	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-GC03R70A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GA01R40A	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-MODESTO-04	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC01R40A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GA01R70A	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GD01R40A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GA02R40A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GA02R70A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC01R40A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01H47A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-191	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC02R40C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01R40C	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC03R70C	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC02R70C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-AJ15BH36A	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GA01R70B	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GD01R40C	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GD01R70A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC01R40D	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01R40E	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC02R40A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PS
	P-GC02R40B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01R40B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC02R70B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-192	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC02R70A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC03R70B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GC01H38A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 6
	P-BAKERSFIELD-04	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-GC03H80B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8000 Series PCL
	P-GC01R40F	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC02R40D	 	CA/Goldpointe C/Floor 2	 	rc-prtvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PS
	P-GC02H36E	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GD01R50C	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-GD01R20A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 201 PCL 6
	P-GC02L23A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	LANIER LP231c/SP C411 PCL 6
	P-KSTCAR50B	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-GC03R70D	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-REDWOODCITY-02	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 201 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-193	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-UNIVERSAL04	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-GC03H40F	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet P4010_P4510 Series PCL 6
	P-GC03R82A	 	CA/Gold Pointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio SP C821DN PS
	P-GC03R82A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio SP C821DN PS
	P-AJ15BR50A	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-AJ191R40A	 	CA/Aerojet 2019/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01H27A	 	CA/GoldPointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet M2727 MFP Series PCL 6
	P-GA02H36C	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-GD01R50D	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-UNIONCITY-03	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC01L48A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	Lexmark Optra S 1250
	P-GC01L44A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	Lexmark Optra S 1250
	P-GC03R40A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GD01R40B	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-194	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC01H45A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-GD01R40D	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-Stockton-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC02H46C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 6 (v4.7)
	P-TURLOCK-02	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-GD01R50A	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GA01R50A	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GA02R50A	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GA02R50B	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GA02R40B	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GA02R40C	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC01R40G	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC01R40H	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC01R30A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-195	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-GC02R40F	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GC02R50A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC02R50B	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC02R50C	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC02R50D	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PS
	P-GC02R75A	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-GC03R50A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC03R50B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC03R50C	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC03R50D	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC03R50E	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC03R40B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-EastLA-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	Lexmark CX410 Series PS3
	P-DUBLIN-02	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-196	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-STOCKTON-02	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-GD01H40C	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet P4010_P4510 Series PCL 6
	P-GC03R75B	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-GC03R75A	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PS
	P-GC01R40I	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-GC01H45E	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL6
	P-GC01H40B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL6
	P-GC01H81B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 Series PCL
	P-GC01H40A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL6
	P-GC02R40G	 	CA/Goldpointe C/Floor 2	 	rc-prtvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PS
	P-GA01H46A	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-GA02H46D	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-GC02H4GC	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-AJ191R50B	 	CA/Aerojet 2019/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-197	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ191R50A	 	CA/Aerojet 2019/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-GC01H80B	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Designjet 800 42 by HP
	P-GC02H46D	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-VISAILA-02	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-VISAILA-01	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-UNIVERSAL06	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	Canon iR3570/iR4570 PCL6
	P-SA01C35A	 	Remote Office-HNC	 	RC-PRTVS01.hncorp.healthnet.com	 	Canon iR2200-3300 PCL6
	P-GC03H41C	 	CA/Goldpointe C/Floor 3	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL 5e
	P-GC02H42HLPR	 	CA/Goldpointe C	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4200 PCL 5e
	P-GC02H42H	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-GC01H5SE	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-AJ15BH5SB	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-AJ15BH5SA	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-AJ15BH5MA	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5M

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-198	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-AJ15BH41B	 	CA/Aerojet 2015B	 	RC-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e
	P-GC02R40H	 	CA/Goldpointe C/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-GD01H47C	 	CA/Goldpointe D	 	RC-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-GC01H10A	 	CA/Goldpointe C/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP DesignJet 1050C by HP
	P-GA02R70B	 	CA/Datacenter/Floor 2	 	RC-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-GA01H10A	 	CA/Datacenter/Floor 1	 	RC-PRTVS01.hncorp.healthnet.com	 	HP DesignJet 1050C by HP
	P-AJ15BH5SD	 		 	RC-SQL20.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-AJ15BH45A	 		 	RC-SQL20.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-AJ15AH81A	 		 	RC-SQL20.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e
	P-AJ15AH5SA	 		 	RC-SQL20.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-SB02R40B	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SB02R40A	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SB02HC20	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	HP Color LaserJet CP2020 Series PCL 6
	P-SB02H90A	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 6
	P-SB02H36B	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SB02H38A	 	CA/SanBernardino	 	sber-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-199	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SD11H90A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-SD11H5SA	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-SD11H4SA	 	CA/SanDiego-Camino	 	sd2- fs01.hncorp.healthnet.com	 	HP LaserJet 4200 PCL 5e
	P-SD11H47B	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-SD11H47A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-SD11H46A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-SD11H42A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-SD11H36A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SD11R50A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-SD11R40A	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SD11H42A-NEW	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-SD11H5SA-NEW	 	CA/SanDiego-Camino	 	sd2-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-SD13H81B	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-SD13H81A	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-SD13H5SA	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PS (v5.3)
	P-SD13H5MA	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PS (v5.3)
	P-SD13H4MA	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PS (v5.3)
	P-SD13H47A	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-SD13H41A	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	HP Universal Printing PCL 6 (v5.3)
	P-SD13C33B	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	Canon iR2200-3300 PCL5e
	P-SD13C33A	 	CA/SanDiego	 	SD-FS01.FS.healthnet.com	 	Canon iR2200-3300 PCL5e
	SJC Test	 		 	sjc-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-200	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SJ02H5SA	 	CA/SanJose	 	sjc-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-SJ02H4SA	 	CA/SanJose	 	sjc-fs01.hncorp.healthnet.com	 	HP LaserJet 4Si MX
	P-SJ02H36A	 	CA/SanJose	 	sjc-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SJ02R40A	 	CA/SanJose	 	sjc-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SMAR01HP5SB	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si/5Si MX PS
	P-SMAR01HP46A	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-SMAR01HP5SA	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	HP LaserJet 5Si/5Si MX PS
	P-SMAR01HP46B	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-SMAR01H43A	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	HP LaserJet 4345 mfp PCL 6
	P-SMAR01R40A	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4000 PCL 6
	P-SMAR01R40B	 	CA/SanMarcos	 	smar-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SM01H36A	 	CA/SanMateo	 	smat-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SM01R40A	 	CA/SanMateo	 	smat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SM01R30A	 	CA/SanMateo	 	smat-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-SM01C30A	 	CA/SanMateo	 	smat-fs01.hncorp.healthnet.com	 	Canon iR3035/iR3045 PCL5e
	P-SR02NR40A	 	CA/SANRAFAEL2/2N	 	SRAF2-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02NH85B	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 8500 PCL
	P-SR02NH47A	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-SR02NH46A	 	CA/SANRAFAEL2/2N	 	SRAF2-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-201	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SR02NH36A	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-SR03SR40A	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-SR03SH55A	 	CA/SANRAFAEL2/3S	 	SRAF2-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-SR03SH50A	 	CA/SANRAFAEL2/3S	 	SRAF2-FSVS01.hncorp.healthnet.com	 	HP DesignJet 500 24 by HP
	P-SR03SH45A	 	CA/SANRAFAEL2/3S	 	SRAF2-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500 PCL 5c
	P-SR03SH38B	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-SR02SR40B	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02SR40A	 	CA/SANRAFAEL2/2S	 	SRAF2-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02SH47A	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-SR02SH46A	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-SR02NR40C	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02NR40B	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02NR50A	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SR02NR50B	 	CA/SANRAFAEL2/2N	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-202	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-SR02SR40E	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.co m	 	RICOH Aficio MP 4002 PCL 6
	P-SR02SR40F	 	CA/SANRAFAEL2/2S	 	SRAF2- FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02SR50A	 	CA/SANRAFAEL2/2S	 	SRAF2-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SR02SR40C	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR02SR40D	 	CA/SANRAFAEL2/2S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR03SR50A	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SR03SR40D	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR03SR50B	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SR03SR50C	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-SR03SR40B	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-SR03SR40C	 	CA/SANRAFAEL2/3S	 	sraf2-fsvs01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	HP LaserJet 4250 PCL 5e	 		 	tig-fscl03.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	HP LaserJet 4350 PCL 5e	 		 	tig-fscl03.hncorp.healthnet.com	 	HP LaserJet 4350 PCL 5e
	P-TI03R70C	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-203	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-TI03R50B	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI03R50A	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI03R40B	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-TI03R40A	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-TI02R70D	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TI02R70C	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TI02R50D	 	OR/TIGARD/floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI02R50C	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI02R50B	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI02R50A	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 6
	P-TI02R40B	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-TI02R40A	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 6
	P-TI02H36C	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-TI03H46A	 	OR/TIGARD/Floor 3	 	TIG-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-204	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-TI02H55B	 	OR/TIGARD/Floor 2	 	TIG-FSVS01.hncorp.healthnet.com	 	HP Color LaserJet CP5520 Series PCL 6
	P-TU02H40A	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP LaserJet 4000 Series PCL 5e
	P-TU04R70C	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TU04R40B	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-TU04R70B	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TU04R70D	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-TU04R40A	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-TU04H38A	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-TU04H38C	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-TU04H38D	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-TU04H42A	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP LaserJet 4200 PCL 6
	P-TU04H36A	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-TU04H36B	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-TU02C45B	 	AZ/Tucson	 	tus-fs01.hncorp.healthnet.com	 	Canon iR3570/iR4570 PCL5e
	P-VIS01H42A	 	CA/VISALIA	 	vis-fs01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-CW01H46A	 	CA/Califa	 	wh2-fs01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-BC04BR70A	 		 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7000 PCL 5e
	P-BC04RH42A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-BC04RH41A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4100 PCL 5e

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-205	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB03RH55C	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-BB02BH47D	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02BH36B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-WC25H47A	 	CA/Woodlandhills/EXEC/Floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC25H42E	 	CA/WOODLANDHILLS/EXEC/FLOOR 25	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-WC24R70D	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC24R70C	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC24R70B	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC24R50A	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 5e
	P-WC24R40B	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-WC24H55A	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-WC24H47B	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PS
	P-WC24H46A	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-WC24H45D	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-206	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-WC24H45B	 	CA/WoodlandHills/Exec/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL
	P-WC24H45A	 	CA/Woodlandhills/EXEC/Floor 24	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL
	P-WC23R70B	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC23R70A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC23H46A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-WC23H38B	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-WC23H38A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-WC25R80B	 	CA/WoodlandHills/Exec/Floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PCL 6
	P-WC25R70E	 	CA/WoodlandHills/Exec/Floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC25R70D	 	CA/WoodlandHills/Exec/Floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC25R70C	 	CA/Woodlandhills/exec/floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC25R70B	 	CA/Woodlandhills/exec/floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC25R70A	 	CA/Woodlandhills/exec/floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 5e
	P-WC25R30A	 	CA/Woodlandhills/exec/floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-207	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-WC25H47D	 	CA/WoodlandHills/Exec/Floor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC25H47B	 	CA/Woodlandhills/EXEC/F loor 25	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC23H36A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-WC22R70A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC22R65A	 	CA/Woodlandhills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP C6501 PCL 6
	P-WC22R40A	 	CA/Woodlandhills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-WC22H47C	 	CA/Woodlandhills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC22H46B	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PS
	P-WC22H46A	 	CA/WoodlandHills/Exec/Floor 22-23	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-WC21R70D	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-WC21R70C	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC21R65A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP C6501 PCL 6
	P-WC21R40B	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-WC21R40A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-208	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-WC21HP36A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-WC21H55A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 6
	P-WC21H47B	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC21H47A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PS
	P-WC21H46D	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-WC21H46C	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-WC21H46A	 	CA/WoodlandHills/Exec/Floor 21	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-WC15R70B	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC15R70A	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-WC15H47A	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-WC15H46B	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-WC15H42C	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-WC15H42B	 	CA/WoodlandHills/Exec/Floor 15	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-MV01C30B	 	CA/MOUNTAINVIEW	 	WH-PRTVS01.hncorp.healthnet.com	 	Canon iR3035/iR3045 PCL5e

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-209	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BC05RR75B	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC05RR75A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC05RR70B	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC05RR40A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 5e
	P-BC05RH46A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-BC05RH42B	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-BC05BR75A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC05BR70C	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BC05BR70B	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC05BR40A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BC05BH81A	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 Series PCL
	P-BC05BH5SL	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BC05BH5SI	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BC05BH5SH	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-210	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BC05BH5SB	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BC05BH4MB	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4
	P-BC05BH40B	 	CA/WoodlandHills/Bldg C/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4050 Series PCL 6
	P-BC04RR75A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WHPRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC04RR70B	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BC04RR70A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BC04RH90A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 9000 PCL 5e
	P-BC04RH81B	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 PCL 5e
	P-BC04RH55A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5550 PCL 6
	P-BC04RH46B	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-BC04RH46A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-BC04RH45A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-BC04BR80A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PS
	P-BC04BR75A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-211	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BC04BR70B	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC04BH90A	 	CA/WoodlandHills/Bldg C/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 9050 PCL 5e
	P-BC03RR80B	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PCL 6
	P-BC03RR75A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PS
	P-BC03RR70C	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BC03RR70B	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC03RH81D	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 8150 Series PCL
	P-BC03RH5SE	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BC03RH47A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BC03RH45C	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500
	P-BC03RH45A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500
	P-BC03RH42E	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 4250 PCL 5e
	P-BC03BR75B	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC03BR75A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-212	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BC03BR70B	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC03BR70A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC03BH46B	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-BC03BH46A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BC03BH38A	 	CA/WoodlandHills/Bldg C/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BC02RR75B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC02RR75A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC02RR70B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC02RR40A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BC02RH85A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 8550 PCL
	P-BC02RH47A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BC02RH45A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-BC02BR75B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BC02BR75A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-213	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BC02BR70B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BC02BH55D	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-BC02BH46C	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL6
	P-BC02BH46B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BC02BH46A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BC02BH38B	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BC02BH38A	 	CA/WoodlandHills/Bldg C/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BC01RR40B	 	CA/WoodlandHills/Bldg C/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 5e
	P-BC01RR30A	 	CA/WoodlandHills/Bldg C/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-BC01RH55A	 	CA/WoodlandHills/Bldg C/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL5c
	P-BC01RH38A	 	CA/WoodlandHills/Bldg C/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BB05RR75D	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05RR75C	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05RR75B	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-214	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB05RR75A	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05RR70C	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB05RR70B	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB05RR20A	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 201 PCL 5e
	P-BB05RH5SF	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si MX
	P-BB05RH5MA	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BB05RH47A	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB05RH46D	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB05RH46C	 	CA/Woodlandhills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-BB05RH46B	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 6
	P-BB05BR75C	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05BR75B	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05BR75A	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB05BR70B	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-215	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB05BH47A	 	CA/WoodlandHills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB05BH46A	 	CA/Woodlandhills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB05BH36A	 	CA/Woodlandhills/Bldg B/Floor 5	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-BB04RR75B	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB04RR75A	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB04RR70B	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB04RR70A	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB04RH5SA	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP LaserJet 5Si
	P-BB04RH47B	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB04RH46B	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-BB04RH38A	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BB04BR80B	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PCL 6
	P-BB04BR75C	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB04BR75B	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-216	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB04BR75A	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB04BR40A	 	CA/WoodlandHills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BB04BH47A	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-BB04BH45B	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4550 PCL 5c
	P-BB04BH45A	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500
	P-BB04BH36A	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-BB03RR75C	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB03RR75B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB03RR75A	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB03RR70B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB03RH55A	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5550 PCL 6
	P-BB03RH47A	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 5c
	P-BB03RH46E	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB03RH46D	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-217	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB03RH46B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-BB03BR80B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PCL 6
	P-BB03BR75B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB03BR75A	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB03BR70C	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB03BR70B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BB03BH55B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 5500 PCL 5c
	P-BB03BH47B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB03BH46D	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4650 PCL 5c
	P-BB03BH46A	 	CA/Woodlandhills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB03BH36B	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3800 PCL 5c
	P-BB03BH36A	 	CA/WoodlandHills/Bldg B/Floor 3	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-BB02RR75A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB02RR70C	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-218	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB02RR70A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PS
	P-BB02RR40A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4002 PCL 5e
	P-BB02RH47C	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02RH47A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02RH46A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB02BR80B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 8001 PCL 6
	P-BB02BR75B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB02BR75A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7502 PCL 6
	P-BB02BR65A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP C6501 PCL 6
	P-BB02BR50B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5002 PCL 5e
	P-BB02BR50A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 5001 PCL 6
	P-BB02BH47E	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02BH47C	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02BH47B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-219	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Printer Name
	 	 Location
	 	 Server Name
	 	 Driver Name

	P-BB02BH47A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB02BH46A	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Universal Printing PCL 5
	P-BB02BH45D	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500
	P-BB02BH45B	 	CA/WoodlandHills/Bldg B/Floor 2	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4500
	P-BB01RR70A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB01RR35A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP C3501 PCL 6
	P-BB01RH46B	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600
	P-BB01BR70A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 7001 PCL 6
	P-BB01BR40B	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BB01BR40A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 4001 PCL 6
	P-BB01BR30A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	RICOH Aficio MP 301 PCL 6
	P-BB01BH47A	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4700 PCL 6
	P-BB01BH46C	 	CA/WoodlandHills/Bldg B/Floor 1	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 4600 PCL 5c
	P-BB04BH36C	 	CA/Woodlandhills/Bldg B/Floor 4	 	WH-PRTVS01.hncorp.healthnet.com	 	HP Color LaserJet 3600

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-220	  	Health Net / Cognizant Confidential

 Final 
  

 3.3 Appendix III – Deskside Services 

3.3.1 Deskside Resource Mobilization Plan 

The table below details the Deskside support resource mobilization plan for Health Net offices: 

 

															
	 	 	 	 	 	 	 	 	 	 	 	 	Steady Description
	 Address
	 	 Zip
	 	 City
	 	 State
	 	 Seat count
	 	 Transition

resource
	 	 State

resource
	 	  

	 WoodHills - Burbank -

53414
	 	91367-6607	 	 Woodland

Hills
	 	CA	 	2,706	 	2	 	5	 	
								
	 Rancho -

GP-C -
 12999
	 	95670-4502	 	 Rancho

Cordova
	 	CA	 	894	 	2	 	2	 	*Federal
								
	 Rancho -

Aerojet – GV022
	 	95742-6418	 	 Rancho

Cordova
	 	CA	 	1,059	 	1	 	2	 	
								
	 Rancho - Sun

Center -
 53065
	 	95670-6142	 	 Rancho

Cordova
	 	CA	 	749	 	1	 	2	 	
								
	 Rancho -

Mercantile -
 12032
	 	95742-7211	 	 Rancho

Cordova
	 	CA	 	55	 	1	 	2	 	 Depot

Location

								
	 WoodHills -

Califa -
 12995
	 	91367-5026	 	 Woodland

Hills
	 	CA	 	5	 	1	 	2	 	 Depot

Location

								
	 WoodHills -

Oxnard -
 12304
	 	91367-4901	 	 Woodland

Hills
	 	CA	 	528	 	1	 	1	 	
								
	 San Rafael -

Kerner -
 60600
	 	94901-5546	 	San Rafael	 	CA	 	351	 		 	1	 	
								
	 Rancho -

GP-A -
 12999
	 	95670-4502	 	 Rancho

Cordova
	 	CA	 	345	 		 	1	 	
								
	 Tigard -

SW
 68th - 57045
	 	97223-8328	 	Tigard	 	OR	 	248	 	1	 	1	 	
								
	 Tempe -

Washington -
	 	85281-1249	 	Tempe	 	AZ	 	188	 	1	 	1	 	
	40209	 		 		 		 		 		 		 	

  

					
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 Final 

															
								
	 Rancho -

GP-D -
 53443
	 	95670-4502	 	 Rancho

Cordova
	 	CA	 	162	 		 	1	 	
								
	 Johnstown -

GV047
	 	15901-1914	 	Johnstown	 	PA	 	156	 	1	 	1	 	*Federal
								
	 Arlington -

GV039
	 	22201-3091	 	Arlington	 	VA	 	154	 	1	 	1	 	*Federal
								
	 HNCA -

53238
	 	92647-3090	 	 Huntington

Beach
	 	CA	 	144	 		 	1	 	
								
	 Irving - 950 -

60553
	 	75038-2604	 	Irving	 	TX	 	142	 	1	 	1	 	
								
	 Hampton -

Ofc - GV053
	 	23666-1500	 	Hampton	 	VA	 	139	 	1	 	1	 	*Federal
								
		 		 		 	Total	 	8,025	 	15	 	26	 	
			
	  
 Other ~ 65 Location
	 	1,200	 	Support Model - Dispatch, Depot support Remote desktop support: onsite (Woodland Hill/Rancho Cordova) and offshore (Coimbatore & Bangalore, India)

 3.3.2 Deskside Locations 
  

													
	 S. No.
	  	 Property (Description – Code)
	  	 City
	  	 State
	  	 Zip
	  	 Seat

Count
	  	 Site Classification

	1	  	Wood Hills - Burbank – 53414	  	 Woodland
 Hills
	  	CA	  	91367-6607	  	2,706	  	Depot
							
	2	  	Rancho - GP-A - 12999	  	 Rancho
 Cordova
	  	CA	  	95670-4502	  	345	  	Campus
							
	3	  	Rancho - Aerojet - GV022	  	 Rancho
 Cordova
	  	CA	  	95742-6418	  	1,059	  	Depot
							
	4	  	Rancho - Sun Center - 53065	  	 Rancho
 Cordova
	  	CA	  	95670-6142	  	722	  	Depot
							
	5	  	Irving - 950 - 60553	  	Irving	  	TX	  	75038-2604	  	142	  	Dispatch
							
	6	  	Huntington Beach - HNCA - 53238	  	 Huntington
 Beach
	  	CA	  	92647-3090	  	144	  	Dispatch
							
	7	  	Johnstown - GV047	  	Johnstown	  	PA	  	15901-1914	  	156	  	Campus
							
	8	  	Tempe - Washington - 40209	  	Tempe	  	AZ	  	85281-1249	  	188	  	Campus
							
	9	  	San Rafael - Kerner - 60600	  	San Rafael	  	CA	  	94901-5546	  	351	  	Depot

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-222	  	Health Net / Cognizant Confidential

 Final 

													
	 S. No.
	  	 Property (Description – Code)
	  	 City
	  	 State
	  	 Zip
	  	 Seat

Count
	  	 Site Classification

							
	10	  	Hampton - Ofc - GV053	  	Hampton	  	VA	  	23666-1500	  	139	  	Dispatch
							
	11	  	Arlington - GV039	  	Arlington	  	VA	  	22201-3091	  	154	  	Campus
							
	12	  	Rancho - White Rock - 65077	  	 Rancho
 Cordova
	  	CA	  	95670-7984	  	135	  	Dispatch
							
	13	  	Tigard - SW 68th - 57045	  	Tigard	  	OR	  	97223-8328	  	248	  	Campus
							
	14	  	Oakland - 180 Grand - 52307	  	Oakland	  	CA	  	94612-3783	  	89	  	Dispatch
							
	15	  	Rancho – International/Prospect Park - 65005	  	 Rancho
 Cordova
	  	CA	  	95670-7338	  	71	  	Dispatch
							
	16	  	San Marcos - Los Vallecitos - 60593	  	San Marcos	  	CA	  	92069-1491	  	45	  	Dispatch
							
	17	  	San Diego - Camino - 1100 - 53375	  	San Diego	  	CA	  	92108-5712	  	45	  	Dispatch
							
	18	  	Tucson - Williams Circle - 40270	  	Tucson	  	AZ	  	85711-7401	  	92	  	Dispatch
							
	19	  	San Bernardino - 53374	  	 San
 Bernardino
	  	CA	  	92408-3535	  	53	  	Dispatch
							
	20	  	Fresno - Palm - 53480	  	Fresno	  	CA	  	93711-5764	  	37	  	Dispatch
							
	21	  	Chatsworth - Prairie - 11798	  	Chatsworth	  	CA	  	91311-6007	  	57	  	Dispatch
							
	22	  	Modesto - Crows Landing - 53520	  	Modesto	  	CA	  	95358-6125	  	13	  	Dispatch
							
	23	  	Mountain View - Ellis - 60610	  	 Mountain
 View
	  	CA	  	94043-2225	  	10	  	Dispatch
							
	24	  	Concord - Stanwell - 60605	  	Concord	  	CA	  	94520-4863	  	9	  	Dispatch
							
	25	  	El Cerrito - San Pablo - 60607	  	El Cerrito	  	CA	  	94530-2166	  	4	  	Depot Support
							
	26	  	San Mateo - 60606	  	San Mateo	  	CA	  	94403-1374	  	7	  	Dispatch
							
	27	  	Oakland - Pendleton - 60604	  	Oakland	  	CA	  	94621-2102	  	19	  	Dispatch
							
	28	  	San Jose - 53239	  	San Jose	  	CA	  	95112-4510	  	7	  	Dispatch
							
	29	  	WoodHills - Califa - 12995	  	 Woodland
 Hills
	  	CA	  	91367-5026	  	5	  	Dispatch

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-223	  	Health Net / Cognizant Confidential

 Final 

													
	 S. No.
	  	 Property (Description – Code)
	  	 City
	  	 State
	  	 Zip
	  	 Seat

Count
	  	 Site Classification

	30	  	Kirk/APG TSC - MTF029	  	Aberdeen Apg	  	MD	  	21005	  	5	  	Dispatch
							
	31	  	Alamogordo - White Sands - GV077	  	Alamogordo	  	NM	  	88310-6151	  	9	  	Dispatch
							
	32	  	Malcolm Grow TSC - MTF030	  	 Andrews
 AFB
	  	MD	  	20762	  	6	  	Dispatch
							
	33	  	Annapolis TSC - MTF018	  	Annapolis	  	MD	  	21402	  	3	  	Depot Support
							
	34	  	Bakersfield - Niles - 53018	  	Bakersfield	  	CA	  	93306-4696	  	9	  	Dispatch
							
	35	  	Baltimore USCG TSC - MTF019	  	Baltimore	  	MD	  	21226	  	1	  	Depot Support
							
	36	  	Beavercreek - GV043	  	Beavercreek	  	OH	  	45431-1673	  	7	  	Dispatch
							
	37	  	Bethesda NNMC TSC - MTF021	  	Bethesda	  	MD	  	20889	  	6	  	Dispatch
							
	38	  	Bolling AFB TSC - MTF022	  	Bolling AFB	  	DC	  	20332	  	3	  	Depot Support
							
	39	  	Boston US Coast Guard Clinic - MTF035	  	Boston	  	MA	  	2109	  	1	  	Depot Support
							
	40	  	Buckeye - GV074	  	Buckeye	  	AZ	  	85326-2704	  	1	  	Depot Support
							
	41	  	Cape Cod US Coast Guard Clinic - MTF036	  	Buzzards Bay	  	MA	  	2542	  	1	  	Depot Support
							
	42	  	Camp Lejeune Naval Hospital - MTF001	  	Camp Lejeune	  	NC	  	28542	  	10	  	Dispatch
							
	43	  	Cape May US Coast Guard Clinic - MTF037	  	Cape May	  	NJ	  	8204	  	1	  	Depot Support
							
	44	  	Dunham TSC - MTF024	  	Carlisle	  	PA	  	17013	  	6	  	Dispatch
							
	45	  	Dover AFB TSC - MTF038	  	Dover AFB	  	DE	  	19902	  	8	  	Dispatch
							
	46	  	Dublin – 60603	  	Dublin	  	CA	  	94568-2842	  	3	  	Depot Support
							
	47	  	Durango - GV067	  	Durango	  	CO	  	81301-5056	  	7	  	Dispatch
							
	48	  	Los Angeles - Whittier - 52313	  	 East Los
 Angeles
	  	CA	  	90022-3116	  	1	  	Depot Support
							
	49	  	Elizabeth City US Coast Guard Clinic - MTF002	  	 Elizabeth
 City
	  	NC	  	27909	  	1	  	Depot Support
							
	50	  	Espanola - GV075	  	Espanola	  	NM	  	87532-2741	  	7	  	Dispatch

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-224	  	Health Net / Cognizant Confidential

 Final 

													
	 S. No.
	  	 Property (Description – Code)
	  	 City
	  	 State
	  	 Zip
	  	 Seat

Count
	  	 Site Classification

	51	  	Fairfax FHC TSC - MTF025	  	Fairfax	  	VA	  	22031-4307	  	1	  	Depot Support
							
	52	  	Fresno - Van Ness - 53142	  	Fresno	  	CA	  	93721-1727	  	31	  	Dispatch
							
	53	  	Ft. Bragg - MTF003	  	Ft Bragg	  	NC	  	28310	  	19	  	Dispatch
							
	54	  	Barquist TSC - MTF020	  	FT Detrick	  	MD	  	21702	  	3	  	Depot Support
							
	55	  	Ft. Eustis - MTF004	  	Ft Eustis	  	VA	  	23604	  	5	  	Dispatch
							
	56	  	 Ft. Knox Army
 Community Hospital -
MTF012
	  	Ft Knox	  	KY	  	40121	  	11	  	Dispatch
							
	57	  	Andrew Rader TSC - MTF017	  	Ft Myer	  	VA	  	22211	  	1	  	Depot Support
							
	58	  	Kenner Army Health Clinic - MTF005	  	Ft. Lee	  	VA	  	23801	  	6	  	Dispatch
							
	59	  	Seymour Johnson - MTF009	  	Goldsboro	  	NC	  	27531	  	5	  	Dispatch
							
	60	  	Groton - GV044	  	Groton	  	CT	  	06340-3414	  	7	  	Dispatch
							
	61	  	Harrisonburg - GV008	  	Harrisonburg	  	VA	  	22801-4323	  	14	  	Dispatch
							
	62	  	Hibbing - Irongate - GV068	  	Hibbing	  	MN	  	55746-3045	  	11	  	Dispatch
							
	63	  	Huntington Beach - MHN - 60552	  	 Huntington
 Beach
	  	CA	  	92647-3090	  	129	  	Dispatch
							
	64	  	Langley Air Force Base Clinic - MTF006	  	Langley	  	VA	  	23665	  	7	  	Dispatch
							
	65	  	Las Vegas - University - GV073	  	Las Vegas	  	NM	  	87701-4278	  	9	  	Dispatch
							
	66	  	 McGuire AFB TSC Bldgs.
 3457 and 3458 -
MTF044
	  	 McGuire
 AFB
	  	NJ	  	8641	  	9	  	Dispatch
							
	67	  	 New London US Coast
 Guard Clinic -
MTF045
	  	New London	  	CT	  	6320	  	1	  	Depot Support
							
	68	  	Newport NACC TSC - MTF047	  	Newport	  	FL	  	02841-1002	  	3	  	Depot Support
							
	69	  	Newport News - GV079	  	 Newport
 News
	  	VA	  	23603-1389	  	1	  	Depot Support
							
	70	  	Patuxent River TSC - MTF031	  	 Patuxtent
 River
	  	MD	  	20670	  	6	  	Dispatch
							
	71	  	Portsmouth Naval	  	Portsmouth	  	VA	  	23708	  	10	  	Dispatch

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-225	  	Health Net / Cognizant Confidential

 Final 

													
	 S. No.
	  	 Property (Description – Code)
	  	 City
	  	 State
	  	 Zip
	  	 Seat

Count
	  	 Site Classification

		  	Medical Center - MTF008	  		  		  		  		  	
							
	72	  	Portsmouth TSC - MTF048	  	Portsmouth	  	NH	  	3804	  	1	  	Depot Support
							
	73	  	Quantico TSC - MTF033	  	Quantico	  	VA	  	22134	  	7	  	Dispatch
							
	74	  	Rancho - GP-D - 53443	  	 Rancho
 Cordova
	  	CA	  	95670-4502	  	162	  	Dispatch
							
	75	  	Rancho - GP-C - 53444	  	 Rancho
 Cordova
	  	CA	  	95670-4502	  	894	  	Depot
							
	76	  	Rancho - Mercantile - 12032	  	 Rancho
 Cordova
	  	CA	  	95742-7211	  	55	  	Dispatch
							
	77	  	Redwood City - Veterans - 60599	  	 Redwood
 City
	  	CA	  	94063-1441	  	9	  	Dispatch
							
	78	  	Sacramento - K St. - 53234	  	Sacramento	  	CA	  	95814-3918	  	11	  	Dispatch
							
	79	  	Scott AFB - MTF013	  	Scott AFB	  	IL	  	62225	  	12	  	Dispatch
							
	80	  	Selfridge - MTF014	  	 Selfridge Air
 National

Guard
	  	MI	  	48045	  	2	  	Depot Support
							
	81	  	Stockton - Exec - 53046	  	Stockton	  	CA	  	95207-5700	  	1	  	Depot Support
							
	82	  	Taos - GV078	  	Taos	  	NM	  	87571-5801	  	6	  	Dispatch
							
	83	  	Turlock - Monte Vista - 60608	  	Turlock	  	CA	  	95382-8608	  	2	  	Depot Support
							
	84	  	Union City – 60602	  	Union City	  	CA	  	94587-1233	  	3	  	Depot Support
							
	85	  	Pentagon Clinic TSC - MTF032	  	Washington	  	WA	  	20310	  	4	  	Depot Support
							
	86	  	Woodbridge FHC TSC - MTF034	  	Woodbridge	  	VA	  	22192	  	2	  	Depot Support
							
	87	  	Wood Hills - Oxnard - 12304	  	 Woodland
 Hills
	  	CA	  	91367-4901	  	528	  	Depot
							
	88	  	Wright-Patterson AFB - MTF016	  	 Wright
 Patterson

AFB
	  	OH	  	45433	  	8	  	Dispatch
							
	89	  	Yorktown USCG TSC - MTF010	  	Yorktown	  	VA	  	23690	  	1	  	Depot Support

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-226	  	Health Net / Cognizant Confidential

 Final 

 3.4 Appendix VI – Database services 

This section below details the Database server inventory in Health Net environment. 

Cognizant will be responsible for All Oracle servers in the Health Net environment. 

 

									
	 Server
	  	 Description
	  	Business	  	DB
Technology	  	Comments
	orac-dev01/02	  	OLTP	  	HNFS	  	Oracle	  	
					
	orac-dev03/04	  	OLTP	  	Commercial	  	Oracle	  	
					
	orac-dev05/06	  	DW	  	Commercial	  	Oracle	  	
					
	orac-dev09/10	  	PEGA	  	Commercial	  	Oracle	  	
					
	orac-stg01/02	  	OLTP	  	HNFS	  	Oracle	  	
					
	orac-prd01/02	  	OLTP	  	HNFS	  	Oracle	  	
					
	orac-prd03/04	  	OLTP	  	Commercial	  	Oracle	  	
					
	orac-prd05/06	  	DW	  	Commercial	  	Oracle	  	
					
	orac-prd09/10	  	PEGA	  	Commercial	  	Oracle	  	
					
	orac-prd11/12	  	PEGA	  	HNFS	  	Oracle	  	
					
	mysql-dev1	  	Web	  	Commercial	  	MySQL	  	
					
	mysql-stg/3/4	  	Web	  	Commercial	  	MySQL	  	replace mysql-
 stg1/2

					
	mysql-prd/3/4	  	Web	  	Commercial	  	MySQL	  	replace mysql-
 prd1/2

					
	whsrvdb010	  	OLTP	  	Commercial	  	Oracle	  	
					
	red1/2/3/4/5/6	  	OLTP	  	Commercial	  	Rdb	  	
					
	topcat/morris	  	OLTP	  	Commercial	  	Rdb	  	
					
	green1/2/3/loaner	  	OLTP	  	Commercial	  	Rdb	  	
					
	amber1/2/3/fred	  	OLTP	  	Commercial	  	Rdb	  	
					
	zappa	  	DW/OLTP	  	Commercial	  	Rdb	  	
					
	fritz/felix/feline	  	DW/OLTP	  	Commercial	  	Rdb	  	

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-227	  	Health Net / Cognizant Confidential

 Final 

 3.4.1 MS SQL server Inventory 

This section details the MS SQL server (2005 and below which are due for upgrade) inventory that is currently hosted in Health Net environment.
Any modification to this list will be handled during transition. 
 Cognizant will be responsible for All MS-SQL servers in the Health Net
environment 
  

											
	 Sl

No
	  	 SQL Server Name
	  	 Environment
	  	Version	  	 Edition
	  	SQL Server ID
	1	  	BLD-APP09\NEWTEST	  	Production	  	9.00.3042.00	  	 Enterprise
 Edition
	  	195
						
	2	  	BLD-FS-SQLDEV01\DEVINST1	  	Development	  	8.00.2305	  	 Enterprise
 Edition
	  	172
						
	3	  	BLD-FS-SQLDEV01\DEVINST2	  	Development	  	9.00.4060.00	  	 Enterprise
 Edition
	  	173
						
	4	  	BLD-FS-SQLDEV02	  	Development	  	9.00.4060.00	  	 Enterprise
 Edition
	  	183
						
	5	  	BLD-FS-SQLVS01\PRDINST1	  	Production	  	8.00.2282	  	 Enterprise
 Edition
	  	145
						
	6	  	BLD-FS-SQLVS02\PRDINST2	  	Production	  	9.00.5057.00	  	 Enterprise
 Edition
	  	154
						
	7	  	BLD-FS-SQLVS03\PRDINST3	  	Production	  	9.00.5057.00	  	 Enterprise
 Edition
	  	181
						
	8	  	BLD-FS-SQLVS11\INGPRD01	  	Production	  	9.00.5000.00	  	 Enterprise
 Edition
	  	176
						
	9	  	BLD-FS-SQLVS12\INGSTG01	  	Production	  	9.00.5000.00	  	 Enterprise
 Edition
	  	168
						
	10	  	BLD-FS-SQLVS13\INGSTG02	  	Production	  	9.00.5000.00	  	 Enterprise
 Edition
	  	169
						
	11	  	BLD-FS-SQLVS14\INGPRD02	  	Production	  	9.00.5000.00	  	 Enterprise
 Edition
	  	177
						
	12	  	BLD-FS-SQLVST01\TSTINST1	  	Test/QA/SIT/UAT	  	8.00.2066	  	 Enterprise
 Edition
	  	174
						
	13	  	BLD-FS-SQLVST02\TSTINST2	  	Production	  	9.00.5057.00	  	 Enterprise
 Edition
	  	175
						
	14	  	BLD-SIM01	  	Production	  	9.00.4035.00	  	Express Edition	  	160
						
	15	  	BLD-SIM02	  	Production	  	9.00.4053.00	  	Standard Edition	  	167
						
	17	  	BLD-SQLDEV01	  	Development	  	9.00.3042.00	  	 Enterprise
 Edition
	  	152
						
	18	  	BLD-SQLQCPRD	  	Production	  	9.00.5000.00	  	 Enterprise
 Edition
	  	193
						
	19	  	BLD-SQLQCTST	  	Test/QA/SIT/UAT	  	9.00.5000.00	  	 Enterprise
 Edition
	  	188
						
	20	  	BLD-SQLSTG01\TSTINST1	  	Test/QA/SIT/UAT	  	8.00.2039	  	Developer	  	186
						
	21	  	BLD-SQLSTG01\TSTINST2	  	Test/QA/SIT/UAT	  	9.00.4220.00	  	 Developer
 Edition (64-bit)
	  	187

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-228	  	Health Net / Cognizant Confidential

 Final 
  

											
	22		BLD-SQLTST01		Test/QA/SIT/UAT		9.00.3042.00		Standard Edition		110
						
	23		BLD-SQLTST02		Test/QA/SIT/UAT		9.00.4035.00		 Enterprise
 Edition
		194
						
	24		BLD-SQLTST10\MHNPOCINST		Test/QA/SIT/UAT		9.00.5057.00		 Enterprise
 Edition
		165
						
	25		COUGAR		Production		9.00.4035.00		Standard Edition		170
						
	26		MERLIN		Production		9.00.4053.00		Standard Edition		171
						
	27		RC-APP100		Production		8.00.2066		 Enterprise
 Edition
		124
						
	28		RC-APP25		Production		8.00.2065		 Enterprise
 Edition
		134
						
	29		RC-APP30		Production		8.00.2065		Standard Edition		151
						
	30		RC-APP39		Production		8.00.2065		 Enterprise
 Edition
		37
						
	31		RC-APP47		Production		8.00.2066		 Enterprise
 Edition
		1
						
	32		RC-APP48		Production		9.00.4060.00		Standard Edition		166
						
	33		RC-APP99		Production		8.00.2282		 Enterprise
 Edition
		102
						
	34		RC-APPTST39		Test/QA/SIT/UAT		8.00.760		 Enterprise
 Edition
		132
						
	35		RC-CMP01		Production		9.00.4060.00		Express Edition		149
						
	36		RC-SAPPRD01		Production		8.00.818		 Enterprise
 Edition
		130
						
	37		RC-SQL01		Production		9.00.5057.00		Standard Edition		103
						
	38		RC-SQL01\DEVINST1		Production		9.00.5057.00		 Enterprise
 Edition
		178
						
	39		RC-SQL09		Production		8.00.2065		Standard Edition		41
						
	40		RC-SQL19		Production		9.00.5057.00		Standard Edition		120
						
	41		RC-SQL20		Production		9.00.5057.00		Standard Edition		129
						
	42		RC-SQL32		Production		8.00.2055		 Enterprise
 Edition
		138
						
	43		RC-SQL44		Production		8.00.2055		Standard Edition		147
						
	44		RC-SQL51		Production		8.00.2066		 Enterprise
 Edition
		155
						
	45		RC-SQL52		Production		9.00.4294.00		Standard Edition		113
						
	46		RC-SQL56		Production		8.00.818		Standard Edition		107
						
	47		RC-SQL57		Production		9.00.5057.00		 Enterprise
 Edition
		122
						
	48		RC-SQL99		Production		8.00.2055		 Enterprise
 Edition
		101
						
	49		RC-SQLDEV02		Development		8.00.2305		 Enterprise
 Edition
		23
						
	50		RC-SQLDEV02\DEVINST1		Development		8.00.2305		 Enterprise
 Edition
		26
						
	51		RC-SQLDEV02\DEVINST3		Development		9.00.5000.00		 Enterprise
 Edition
		123
						
	52		RC-SQLDEV03		Development		8.00.2282		 Enterprise
 Edition
		57

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-229		Health Net / Cognizant Confidential

 Final 
  

											
	53		RC-SQLDEV03\DEVINST1		Development		8.00.2282		 Enterprise
 Edition
		161
						
	54		RC-SQLDEV03\DEVINST2		Development		8.00.2282		 Enterprise
 Edition
		163
						
	55		RC-SQLTST51		Test/QA/SIT/UAT		8.00.2066		 Enterprise
 Edition
		114
						
	56		RC-SQLVS01		Production		8.00.2282		 Enterprise
 Edition
		30
						
	57		RC-SQLVS02\PRDINST1		Production		8.00.2282		 Enterprise
 Edition
		31
						
	58		RC-SQLVS03\PRDINST3		Production		9.00.5000.00		 Enterprise
 Edition
		106
						
	59		RC-SQLVS04\PRDINST4		Production		9.00.4262.00		 Enterprise
 Edition
		179
						
	60		RC-SQLVS10\HNIPRDINST		Production		9.00.4220.00		 Enterprise
 Edition
		69
						
	61		RC-SQLVS12\HNTSTINST		Production		9.00.4220.00		 Enterprise
 Edition
		127
						
	62		RC-SQLVS13\HNISTRSSINST		Production		9.00.4053.00		 Enterprise
 Edition
		99
						
	63		RC-SQLVS16\MHNUNITYPRD		Production		9.00.5057.00		 Enterprise
 Edition
		189
						
	64		RC-SQLVS17\MHNUNITYTST		Test/QA/SIT/UAT		9.00.5057.00		 Enterprise
 Edition
		190
						
	65		RC-SQLVS30		Production		9.00.5324.00		 Enterprise
 Edition
		97
						
	66		RC-SQLVS40\TSTRPTINST1		Production		9.00.5000.00		 Enterprise
 Edition
		108
						
	67		RC-SQLVS43\TSTINST1		Test/QA/SIT/UAT		9.00.3042.00		 Enterprise
 Edition
		95
						
	68		RC-SQLVS44\TRNINST1		Production		9.00.5000.00		 Enterprise
 Edition
		105
						
	69		RC-SQLVS46\DEVINST1		Production		9.00.5000.00		 Enterprise
 Edition
		143
						
	70		RC-SQLVS50		Production		9.00.4035.00		 Enterprise
 Edition
		104
						
	71		RC-SQLVS51\REPLICATE		Production		9.00.5000.00		 Enterprise
 Edition
		157
						
	72		RC-SQLVSTST01		Test/QA/SIT/UAT		8.00.2282		 Enterprise
 Edition
		32
						
	73		RC-SQLVSTST02\SQLINST1		Test/QA/SIT/UAT		8.00.2282		 Enterprise
 Edition
		33
						
	74		RC-SQLVSTST03\SQLINST3		Production		9.00.4035.00		 Enterprise
 Edition
		133
						
	75		RC-WEB01		Production		9.00.3042.00		 Enterprise
 Edition
		159
						
	76		RC-WEB76		Production		9.00.3042.00		 Enterprise
 Edition
		117
						
	77		RC-WEB77		Production		9.00.3042.00		 Enterprise
 Edition
		126

  

					
	SOW#4 (Information Technology) Ex A-3-1		A-3-1-230		Health Net / Cognizant Confidential

 Final 
  

											
	78	  	RC-WEBDEV01	  	Development	  	9.00.4053.00	  	 Enterprise
 Edition
	  	136
						
	79	  	RC1-RDR02	  	Production	  	8.00.2066	  	Standard Edition	  	144
						
	80	  	WH-APP05	  	Production	  	8.00.760	  	Standard Edition	  	153
						
	81	  	WH-EWFM-DBS	  	Production	  	8.00.2066	  	 Enterprise
 Edition
	  	111
						
	82	  	WH-IVRSW01	  	Production	  	8.00.2301	  	Standard Edition	  	119
						
	83	  	WH-MASQLDEV02	  	Development	  	8.00.2039	  	Standard Edition	  	128
						
	84	  	WH-Recorder	  	Production	  	8.00.818	  		  	197
						
	85	  	WH-SQL01	  	Production	  	7.0.842	  	Standard Edition	  	61
						
	86	  	WH-SQLDEVVS01	  	Development	  	8.00.2191	  	 Enterprise
 Edition
	  	44
						
	87	  	WH-SQLDEVVS02\SQLINST1	  	Development	  	8.00.2191	  	 Microsoft SQL
 Server Developer Edition
	  	45
						
	88	  	WH-SQLVS01	  	Production	  	9.00.5057.00	  	 Enterprise
 Edition
	  	162
						
	89	  	WOLFMAN	  	Production	  	9.00.4035.00	  	Standard Edition	  	182

 3.4.2 MYSQL server Inventory 

This Section details the MYSQL server inventory that is currently hosted in HealthNet environment. 

Cognizant will be responsible for All MYSQL servers in the Health Net environment 

 

													
	 Host

Name
	  	 IP address
	  	 Instance
	  	 Port
	  	 MySQL Version
	  	 Application
	  	 Environment

	mysql-prd4	  	 167.238.156.179
  
	  	One	  	3306	  	 5.1.46sp1-enterprise-

gpl-advanced
 MySQL Enterprise

Server - Advanced
 Edition
(GPL)
	  	AMES	  	Production
	 mysql-prd4
  
	  	 167.238.156.179
  
	  	Two	  	3308	  	  	HNCONNECT	  	Production
	mysql-stg1	  	 should be
 decomm

 
	  	One	  	3306	  	  	AMES	  	Staging
	mysql-prd1	  	 should be
 decomm

 
	  	One	  	3306	  	  	AMES	  	Production
	 mysql-
 prd2
	  	 should be
 decomm

 
	  	One	  	3306	  	  	AMES	  	Production
	mysql-dev1	  	167.238.173.22	  	One	  	3306	  	  	AMES	  	Development
	mysql-dev1	  	167.238.173.22	  	Two	  	3308	  	  	HNCONNECT	  	Development
	mysql-stg4	  	167.238.157.75	  	One	  	3306	  	  	AMES	  	Staging
							
	mysql-stg3	  	 167.238.157.74
  
	  	One	  	3306	  	 5.1.46sp1-enterprise-

gpl-advanced-log
 MySQL
Enterprise
 Server - Advanced

Edition (GPL)
	  	AMES	  	Staging
	mysql-stg3	  	 167.238.157.74
  
	  	Two	  	3308	  	  	HNCONNECT	  	Staging
	mysql-stg4	  	 167.238.157.75
  
	  	Two	  	3308	  	  	HNCONNECT	  	Staging
	mysql-prd3	  	 167.238.156.178
  
	  	One	  	3306	  	  	AMES	  	Production
	mysql-prd3	  	167.238.156.178	  	Two	  	3308	  	  	HNCONNECT	  	Production

  

					
	SOW#4 (Information Technology) Ex A-3-1	  	A-3-1-231	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3-2 

SOLUTION DESCRIPTION—ITO PHASE II 
  

									
	 1.
		INTRODUCTION		 	2	  
			
	 2.
		SCOPE DEFINITION		 	3	  
				
			2.1.		IN-SCOPE SERVICES		 	3	  
				
			2.2.		OUT-OF-SCOPE AND SCOPE EXCLUSIONS		 	3	  
			
	 3.
		SOLUTION DESCRIPTION		 	3	  
				
			3.1.		ITO – CORE SERVICES		 	3	  
				
			    3.1.1.		Data Center		 	4	  
				
			    3.1.2.		DC Network (LAN and WAN)		 	19	  
				
			    3.1.3.		Security		 	39	  
				
			    3.1.4.		Servers		 	52	  
				
			    3.1.5.		Storage		 	70	  
				
			    3.1.6.		Backup		 	81	  
				
			    3.1.7.		Middleware		 	89	  
				
			    3.1.8.		Directory Services		 	93	  
				
			    3.1.9.		DNS/DHCP		 	97	  
				
			    3.1.10.		Messaging and Collaboration		 	100	  
				
			    3.1.11.		Monitoring Tools		 	103	  
				
			    3.1.12.		VoIP		 	112	  
				
			    3.1.13.		Thin Client		 	118	  
				
			    3.1.14.		Service Desk		 	120	  
				
			3.2.		ITO SERVICE DELIVERY		 	126	  
				
			    3.2.1.		Delivery Location and Organization		 	128	  
				
			    3.2.2.		Service Management		 	132	  

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-1		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3-2 

SOLUTION DESCRIPTION—ITO PHASE II 

1. INTRODUCTION 
 Cognizant would like to thank Health Net
for its invitation to submit a proposal for a seamless Transition of outsourced infrastructure services to Cognizant from Health Net and incumbent vendors in a manner that will minimize business disruption and business risk to Health Net. The Health
Net and Cognizant partnership will focus on services, solutions and a Service Delivery platform that will support rapid scalability, growth, and change in the composition and location of Health Net’s businesses. Cognizant looks forward to this
opportunity of extending our partnership to ITO services on a similar relationship paradigm that places excellence in execution and responsiveness to Health Net’s business needs at the forefront of our engagement model. This proposal addresses
the IT Solutions that will be delivered as part of Infrastructure Outsourcing. 
 Cognizant understands Health Net’s business environment by virtue of
its long-standing relationship and exposure to Health Net’s IT and business processes. This document provides an overview of the scope of IT services, solution approach for Infrastructure Management, Storage, Service delivery with security and
compliance controls. Leveraging Cognizant’s comprehensive business process management expertise, the proposed ITO solution outlines process harmonization, optimal organization design and change management, and offering transformational benefits
to meet the Health Net’s objective. 
 Cognizant will provide all IT infrastructure services to Health Net in a unified BPaaS model with improved
control over capability and increasing capacity. As part BPaaS Service Transition, Cognizant Infrastructure team will be working on moving them to Cognizant’s Data Center at Centennial, CO. Once the applications are migrated to Cognizant Data
Center, Cognizant Infrastructure team will be focused on providing end to end services for BPaaS Assets Infrastructure needs. The foundation towers proposed in this proposal will be a part of both ITO and BPaaS and the actual split in scope will
happen at the core and application layer. The ITO support solution covers end to end support for all applications which are not hosted under the BPaaS model. The overall scope includes management, support and hosting of BPaaS assets. Infrastructure
Management of Deployed BPaaS Assets, that include:- 
  

	 	•	 	Data Center Hosting Services 

  

	 	•	 	Network Management 

  

	 	•	 	Infrastructure Server, Middleware and Database Management 

  

	 	•	 	Capacity Planning and Capacity Management 

  

	 	•	 	Service Desk Support 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-2		Health Net / Cognizant Confidential

 Final 
  

 2. SCOPE DEFINITION 

The overall scope includes the hosting management and support for ITO application portfolio. Below is a summary of key scope items:- 

 

	 	•	 	Hosting of all the infrastructure at Cognizant data center 

  

	 	•	 	Provision of infrastructure hardware platform 

  

	 	•	 	Provision of Operating Systems and Infrastructure Application Software 

  

	 	•	 	ITIL framework based “dedicated” service delivery on 24x7 supporting SLA using Cognizant’s global delivery model with an exception of federal services support scope which will be delivered from US
delivery center 

  

	 	•	 	Provide periodic reporting and metrics / dashboards to Health Net. 

 The foundation towers will be a part of
both ITO and BPaaS and the actual split in scope will happen at the core and application layer. The ITO support solution covers end to end support for all applications which are not hosted under the BPaaS model. This will be more aligned to
traditional ITO support and includes hosting of those applications as well providing support to all Health Net end users. 
 2.1. In-Scope Services

 Foundation services layers will be common for both the BPaaS and ITO portfolios. However, even for the foundation towers like network, security,
active directory there will be logical separation for ITO and BPaaS scope. The core layer environment will be separate for BPaaS and ITO. The document describes the approach towards setting up and target state of the ITO environment as well as the
operational aspects of service delivery. 
 Scope items are defined part of Exhibit document Ex A-1 Scope Model. 

2.2. Out-Of-Scope and Scope Exclusions 
 Any activity not
described explicitly in the above In scope section will be treated as out of scope. The activities identified as Out of Scope for this engagement are as follows: 

Network and Links 
 Implementation, configuration and
documentation of network devices including Riverbeds at Health Net Boulder data center. 
 3. SOLUTION DESCRIPTION 

3.1. ITO – Core Services 
 This section details
different services offered as part of this ITO engagement with Health Net. This section details the solution approach, deliverables, assumptions, dependency, associated risks and mitigations for the foundation services / use cases. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-3		Health Net / Cognizant Confidential

 Final 
  

 3.1.1. Data Center 

Cognizant has architected its solution approach based on Health Net’s objectives and aligned to Health Net requirements, landscape and complexities.
Solution has been architected with the information we learnt on Health Net’s infrastructure estate, the locational spread, the required support coverage, environment complexity, scope of activities and other key factors as defined in ITO Phase1
Documentations. 
 3.1.1.1. Solution Approach 

Cognizant will setup two data centers to meet Health Net’s initiatives. For the Primary Data center (DC1), Cognizant will use our partner Latisys to
deliver the DC1 facility. For the Secondary Data center (DC2), Cognizant will utilize space in its Data center in Phoenix (Cyrus One facility). 
 Blade
Servers: 
 Cognizant proposes Cisco UCS Blade servers for Server environment. 
  

			
	 Blade Server Model
	  	 Hardware Configuration

	5108 chassis (x 23)	  	 •    Per Chassis (H x W X D) – 6RU: 10.5 x 17.5 x 32

 
 •    Power (Per Chassis)
– 4 2500 W capacity, 200v -240v, 50 to 60 HZ single-phase

		
	6296 Cisco Switch (x 3 pair)	  	 •    (H X W x D) – 3.44 x 17.3 x29.5

 
 •    Power – 750
W

 The diagram below depicts the rack details for the following UCS blade: 

 
 

 
 Figure: Rack Components 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-4	  	Health Net / Cognizant Confidential

 Final 
  

 Note—With the flexibility of the Cisco Chassis we can utilize all the slots to accommodate different
workloads. (E.g. The 4 open slots in the management chassis could be used for Cloud or VDI if needed. For the open rack space, the same rule applies but it will be dependent on DC review to make sure we have enough power and the rack can support
more weight.) 
 AIX Servers: 
  

			
	 Server Model
	  	 Hardware Configuration

	P750 (3)	  	 •    8.55“H x 17.6“W x 33.78“D (217 mm x 447 mm x 858 mm);
Weight: 155 lb (70.3 kg)2
  

•    200 V to 240V AC, single phase

		
	P760 (3)	  	 •    Same as Above

  
 

 
 Figure: Aix Server 

Solaris Servers: 
  

			
	 Server Model
	  	 Hardware Configuration

	T4-4 (12)	  	 •    Height: 219mm (8.62 in); 5RU

 
 •    Width: 445 mm (17.5
in.)
  
 •    Depth:
700mm (27.6 in.)
  

•    Weight: Approx. 79 kg (175 lbs.) max., without rackmount kit

 
 •    Four hot-swappable
AC 2,060 W redundant (2 + 2) power supplies
  

•    Maximum operating input current at 200 VAC: 14.6A

 
 •    Maximum operating
input power at 200 VAC:2770W

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-5	  	Health Net / Cognizant Confidential

 Final 
  

 

 
 Figure: Solaris Server 

HP Alpha Servers: 
  

			
	 Blade Server Model
	  	 Hardware Configuration

	 BL890 (9, 4 C7000

Chassis)
	  	 •    Height 17.4 in (442 mm)

 
 •    Width 17.6 in
(447.04 mm)
  

•    Depth 32 in (813 mm)

 
 •    Max input power per
line cord 7836VA Max 2400W PSU Max input current per line cord24A at 200 VAC 23.1A at 208 VAC Max input power per line cord 8340 VA Max

		
	 Alpha Severs
	  	 •    DS15A 5.1 x 17.6 x 19 - 3U 1 x 400w qty 2

 
 •    ES40 13.87 x 17.6 x
30.1 -8U 1 x 720w qty 2
  

•    GS160 67 x 55.1 x 39.4 39U 1 x 2000w qty 2

 
 •    DS25 8.69 x 17.5 x
29.187 5U 2 x 500w qty 4
  

•    ES80 79 x 24 x 47 41U 2 x 700w qty 1

 
 •    GS1280 79 x 24 x 47
41U 1 x 2800w qty 2
  

•    ES45 13.87 x 17.6 x 30.1 8U 1 x 1080w qty 3

  
 

 
 Figure: HP Alpha Servers 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-6	  	Health Net / Cognizant Confidential

 Final 
  

 Storage Hitachi VSP: 
  

			
	 Model
	  	 Hardware Configuration

	 Hitachi VSP 1
	  	 •    VSP 4 19” racks , will need space on both the left and right
side
  
 •    (H x W x
D)- 78.9 x 24 x 43.3 (x4, plus 1 space to left and right)
  

•    Power – Each rack requires 4 L6-30 connections 208V for a total of 16

		
	 Hitachi VSP 3
	  	 •    VSP 4 19” racks , will need space on both the left and right
side
  
 •    (H x W x
D)- 78.9 x 24 x 43.3 (x4, plus 1 space to left and right)
  

•    Power – Each rack requires 4 L6-30 connections 208V for a total of 16

  
 

 
 Figure: Storage Hitachi 

Sepaton: 
  

			
	 Model
	  	 Hardware Configuration

	Sepaton	  	 •    1 rack (ITO Phase 1, Adding 3 more Rack for ITO Solution, standard
19” rack will need 1 space for expansion
  

•    (W x D) – 24 x 40

 
 •    Power –
120/208 VAC – 3 phase, 30A/phase (3P+PE)

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-7	  	Health Net / Cognizant Confidential

 Final 
  

  
 

 
 Figure: Sepaton 
  

 
 Figure: Sepaton 

NetBackup: 2 Additional racks, Plus 2 racks from ITO Phase 1. 
  

			
	 Model
	  	 Hardware Configuration

	NetBackup (4 appliance from ITO Phase 1, and adding 3 more media appliance for ITO Phase 2)	  	 •    Each appliance (W x D) – 2U:17.3 x 27

 
 •    Power - 100 to 127,
200 to 240, Amps: 7 (100V to 127V), 3.5 (200V to 240V) L6 -30P

 Note: 2 Media servers planned for Federal and rest for Commercial, this will be finalized during the LLD Phase 

Network 
 This section provides configuration details for
all the network devices used in the Centennial DC. 
  

			
	 Model 
	  	 Hardware Configuration

	CISCO2951/K9	  	 •    (H x W x D) – 2U : 3.5 x 17.25 x 18.5 in

 
 •    Dual Power –
100 to 240 VAC and operating power 680 W

		
	ASA5525	  	 •    (H x W x D) – 1U: 1.75 x 17.5 x 14.25 in

 
 •    Power – 100 to
240 VAC and operating power 108W

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-8	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Model 
	  	 Hardware Configuration

	Nexus 2232TM-E	  	 •    (H x W x D) – 1U: 1.72 x 17.3 x 17.7

 
 •    Dual Power –
100 to 240 VAC and operating power 800W

		
	ASA 5585	  	 •    (H x W x D) – 2U: 3.5 x 19 x 26.5 in.

 
 •    Dual Power –
120 to 240V, and operating power 800 W

		
	ASA 5545	  	 •    (H x W x D) – 1U: 1.67 x 16.7 x 19.1 in

 
 •    Power – 100 to
240 VAC and operating power 125W

		
	ASR 1004	  	 •    (H x W x D) – 4U: 7x17.2x18.2 in

 
 •    Dual Power –
120 to 240V and operating power 960 W

		
	UCS 6296UP	  	 •    (H x W x D) – 2 RU 3.44 x 17.3 x 29.5 in.

 
 •    Dual Power –
100 to 240V and operating power 950 W

		
	Cisco 3750 Switch	  	 •    (H x W x D) – 1U: 1.75 x 17.5 x 18.0 in.

 
 •    Dual Power –
100 to 240V and operating power 660 W

		
	ASR1002-X	  	 •    (H x W x D) – 2U: 3.5 x 17.2 x 22.0 in.

 
 •    Dual Power –
120 to 240V and operating power 560 W

		
	F5 5200V	  	 •    (H x W x D) – 1U:1.75 x 17 x 21 in.

 
 •    Dual Power –
90-240 VAC operating power 800 W

		
	F5 2000S	  	 •    (H x W x D) – 1U:1.75 x 17 x 21 in.

 
 •    Power – 90-240
VAC operating power 400 W

		
	INFOBLOX Trinzic 2210	  	 •    (H x W x D) – 2U:3.46 x 17.36 x 21.26 in.

 
 •    Dual Power –
90-264 VAC operating power 960 W

		
	McAfee IPS 6050	  	 •    (H x W x D) – 2U:3.5 x 16.75 x 30 in.

 
 •    Power – dual
power supply and operating power 450 W

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-9	  	Health Net / Cognizant Confidential

 Final 
  

 

 
 Figure: Rack Diagram 

Overall Layout DC1: 
 This section describes data center
floor layout. The space is broken into functional areas consisting of Core Network, Network services, Tape Library, SAN Storage, UCS blade compute and management / SCCM compute. The initial build-out will include the Core Network, Network Services
and a mix of standard compute, Standalone, SAN Storage and tape library functional areas. The remaining space will be reserved for future growth and developed as required. 
  

	 	•	 	Core Network: Contains the core routers, WAN edge, carrier devices, network fibre backbone and network copper cabling infrastructure, etc. 

 

	 	•	 	Network Services: Contains the SAN Switches, and SAN fibre cabling infrastructure 

  

	 	•	 	Tape Library: Contains Automated Tape Library units 

  

	 	•	 	SAN Storage: Contains Storage Arrays (HNAS, SAN), Sepaton , HCP/HDI 

  

	 	•	 	Standard / standalone Compute: Contains standard servers (Blades and Rack) 

  

	 	•	 	Cage: Physical Cage around racks is as per standard recommended by Industrial security team 

  

	 	•	 	Raise floor to the ceiling cage or standard wall height with cap on top of the cage. As per the Centennial DC setup, there are motion sensors below the raised floor 

 

	 	•	 	Enable security control at cage level instead of rack level 

  

	 	•	 	Security will consist of cameras, notification setup at cage door when someone opens the door. This is the standard recommendation by the industrial security team being used in Health Net MRI rooms. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-10		Health Net / Cognizant Confidential

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	 	•	 	Power Requirement: The power requirement is provided in the below table: 

  

					
	 Centennial DC - Sq. ft.

	 Racks
	  	 Power/Rack (Kw)
	  	 Total Power (Kw)

	48	  	8.75	  	~420

 Rack Layout: 
 The
following diagram represents the rack layout of the DC1: 
  
 

 
 Figure: Rack Layout – DC1 

Secondary Data Center (DC2) – Phoenix DC 
 Server
Blades: 
  

			
	 Model
	  	 Hardware Configuration

	Cisco - 5108 chassis (x 6)	  	 •    Per Chassis (H x W X D) – 6RU: 10.5 x 17.5 x 32

 
 •    Power (Per Chassis)
– Four 2500 W output, 200v -240, 50 to 60 HZ single-phase

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-11	  	Health Net / Cognizant Confidential

 Final 
  

 

 
 Figure: Rack DC2 

AIX Servers: 
  

			
	 Server Model
	  	 Hardware Configuration

	 P750 (3)
	  	 •    8.55“H x 17.6“W x 33.78“D (217 mm x 447 mm x 858
mm); weight: 155 lb (70.3 kg)2
  

•    200 V to 240 V ac, single phase

		
	 P760 (3)
	  	 •    Same as Above

  
 

 
 Figure: AIX Server 

Solaris Servers: 
  

			
	 Server Model
	  	 Hardware Configuration

	T4-4 (8)	  	 •    Height: 219mm (8.62 in); 5RU

 
 •    Width: 445 mm (17.5
in.)
  
 •    Depth:
700mm (27.6 in.)
  

•    Weight: Approx. 79 kg (175 lbs.) max., without rackmount kit

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-12	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Server Model
	  	 Hardware Configuration

		  	 •    Four hot-swappable AC 2,060 W redundant (2 + 2) power supplies

 
 •    Maximum operating
input current at 200 VAC: 14.6A
  

•    Maximum operating input power at 200 VAC:2770W

  
 

 
 Figure: Solaris Servers 

 

			
	 HP Integrity and
Alpha Servers:Blade
Server Model
	  	 Hardware Configuration

	 BL870 (14, 4
 C7000
Chassis)
	  	 •    Height 17.4 in (442 mm)

 
 •    Width 17.6 in
(447.04 mm)
  

•    Depth 32 in (813 mm)

 
 •    Max input power per
line cord 7836VA Max 2400W PSU Max input current per line cord24A at 200 VAC 23.1A at 208 VAC Max input power per line cord 8340 VA Max

		
	B890 (6, 3 C7000)	  	 •    Height 17.4 in (442 mm)

 
 •    Width 17.6 in
(447.04 mm)
  

•    Depth 32 in (813 mm)

 
 •    Max input power per
line cord 7836VA Max 2400W PSU Max input current per line cord24A at 200 VAC 23.1A at 208 VAC Max input power per line cord 8340 VA Max

		
	Alpha Severs	  	 •    DS15A 5.1 x 17.6 x 19 – 3U 1 x 400w qty 2

 
 •    ES40 13.87 x 17.6 x
30.1 -8U 1 x 720w qty 2
  

•    GS160 67 x 55.1 x 39.4 39U 1 x 2000w qty 2

 
 •    DS25 8.69 x 17.5 x
29.187 5U 2 x 500w qty 4
  

•    ES80 79 x 24 x 47 41U 2 x 700w qty 1

 
 •    GS1280 79 x 24 x 47
41U 1 x 2800w qty 2
  

•    ES45 13.87 x 17.6 x 30.1 8U 1 x 1080w qty 3

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-13	  	Health Net / Cognizant Confidential

 Final 
  

 

 
 Figure: HP Alpha Servers 

Storage VSP: 
  

			
	 Model
	  	 Hardware Configuration

	Hitachi VSP 2	  	 •    VSP 3 19” racks , will need space on both the left and right
side
  
 •    (H x W x
D)- 78.9 x 24 x 43.3 (x4, plus 1 space to left and right)
  

•    Power – Each rack requires 4 L6-30 connections 208V for a total of 16

 
 •    Will add to
extended cabinets

 Figure: Hitachi Storage (HCP) 

Storage Sepaton: 
  
 

 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-14	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Model
	  	 Hardware Configuration

	Sepaton (x2)	  	 •    1 rack ( ITO Phase 1, standard 19” rack will need 1 space for
expansion, for ITO add 2 additional racks
  

•    (W x D) – 24 x 40

 
 Power - 120/208 VAC - 3 phase, 30A/phase (3P+PE)

  
 

 
 Figure: Storage Sepaton 

Storage Spectra Logic: Hardware Configuration 

Consists of One base cabinet for ITO Phase 1 and for ITO where adding two more extended cabinets, not traditional size, will need up to 5 free spaces to the
right (facing the product) for future growth 
  

	 	•	 	(W x D) – 29 x 43.25, see page 19 of the document below for details (not standard size) 

  

	 	•	 	Power - NEMA L6-20P, male or NEMA L6-30P, male IEC 60320-C19, female 

  
 

 
 Figure: Storage Logic Storage Device 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-15	  	Health Net / Cognizant Confidential

 Final 
  

 Storage HNAS / NetBackup / HDI: 

 

			
	 Model
	  	 Hardware Configuration

	NetBackup (x2)	  	 •    Each appliance (W x D) – 2U:17.3 x 27

 
 •    Power - 100 to 127,
200 to 240, Amps: 7 (100V to 127V), 3.5 (200V to 240V) L6 -30P

 Network Environment: 
 The
diagram below depicts the network components in the Rack: 
  
 

 
 Figure: Rack Details of Network Component DC2 

DC2 over all Layout: 
 This section describes data center
floor layout. The space is broken into functional areas consisting of Core network, Network services, Tape library, SAN Storage, UCS compute blade, management and SCCM Compute. The initial build-out will include the Core network, Network services
and a mix of standard compute, Standalone SAN Storage, and Tape library functional areas. The remaining space will be reserved for future growth and developed as required. 
  

	 	•	 	Core network: Contains the core routers, WAN edge, carrier devices, network Fiber backbone and network copper cabling infrastructure etc. 

  

					
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	 	•	 	Network services: Contains the SAN Switches, and SAN Fiber cabling infrastructure 

  

	 	•	 	Tape library: Contains Automated Tape Library units 

  

	 	•	 	SAN Storage: Contains Storage Arrays (SAN), Sepaton 

  

	 	•	 	Standard / Standalone compute: Contains standard servers (Blades and Rack) 

  

	 	•	 	Cage: Physical Cage around racks is as per standard recommended by Industrial security team. 

  

	 	•	 	Raise floor to ceiling Cage OR standard wall with cap on top of cage to cover from top. As per Centennial DC setup, there are motion sensors below the floor 

 

	 	•	 	Enable security control at cage level instead at rack level 

  

	 	•	 	Security will consist of cameras, notification setup at cage door when someone opens the door. This is the standard recommendation by Industrial security team being used in Health Net MRI(Machine Room Instrument) rooms

  

	 	•	 	Power Requirement: The power requirement is mentioned below: 

  

					
	 Phoenix DC - Sq. ft.

	 Racks
	  	 Power / Rack (KW)
	  	 Total Power (Kw)

	24	  	~3.375	  	~81

 The following figure depicts the DC2 Rack Layout: 

 
 

 
 Figure: DC2 Rack Detail 

3.1.1.2. Service Deliverables 
 The
services to be delivered as part of this Health Net engagement are as below: 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-17	  	Health Net / Cognizant Confidential

 Final 
  

 VMware Infrastructure Build 
  

	 	•	 	Build VMware infrastructure for Federal and Commercial as per design 

  

	 	•	 	Testing Federal and Commercial to logically separate access restriction 

  

	 	•	 	VMware functionality testing for vMotion, High Availability, VCenter heartbeat, etc. 

 Storage and Backup
Infrastructure Build 
  

	 	•	 	Build the Storage and backup infrastructure for Federal and Commercial as per design 

  

	 	•	 	Testing Federal and Commercial to logically separate access restriction 

  

	 	•	 	Testing Storage replication across DC for HCP, Zoning, performance and monitoring components. 

 Network
Build and Link Connectivity 
  

	 	•	 	Build the Network infrastructure at DC1 and DC2 as per design 

  

	 	•	 	Testing Routing reachability between Centennial DC LAN and Boulder DC LAN (server Segment) 

  

	 	•	 	Testing Routing reachability between Centennial DC LAN and Remote Location LAN 

  

	 	•	 	Testing Logical Separation of Federal and Commercial traffic on DC firewall 

  

	 	•	 	Testing firewall filters at Centennial DC, to permit legitimate traffic in-out of Centennial DC over P2P and MPLS Links 

  

	 	•	 	Testing WAN traffic optimization between Centennial DC and remote locations with Riverbed Appliance, for VDI and File/Print traffic 

Note:- Health Net Information Security team to validate the hardening of network and security equipment implemented at Centennial and
Phoenix. 
 3.1.1.3. Steady State Support Deliverables 
  

			
	 Solution
	  	 Description

	 Solution Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery Location
	  	 •    Onsite – Health Net Offices

 
 •    Offshore –
Bangalore ; Coimbatore

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-18	  	Health Net / Cognizant Confidential

 Final 
  

 DC Operation Services 
  

			
	 Support Team
	  	 24x7 Surveillance of DC room / Infrastructure
component

		  	 •    Coordination and tracking of all Data center service visits

		
		  	 •    Visual / Physical site inspecting / floor walk in the Data center

		
		  	 •    Backup Tape handling–Loading / Unload tape in Tape library

		
		  	 •    Monitor Power / Cooling / Data center cleaning

		
		  	 •    Basic observation and reporting on the environment in the Data center

		
		  	 •    Develop an annual preventive maintenance schedule

		
		  	 •    Route maintenance of critical infrastructure (UPS and Battery Systems, Power Distribution, Chillers,
Generators, etc.)

 3.1.1.4. Assumptions 

3.1.1.5. Dependency 
 Below
are the dependencies on Health Net: 
  

	 	•	 	Testing connectivity between DC1 and the incumbent DC 

  

	 	•	 	Testing MPLS connectivity / performance between DC and Remote sites 

  

	 	•	 	Decision on cage type will be determined before DC build out. 

 3.1.1.6. Risk and Mitigations 

In the following section we will discuss about the risks and mitigations in detail mapping them with their respective probability and impact. 

 

									
	 S.No
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	 1
	  	Support of Key SME’s from incumbent during Implementation	  	High	  	Medium	  	Involve Health Net to facilitate and govern the Implementation, requiring integration with Boulder DC

 3.1.2. DC Network (LAN and WAN) 

The proposed Data Center Network at Centennial and Phoenix is flexible and scalable to accommodate the additional growth requirements. ITO Phase 1 Network
architecture will have the following additional infrastructure components added to support the ITO solution requirements. 

  

					
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 Final 
  

	 	•	 	DMZ and Internet 

  

	 	•	 	Extranet Zone for Partner Connectivity 

  

	 	•	 	Additional Servers and Applications 

  

	 	•	 	WAN MPLS Bandwidth Upgrade 

 Please refer the ITO Phase 1 modified solution document for the revised ITO Phase
1 Network Design. This document is focused on the ITO Network component additions considered for Centennial and Phoenix Data Centers. 
 Network ITO
Additions 
 Following table provides an overview of the ITO Phase 1 Modified and the additional Network components added for ITO requirement. 

 

					
	 Description
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	Architecture	  	 •    Modular Layer architecture with dedicated Core, Aggregation and Access
	  	 •    Architecture remains same with the following component additions

 
 •    DMZ and
Internet
  

•    Partner Connectivity

 
 •    Additional
Server’s Support
  

•    Additional Application’s Support

 
 •    WAN MPLS bandwidth
upgrade

			
	Core and Aggregation	  	 •    2 additional N56128 at Centennial will be deployed at Access which will be integrated to the existing 2x
N7710 with VDC support for Core, Aggregation, WAN Edge and DCI Edge
	  	 •    Additional VDCs for DMZ and Extranet Zone

 
 Additional N56128 will be added to the existing ITO Phase 1
architecture

			
	DMZ and Internet	  	 •    Not Available
	  	 •    Dual Internet Service Provider

 
 •    DMZ Security
Controls
  

•    External Facing Servers

 
 •    External DNS

 
 •    External Server /
application Load Balancers
  

•    Global Traffic Manager

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-20	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Description
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	Extranet Zone	  	 •    Not Available
	  	 •    Partner Site to Site VPN

			
		  		  	 •    Partner COLO Routers

 
 •    Partner
Server

			
	Server Farm	  	 •    Cisco UCS manager to connect to the Nexus 56128

 
 •    UCS Chassis
connects to 6296 Fabric interconnect using dual 10 Gig links
  

•    Cisco FEX Nexus 2232 for connecting the 1 Gig port requirements

 
 •    F5 Load Balancers
with 2 x virtual context for federal and Commercial for respective server application load balancing
	  	 •    Additional ports on Nexus 5K

 
 •    Additional Nexus 2K
FEX
  
 •    Additional
UCS Domain (pair of FI) for Centennial
  

•    Additional Physical servers

			
	Storage Area Network	  	 •    FCoE from UCS Chassis to the Fabric Interconnect (3x FI 6296)

 
 •    Dedicated 2x MDS
9513 for SAN
  

•    Dedicated 2x Cisco 9250i for FCIP Replication

 
 •    HBA Interfaces for
the Physical Servers
	  	 •    Additional FC Ports on MDS 9513

 
 •    Increase in
Replication and Migration Traffic in DCI links

			
	Services	  	 •    All the network devices Routers, Firewall, IPS, WAN optimizer, L/B
connect to the respective VDCs on the N7710
  

•    All the HNAS connect to the N7710
	  	 •    Additional DMZ Load Balancers

 
 •    Global Traffic
Management
  
 •    NTP
Service through Infoblox
  

•    IP Address Management (IPAM) through Infoblox

			
	Security	  	 •    ASA 5585 SSP 40 with dedicated Security Contexts for providing
Firewall Security
  

•    McAfee 6050 IPS for WAN traffic inspection

 
 •    Logical Separation
of Federal and Commercial Traffic 
  

•    Cisco ACS for Authentication
	  	 •    Additional DMZ Firewall

 
 •    Remote Access VPN
Firewall
  

•    Partner VPN Firewall

 
 •    Intrusion
Prevention Systems

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-21	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Description
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	WAN MPLS	  	 •    Dedicated 2x ASR 1004 for WAN MPLS

 
 •    Centennial
-Redundant WAN link from ATT providing MPLS Services for Health Net Commercial, Federal and Cognizant.
  

•    Phoenix—Single MPLS link from ATT for Federal, Commercial and Cognizant links

 
 •    Existing GET VPN
encryption service from ATT is considered for Federal MPLS
  

•    Redundant McAfee IPS Required for WAN traffic.

 
 •    Riverbed required
for Federal and Commercial MPLS Traffic Optimization
  

•    Additional 11 Remote Locations require Riverbed Steelhead appliances
	  	 •    WAN MPLS bandwidth upgrade

 
 •    Dedicated GET VPN
Key routers

			
	Data Center Interconnect	  	 •    Dedicated Nexus 7k VDC and 2x ASR 1006 for the DCI Edge

 
 •    2x Nexus 7004 at
Boulder
  
 •    2 x 10
Gig Link for Centennial to Boulder, terminated on the N7k VDC with MACSec Encryption
  

•    2 x 10 Gig Link for Centennial to Phoenix, terminated on the ASR with IPsec
Encryption
	  	 •    Additional Traffic handling

			
		  	 •    Design to minimize the latency. No Riverbed, Firewall or IPS for the
DCI
	  	

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-22	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Description
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	Monitoring and Management	  	 •    2 x 4506 for Out of Band Management

 
 •    2x Avocent ACS 6048
with Modem
  

•    Cisco Prime Infrastructure

 
 •    HP NNMi

 
 •    Cisco NAM 2320

 
 •    Riverbed CMC

 
 •    F5 Enterprise
Manager
	  	 •    All newly added devices will have infrastructure management capability configured

 DC Network BOM 
 Following
table provides an overview of the Network hardware considered for ITO Phase 1 modified and ITO. 
  

									
	 Device
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	 Device
	  	 Centennial
Count
	  	 Phoenix
Count
	  	 Centennial

Count
	  	 Phoenix
Count

	 Nexus 7710
	  	2	  	2	  		  	
	 Nexus 56128
	  	2	  	2	  	2	  	
	 N2K-C2232PP
	  	2	  	2	  		  	
	 Cisco Prime Infrastructure
	  	1	  	1	  		  	
	 Cisco ASR1006
	  	2	  	2	  		  	
	 Cisco Prime NAM 2320
	  	1	  	1	  		  	
	 ASA 5585-X
	  	2	  	2	  	2	  	2
	 Cat4500 E-Series 6-Slot
	  	2	  	2	  		  	
	 ASR 1004
	  	2	  	2	  	2	  	2
	 F5 LTM 5200V
	  	2	  	2	  	2	  	2
	 Riverbed 7055
	  	2	  	2	  	License upgrade	  	License upgrade
	 MCAFEE M-6050
	  	2	  	2	  	2	  	2

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-23	  	Health Net / Cognizant Confidential

 Final 
  

									
	 Device
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	 Avocent ACS6048
	  	2	  	2	  		  	
	 Cisco ACS (virtual edition)
	  	1	  	1	  		  	
	 Riverbed CMC (virtual edition)
	  	1	  	0	  		  	
	 F5 Enterprise Manager (virtual edition)
	  	1	  	1	  		  	
	 MDS 9513
	  	2	  	2	  		  	
	 MDS 9250i
	  	2	  	2	  		  	
	 F5 GTM 2000s
	  		  		  	2	  	2
	 INFOBLOX Trinzic 2210
	  		  		  	2	  	2
	 Cisco 2951
	  		  		  	2	  	2
	 ASA 5525
	  		  		  	6	  	6
	 ASA5545
	  		  		  	2	  	2
	 ASR1002-X
	  		  		  	2	  	0
	 Nexus 2232TM-E
	  		  		  	12	  	6
	 UCS 6296UP
	  	2	  	2	  	1	  	0
	 Catalyst 3750X – 48 port
	  		  		  	2	  	2

 BOM details for Network in ITO Phase 1 Modified can be referenced from Ex A-3-A table Network BOM for DC & DR
in section 2.2.2.2 
 Boulder DC 
 Following are the
Network device proposed at Boulder to support the 10 Gig link termination and service integration. 
  

					
	 Device
	  	 ITO Phase 1 Modified
	  	 ITO Additions

	 Device
	  	Boulder DC Count	  	Boulder DC Count
	 Nexus 7004
	  	2	  	0

 Note: There is no additional network hardware considered in ITO solution for Boulder. Low latency is the primary
consideration between DCI links (2x 10 Gig Links), hence WAAS is not conisdered to optimize the inter DC traffic. 
 BOM details for Network in ITO
Phase 1 Modified can be referenced from Ex A-3-A table Network BOM for DC & DR in section 2.2.2.2 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-24	  	Health Net / Cognizant Confidential

 Final 
  

 Port Count Sheet 

Below table shows port counts for both ITO Phase 1 and ITO Phase 2. 
  

																			
	 Access Switch connectivity 56128 @

Centennial (Total of 4 X 56128) and

Phoenix (Total of 2 X 56128)
	  	 Core Switch connectivity 2 x 7710 @

DC1 and DC2

	 Device
	  	 10G Ethernet
	  	 Device
	  	 10G Ethernet ports

	  	 DC1 ITO

Phase 1
	  	 DC1 ITO

Phase 2
	  	 DC2 ITO

Phase 1
	  	 DC2 ITO

Phase 2
	  	  	 DC1 ITO

Phase 1
	  	 DC1 ITO

Phase 2
	  	 DC2 ITO

Phase 1
	  	 DC2 ITO

Phase 2

	 Nexus 5k Cross

connects
	  	12	  		  	12	  		  	Nexus 7k VDC cross connects	  	40	  		  	40	  	
	 Nexus 5k to 7K
	  	32	  		  	32	  		  	ASA firewall	  	24	  		  	24	  	
	 Nexus 2232
	  	8	  		  	8	  		  	McAfee IPS	  	4	  		  	4	  	
	 Nexus 5k to FI
	  	32	  	32	  	32	  		  	F5 L/B	  	8	  		  	8	  	
	 Spare for implementation Contingency
	  	16	  		  	16	  		  	HNAS (2)	  	8	  		  	8	  	
	 8x Nexus 2K

(Aix and Sun)
	  		  	32	  		  	8	  	NetBackup (4)	  	8	  	30	  	8	  	
	 VMS

(19 server, 6chassis)
	  		  	48	  		  	8	  	MDS 9250 FCIP	  	4	  		  	4	  	
		  		  		  		  		  	HCP (1)	  	8	  		  	8	  	
		  		  		  		  		  	HDI (1)	  	4	  		  	4	  	
		  		  		  		  		  	Sepaton	  	4	  	22	  	4	  	10
		  		  		  		  		  	Spectralogic	  	2	  		  	2	  	
		  		  		  		  		  	ASR-WAN	  	4	  		  	4	  	
		  		  		  		  		  	ASR -DCI	  	6	  		  	6	  	
		  		  		  		  		  	Nexus 5K to N7k Agg	  	32	  		  	32	  	
		  		  		  		  		  	Spare for implementation Contingency	  	16	  		  	16	  	

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-25	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 Access Switch connectivity 56128 @

Centennial (Total of 4 X 56128) and

Phoenix (Total of 2 X 56128)
	  	 Core Switch connectivity 2 x 7710 @

DC1 and DC2

		  		  		  		  		  	ASA 5525	  		  	8	  		  	8
		  		  		  		  		  	Extranet VPN	  		  		  		  	
		  		  		  		  		  	McAffee IPS ( Internet)	  		  	4	  		  	4
		  		  		  		  		  	External LB (f5)	  		  	8	  		  	8
		  		  		  		  		  	GTM (f5)	  		  	4	  		  	4
		  		  		  		  		  	Netscaler (VDI)	  		  	4	  		  	4
		  		  		  		  		  	ASR - Internet	  		  	4	  		  	4
		  		  		  		  		  	Nexus 2232 (DMZ)	  		  	8	  		  	8
		  		  		  		  		  	 N7k VDC 3

Cross Connect DMZ
	  		  	4	  		  	4
		  		  		  		  		  	 N7k VDC 5

Cross Connect Partner
	  		  	4	  		  	4
		  		  		  		  		  	 Nexus 2232 TO 7k -

Partner VDC
	  		  	4	  		  	4
		  		  		  		  		  	Spare for implementation Contingency	  		  	20	  		  	20
		  		  		  		  		  	Nexus 2232 TO 7k - WAN VDC	  		  	4	  		  	4
		  		  		  		  		  	NAM2320	  		  	2	  		  	2
	 Ports per Access Switch
	  	50	  	56	  	50	  	8	  		  	86	  	65	  	86	  	44
	 Total ITO Phase 1 Port counts
	  	100	  		  	100	  		  		  	172	  		  	172	  	
	 Total ITO Port counts
	  		  	112	  		  	16	  		  		  	130	  		  	88
	 Ports per
	  		  	106	  		  	58	  		  		  	151	  		  	130
	 Access Switch
	  		  		  		  		  		  		  		  		  	
	 *Total port counts (ITO Phase 1 + ITO Phase 2)
	  	212	  		  		  	116	  		  		  	302	  		  	260

  

	*	Total Port support @Centennial DC : 4 x 56128 ( 384 ports) and @ Phoenix : 2 * 56128 ( 192 ports) 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-26	  	Health Net / Cognizant Confidential

 Final 
  

 Network Diagram 

Following diagram depicts the combined network view of Centennial and Phoenix data centers. ITO Phase 1 Network diagram has been modified with the ITO Phase 2
additions. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-27		Health Net / Cognizant Confidential

 Final 
  

  
 

 
 Figure: Combined Network View of Centennial and Phoenix Data centers 

3.1.2.1. DC LAN 
 Nexus 7710 will be configured with
additional VDCs (DMZ VDC and Extranet VDC) to support the ITO Solution requirements. The below table provides a quick overview of the VDC design. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-28		Health Net / Cognizant Confidential

 Final 
  

			
	 VDC Name
	  	 Purpose

	 WAN VDC
	  	 •    MPLS access with logical segregation for Federal and Commercial traffic

		
		  	 •    Multiple VRF will be created to segregate the traffic (Eg:, FED-
VRF, Non-FED-VRF)

		
	 AGG VDC
	  	 •    Multiple VRF will be created to segregate the traffic (Eg:, FED-
VRF , Non-FED-VRF)
  

•    FHRP for Server VLANs

 
 •    All communication
between different environment will be restricted using Firewall
  

•    Only required route will be leaked between environment

 
 •    If communication
need to be restricted between any specific server with same VLAN then Private VLANS (PVLAN) feature in Nexus can be deployed
  

•    Multi Chassis Ether Channel Support

 
 •    All unused ports
will kept administratively down at Base VDC(Default VDC)
  

•    Dedicated Fabric for the SAN and no FCoE on Nexus 5K

		
	 Core VDC
	  	 •    Core routing, all the environment IP routes will be learned and
advertised to respective WAN VRF’s
  

•    Dynamic routing protocol

 
 •    Firewall context
protection between Agg-VDC and Core VDC
  

•    ACLs on the Nexus will be used to secure the DCI link

 
 •    No firewall will be
configured between Data center replication link

		
	 Extranet VDC
	  	 •    Partner Routers access to Health Net Infrastructure

 
 •    Firewall and IPS
protection
  

•    Private VLAN configured to restrict communication between different vendor
host/server.
  

•    Static routing preferred at this VDC due to multiple vendor equipment’s
connected

		
	 DMZ VDC
	  	 •    Multi-homed ISP access

 
 •    BGP routing
Protocol
  

•    External facing services

 
 •    Firewall contexts
for the DMZ segments
  

•    IPS protection
  

•    Global Load Balancing

 
 •    Local Traffic
Manager

		
	 DCI VDC
	  	 •    2 X 10 G Link for Inter DC Communication

 
 •    Encryption will be
configured to secure the data for the purpose of federal compliance

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-29	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.2.1.1. Solution Approach 

In addition to the existing network infrastructure in ITO Phase 1 modified phase, following devices will be added for the DC LAN for ITO Phase 2 migration.

  

					
	 Additional ITO Device
	  	 Centennial
	  	 Phoenix

	 Nexus 2232TM-E

32 x 1/10GBASE-T host interfaces and modular uplinks (8 x 10 Gigabit Ethernet fabric interfaces)
	  	12	  	6
	 Catalyst 3750X – 48 port
	  	2	  	2

 Fabric extender considered for the servers will be dual attached to additional pair of N56128. All the physical server will be
dual homed to Fabric extender for redundancy purpose. A dedicated 2 X 3750X stack switch will be placed at DMZ to accommodate the 1G connections. Servers with high throughput requirements (eg: VMS) can be directly attached to the 5Ks. 

Additional VDC will be created for Extranet / DMZ and additional switch will be patched to the vdc as required. A pair of 3750 is considered for DMZ VDC.
Extranet VDC and WAN VDC will have a pair of N2k FEX each to meet the 1 Gig port connectivity requirements. 
 3.1.2.2. DMZ 

DMZ and Internet Zone is considered for enabling secured Internet access for the proposed Centennial and Phoenix data centers. Internet Service Provider level
redundancy and Infrastructure High-Availability are considered along with adequate internet bandwidth. Dedicated Physical F5 is considered for DMZ. 

3.1.2.2.1. Solution Approach 
 A dedicated pair of Cisco
ASR 1004 is considered for terminating the internet circuits. Current assumption is to use Health Net owned public IP address segments for both Centennial and Phoenix data centers. BGP Routing protocol will ensure full route exchange with the
service providers. Though the proposed hardware support dual-stack, the current network is designed for IPv4 protocol. 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-30	  	Health Net / Cognizant Confidential

 Final 
  

 Internet bandwidth sizing done based on the current internet circuits available at Boulder, (dual connection
through SIAU). During the Assessment/design phase of the discussion Cognizant will work with Health Net to review the current internet circuit utilization at Boulder and validate the proposed internet bandwidth. 

Internet Bandwidth 
 Following table shows the proposed
internet bandwidth for the Centennial and Phoenix DCs 
  

							
	 Data Center
	  	 Details
	  	Telco Provider	  	B/W (Ethernet Handoff)
	Centennial	  	Internet Link	  	Level3	  	150 Mbps
		  	Internet Link	  	Qwest	  	150 Mbps
	Phoenix	  	Internet Link	  	Level 3	  	150 Mbps
		  	Internet Link	  	Qwest	  	150 Mbps

 Note : Cognizant will work with Health Net to review the current internet circuit utilization at Boulder and validate the
proposed internet bandwidth. 
 A dedicated VDC is considered on the Nexus 7710 for DMZ zone. Equal Cost Multi Path (ECMP) using 10 Gig links will be used
for connecting Nexus 7Ks and the Internet ASR routers. This path will be protected with a dedicated pair of Cisco ASA 5585 firewalls and McAfee IPS. Additional firewall contexts will be defined on the firewall to support DMZ server infrastructure. A
dedicated pair of Cisco 3750 is considered to support the 1 Gig connectivity requirements. Logical segregation of Federal and Commercial traffic will be achieved by using VRFs feature. 

F5 5200v is considered for the application load balancing for the external facing servers. This mid-range appliance from the F5 is capable of 4 VCMP (virtual
Appliance), however the current requirement is only for 2 (Federal and Commercial), with the additional 2 virtual appliances for future use. The B/w supported by 5200v is 15 Gbps. SSL offloading for the external facing servers will be performed by
the load balancers. 
 F5 2000s is considered for Global Load Balancing Solution. This is a DNS based solution that will help to redirect the traffic to the
appropriate data centers based on the defined load balancing policy and application availability. GTM will be tightly integrated with the external DNS servers to achieve the global availability feature. 

NTP and IP Address Management (IPAM) will be configured on the Infoblox devices. 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-31	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.2.3. WAN 

ITO Phase 1 WAN architecture will be modified to meet the ITO solution WAN requirements. Following components will be added 

 

	 	•	 	WAN MPLS bandwidth upgrade 

  

	 	•	 	GET VPN Key Server migration 

  

	 	•	 	Legacy P2P link strategy (TBD) 

  

	 	•	 	Pair of Nexus 2K with 1 Gig port capability 

 3.1.2.3.1. Solution Approach 

As part of ITO, all the remote sites will be accessing Centennial and Phoenix data center for day to day business purpose. Cognizant has compared the current
WAN MPLS bandwidth at Boulder and the following points are considered for performing the WAN MPLS bandwidth sizing. 
  

	 	•	 	Commercial circuit bandwidth at Boulder is 2x OC12 (622 Mbps) 

  

	 	•	 	Federal circuit bandwidth at Boulder is 2x OC3 (150 Mbps) 

  

	 	•	 	Boulder data center is hosting both Production and Non-Production environment. With the proposed data center model, Production and Non-Production environment will be split between Centennial and Phoenix Data Centers

  

	 	•	 	Proposed MPLS bandwidth will be reviewed and validated with Health Net 

  

	 	•	 	Consider additional load due legacy p2p link to MPLS migration 

  

	 	•	 	Review the current utilization on the Boulder MPLS circuit 

  

	 	•	 	ITO Phase 1 is proposed with a Unilink access link carrying both Federal and Commercial MPLS Traffic. Review Unilink vs Separate link approach to ensure future scalability of the MPLS circuit bandwidth.

  

	 	•	 	Centennial has redundant access link to ATT MPLS 

  

	 	•	 	Phoenix is the Test/Dev/DR site and has only single access link to ATT MPLS 

  

	 	•	 	Traffic backhauling through DCI link is not considered to minimize the overhead to production environment at Centennial 

  

	 	•	 	In case of hardware failure on the WAN primary ASR, the circuit will need to be manually swapped to the second ASR 

  

	 	•	 	No change for the Cognizant MPLS bandwidth (45 Mbps) 

  

	 	•	 	Assessment of the current WAAS appliances and replica of the current polices will be configured in the target environment updated with same software version will be deployed for compatibility 

 

	 	•	 	SMB2/3, CIFS, ICA and other standard protocals will be optimized and SSL optimization services will be turned on globally with cert & key additions 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-32		Health Net / Cognizant Confidential

 Final 
  

 WAN MPLS Link Bandwidth 

Following table summarize the proposed bandwidth and the Telco service provider details 

 

							
	 Data Center
	  	 Details
	  	Telco Provider/LEC	  	B/W (Ethernet Handoff)
	Centennial	  	Federal- Primary	  	ATT/Centurylink	  	150 Mbps
		  	Non-Federal-Primary	  	ATT/Centurylink	  	700 Mbps
	Centennial	  	Federal- Secondary	  	ATT/Level3	  	150 Mbps
		  	Non-Federal- Secondary	  	ATT/Level3	  	700 Mbps
	Phoenix	  	Federal- Primary	  	ATT/Integra	  	150 Mbps
		  	Non-Federal-Primary	  	ATT/Integra	  	700 Mbps

 Cognizant expects all the legacy P2P link from Boulder to remote sites will be migrated to MPLS prior to ITO build. For
budgeting purpose, we have considered a pair of ASR 1002 in Centennial for legacy link termination and will be reviewed during the LLD phase. 
 Boulder DC
is hosting the GET VPN Key Servers. For ITO, a Pair of Cisco 2900 is considered for GET VPN Key Server migration. A pair of Nexus 2k is considered for 1 Gig port requirement in the WAN VDC. 

Riverbed model considered for the ITO Phase 1 is 7055L. This model license is upgradable to 7055H for supporting higher throughput. 

HealthNet Locations 
 Network managed Services : Cognizant will
assume responsibility (which includes maintenance and steady state support _) of Network components in HealthNet locations which are currently managed by incumbent vendor, post transition of responsibilities. All HealthNet owned network devices
shall be assessed and refreshed based on EOL schedule. 
 3.1.2.4. Service Deliverables 

Network Services implementation will be validated with the following tests. 

 

	 	•	 	Testing the circuit to ensure and validate the reported bandwidth and latency parameters 

  

	 	•	 	Testing the external facing services connectivity over the Internet 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-33	  	Health Net / Cognizant Confidential

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	 	•	 	Testing connectivity to the business partners 

  

	 	•	 	Testing connectivity over Redundant P2P Links between Centennial-Boulder and Centennial-Phoenix with encryption 

  

	 	•	 	Testing Routing reachability between data centers and remote locations 

  

	 	•	 	Testing Logical Separation of Federal and Commercial traffic on the DC firewall. 

  

	 	•	 	Testing firewall filters at the Centennial DC, to permit legitimate traffic in and out of Centennial DC over P2P and MPLS Links 

  

	 	•	 	Testing WAN traffic optimization between DC and Remote locations for the qualified traffic 

  

	 	•	 	Health Net Info Sec team to validate the hardening of network and security equipment implemented at Centennial and Phoenix DCs 

3.1.2.5. Steady State Support Deliverables 
  

			
	 Solution
	  	 Description

		
	 Solution Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore ; Coimbatore

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-34	  	Health Net / Cognizant Confidential

 Final 
  

 The delivery model for Network platform is as depicted below: 

 
  
 

 
 Figure: Delivery Model—Network 

The high level activities for network services are mentioned below: 

Level 1 Services 
 L1 Services will be provided in
accordance with the procedures documented in the SOPs and will include the following: 
  

			
	 L1 Team
	  	 Basic incident management—incident logging and
tracking

		  	 •    Monitoring link UP and DOWN times

		
		  	 •    Monitoring routers and switches for CPU and memory utilization

		
		  	 •    Monitoring—performance and capacity of network devices

		
		  	 •    Monitoring bandwidth utilization

		
		  	 •    LAN/TCP/IP configuration

		
		  	 •    Pre designed Link re-routing

		
		  	 •    Performing health check as per defined procedure

		
		  	 •    Vendor management

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-35	  	Health Net / Cognizant Confidential

 Final 
  

 Level 2 Services 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include: 

 

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

			
	 L2 Team
	  	 Configuration management and change control

		
		  	 •    Performance and availability management

		
		  	 •    Working with service providers to implement new or upgraded data network

		
		  	 •    Managing router tables and IP addresses

		
		  	 •    Network device configuration

		
		  	 •    Perform hardware diagnostics

		
		  	 •    Implement firmware and software upgrades and patch installation and management

		
		  	 •    Problem management and troubleshooting

		
		  	 •    Handling escalated routing issues and routing changes

		
		  	 •    Performing network integration tests

		
		  	 •    Bandwidth management

		
		  	 •    IMAC of Network devices

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 Network Support group. This team will work with Vendors when required. 
  

			
	 L3 Team
	  	 Performing operational planning for capacity and performance
purposes

		
		  	 •    Conducting feasibility studies for implementation of new technologies

		
		  	 •    Performing project management and project estimation

		
		  	 •    Reviewing efficiency and effectiveness of problem control process

		
		  	 •    Network design and architecture

		
		  	 •    Root Cause Analysis

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-36	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.2.6. Assumptions 

The following are the key assumptions: 
  

	 	•	 	Health Net will provide public IPv4 addresses and associated AS numbers 

  

	 	•	 	Completion of the legacy P2P links to MPLS migration 

  

	 	•	 	No requirement of Layer 2 VLAN extension across the DCs or to any Health Net locations 

  

	 	•	 	MPLS provider manages the Routing, QoS and MTU (Jumbo frame) within the MPLS cloud 

  

	 	•	 	Federal and Commercial Separation through logical segregation of the Network devices 

  

	 	•	 	Private v-lans will be configured to secure communication with the vlan 

  

	 	•	 	SNMP alerts of all network devices will be configured and pointed to monitoring tools 

  

	 	•	 	Current Network design is only based on TCP/IP protocol. Support for any legacy protocol (SNA, DECnet) will need additional review 

  

	 	•	 	DCI link will be secured with the Nexus Security features. No Firewall/IPS/Riverbed considered for the DCI link 

  

	 	•	 	FCIP based SAN replication across the DC Interconnect link 

  

	 	•	 	Appropriate policy routing will configured to restrict route redistribution 

  

	 	•	 	SoC provider will provide the local log collector to collect all the LOG from network and security device at Centennial and Phoenix Data centers. 

3.1.2.7. Dependency 
 The following are the dependencies:

  

	 	•	 	Details of Public and Private IP schema used across Health Net (Boulder DC, branches, etc.) 

  

	 	•	 	Health Net to provide Public IPv4 Addresses for both Centennial and Phoenix DCs 

  

	 	•	 	Health Net to provide private IP addresses for both Centennial and Phoenix DCs 

  

	 	•	 	VLAN schema details supporting the current Server and Application Architecture 

  

	 	•	 	Understanding of Health Net naming conventions, VLAN tag’s, etc., to retain the same in new DC and DR. 

  

	 	•	 	Detailed understanding of existing Health Net routing architecture (LAN/WAN) at Boulder DC and Remote Locations 

  

	 	•	 	Network configuration at Boulder DC to facilitate the migration 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-37		Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Incumbent to provide the historic circuit utilization stats to validate the proposed Internet and MPLS bandwidth 

  

	 	•	 	Coordination with external partners to facilitate the Partner VPN connectivity 

  

	 	•	 	Coordination with external partners to facilitate the COLO routers and circuit 

  

	 	•	 	Completion of legacy point to point link to MPLS migration 

  

	 	•	 	Coordination with the SoC vendor to establish direct connectivity to Centennial and Phoenix DCs 

  

	 	•	 	All network device Log will be sent to the LOG server 

  

	 	•	 	SSL certificate for the published URLs 

  

	 	•	 	Provide application specific load balancing requirements (if any) 

  

	 	•	 	Provide GET VPN Server configuration details to facilitate the GET VPN Key Server migration 

  

	 	•	 	Health Net SoC to provide local SIEM log connector at the proposed Cognizant Data Center to conserve the bandwidth consumption 

  

	 	•	 	Copy of the requirements document for information security compliance, to complete the hardening of network and security equipment for Health Net information security team signoff. 

 

	 	•	 	Availability of incumbent SMEs to understand the details of the existing network and security setup in Health Net hosted DC at Boulder 

3.1.2.8. Risk and Mitigations 
 The following are the
risks and mitigations: 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	1	  	Legacy P2P link to MPLS migration	  	Medium	  	Medium	  	Cognizant expect all the p2p link will be migrated to MPLS. However we have considered a pair of ASR1002 for link termination, if any of the legacy p2p link requires migration to Centennial DC
					
	2	  	Health Net owned Public IPv4 Address availability for the external facing services	  	Low	  	High	  	 As per ARIN, there is couple of IP segments owned by Health Net.

Validate and confirm the availability of the public IPv4 address with Health Net and decide on ‘hard cutover vs Parallel build’ approach for the
external facing services

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-38	  	Health Net / Cognizant Confidential

 Final 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	4	  	Understanding of existing Boulder Data center firewall rules, load balancers policies, VLAN L2/L3, routing details, for developing low level design for Centennial and Phoenix DCs	  	High	  	High	  	Engage with incumbent SMEs to understand the details of existing DC network design considerations and security policies
					
	5	  	WAN Link upgrade commissioning timelines at Centennial / Phoenix DC for MPLS circuits	  	Low	  	Low	  	Early initiation of link upgrade order placing and alignment of project to meet the target timelines
					
	6	  	Partner Site to Site VPN migration	  	High	  	High	  	 Early initiation of the communication to all the respective partners and build the tunnel.

Engage project management team to track and coordinate the build effort

					
	7	  	Partner circuit and COLO router migration. Telco circuit migration can take up to 90 to 120 days	  	High	  	High	  	Early initiation of the communication to all the respective partners to provision circuit and router for Centennial and Phoenix DCs. Engage project management team to track and coordinate the build
effort

 3.1.3. Security 

3.1.3.1. Solution Approach 
 Cognizant proposes DMZ and
Extranet partner zone security solution at two data centers to meet Health Net’s initiatives. 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-39	  	Health Net / Cognizant Confidential

 Final 
  

 Primary Data center (DC1) – Centennial DC 

This section provides infrastructure details for DC1 facility. 
  

 
 

 
 Figure: DC1 Infrastructure Facility 

 
 The solution will have DMZ and Extranet partner zone security infrastructure networks and
it will be reachable by the Health Net’s remote access users and Health Net’s business partner. These both DMZ and partner zones are isolated from ASA 5585-x virtual contexts. 

The proposed zones has one set of ASA 5585-x which will be placed behind the internet router and these Firewalls has long provided the first line of defense
in Health Net’s Internet security infrastructures. There will be two Virtual contexts to connect Internet and External partner to segregate the traffic between Internet and external partner traffic. They accomplish this by associating Health
Net’ s security policies about internal or external Health Net users’ to access rights to the connection information surrounding each access attempt. Before getting into Health Net’s network, the user policies and connection
information must match up, otherwise the firewall does not grant access to Health Net’s internal network. The proposed firewall has 10 Gbps performance to packet switch or route the traffic between segments. And important point is these two
internet ASA 5585-x of firewalls are in clustering mode (for High availability). 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-40		Health Net / Cognizant Confidential

 Final 
  

 There are 3 pair of VPN boxes are placed in the Health Net’s network to connect Federal, Commercial and
External Partner VPNs and we specified deployment classifications are Site to site and remote access VPNs, VPNs extend the Health Net’s network to mobile workers, and remote offices. VPN enable users to connect to Health Net’s corporate
intranets or extranets whenever, wherever, or however they require. Remote access VPNs provide connectivity to a corporate intranet or extranet over a shared infrastructure with the Health Net’s security policies as a private network and
proposed concurrent VPN users are maximum 750 only and 300 Mbps of throughput in ASA 5525-x in each box vpn users are maximum 2500 concurrent users only and 400 Mbps of throughput in ASA 5545 box. 

The proposed McAfee box delivers the most comprehensive and accurate Intrusion Prevention System (IPS) and Network Threat Behavior Analysis (NTBA) for Health
Net’s network to protect from spyware and known, zero-day, and encrypted attacks. All the traffic from Internet firewalls or access or core switch should forward traffic to monitor on IPS box before getting into Health Net’s internal
network. And the IPS box will be fine-tuned according Health Net’s security guidelines. The proposed IPS box has capability to have virtualization sensors and virtual sensors will be connected to two segment one DMZ and other one will be
extranet Partner zones in case if we required after gathering actual requirement from Health Net’s team during the Due Diligence sessions. 

Secondary Data center (DC2) – Phoenix DC 
 This
section is similar to the DC1 as detailed above. 
 3.1.3.2. Service Deliverables 

 

	 	•	 	Design and implement DMZ and perimeter security 

  

	 	•	 	Testing firewall filters at the Centennial DC, to permit legitimate traffic in and out of Centennial DC over P2P and MPLS Links 

  

	 	•	 	Create and maintain Design, Build and Run book documents 

 3.1.3.3. Steady State Support
Deliverables 
  

			
	 Solution
	  	 Description

	 Solution Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support

		
		  	 •    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery Location
	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-41	  	Health Net / Cognizant Confidential

 Final 
  

 The delivery model for Security platform is as depicted below: 

 
  
 

 
 Figure: Delivery Model – Security 

The high level activities for Security services are mentioned below: 

  

					
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 Final 
  

 Level 1 Services 

L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
	 L1 Team
		 •    Monitoring the Firewall device and logs

		
			 •    Log incidents and escalate to next level

		
			 •    Respond to alerts from monitoring system

		
			 •    Generate reports—Weekly, monthly and adhoc for customer review

		
			 •    Monitoring the IDS/IPS device and logs

		
			 •    Log incidents and escalate to next level

		
			 •    Respond to IDS/IPS alerts

		
			 •    Generate reports—Weekly, monthly and adhoc for customer review

		
			 •    Monitoring the IDS/IPS device and logs

		
			 •    Monthly Security Dashboard / Daily /Weekly/ Monthly Log reports

		
			 •    Facilitate Critical Incident support

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

			
			Firewall Request
		
			 •    Create/Modify Firewall Rules

		
			 •    Adding IP, Services to the group

		
			 •    Pushing firewall rules

		
			 •    Daily Health checks and event logs analysis

		
			 •    Troubleshooting connectivity related issues

		
	 L2 Team
		 •    Installation and Configuration of Firewalls

		
			 •    Version upgrade/patching firewall devices

		
			 •    Prepare documentation of known errors and KEDB

		
			 •    Alert appropriate teams for Capacity issues and remediation actions

		
			 •    Change request creation

		
			 •    Assist L3 team on Change request implementation as per process

		
			 •    Install and Configure the IDS/IPS

		
			 •    Signature Configuration

		
			 •    Perform Signature update

		
			 •    Tuning IDS/IPS signature as per
requirement

  

					
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 Final 
  

			
			 •    Shun/Block attacker IP address

		
			 •    Event Correlation and analysis

		
			 •    Administration of Policy, profiles and rule set configuration

		
			 •    Performance statistics reports on noncompliance systems

		
			 •    Install and Configure the IDS/IPS

		
			 •    Signature Configuration

		
			 •    Perform Signature update

		
			 •    Create and update KEDB (Knowledge Event Database).

		
			 •    Create and modify the reports limited to data points provided within SIEM.

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 Security Support group. This team will work with Vendors when required. 
  

			
			 •    Create, modify, delete policies

		
			 •    Pushing business Impacting changes on the Firewall

		
			 •    Work on Severity 1/critical incidents

		
	 L3 Team
		 •    Work on Incidents escalated by L2 team and document the resolution for future references

		
			 •    Installation and Configuration of high End Firewalls

		
			 •    VPN Configuration

		
			 •    Signature Fine tuning

		
			 •    IDS/IPS health check

		
			 •    Approve signature upgrade

		
			 •    TCP intercepts (Preventing Denial-of-Service Attacks)

		
			 •    Review, validate and approve security policies

		
			 •    Minimizing downtime by checking planned maintenances and new implementations

		
			 •    Enforcing best practices surrounding security incident response

		
			 •    Outbreak prevention plan for various security threats

		
			 •    Participate in root cause analysis for major security outbreaks

		
			 •    Signature Fine tuning

		
			 •    IDS/IPS health check

  

					
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 Final 
  

 3.1.3.4. Assumptions 

The following are the assumptions considered under Security. 
  

	 	•	 	Assuming that the VPN licenses are not exceed more than 750 on each ASA 5525-x box for Federal and Commercial users and 2500 users on ASA 5545-x box for External partners. 

 

	 	•	 	All security products will be validated during the assessment phase. 

 3.1.3.5. Dependency

 The following are the dependencies considered under Security. 

 

	 	•	 	The proposed new or existing hardware / software should be ready while time of Implement / deploy. 

  

	 	•	 	Health Net will provide complete security guidelines and provide SPoC for the same. 

3.1.3.6. Risk and Mitigations 
  

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

	 1
	  	Support of Key SME’s from incumbent during Implementation	  	High	  	Medium	  	Involve Health Net to facilitate and govern the Implementation, requiring integration and other security products at Cognizant target Data centers
					
	 2
	  	Proposed boxes’ Performance	  	High	  	Medium	  	Cognizant has sized based on the available information. However, performance reports have not been made available which may require an adjustment after performance baseline during the Transition phase. Any changes required due to
performance adjustments will be managed and priced under the change process.

  

					
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 Final 
  

 3.1.3.7. Identity and Access Management 

In Scope 
 The following
requirements are considered to be in scope for this project. 
  

	 	•	 	Management and administration of computer accounts following prescribed access control procedures 

  

	 	•	 	Assists in computer account security procedures and forms build 

  

	 	•	 	SOX & Priviledged Accounts 

  

	 	•	 	Maintenance of computer account security files on all users 

  

	 	•	 	Assists in developing policies and procedures to create, modify and delete accounts 

  

	 	•	 	Support and follow-ups on password reset issues for Health Net associates (HNCORP,HNFS) 

  

	 	•	 	Planning and implementation of Health Net policies and procedures 

  

	 	•	 	Ensuring Health Net policy adherence 

  

	 	•	 	Assists in build and maintenance of Access Administration procedures and documentation 

  

	 	•	 	SOX Compliance 

  

	 	•	 	Priviledged account creation (Management) 

  

	 	•	 	Generate daily report of ISRs 

  

	 	•	 	Number of ISRs completed by agent each day 

  

	 	•	 	Number of ISRs received each day 

  

	 	•	 	Number of Accounts created by agent each day 

  

	 	•	 	Number of USERS provisions by agent each day 

  

	 	•	 	Number of SYSTEMS provisioned by agent each day 

  

					
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 Out of Scope 

Any activity not described explicitly in the above In scope section will be treated as outside of the scope. 

 

	 	•	 	Support Access Management Tool hosted in Incumbent datacenter 

  

	 	•	 	Technical issues related to systems / applications. 

 Solution Approach 

Cognizant will follow the Health Net’s current solution. 

Activities 
  

	 	•	 	Creates, modifies and deletes computer accounts following prescribed access control procedure. 

  

	 	•	 	Changes dial-in passwords periodically and notifies users. 

  

	 	•	 	Handles password reset issues for Health Net associates by receiving, tracking, responding, resolving and coordinating these requests via phone calls, email, web/self-service, and IVR including analyzing and
prioritizing problems to quickly arrive at workable solutions (Comes under Service desk). 

  

	 	•	 	Assures timely, appropriate response to customer calls to Access Administration. 

  

	 	•	 	Inform all Access administration personnel of any perceived trends, positive or negative, in calls being received and solutions used. Whenever possible addresses the cause of customer problems so that recurring
situations may be avoided Remains current on policies and procedures that may impact customers. Identifies potential technology impacts and devises solution prior to implementation. 

 

	 	•	 	Ensures that all Health Net policies are adhered to such as, but not limited to, Health Net confidentiality policy. 

  

	 	•	 	Assists with the development and maintenance of Access Administration procedures and documentation. 

  

	 	•	 	Assist Access Administration Supervisor when necessary Performs other related duties including projects support, training and communication activities as assigned by management Cognizant 85% of all ISRs to be completed
in 5 business days. The remaining 15% to be completed in 8 business days. 

  

	 	•	 	Reporting/Document Creation. 

  

					
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 Final 
  

 Management of Privileged User IDs and Cognizant User IDs 

For the operating systems, software tools and network infrastructure systems and devices, cognizant will perform the following: 

 

	 	•	 	Provision and manage user IDs (following prescribed access control procedures for SOX compliance) 

  

	 	•	 	Perform quarterly employment verification and remove user IDs, as appropriate 

  

	 	•	 	Administrator passwords for user IDs and privileged user IDs 

  

	 	•	 	Revalidate privileged authorizations and continued business need annually and remove user IDs, as appropriate 

  

	 	•	 	Provide Health Net a list of privileged user IDs for revalidation and remove privileged user IDs, as directed by Health Net. 

Health Net User ID Administration 
 For the operating
systems, software tools and network infrastructure systems and devices, cognizant will perform the following: 
  

	 	•	 	Provision and manage Health Net identified user IDs for Health Net personnel 

  

	 	•	 	Investigate Health Net user ID security issues 

  

	 	•	 	Perform password resets for user IDs 

  

	 	•	 	Investigate Health Net user ID password issues. 

 Compliance Reports 

 

	 	•	 	Perform annual employment verification for Health Net employees 

  

	 	•	 	Maintain audit records for privileged user ID approvals, verifications and revalidations and retain such records for the required duration 

 

	 	•	 	Provide for Health Net’s review and approval, for non-expiring passwords and policy exception requests 

  

	 	•	 	Capture system security logs of privileged access and log-on/log-off activities as defined in the Information Security Controls Document. 

Tools 
 Cognizant would leverage the exiting tools as
shown in the table below. Any more Applications will be discussed and finalized during transition phase. 
  

			
	 Technology or Application
	  	 Tools used for Access Admin support

	Commercial	  	
	ABS/VMS	  	Blue zone / SYSGEM / AD

  

					
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 Final 
  

			
	 Technology or Application
	  	 Tools used for Access Admin support

	Access to Home Drive	  	AD
	AMES	  	PORTAL (IE)
	Business Objects	  	AD
	Citrix (XENAPP) without Remote Printing	  	Command prompt (script)
	CSI	  	Blue zone, AD
	EIS Access	  	BMC Remedy
	Entrendex CA	  	BMC Remedy
	Essbase -FMRS	  	MS Excel
	Extend Access	  	AD
	FARE	  	Bluezone, AD
	FileNet	  	FileNet
	Formulary and Benefits	  	BMC Remedy
	FTE to Temp	  	AD
	Genelco	  	Bluezone
	Healthnet.com Support PORTAL (IE)	  	PORTAL (IE)
	HFX	  	PORTAL (IE)
	HNCAP	  	SYSGEM
	HNCS Windows	  	AD, Bluezone
	HNPLAN	  	NA (Done by ESSBASE Team)
	iHealth	  	PORTAL (IE)
	IBM	  	Bluezone
	IBM Mainframe	  	Bluezone
	ICON Development	  	AD
	Information Warehouse MHNGS	  	AD
	IST	  	AD
	Knowledge Base	  	AD
	Lotus Notes Shared email Account	  	Lotus Notes /ISR
	MACESS.exp	  	Sungard EXP MACESS
	MAGIC	  	AD
	MC400	  	Bluezone
	MDMMDR	  	AD, SYSGEM
	MEDai	  	AD
	MFM Pro (Burgess)	  	AD
	MHN Data Warehouse	  	Bluezone
	MHN Lawson	  	Bluezone
	MHN Prelude	  	Bluezone
	MHN SIR	  	PORTAL (IE)
	MHN Symphony	  	Bluezone
	MHN Unity	  	AD
	MTM-Rxellent Care	  	BMC Remedy
	Name Change	  	Lotus Notes
	Network Data Systems	  	AD
	New Shared Directory	  	AD, BMC Remedy

  

					
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 Final 
  

			
	 Technology or Application
	  	 Tools used for Access Admin support

	OCOE (new application)	  	AD
	ODS	  	SYSGEM
	Omni HNFS	  	MS Excel, Portal (IE)
	Pega Access	  	MS Excel, Portal (IE)
	Planview (ITG Associates only)	  	MS Excel, Portal (IE)
	PSA Archive	  	PORTAL (IE)
	PSALPAD	  	Unix Team
	Qcare	  	Bluezone
	Qfinity	  	BMC Remedy
	Quality Center	  	AD
	BMC Remedy	  	BMC Remedy
	Review Manager	  	Portal (IE)
	RightFAX	  	AD
	SALSA	  	AD
	Share Drive	  	AD
	Special Access: unmanaged de	  	AD
	Temp to FTE	  	AD
	Unity—HN	  	AD
	Unity Reporting	  	Lotus approval
	Unix	  	putty
	Unlisted Applications	  	AD
	UPS 2	  	Bluezone
	Valutech	  	Bluezone
	VPN without Remote Printing	  	AD
	XEN Desktop	  	BMC Remedy
	Federal	  	
	AMES	  	PORTAL (IE)
	Dial In/VPN	  	AD
	Extend Access	  	AD
	FTE to Temp	  	AD
	IBM	  	Bluezone
	ICON Development	  	AD
	Lotus Notes Shared email Account	  	Lotus notes
	Name Change	  	Lotus notes
	Network Shared Drive	  	AD
	RightFAX	  	AD
	Symphony	  	Bluezone
	Temp to FTE	  	AD

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-50	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Solution
	  	 Description

	 Solution Highlights
	  	 •    A dedicated Onsite / Offshore delivery team performing all in-scope activities

		
	 Support Coverage
	  	 •    8x5 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    8x5
dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery Location
	  	 •    Onsite—Health Net Offices

 
 •    Offshore –
Bangalore

 Assumptions 
  

	 	•	 	Health Net will provide approved policies & procedures for user IDs for Health Net personnel 

  

	 	•	 	Health Net will establish the criteria for resetting passwords and disclosing such passwords to authorized personnel 

  

	 	•	 	Health Net CID shall be created within 10 working days of Cognizant initiating the request. 

  

	 	•	 	Cognizant deliverables shall be signed off by Health Net within a timeframe jointly agreed upon by Health Net and Cognizant for Access Management support deliverable. 

 

	 	•	 	Health Net shall provide work stations (desktop or laptop) to Cognizant’s onsite personnel. 

  

	 	•	 	Health Net shall provide Cognizant onsite personnel with the necessary phone, email, network and communication capabilities. 

Risks 
  

	 	•	 	Delay in obtaining timely approval on PDLC artifacts/SOW will affect Resource ramp up timelines Pending ISR approvals & Delay in response of other teams / clarification response from the requestor / delay in
required approval from IT department / outage issues with computer systems will delay closure of ISR’s will delay closure of ISR’s 

  

	 	•	 	Enough licenses of all In-scope application would be needed to be maintained to create users for the respective applications. E.g. Macess. 

Dependency 
  

	 	•	 	Health Net will Approve non-expiring passwords and policy exception requests 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-51	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.4. Servers 

The existing private cloud infrastructure in ITO Phase 1 will be extended by adding additional Blade servers to host the Windows and Linux Operating
environment. The new infrastructure for OpenVMS, Solaris and AIX will be added to support the ITO Asset. 
 For details, please refer to the “ITO Phase
1 solution document” for the Rack layout, Architecture Design and Configuration Information. All the servers will be built as per Health Net Security Standards. 
  

			
	 Use case
	  	 Specifications & Activites

	Server/VM	  	 •    Assets

 
 •    OS licenses for
Net-New Servers
  

•    Build services for Net-New servers in the primary and secondary Data center

 
 •    Run services

 
 •    Server
provisioning, monitoring and management for net new servers in Cognizant Data centers
  

•    Performance and capacity management

 
 •    Patching and
upgrades management
  

•    Asset refresh and disposal

 
 •    Live migration of
VM and Storage
  

•    Support Non-Disruptive upgrades

 
 •    Support VM
replication for purpose of DR
  

•    Server provisioning, monitoring and management for new servers in Data center and Health
Net remote sites
  

•    Issue resolution

 
 •    Security
management
  

•    Audit and compliance reporting

 Following are the additional Server infrastructure proposed in both DC. 

 

	 	•	 	x86 Server for hosting Windows and Linux 

  

	 	•	 	Open VMS Server 

  

	 	•	 	Solaris Server 

  

	 	•	 	AIX Server 

  

					
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 Final 
  

 The table below shows the platform wise server summary showing AS IS and Target state in ITO. 

 

													
	 OS Platform
	  	 AS IS State
	  	 Target State
	  	 Comments

	  	 Physical 
	  	 Virtual
	  	 Physical
	  	 Virtual
	  	 %

Virtualization
	  
	AIX	  	20	  	59	  	12	  	67	  	100	  	 71 AIX LPARs

to be hosted in 12 IBM P Series Server (P750/760) with 10 LPAR/Server

	Solaris	  	161	  	110	  	20	  	277	  	100	  	277 Solaris LDOMs to be hosted in 20 Oracle T series Server(T4-4) with 20 LDOMS/Server
	Windows / Linux	  	*471	  	*1040	  	**349	  	1162	  	77	  	 1162

Windows/Linux VMs to be hosted in 56 UCS Server (B200M3) with 20 VMs/Server

	OpenVMS	  	32	  	Nil	  	44	  	Nil	  	Nil	  	Lift and Shift of 14 Alpha Servers

  

	*	Note – includes remote sites 

	**	Note – this included Servers from ITO Phase 1 

 The existing private cloud infrastructure in ITO
Phase 1 will be extended by adding additional 70 UCS Blade servers to host the windows and Linux virtual machines. The new Infrastructure for Solaris,AIX and OpenVMS will be added to support ITO applications. 

The remote locations will have additional 60 UCS Rack servers to take load of ITO applications. 

 

					
	 	  	 Description
	  	 Server Hardware Details

	Scope	  	Windows / Linux- x86	  	 DC1 - 184 Cisco UCS Blades-23 Chassis (Unified Computing Systems)
  

•    56 - B2003 M3 2 socket 10 core 384GB memory- ESX Blades

 
 •    128 - B2003 M3 2
socket 10 core 384GB memory- Blades for Physical Server (Windows, Linux)
  

•    6 - C420 M3 2 socket 8 core 256GB Memory

 
 •    15 - C220 M3 2
socket 10 Core 128GB Memory
  
 DC2 - 46 Cisco UCS Blades-6 Chassis (Unified Computing
Systems)

  

					
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 Final 
  

					
	 	  	 Description
	  	 Server Hardware Details

		  		  	 •    14 - B2003 M3 2 socket 10 core 384GB memory- ESX Blades

 
 •    32 - B2003 M3 2
socket 10 core 384GB memory- Blades for Physical Server (Windows, Linux)
  

•    2 - C420 M3 2 socket 8 core 256GB Memory

 
 •    10 – C220 M3 2
socket 10 Core 128GB Memory
  
 Remote Sites-

 
 •    2 - C420 M3 2
socket 8 core 256GB Memory
  

•    25 – C220 M3 2 socket 8 core 128GB memory

 

	  	Solaris	  	 DC1- 12 Oracle Solaris Servers
  

•    12 - SPARC T4-4 4 socket 8 core 512GB memory

 
 DC2- 8 Oracle Solaris Servers

 
 •    8 - SPARC T4-4 4
socket 8 core 512GB memory

			
		  	AIX	  	 DC1- 6 IBM Power Servers
  

•    3 - IBM Power 750 3 socket 8 core 256GB memory

 
 •    3 – IBM Power
760 2 socket 12 core 256GB memory
  
 DC2- 6 IBM Power Servers

 
 •    3 - IBM Power 750 3
socket 8 core 256GB memory
  

•    3 – IBM Power 760 2 socket 12 core 256GB memory

			
		  	VMS	  	 DC1- 8 HP Integrity Blades and 16 existing Alpha servers (lifted and shifted)

 
 •    8 – HP
Integrity 890c i4 8 socket 8 core 256GB memory
  

•    16 – existing Alpha servers (lifted and shifted)

 
 DC2- 20 HP Integrity Blades and 3 existing Alpha servers (lifted and shifted)

 
 •    14 – HP
Integrity 870c i4 8 socket 8 core 256GB memory (7 for Dev, and 7 for Test)
  

•    6 – HP Integrity 890c i4 8 socket 8 core 256GB memory (For DR)

 
 •    3 – existing
Alpha servers (lifted and shifted)

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-54	  	Health Net / Cognizant Confidential

 Final 
  

 The diagram below depicts Centennial Data center (DC1)—Physical rack layout: 

 
 

 
  
 

 
  
 

 
 Figure: Rack Diagram 

Note: we estimated the 6 rack that will be required for lift and shift of the Alpha servers for the Centennial Data Center. We may modify based off the LLD
phase of this project. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-55		Health Net / Cognizant Confidential

 Final 
  

 The diagram below depicts Phoenix Data center (DC2)—Physical rack layout: 

 
 

 
 Figure: Rack Layout 

Note: we estimated the 1 rack that will be required for lift and shift of the Alpha servers for the Centennial Data Center. We may modify based off the LLD
phase of this project. 
 3.1.4.1. Solution Approach 

Cognizant will deliver WAN connected highly virtualized production and test environments utilizing current generation Hypervisors including Microsoft Hyper-V
and VMware ESXi on Cisco UCS converged platform. The delivered open systems environments will consist of the following: Wintel (with current Microsoft versions through Windows 2012), Red Hat Enterprise Linux, Suse Linux.. Cognizant will use latest
vendor specific virtualization technology (LPARs/LDOMs) for hosting non x86 (UNIX) based applications. The legacy UNIX platform will consist of following platform. 

  

					
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 Final 
  

	 	•	 	Cisco UCS 

  

	 	•	 	AIX- IBM Power 

  

	 	•	 	Solaris-Oracle SPARC 

 Cognizant will procure latest HP itanium blade server for hosting OpenVMS application
and shall lift and shift of existing Alpha servers from incumbent DC to cognizant DC. The server level physical segregation to be maintained to isolate Commercial and Federal data throughout the entire infrastructure. The Server reference
architecture diagram for Commercial and Federal Architecture is shown below for illustration. 
  
 

 
 Figure: Commercial Reference Architecture 

  

					
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 Final 
  

 

 
 Figure: Federal Reference Architecture 

UCS Server Design 
 There are 23 Cisco UCS blade chassis,
with 230 B200 M3 blades and 60 C220/420 M3 rack server will be configured across two data center and branch locations. Six UCS 6296 96-port Fabric Interconnect devices are used to provide 32 X 10 GB Ethernet connection to networking. Network traffic
is isolated by using separate VLANs. Hitachi HDS VSP storage is used to provide storage luns to the ESXi cluster and Physical Servers. There are 32 x 8 GB FC connections between the SAN Storage and the UCS blade Chassis through UCS Fabric
Interconnect Fabric and SAN switches. In this solution, vCenter Server is hosted on a virtual machine in one of the ESXi blades to provide virtualization management. The actual server distribution of the server between Federal and Commercial will be
decided during LLD phase. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-58		Health Net / Cognizant Confidential

 Final 
  

 The UCS hardware details for Centennial, Phoenix and branch locations are illustrated below in the diagram.

  
 

 
 Figure: UCS Server Design 

  

					
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 Final 
  

 Design Highlights 
  

	 	•	 	High availability, scalability and robust infrastructure 

  

	 	•	 	Standardization of server architecture to reduce cost of maintenance, and improve serviceability with the help of few support staff over time. 

 

	 	•	 	Will utilize a Reference Architecture approach with UCS B200 M3 blades (Cisco Unified Computing Systems) and Cisco C220/420 M3 servers. 

 

	 	•	 	Cisco UCS Chassis will utilize 4x10Gbps ports for Networking and Storage 

  

	 	•	 	Cognizant chose UCS because of its agile and flexible capabilities and its wide range acceptance by many storage vendors. Cisco UCS manager is the industry leader in scalable virtualized environments on converged
networks 

  

	 	•	 	VCenter Server will be used to provision and manage the workloads and ESXi hosts within the virtual environment. 

  

	 	•	 	Federal VM’s will be isolated from Commercial VM’s by residing on designated Federal B200 M3 blades which will be in the same Chassis as Commercial Blades. This configuration needs to meet NIST guidelines ,
Rapid provisioning and management with Cognizant proprietary provisioning tool—Cloud360 

 VMware 

Design Decisions 
  

	 	•	 	VMware vSphere ESXi version 5.5 will be used as the hypervisor for this service. 

  

	 	•	 	Microsoft windows 2012 hyper-v will be used in branch locations with a maximum of 2 VM with local storage, if over 2 VM will utilize Vmware hypervisor.vSphere ESXi servers will be installed and booted from SAN LUNs.
Boot LUNs will have mirrored raid level. 

  

	 	•	 	The server platform will be Cisco UCS B200 M3 blade, each configured with 2x 10 Core CPU and 384GB RAM. 

  

	 	•	 	Each server will have Cisco UCS VIC 1240 modular LOM CNA Card to configure multiple Virtual NICs and HBAs. 

  

	 	•	 	Each Chassis will have 2204 utilizing 2 10G ports in each card (two total with 8 ports available) 

  

	 	•	 	Each Chassis will connect to a 6296, which it will have 16 ports to the 56128 for LAN and 16 ports to the MDS 9513 for Storage. 

Design Rationales 
  

	 	•	 	VMware vSphere ESXi hypervisor is the industries most trusted and proven virtualization platform 

  

	 	•	 	Health Net’s existing virtualization platform is also VMware. Hence VMware vSphere will be used as the virtualization platform. 

  

					
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	 	•	 	The preferred hardware platforms for VMware host is UCS B200 M3 blade series server platform which has sufficient specification (memory and CPU) and expandable to cater the anticipated requirements of the compute
requirements within the service. 

  

	 	•	 	For planned maintenance activity, ESXi host maintenance can perform using vMotion to migrate Live VM’s to other ESXi hosts. 

VMware vCenter Server 
 This will be used as the
central point for configuring and managing virtualized IT environments. It provides essential data center services such as access control, performance monitoring, and alarm management. The vCenter heart beat software will be used to provide high
availability. Cognizant will configure vCenter linked mode to ensure both data centers are maintained from single vCenter pane. 
  

 
 Figure: VMware vCenter server 

  

					
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 Final 
  

 VMware Site Recovery Manager 

VMware vCenter Site Recovery Manager (SRM) will be used for disaster recovery of business critical application. The actual number of VMs to be protected using
VMware SRM will be decided during the LLD phase. 
 VMware SRM coordinates the recovery process with the underlying replication mechanisms that the virtual
machines at the protected site are shut down cleanly and the replicated VMs can be powered up. 
  
 

 
 Figure: VMware Site Recovery Manager 

AIX- IBM Power Platform 
 Cognizant is standardizing on
version of AIX 7.1 with newer Power 7 hardware which provides backward compatibility for older versions of AIX (AIX 6/5 etc.). The IBM Power server environment will be configured with VIO servers to provide redundant network and SAN connectivity.

 The OS and Application will be restored after base OS build to recover the AIX application environment and application re-configuration will be done
manually as per the available run books. 

  

					
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 Final 
  

 The AIX hardware details for Centennial and Phoenix is illustrated below in the diagram. 

 
 

 
 Figure: AIX Server Detail 

Connectivity Details for IBM P 7xx series servers 
  

	 	•	 	Network interface – 10Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	2 Management Interface – 1Gbps for Management 

  

	 	•	 	8 HBA- 8Gbps for SAN connectivity 

 Solaris-Oracle SPARC Platform 

Cognizant has considered scalable Oracle T4-4 SPARC model to consolidate and virtualize entire workload. The Solaris infrastructure will be standardized on
Solaris 11 platform and older version will be retained only in case of application incompatibility. Logical Domains Manager to be used to create and manage logical domains (LDOMs) on SPARC servers. 

The OS and Application will be restored after base OS build to recover the Solaris application environment and application re-configuration will be done
manually as per the available run books. 

  

					
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 Final 
  

 The Solaris hardware details for Centennial and Phoenix is illustrated below in the diagram. 

 
 

 
 Figure: Solaris Server Detail 

Connectivity Details for Solaris 
  

	 	•	 	6 Network interface – 10Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	2 Management Interface – 1Gbps for Management 

  

	 	•	 	10 HBA- 8Gbps for SAN connectivity 

 Open VMS-HP Integrity Platform 

Cognizant will procure HP Intel Itanium (latest i4) blade based on C7000 Chassis (similar platform as Boulder DC) for hosting most business critical OpenVMS
application. The OpenVMS version 8.4 shall be evaluated. The environment shall be the physical environment with no virtulization. 
 Cognizant will work
with Health Net and incumbent for lift and shift of legacy Alpha Servers to Cognizant DC, however it recommends Health Net to migrate all the existing Alpha based applications to Itanium platform before the cut-over. 

Have factored 2 Itanium servers for backup in production cluster and if required will ship two extra severs from PHX to DEN which is already factored part of
the solution. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-64		Health Net / Cognizant Confidential

 Final 
  

 The HP Integrity hardware details for Centennial and Phoenix is illustrated below in the diagram 

 
 

 
 Figure: HP Open VMS Details 

Connectivity Details for HP Integrity-Open VMS 
  

	 	•	 	8 Network interface per Chassis – 10Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	2 Management Interface – 1Gbps for Management 

  

	 	•	 	8 HBA per Chassis- 8Gbps for SAN connectivity 

 3.1.4.2. Service Deliverables 

 

	 	•	 	Design, Build and Manage scalable, reliable server environment in DC1 and DC2 to meet Federal and Commercial requirement for Health Net Infrastructure and Business applications 

 

	 	•	 	Create initial Service catalog for rapid provisioning, this will be a living catalog and will evolve over time. 

  

	 	•	 	Create initial customer reports based of detail design 

  

					
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	 	•	 	Design and Implementation of highly scalable virtualized infrastructure across multiple server platforms. 

  

	 	•	 	Create secure and scalable server virtualization with VMware vSphere for hosting x86 Platform- Wintel and Linux 

  

	 	•	 	Create secure and scalable server virtualization with IBM PowerVM based virtualization for hosting AIX platform. 

  

	 	•	 	Create secure and scalable server virtualization with Oracle Solaris based virtualization for hosting Solaris Platform. 

  

	 	•	 	Create secure and scalable server virtualization with HP OpenVMS Virtualization for hosting Health Core ABS application. 

  

	 	•	 	Test the server environment for operation readiness 

  

	 	•	 	Create and maintain Build and Run book documents 

 3.1.4.3. Steady State Support
Deliverables 
  

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated Onsite / Offshore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24x7
Onsite support:
  

•    8x5 dedicated support – (Federal onsite) with the rest on call

		
	 Delivery
 Location
	  	 •    Onsite—Health Net Offices

 
 •    Offshore –
Bangalore; Coimbatore

 Level 1 Services 

“Level1” Services will be provided for the servers. L1 Services will be provided in accordance with the procedures documented in the SOPs and will
include the following: 
  

			
	 L1 Team
	  	 •    Servers status Monitoring

 

	  	 •    Monitor server logs and do initial troubleshooting steps define in
Run book
  

	  	 •    Escalate to L2 team when necessary

 

	  	 •    Carry out daily, weekly and other regular reporting activities as
defined in the SOPs
  

	  	 •    User / group account management, access permissions

 

		  	 •    Act as the central point of contact between Health Net and
Cognizant for tickets
  

		  	 •    Broadcast communications authorized by the Health Net to users.

 

		  	 •    Where applicable, keep Health Net informed and notified on the service status and progress

  

					
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 Level 2 Services 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include: 

 

	 	•	 	Incident Management Services 

  

	 	•	 	Change Management Services 

  

	 	•	 	Maintenance of server configuration documentation in the CMDB (Configuration Management Database) 

  

	 	•	 	Managing and configuring VMware Enterprise Plus 

  

			
		  	 •    Security Management – OS hardening / Password management

		
		  	 •    Carry out scheduled server maintenance / reboot activities

		
		  	 •    Administration of Physical and Logical server Partitions

		
		  	 •    Administering clusters ( Adding packages , modifications to package configuration, startup/shutdown of
packages)

		
		  	 •    Installation of patch bundles / firmware upgrades

		
		  	 •    Deploying patches to Windows, RHEL, Solaris & AIX servers

		
	L2 Team	  	 •    Configuration of new hardware

		
		  	 •    Disk space management

		
		  	 •    Performance management like Kernel Tuning

		
		  	 •    Installation of packages / applications

		
		  	 •    Volumes / File system management

		
		  	 •    Escalate any technical problem to L3 team when necessary

		
		  	 •    Implementation of Service improvement plan / Best practices

		
		  	 •    Maintain Incident information in the KEDB (Known error Database)

		
		  	 •    Carry out daily, weekly and other regular reporting activities for Incidents.

 Types of Incidents include following: 
  

			
	 	  	 Server Monitoring

	 L2 Team
	  	 •    Server availability

		  	 •    Space, Memory and Cache

  

					
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		  	 •    Replication / Stand by monitoring

		
		  	 •    Unauthorized / Inactive User Access

		
		  	 •    Backup status

		
		  	 •    Disk space / Table space utilization

		
		  	 •    Security and configuration exception alerts

  

			
	 	  	 Basic Administration

		
		  	 •    Startup/shutdowns of Servers

		
		  	 •    Additional Space allocation

		
	L2 Team	  	 •    Initial troubleshooting

		
		  	 •    Set up server auditing

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 server Support group. This team will work with Vendors when required. 
  

			
		  	 •    Server planning and Design services

		
		  	 •    Design any special application or security requirements.

		
		  	 •    Setup redundant / load balanced servers for application requiring high availability – Server
clustering / network /Server load balancing

		
		  	 •    Administration / handling issues related to clusters.

		
		  	 •    Provide technical escalation support to L1 and L2 team when required

		
		  	 •    Troubleshoot installation

		
		  	 •    Validate the new servers before releasing to production

		
	L3 Team	  	 •    Work closely with Problem Management organization on the remediation of all problems directly or
indirectly related to server engineering

		
		  	 •    Capacity Management

		
		  	 •    Troubleshoot major server issues on virtual and physical servers

		
		  	 •    Conduct Root Cause Analysis (RCA) on Severity 1 issues

		
		  	 •    Monitor for patches and test

		
		  	 •    Prepare work plan for major maintenance activity

		
		  	 •    Deploy patch

		
		  	 •    Confirm patch efficacy, no adverse effects

		
		  	 •    Disaster recovery solution design, benchmarking, load testing, implementation, configuration, monitoring
and troubleshooting, both internal and external

  

					
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 Patch Management: 

Patch Management for Windows Servers will be through SCCM 2012 and RedHat Network ( Satallite Server ) will be used for Patching Redhat Linux servers. The
Satellite server Connects to Redhat network to download the patches. The Linux servers will be configured to communicate with Satellite servers patching updates. For Solaris servers, Oracle OEM Ops Center is planned for automating Solaris patching
and it integrates with OEM 12c Cloud Control, for AIX servers patching will be a manual activity. 
 3.1.4.4. Assumptions 

The following assumptions are considered for this engagement with Health Net: 

 

	 	•	 	Cognizant will purchase Microsoft Windows Data center licenses and Red hat Enterprise subscriptions if needed to accomplish the design objectives of the solution architecture 

 

	 	•	 	Cognizant will work with Health Net to ensure License compliance 

  

	 	•	 	Tool based (3rd party) V2V migration approach for virtual servers hosted in VMware environment. 

  

	 	•	 	Increase Virtualization footprint by converting existing 112 Physical (x86) Servers in Boulder DC and reduction of 50% of Physical (x86) server footprint in branch locations. 

 

	 	•	 	Lift and Shift approach for all the legacy servers where application migration is not possible. 

  

	 	•	 	All remote AIX will be removed as we determined they are for TSM 

  

	 	•	 	All Alpha servers will be lifted and shifted 

  

	 	•	 	All Physical Sun, AIX servers to be virtualized to LDOM and LPAR respectively. 

  

	 	•	 	Cognizant will not install and support unlicensed software in the execution of this contract 

  

	 	•	 	Advance notice for any large project with space requirement above the 10% additional capacity 

  

	 	•	 	Cognizant to have prebuilt small, medium , and large VM profiles (for Windows and LINUX) in our Service catalog within Cloud 360 to help with rapid provisioning, but Cognizant will refine this during the detail design
workshops with Health Net 

  

	 	•	 	Federal and Commercial servers may be physically co-located with spares in the chassis 

  

	 	•	 	OS images will be built as per the security standard provided by Health Net. 

  

					
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 Final 
  

 3.1.4.5. Risk and Mitigations 

 

									
	 S.No
	  	 Risk Description
	  	Probability	  	Impact	  	 Mitigation Strategy

					
	 1
	  	Migration of Legacy applications	  	Medium	  	Medium	  	Cognizant will perform either P2V or P2P or Lift and Shift of the server.
					
	 2
	  	WAN Performance/connectivity issue during data migration	  	Low	  	High	  	Forklift high critical server data to mitigate WAN performance issues
					
	 4
	  	Licensing to ensure DC failover	  	Medium	  	Medium	  	Cognizant will review licensing with vendors to address gaps
					
	 5
	  	Multiple Virtualization Solutions complicate management and require subject matter experts to possess deep knowledge of multiple competitive products.	  	Medium	  	Medium	  	Cognizant will ensure that all subject matter experts possess the required knowledge to administrate deployed virtualization solutions
					
	 6
	  	Blade based solutions draw more power than the typical rack infrastructure	  	Low	  	Low	  	Cognizant will work with DC managers to ensure that implemented UCS have adequate power and cooling
					
	 7
	  	Vendor licensing changes during the life of UCS	  	Medium	  	Medium	  	Cognizant will work with solution providers to identify potential EOL and availability issues to ensure that UCS as deployed will not be impacted

 3.1.5. Storage 
 Storage
Requirements for Corp IT, Federal and Commercial servers that are being migrated from the Incumbent data centers to the newly built DC’s are fulfilled by upgrading the Storage Infrastructure at both Centennial DC and Phoenix DC. Storage
Infrastructure at the new DC’s are designed to support the scalability requirements without making major changes. This solution covers the design and approach for preparing the storage infrastructure at new DC’s in Centennial and Phoenix
to cater the storage needs for Corp IT, Federal and Commercial application servers which are going to be migrated from the incumbent Data centers. 

Detailed design on the newly built Storage Infrastructure at Centennial and Phoenix is available in the ITO Phase 1 Solution Document . 

  

					
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 Final 
  

 3.1.5.1. Solution Approach 

Cognizant will be upgrading the Storage and Backup Infrastructure components in Centennial and Phoenix DC’s. In Centennial DC, existing Hitachi VSP (ITO
Phase 1) will be upgraded and additional Hitachi VSP will be installed. In Phoenix, the existing Hitachi VSP (ITO Phase 1) will be upgraded to support the data storage capacity. 

 

	 	•	 	Summary of Storage upgrade: 

  

	 	•	 	Upgrade ITO Phase 1 VSP from 263TB to 1228TB a 965TB increase 

  

	 	•	 	Build a Second VSP with 772TB 

  

	 	•	 	Total increase of 1737TB in Centennial 

  

	 	•	 	2.75 PB usable capacity across both Data center after the upgrading the existing VSP storage and installation of additional VSP in Centennial 

 

	 	•	 	Out of the 2.7 PB we will use about 1735 for BPaaS servers across both DC 

  

	 	•	 	Out of the 2.7 PB we will use about 389 TB for Federal and 388 TB for Corp IT servers across both DC 

  

	 	•	 	HDS VSP Storage for all tiers of SAN storage, Thin Provisioning, Automatic Tiering 

  

	 	•	 	All Storage pools configured to be Dynamic Tiering Pools. 

  

	 	•	 	Install a new HDS HUS 150 Array with 30 TB at Woodland Hill 

  

	 	•	 	Install a new HDS HUS 150 Array with 25 TB at Rancho Cordova 

  

	 	•	 	Upgrade the SAN Switch ports in both Data center to increase port availability 

  

	 	•	 	Cisco MDS 9250i switch is considered for Storage Replication from Boulder to Centennial using FCIP technology 

  

	 	•	 	HUR replication to continue with Incumbent (Boulder,co DC) until migration completed in July of 2016. Also, enhance replication between Centennial and Phoenix as requirements evolve over the migration period. Enable
HNAS replication between DC1 (Centennial) and DC2 (Phoenix) 

  

	 	•	 	Leverage the HUR Replication to meet the RPO requirements for DR for production 

  

	 	•	 	Leverage the installed Hitachi management and monitoring tools for managing upgraded storage environment and new VSP added in Centennial DC. 

 

	 	•	 	Monitoring and Management of the Storage environments in the Centennial and Phoenix DC 

  

	 	•	 	Assess the servers which will be retained in Woodland Hills and Rancho Cordova and backup options (local/remote) will be developed based on the assessment outcome 

  

					
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 Storage Infrastructure – Centennial Data Center 

The diagram below depicts the High Level Storage and Backup architecture at Primary DC 

 
 

 
 Figure: High Level Storage and Backup architecture at Primary DC—Centennial 

  

					
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 VSP Architecture 

The VSP Architecture for both DC1 and DC2 is as depicted below. 
  

 
 Figure: VSP Architecture 

The reference for the detailed architecture of proposed Storage Infrastructure at Centennial (DC1) & Phoenix (DC2) is available in the ITO Phase 1
Solution Document. 
 VSP Capacity Summary – Centennial 
  

							
	 Storage Array 
	  	Usable Capacity –
ITO Phase 1	  	Usable Capacity
- ITO Upgrade	  	Total Usable Capacity
	HDS VSP #1	  	263 TB	  	965 TB	  	1228 TB
	HDS VSP #2	  	0	  	772 TB	  	772 TB
	Total Usable Capacity at Centennial DC	  	2 PB

 VSP Storage Disk Configuration 

VSP Storage Pool Configuration: 
  

	 	•	 	All storage pools will be configured using standard pool build layout design given in below table. 

  

					
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	 	•	 	Each Standard Pool build produce 193 TB of Usable Capacity after the raid overhead + Hot Spares. 

  

	 	•	 	Total No. of pools in VSP 1 Upgrade – 5 x 193 TB = 965 TB usable capacity 

  

	 	•	 	Total No. of pools in VSP 3 New Install—4 x 193 TB = 772 TB usable capacity 

 Standard Pool Build

  

																			
	 Tier 1 
	  	 Disk Type
	  	RAID	  	RAID
Type	  	Usable
(TB)
Ask	  	Tier (%)	  	RAID
Groups
Required	  	Usable
(TB)
Configured	  	Disks	  	HS
	Disk Tier1	  	3.2 TB Flash module Drive	  	5	  	7D+1P	  	165	  	13.00%	  	1	  	21	  	8	  	1
	Disk Tier2	  	 1.2 TB 10K rpm

SAS 2.5”
 Drive
	  	6	  	14D+2P	  		  	54.00%	  	8	  	120	  	128	  	2
	Disk Tier 3	  	 4TB

7.2Krpm NL-SAS 3.5”

Drive
	  	6	  	14D+2P	  		  	33.00%	  	1	  	52	  	16	  	2
	 HNAS VDI
 Disk
	  	 900GB

10K rpm SAS 2.5”

Drive
	  	0	  	0	  	0	  	N/A	  	0	  	0	  	0	  	0
		  		  		  		  		  		  	  
	  	  
	  	  
	  	  

											Total		71		193		564		13
		  		  		  		  		  		  	  
	  	  
	  	  
	  	  

  

					
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 Storage Infrastructure – Phoenix Data Center 

The diagram below depicts the High Level Storage and Backup architecture at Secondary DC 

 
  
 

 
 Figure: High Level Storage and Backup architecture at Secondary DC - Phoenix 

VSP Capacity Summary – Phoenix 
  

							
	 Storage Array 
	  	 Usable Capacity –

ITO Phase 1
	  	 Usable Capacity - ITO Upgrade
	  	 Total Usable Capacity

	 HDS VSP #1
	  	52 TB	  	772 TB	  	824 TB
	 Total Usable Capacity at Phoenix DC
	  	824 TB

 VSP Storage Disk Configuration 

VSP Storage Pool Configuration: 
  

	 	•	 	All storage pools will be configured using standard pool build layout design given in below table. 

  

	 	•	 	Each Standard Pool build produce 193 TB Usable Capacity after the raid overhead + Hot Spares. 

  

	 	•	 	Total No. of pools in VSP Upgrade – 4 x 193 TB = 772 TB usable capacity 

  

					
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 Standard Pool Build 
  

																			
	 Tier 1
	  	 Disk

Type
	  	 RAID
	  	 RAID Type
	  	 Usable (TB)
Ask
	  	 Tier (%)
	  	 RAID
Groups
Required
	  	 Usable (TB)
Configured
	  	 Disks
	  	 HS

	Disk Tier1	  	3.2 TB Flash module Drive	  	5	  	7D+1P	  	165	  	13.00%	  	1	  	21	  	8	  	1
	Disk Tier2	  	 1.2 TB 10K rpm

SAS 2.5” Drive
	  	6	  	14D+2P	  		  	54.00%	  	8	  	120	  	128	  	2
	Disk Tier 3	  	 4TB

7.2Krpm
 NL-SAS 3.5”
Drive
	  	6	  	14D+2P	  		  	33.00%	  	1	  	52	  	16	  	2
	 HNAS VDI

Disk
	  	 900GB

10K rpm SAS
 2.5”
Drive
	  	0	  	0	  	0	  	N/A	  	0	  	0	  	0	  	0
		  		  		  		  		  		  	  
	  	  
	  	  
	  	  

											Total		71		193		564		13
		  		  		  		  		  		  	  
	  	  
	  	  
	  	  

  

					
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 Final 
  

  
 

 
 Figure: High Level Storage Allocation 

Regional Sites – Storage Configuration 
 VSP
Capacity Summary – Centennial 
  

							
	 Storage Array
	  	 Usable Capacity –

ITO Phase 1
	  	 Usable Capacity - ITO Upgrade
	  	 Total Usable Capacity

	 HDS HUS 150
 Woodland Hills
	  	0	  	30 TB	  	30 TB
	 HDS HUS 150
 Rancho Cordova
	  	0	  	25 TB	  	25 TB
	Total Usable Capacity at Regional Sites	  	55 TB

  

					
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 Final 
  

 3.1.5.2. Service Deliverables 

 

	 	•	 	Design, build and manage scalable, reliable online and offline storage environment in the primary and secondary DC’s. 

  

	 	•	 	Logical Separation of Storage infrastructure for Federal and Commercial applications and data. 

  

	 	•	 	Storage Management Tools for live monitoring and notifications for all the Storage components in the Data center. 

3.1.5.3. Steady State Support Deliverables 
  

			
	 Solution
	  	 Description

	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24x7
Onshore support:
  

•    8x5 dedicated support – (Federal onsite) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 The high level activities of storage and backup services are described below: 

Level 1 Services: Storage 

L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
		  	 •    FC / director port monitoring

		
		  	 •    Array event monitoring

		
		  	 •    Storage array performance monitoring

		
		  	 •    Disk drives health monitoring

		
	 L1 Team
	  	 •    Array disk space capacity monitoring and reporting

		
		  	 •    Event monitoring

		
		  	 •    Storage controller Monitoring (CPU) and reporting

		
		  	 •    Where applicable, keep Health Net informed and notified on the status and progress

  

					
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 Level 2 Services: Storage 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include: 

 

	 	•	 	Incident management services 

  

	 	•	 	Change management services 

  

			
			 •    LUN/Meta device configuration (creation, deletion, allocation)

		
			 •    Host systems configuration in the array manager (addition, modification)

		
			 •    Array event analysis

		
	 L2 Team
		 •    FC / HBA configuration in the host server

		
			 •    Multi-path configuration

		
			 •    Port configuration

		
			 •    Zone configuration

		
			 •    Event analysis

 Types of incidents include following: 
  

			
	Server Monitoring
		
			 •    Storage availability

		
			 •    Space, Memory and Cache

		
	L2 Team		 •    Unauthorized / Inactive User Access

		
			 •    Backup

		
			 •    Disk space utilization

		
			 •    Security and configuration exception alerts

  

			
	Basic Administration
		
			 •    Startup/shutdowns of Storage and Backup

		
	 L2 Team
		 •    Additional Space allocation

		
			 •    Initial troubleshooting and incident management

		
			 •    Set up storage and backup auditing

 Level 3 Services: Storage 

All unknown / new errors and problems will be resolved by L3 Storage Support group. This team will work with Vendors when required. 

 

			
			 •    Storage array performance analysis

		
			 •    Hardware modification (replacement/ expansion)

		
	L3 Team		 •    FC / HBA hardware modification (replacement/ expansion)

		
			 •    Device parameter configuration

		
			 •    Fabric firmware upgrade / management

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-79		Health Net / Cognizant Confidential

 Final 
  

 3.1.5.4. Assumptions 

The following are the assumptions considered under Storage: 
  

	 	•	 	Cognizant will work with Health Net to ensure License compliance 

  

	 	•	 	Advance notice for any large project with space requirement above the 10% additional capacity Intrust 

  

	 	•	 	Federal and Commercial servers may be physically co-located in the same storage but logically separated. 

  

	 	•	 	The incumbent to supply details of current storage environment on the following during assessment phase: 

  

	 	•	 	IOPS 

  

	 	•	 	Performance 

  

	 	•	 	HUR capabilities 

  

	 	•	 	Capacity utilization 

 3.1.5.5. Dependency 

The following are the dependencies considered under Storage: 
  

	 	•	 	Detailed server level capacity requirements for the data migration 

  

	 	•	 	Application Level performance requirements 

  

	 	•	 	Health Net to facilitate access or details to the incumbent DC Storage infrastructure during the low-level Assessment/design phase to gather required information. 

3.1.5.6. Risk and Mitigations 
  

									
	 No
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	1	  	Host Compatibility Issues	  	Medium	  	High	  	Prior to the Host integration and the storage, detailed host compatibility exercise to be carried out and appropriate firmware, drivers to be installed/updated.

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-80	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.6. Backup 

Backup Infrastructure built in the Centennial DC and Phoenix DC will be utilized to meet the backup requirements for the newly built servers
and servers which are getting migrated from incumbent data center. This solution covers the design and approach for preparing the existing backup infrastructure by upgrading the backup storage capacity and adding more tape drives and tape medias in
the tape libraries. 
 Detailed Backup Infrastructure design is described in the ITO Phase 1 Solution Document. 

3.1.6.1. Solution Approach 

Cognizant will build backup pools to support ITO, which will be logically separated from Federal backup pools using dedicated VLAN. Following
upgrades or addition will be made to back environment for supporting ITO asset data backup. 
  

	 	•	 	Build infrastructure for Storage and Backup 

  

	 	•	 	Build different pools support Federal and Commercial separation 

  

	 	•	 	Dedicated VLAN for Backup for network based backup clients. 

  

	 	•	 	LAN Free (SAN-based) backups to be used for servers exceeding a defined storage capacity threshold > 600GB 

  

	 	•	 	Encryption will be enabled for data at rest 

  

	 	•	 	Design/move current processes to CTS, but for some backups we may need to adjust the process to support HNT requirments. Creating implementation Plan Procurement of required infrastructure 

 

	 	•	 	Upgrade the Sepaton Storage Capacity by adding additional SRE nodes 

  

	 	•	 	Upgrade the Tape Libraries by adding additional 99 ( 66 for Centennial and 33 for Phoenix) LTO-6 Tape Drives 

  

	 	•	 	Upgrade the Spectra Logic Tape Library to add more slots( 2300 for Centennial and 1900 for Phoenix) for a total of 4200 tapes 

  

	 	•	 	Add additional NetBackup Media Servers to handle the increased backup load 

  

	 	•	 	Add AIR+OST License and configure to use for NBU Servers and Sepaton 

  

	 	•	 	Cognizant understands that all the backup media is owned and maintaied by Iron Mountain for Health Net. Cognizant will access these backups for any restoration and proposes to retain/lift & shift small setup of
existing Incumbent Backup plaform to restore historical backup in Cognizant DC 

  

	 	•	 	Tape Libraries in Boulder, Rancho Cordova and Woodland Hills will be assessed and necessary steps will be taken for future restoration purposes 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-81		Health Net / Cognizant Confidential

 Final 
  

 Backup Environment 

Backup Software 
 Cognizant would implement Symantec
NetBackup as the data center backup and recovery technology. Symantec NetBackup 7.5 provides a comprehensive yet integrated approach to protecting data for next generation data centers. 

Backup Infrastructure Features 
  

	 	•	 	An highly agile and enterprise backup and recovery solution 

  

	 	•	 	The Sepaton’s patented Content AwareTM de-duplication technology delivers the fastest time to safety and most efficient capacity reduction of any solution available today 

 

	 	•	 	The only data protection solution that can effectively de-duplicate separate parallel backup streams (multi stream) and across multiplexed data volumes, as required for large database environments such as Oracle, DB2
and SQL 

  

	 	•	 	Delta ScaleTM architecture makes it easy to increase storage capacity and maintain performance as your needs grow 

  

	 	•	 	Enables fast and secure replication and transmission of massive backup volumes to remote disaster recovery sites over a wide area network. Replication is performed automatically 

 

	 	•	 	Byte differential Content AwareTM de-duplication reclaims storage space continuously as it operates, freeing capacity sooner and saving administration time 

 

	 	•	 	Symantec NetBackup OST features such as Auto Image Replication (A.I.R.), Optimized Synthetic Backups, GRT and Symantec NetBackup Accelerator, which we have purchased the licenses but it will be implemented in later
projects 

  

	 	•	 	Delta ScaleTM architecture’s secure multi-tenancy capability allows data managers to allocate performance, capacity bandwidth and quality of service as needed by their enterprise’s various segments,
departments and business units 

  

	 	•	 	Encrypts data at rest while maintaining its blazing fast time to safety and industry-leading backup performance (Sepaton S2100-ES3’s encryption of data at rest capability integrates with industry standard
interoperability protocols for encryption key managers (EKM) that are compliant with industry-standards) 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-82		Health Net / Cognizant Confidential

 Final 
  

 Backup Data Flow Diagram 
  

 
 Figure: Data Flow Diagram 

Backup to Tape 
 The disk-to-disk-to-tape (D2D2T)
combination allows backup administrators to have the following: keeping off-site backups in Iron Mountain location, while retaining fresh backups on disk for ultrafast restores. The D2D2T model uses a two-tiered architecture that can effectively
handle both near-line and archival data. Dual-stage disks and automated tape backup effectively address the data protection gaps and performance limitations that result when either technology is used individually, enhancing a Health Net’s
existing tape backup process. All the backups to tape and disk will be encrypted. 
 Note: Health Net will own the Iron Mountain contract and
relationship. 
 NDMP Backup 
 Symantec NetBackup
for NDMP helps provide reliable, high-performing backup and recovery services for NDMP enabled Network Attached Storage (NAS). To streamline operations, NetBackup for NDMP extends its advanced media management and virtually unlimited scalability via
the Network Data Management Protocol (NDMP). 
 NDMP facilitates communication between Symantec NetBackup for NDMP and a NDMP server application to initiate
backup and restore tasks. This communication integrates the protection of NAS into a consolidated, Data center—strength backup solution: 
 Backup
Operations 
 Support Team ( Backup Operations ) shall maintain the approved list, Backup details & policy for all the Servers , Application and
data that are to be backedup. Backup team will review backup requirement at regular intervals with HealthNet and based on the RPO & RTO. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-83		Health Net / Cognizant Confidential

 Final 
  

 Sepaton Encryption 
  

	 	•	 	Hardware-accelerated compression and encryption 

  

	 	•	 	Leverages high-performance HiFn DX 1845 to do compression and encryption in unified pipeline 

  

	 	•	 	Massive bandwidth provides compression and encryption throughput for 2 x 8Gbps Fiber Channel ports ingesting data with 100% change rate per SRE node 

 

	 	•	 	Key management is external to VTL using an OASIS KMIP-compatible key manager (or the HP proprietary Enterprise Key Manger or the SafeNet Enterprise Key Manager which are both supported by our architectural approach)

  

	 	•	 	Communication with the Key Manager is via the CryptSoft KMIP SDK 

  

	 	•	 	Provides linear scalability as SRE nodes are added to the system 

  

	 	•	 	Performs predictably - no CPU performance impact on ingest or de-duplication processing 

  

	 	•	 	All customer data is encrypted before landing on disk 

  

	 	•	 	Encryption keys never stored on disk 

 Sepaton Key Management 

Key Management Availability: The VTL only needs to access the key manager at startup. The key is cached in memory (not on disk) while the VTL is
running. At boot time the system interrogates the list of key managers (up to nine of them) to get the key. If no key manager responds, the system goes into maintenance mode. You can safely take key managers down for system maintenance once the
Sepaton system has retrieved the key. 
 For security reasons, the VTL never stores the key on disk. It always checks for a key on reboot so that IT
can revoke the key (or more commonly) disable the key manager in the event of a data center-wide security intrusion. If this were to happen, shut down the key manager and reboot the VTL to prevent access to live data on the VTL. 

Spectrologic Encryption 
 Spectra logic will be using
Spectra BlueScale encryption key management. Spectra Logic BlueScale encryption key management provides an easy-to-use interface that lets Cognizant to quickly implement Spectra Logic encryption. The key is automatically handled in multiple software
layers, as well, so it is not apparent to the end user. LTO tape drives use AES-256 bit encryption keys generated within BlueScale to encrypt data. This data cannot be read until it is decrypted, which requires the use of the same key that was used
during data encryption. This kind of encryption requires creation, tracking and protection of the encryption keys. The life cycle of a BlueScale encryption key includes the following stages: 

 

	 	•	 	Encryption User Definition 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-84		Health Net / Cognizant Confidential

 Final 
  

	 	•	 	Key Creation/Deletion 

  

	 	•	 	Key Escrow 

  

	 	•	 	Key Use in Data Encryption/Decryption 

 The following encryption type will be used: 

 

	 	•	 	Professional (32 keys) 

 Note: See the following link for more details on Spectra logic encryption: 

(https://www.spectralogic.com/index.cfm?fuseaction=home.displayFile&DocID=1902) 

Backup Overview – Primary DC (Centennial) 
  

	 	•	 	The expanded backup solution to support ITO at Centennial DC will be utilized to protect the Federal and Commercial servers either moving from incumbent DC’s or installed in Centennial DC 

 

	 	•	 	Federal and Commercial backup data will be logically separated by creating separate backup pools at Sepaton and Tape Library. 

  

	 	•	 	Cognizant to implement A.I.R (auto image replication) with the Sepaton device, which allows DC1 Sepaton to replicate to DC2 Sepaton. For now, the design will have the data moved from source via dedicated backup VLAN or
LAN-Free to the Sepaton device where it utilize tools like de-duplication and compression. Once it has arrived in the Sepaton the data will be laid out in a pre-defined structure (LLD – low level design phase). After the data meets pre-defined
qualification (LLD – Low level design phase) the data then will be moved to the Spectra logic to either a Federal pool or Commercial pool. Lastly, in the Spectra Logic device will have pre-defined qualification (during LLD) to move the tape to
a remote location using Iron Mountain. 

  

	 	•	 	Add 3 NBU Media Servers to the existing backup infrastructure ( 2 for Commercial and 1 for federal ) 

  

	 	•	 	Upgrade the Sepaton Storage by adding SRE nodes and controller to provide additional 600 TB Backup Storage. 

  

	 	•	 	Upgrade the SpectraLogic Tape Library by adding 2300 Tape Slots and 66 LTO-6 FC Tape Drives. 

 NBU Appliance
Sizing 
  

													
	 Component
	  	ITO Phase 1 Sizing	 	  	ITO Upgrade	 	  	Total	 
	 NBU Master Server
	  	 	1	  	  	 	0	  	  	 	7	  
	 NBU Media Servers
	  	 	3	  	  	 	3	  	  
	 NBU License
	  	 	40 TB	  	  	 	960 TB	  	  	 	1000 TB	  

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-85	  	Health Net / Cognizant Confidential

 Final 
  

 Sepaton Storage Sizing 
  

							
	 Component
	  	 ITO Phase 1 Sizing
	  	 ITO Upgrade
	  	 Total

	 Sepaton Capacity
	  	114 TB	  	600 TB	  	714 TB

 SpectraLogic Tape Library Sizing 
  

							
	 Component
	  	 ITO Phase 1 Sizing
	  	 ITO Upgrade
	  	 Total

	 T950 Tape Slots

	  	700	  	2300	  	3000
	 LTO-6 FC Tape Drives
	  	16	  	66	  	82

 Backup Overview – Secondary DC (Phoenix) 
  

	 	•	 	The expanded backup solution to support ITO at Phoenix DC will be utilized to protect the Federal and Commercial servers either moving from incumbent DC’s or installed in Phoenix DC. 

 

	 	•	 	Federal and Commercial backup data will be logically separated by creating separate backup pools at Sepaton and Tape Library. 

  

	 	•	 	Cognizant to implement A.I.R (auto image replication) with the Sepaton device, which allows DC1 Sepaton to replicate to DC2 Sepaton. For now, the design will have the data moved from source via dedicated backup VLAN or
LAN-Free to the Sepaton device where it utilize tools like de-duplication and compression. Once it has arrived in the Sepaton the data will be laid out in a pre-defined structure (LLD – low level design phase). After the data meets pre-defined
qualification (LLD – Low level design phase) the data then will be moved to the Spectra logic to either a Federal pool or Commercial pool. Lastly, in the Spectra Logic device will have pre-defined qualification (during LLD) to move the tape to
a remote location using Iron Mountain. 

  

	 	•	 	Add 2 NBU Media Servers to the existing backup infrastructure ( commercial and federal ) 

  

	 	•	 	Upgrade the Sepaton Storage by adding SRE nodes and controller to provide additional 418 TB Backup Storage. 

  

	 	•	 	Upgrade the SpectraLogic Tape Library by adding 1900 Tape Slots and 33 LTO-6 FC Tape Drives. 

 NBU Appliance
Sizing 
  

							
	 Component
	  	 ITO Phase 1 Sizing
	  	 ITO Upgrade
	  	 Total

	NBU Master Server	  	1	  	0	  	5
	NBU Media Servers	  	2	  	2	  
	NBU License	  	10 TB	  	590 TB	  	600 TB

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-86	  	Health Net / Cognizant Confidential

 Final 
  

 Sepaton Storage Sizing 
  

							
	 Component
	  	 ITO Phase 1 Sizing
	  	 ITO Upgrade
	  	 Total

	Sepaton Capacity	  	54 TB	  	418 TB	  	472 TB

 SpectraLogic Tape Library Sizing 
  

							
	 Component
	  	 ITO Phase 1 Sizing
	  	 ITO Upgrade
	  	 Total

	T950 Tape Slots	  	100	  	1900	  	2000
	LTO-6 FC Tape Drives	  	6	  	33	  	39

 3.1.6.2. Service Deliverables 
  

	 	•	 	Design, build and manage scalable, reliable online and offline storage environment in the primary and secondary DCs 

  

	 	•	 	Logical separate Backup setup for Federal and Commercial applications and data 

  

	 	•	 	Deploy Disk-to-Disk backup and Disk-to-Tape data vaulting 

  

	 	•	 	Encryption for data at rest by leveraging the Sepaton and SpectraLogic encryption mechanism. 

  

	 	•	 	Tape Offsite Management for long term retention and retrieval. 

 3.1.6.3. Steady State
Support Deliverables 
  

			
	 Solution
	  	 Description

	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24x7
Onshore support:
  

•    8x5 dedicated support – (Federal onsite) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net offices

 
 •    Offshore –
Bangalore (India) ; Coimbatore (India)

 Level 1 Services: Backup and Recovery 

L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
		  	 •    Proactive monitoring and management of the backup environment (Client / Catalog Backup
Jobs)

		
		  	 •    Troubleshooting and preliminary investigations of problem tickets

		
	 L1 Team
	  	 •    Unresolved tickets escalating to L2 team ( whenever necessary )

		
		  	 •    Updating the problem tickets as per the observations and preliminary investigations

		
		  	 •    Monitoring backup server logs, OS logs, alert logs, event logs.

		
		  	 •    Maintaining and updating the log register

		
		  	 •    Monitoring of Scratch Pools

  

					
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 Final 
  

 Level 2 Services: Backup and Recovery 

L2 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
			 •    Updating operation handbook / Run books.

		
			 •    Automation of backup jobs through scripting

		
			 •    Updating the design documents with respect to changes implemented

		
	 L2 Team
		 •    Troubleshooting, configuration management, Implementing changes

		
			 •    Restarting of failed backup jobs or running the jobs manually (whenever required)

		
			 •    Client configuration or de-configuration support

		
			 •    Coordinate hardware and software vendor technical support

		
			 •    Master / Media server configuration

 Level 3 Services: Backup and recovery 

L3 Services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
			 •    Hardware configurations (Tape, Drive, VTL, etc.)

		
			 •    Handle backup / Restore requests

		
			 •    Create / delete / modify storage pools

		
	 L3 Team
		 •    Diagnosing, analyzing, performance management and capacity planning

		
			 •    Configuring backup/Recovery policies and maintaining record of changes to policies

		
			 •    Implementing best practices and recommendations (Data Depute)

		
			 •    Resolving escalated issue and creating the K.E.D.B. Conducting Root Cause Analysis (RCA) on Severity 1/2
issues

 3.1.6.4. Assumptions 

The following are the assumptions considered under Backup: 
  

	 	•	 	Health Net to provide and own the Iron Mountain contract for Tape offsite management. 

3.1.6.5. Dependency 
 The
following are the dependencies considered under Backup: 
  

	 	•	 	Health Net to perform acceptance testing and sign-off on the following: 

  

	 	•	 	Backup Performance (LAN and LAN-Free) 

  

	 	•	 	RTO and RPO 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-88		Health Net / Cognizant Confidential

 Final 
  

 3.1.6.6. Risk and Mitigations 

 

									
	 No
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	1	  	Host Compatibility Issues	  	Medium	  	High	  	Prior to the Backup Client configuration, detailed host compatibility exercise to be carried out to rule out compatibility issues between backup software, host operating system and application software’s. Necessary
Firmware/Drivers to be updated.

 3.1.7. Middleware 

3.1.7.1. Solution Approach 

The future architecture of the middleware will be similar to the current setup. Below is the overall environment that Cognizant will setup and
manage 
  

	 	•	 	WebLogic servers 

  

	 	•	 	IIS 

  

	 	•	 	BizTalk 

  

	 	•	 	Apache 

  

	 	•	 	Site Minder 

  

	 	•	 	Oracle Service Bus 

 Cognizant strategy towards middleware migration will be to continue the
same architecture and schematics at the start of the engagement. The basic approach will be to maintain the same cluster environment and configurations at the application level. 

The current Middleware landscape in Health Net ITO environment is illustrated below: 

 

			
	 Current Landscape in Health Net

	 Technology
	  	 No of Instances

	 WebLogic 7.0, 8.1, 8.1.5, 9.1, 9.2, 10.0.1, 11gR1
	  	200
	 IIS 5.x, 6.x, 7.x
	  	100
	 BizTalk
	  	10

 As per Health Net technology road map the existing TIBCO applications are to be migrated to WebLogic gradually.
Cognizant is planning for AS IS migration from existing Data Center to the cognizant Data Centers. 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-89	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.7.2. Service Deliverables 

 

	 	•	 	Build , Migrate and support the Middleware environment 

  

	 	•	 	Create and maintain Design, Build and Run book documents 

 3.1.7.3. Steady State Support
Deliverables 
  

			
	 Solution
	  	 Description

	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore

 The high level activities for Middleware services are mentioned below: 

Level 1 Services 
 L1 Services will be provided in
accordance with the procedures documented in the SOPs and will include the following: 

			
		
		  	 •    Logging and Tracking requests

 
 •    Contribute
information to knowledge base

		
		  	 •    Perform initial troubleshooting to determine the nature of the issue

		
		  	 •    Create ticket and log all troubleshooting steps performed

		
	 L1 Team
	  	 •    Escalate unsolved issue to Level -2

		
		  	 •    Direct call handling from Health Net – Service request

		
		  	 •    Start/stop instances

		
		  	 •    Deploy applications

		
		  	 •    Check build logs

		
		  	 •    Web/App server Instance/Cluster Member creation through Automated Scripts

		
		  	 •    Deploying Applications via Automated Scripts

		
		  	 •    Validating Prerequisites

		
		  	 •    Web /app Server Installation via Automated Scripts

 
 •    Web/App Server
Checklist/verification via Defined Process

  

					
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 Final 
  

			
			 •    Check Build Logs

		
			 •    Web/App server Performance Monitoring / Perform incident analysis

		
			 •    Generating Performance reports from log files

		
			 •    Generate reports/ Distribute reports

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

			
			 •    Create and modify build script

		
			 •    Diagnose common build and deploy problems

		
			 •    Analyzing performance reports

		
			 •    Web/application server performance monitoring

		
			 •    SSL configuration and certificate management

		
			 •    Create Environment Map

		
			 •    Perform Build and Deployments

		
			 •    Diagnose Common Build/Deploy Problems

		
			 •    Web/App server Performance Monitoring

		
	 L2 Team
		 •    Analyzing Performance reports

		
			 •    Integrating Webserver for Single Sign On functionality

		
			 •    SSL Configuration and Certificate Management

		
			 •    Install and Configure other Tools commonly used/ Supporting Other Tools

		
			 •    Report analysis

		
			 •    Contribute information to knowledge base

		
			 •    Identification of improvement opportunities

		
			 •    Working with OEM/3rd party vendors for problem resolution and break fix resolutions

		
			 •    Escalate any technical problem to L3 team when necessary

		
			 •    Implementation of Service improvement plan / Best practices

		
			 •    Create and update KEDB (Knowledge Event Database).

		
			 •    Hardening of servers

  

					
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 Level 3 Services 

All unknown / new errors and problems will be resolved by L3 Middleware Support group. This team will work with Vendors when required. 

 

			
			 •    Java/Admin Console Administration - Advanced Administration

		
			 •    Writing/Updating Webserver/web-Application start, stop scripts / Creating WAS Image

		
			 •    Work on Severity 1/critical incidents

		
			 •    Work on Incidents escalated by L2 team and document the resolution for future references

		
	 L3 Team
		 •    Shell / Perl scripting with respect to Web/App server Admin Tasks

		
			 •    Creating Ant/JACL/JAYTHON scripting with respect to Web/App server Admin Tasks

		
			 •    Heap Dump/ Java Core File Analysis

		
			 •    Web/App server Performance Tuning / Capacity planning

		
			 •    Web/App Server Migration

		
			 •    Diagnose Critical Build/Deploy Problems

		
			 •    Patch Administration - Selecting the Patch/Downloading/Applying/Testing for the First Time

		
			 •    Minimizing downtime by checking planned maintenances and new implementations

		
			 •    Planning and implementation of Continuous improvement Plan

		
			 •    DR Planning

		
			 •    Cluster Design

		
			 •    Taking Change Board Approval

		
			 •    Define standards / Define strategy

		
			 •    Review and Approve information submitted to knowledge base

		
			 •    Knowledge gap analysis

		
			 •    Identification of improvement opportunities

 3.1.7.4. Assumptions 

The following are the assumptions considered under Middleware: 
  

	 	•	 	Target versions of Middleware components will be same as current environment. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-92		Health Net / Cognizant Confidential

 Final 
  

 3.1.8. Directory Services 

3.1.8.1. Solution Approach 

Current Architecture 

Health Net has three forests HEALTHNET.COM, EXT.HEALTHNET.COM and FS.EXT.HEALTHNET.COM. HEALTHNET.COM is an internal forest and has 3 child
domains HNCORP.HELATHNET.COM, FS.HEALTHNET.COM and RMT.HEALTHNET.COM as shown in the diagram below: 
  
 

 
 Figure: Health Net Architecture 

HEALTHNET.COM has no resource or user in it and for administrative use only. HNCORP is used for corporate and subsidiary users. FS is used for Federal users.
EXT.HEALTHNET.COM, FS.EXT.HEALTHNET.COM, and RMT.HEALTHNET.COM are placed in DMZ for outside facing web and application servers. PRE, DEV, SYS, QAS, and TST are development environments and a replica of production. 

Target Architecture 
 To meet the HealthNet Security and
compliance requirement , Cognizant proposes a new active directory architecture to meet HealthNet Commerical and Federal requirement. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-93		Health Net / Cognizant Confidential

 Final 
  

 The Below diagram details the Proposed new AD Architecture 

 
 

 
 Proposed AD logical Architectue in Primary ( Centennial) Datacenter 

 
 

 
 Figure: Proposed AD Architecture in Primary DC 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-94		Health Net / Cognizant Confidential

 Final 
  

 Proposed AD logical Architectue in Primary ( Phoenix) Datacenter 

 
  
 

 
 Figure: Proposed AD Architecture in Secondary DC 

Cognizant would build new Active directory in both datacenter which meets the security guidelines outlined by Health net Security Team (InfoSec Team). Active
directory solution is detailed in the Security Solution document HN_CTS_SOW4(IT)_Ex_A-3-3(security solution) 
 3.1.8.2. Service
Deliverables 
  

	 	•	 	Design, Build the Directory services in cognizant DC 

  

	 	•	 	Transfer all FSMO roles (Active Directory specific roles) to new domain controllers 

  

	 	•	 	Create and maintain Build and Run book documents 

  

	 	•	 	Testing and Validate replication of Active Directory objects to new domain controllers 

  

	 	•	 	Support the Windows CA’s integrated with AD for internal PKI which Health Net leverages 

3.1.8.3. Steady State Support Deliverables 
  

			
	 Solution
	  	 Description

	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope
activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery Location	  	 •    Onsite—Health Net Offices

 
 •    Offshore –
Bangalore

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-95	  	Health Net / Cognizant Confidential

 Final 
  

 Cognizant directory service support team will organize in L1 / L2 / L3 groups providing monitoring and
management services. This team will be a part of the overall platform services team and not an isolated separate tower. The delivery model for Directory Services platform is covered in the above section no. 3.1.4.3. 

The high level activities for Directory services are mentioned below: 

Support Services 
  

			
			 •    Logging and Tracking requests

		
			 •    Perform initial troubleshooting to determine the nature of the issue

		
			 •    Create ticket and log all troubleshooting steps performed

		
			 •    Escalate unsolved issue to Level -2

		
			 •    User Administration

		
	L1/L2/L3 Team		 •    Management and creation of policies, rules and permissions

		
			 •    Password reset / Account management

		
			 •    Create/modify group

		
			 •    Create/Modify GPO

		
			 •    Adding new RIS/WDS/SMS OS images

		
			 •    Management of schema , site services , replication , group policy

		
			 •    Create/manage Site links / trust / inter forest trusts / OU structure

		
			 •    Working with OEM/3rd party vendors for problem resolution and break fix resolutions

		
			 •    Escalate any technical problem to L3 team when necessary

		
			 •    Implementation of Service improvement plan / Best practices

		
			 •    Create and update KEDB (Knowledge Event Database).

		
			 •    Generate reports/ Distribute reports

		
			 •    Delegate permission /

		
			 •    Designing the Group Policy requirements

		
			 •    Participation in the CAB / Architecture Board

		
			 •    Backup and restore of objects

			 •    

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-96		Health Net / Cognizant Confidential

 Final 
  

 3.1.8.4. Assumptions 

The following are the assumptions considered under directory services: 

 

	 	•	 	Novel eDirectory and Sun One Directory Services shall be removed ( decommissioned) from the Health Net system 

  

	 	•	 	Existing domain controllers are running on Windows Server 2003 or 2008 R2 

 3.1.8.5.
Dependency 
 The following are the dependencies considered under directory services: 

 

	 	•	 	Application migration needs to be done by respective application owners 

  

	 	•	 	Application testing if any needs to be performed by application teams due to change in AD Schema 

  

	 	•	 	Directory services depends on DNS heavily, as Health Net is using Infoblox appliance it should be migrated first. 

3.1.8.6. Risk and Mitigations 
  

									
	 S.No
	  	 Risk Description
	  	 Probability
	  	 Impact
	  	 Mitigation Strategy

	1	  	New domain structure might cause issues with applications dependent on directory services	  		  		  	The applications compatibility must be thoroughly tested against the New AD in dev/test environment before moving on to production

 3.1.9. DNS/DHCP 

3.1.9.1. Solution Approach 

Current Architecture 

Health Net currently has a mix of Windows and INFOBLOX appliance for DNS and DHCP service. Cognizant understands the decommission plan of
windows servers (if required) and all DNS and DHCP services into INFOBLOX. 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-97	  	Health Net / Cognizant Confidential

 Final 
  

 DNS and DHCP service has been segregated for commercial and federal segments for internal DNS
and DHCP requests. These are configured in pairs of redundancy. Boulder data center holds the primary service and geographical redundancy has been added at Gold Pointe for commercial and at Aerojet for Federal. Additional appliance has been placed
for caching internet bound DNS queries. 
 External DNS Nameserver are placed in DMZ for DNS queries by external clients, holds secondary
external zones and do not allow recursion or dynamic DNS updates. 
 Target Architecture 

Cognizant Centennial data center will replicate the DNS and DHCP service architecture using Infoblox appliance. All existing DNS zones and DHCP
scopes will be carried forward as is. Count of Infoblox appliance will be maintained as per current setup. 
 3.1.9.2. Service
Deliverables 
  

	 	•	 	Implement and support DNS/DHCP 

  

	 	•	 	Create and maintain Build and Run book documents 

 3.1.9.3. Steady State Support
Deliverables 
  

			
	 Solution
	  	 Description

		
	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore

 Cognizant DNS/DHCP support team will organize in L1 / L2 / L3 groups providing monitoring and management services. This team
will be a part of the overall platform services team and not an isolated separate tower. The delivery model for Directory Services platform is covered in the above section no. 3.1.4.3. 

The high level activities for the support services are mentioned below: 
  

			
		  	 •    Logging and Tracking requests

		
	 L1/L2/L3
 Team

	  	 •    Perform initial troubleshooting to determine the nature of the issue

		  	 •    Create ticket and log all troubleshooting steps
performed

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-98	  	Health Net / Cognizant Confidential

 Final 
  

			
			 •    Configure/manage DNS

		
			 •    Adding new forward and reverse lookup zone

		
			 •    Transferring DNS zones

		
			 •    Adding/remove resource records

		
			 •    Configure/Manage DHCP

		
			 •    Modifying/manage existing scope

		
			 •    Mapping subnet to site

		
			 •    Working with OEM/3rd party vendors for problem resolution and break fix resolutions

		
			 •    Escalate any technical problem to L3 team when necessary

		
			 •    Implementation of Service improvement plan / Best practices

		
			 •    Create and update KEDB (Knowledge Event Database).

		
			 •    Generate reports/ Distribute reports

 3.1.9.4. Assumptions 

The following are the assumptions considered under DNS/DHCP: 
  

	 	•	 	DNS/DHCP in Windows server shall be decommissioned at Cognizant Data Centre. 

 3.1.9.5.
Dependency 
 The following are the dependencies considered under DNS/DHCP: 

 

	 	•	 	Current configurations on Infoblox appliances need to be shared by the incumbent vendor 

  

	 	•	 	Appropriate changes to be done on routers/switches to allow communication between clients and new Infoblox appliance for DHCP 

  

	 	•	 	Application testing (if DNS server IP is hardcoded ) needs to be performed by application teams due to change in DNS server 

  

	 	•	 	Health Net to decide about decommissioning of existing appliances and DNS/DHCP servers in IBM Boulder data center. 

3.1.9.6. Risk and Mitigations 

The applications compatibility must be thoroughly tested against the new DNS server in dev/test environment before moving on to production.

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-99		Health Net / Cognizant Confidential

 Final 
  

 3.1.10. Messaging and Collaboration 

3.1.10.1. Solution Approach 

The Health Net current email infrastructure consists of IBM Lotus Notes on Solaris and Windows 2000/2003 platform. Cognizant strategy towards
Lotus Notes migration will be to continue the same As-is architecture. The basic approach shall be to migrate the existing lotus notes environment from incumbent DC to cognizant DC on new solaris platform. 

 

	 	•	 	Provide system administration services including mailbox administration, add/move/delete, mailbox permissions, and creation of distribution lists and owners 

 

	 	•	 	Perform application upgrades for messaging environment (e.g., service packs, hot fixes, and version/currency upgrades) 

  

	 	•	 	Continue to use AXS-one for email archiving messages 

 E- mail Archiving - Lotus Notes Archival

  

	 	•	 	AXSone (AXS-One Archiving System 3.9 ) which is currently used by Health Net for Archiving solution and also for integrity, security, privacy and retention policy will be migrated to Cognizant datacenter

 Current Archive Data count is : 
  

			
	Number of Archive Files	  	~50 TB

 3.1.10.2. Service Deliverables 

 

	 	•	 	Design , Build , migrate the Lotus Notes messaging environment 

  

	 	•	 	Create and maintain Design, Build and Run book documents 

  

	 	•	 	Support for Good, Video Conferencing & Same Time services 

 3.1.10.3. Steady State
Support Deliverables 
  

			
	 Solution
	  	 Description

	Solution Highlights	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	Support Coverage	  	 •    24x7 dedicated support – Offshore/Onsite (Commercial) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on
call

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-100	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Solution
	  	 Description

	Delivery Location	  	 •    Onsite - Health Net Offices

 
 •    Offshore –
Bangalore

 The high level activities for Directory services are mentioned below: 

Level 1 Services 
 L1 Services will be provided in
accordance with the procedures documented in the SOPs and will include the following: 
  

			
		  	 •    Logging and Tracking requests

		
		  	 •    Perform initial troubleshooting to determine the nature of the issue

		
		  	 •    Create ticket and log all troubleshooting steps performed

		
		  	 •    Escalate unsolved issue to Level -2

		
	L1 Team	  	 •    Mailbox management – create/modify/delete

		
		  	 •    Create/modify/delete DL

		
		  	 •    E Mail Queue—Manual/automated

		
		  	 •    Establishing Mail Quotas

		
		  	 •    Moving User Mail Files

		
		  	 •    Restarting the Router

		
		  	 •    Setting a user for Mail Archiving

		
		  	 •    Managing Roaming Users

		
		  	 •    Creating/ Renaming/ Deleting Groups

		
		  	 •    Generate reports/ Distribute reports

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

			
		  	 •    Move mailbox between servers / stores

		
		  	 •    Check the database White space

		
		  	 •    Configure mailbox settings manually

		
	L2 Team	  	 •    Troubleshoot Email delivery issues

		
		  	 •    Create /Delete /Modify PFs

		
		  	 •    Backup administration of database and logs. Online and
offline

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-101	  	Health Net / Cognizant Confidential

 Final 
  

			
		
			 •    Message Tracking / Mail queue analysis / Incoming and outgoing mail traffic

		
			 •    Creating Replicas on Multiple Servers

		
			 •    Creating an Organizational Policy

		
			 •    Implementing Mail Delivery Controls / Transfer Controls

		
			 •    Implementing Blacklist Tag and Whitelist Tag Mail Rule Conditions

		
			 •    Setting up Message Tracking

		
			 •    Setting up Message Recall

		
			 •    Extending an Notes ID Expiration Date

		
			 •    Changing a User’s Location Within the Organizational Hierarchy

		
			 •    Working with OEM/3rd party vendors for problem resolution and break fix resolutions

		
			 •    Escalate any technical problem to L3 team when necessary

		
			 •    Implementation of Service improvement plan / Best practices

		
			 •    Create and update KEDB (Knowledge Event Database).

			

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 Support group. This team will work with Vendors when required. 
  

			
			 •    Work on Severity 1/critical incidents

		
			 •    Work on Incidents escalated by L2 team and document the resolution for future references

		
	L3 Team		 •    Patch Administration—Selecting the Patch/Downloading/Applying/Testing for the First
Time

		
			 •    Review and Approve information submitted to knowledge base

		
			 •    Knowledge gap analysis

		
			 •    Identification of improvement opportunities

 3.1.10.4. Assumptions 

The following are the assumptions considered under messaging and collaboration: 

 

	 	•	 	Incumbent to provide AD and Mail related permissions to Cognizant consultant during migration. 

  

	 	•	 	In Notes Domino there are approx. 15,135 user mailboxes. 

  

	 	•	 	There is ~50 TB data present in current archival solution, only these data can be considered for migration. 

  

	 	•	 	Cognizant team will work in coordination with Health Net team to finalize the schedule for each migration. 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-102		Health Net / Cognizant Confidential

 Final 
  

 3.1.10.5. Dependency 

The following are the dependencies considered under messaging and collaboration: 

 

	 	•	 	Current Lotus Notes Architecture and configuration documentation for assessment 

  

	 	•	 	Access to Lotus Notes environment to Cognizant team for assessment activities 

  

	 	•	 	Transfer of the email archival data to Cognizant 

 3.1.10.6. Risk and Mitigations 

 

					
	 Risks
	  	 Impact
	  	 Mitigation

	Clearly defined business requirements and objectives for target platform	  	Medium	  	Cognizant would work closely with Health Net to capture the business requirements and objectives of the target platform
			
	Loss of data and/or business continuity during migration effort	  	High	  	This is a residual risk and can be managed by good programme communication and escalation processes
			
	Migration preparation activities will not finish on time for planned migration	  	High	  	This activity will run parallel to design, build and validate and will be placed on the critical path of the project plan

 3.1.11. Monitoring Tools 

3.1.11.1. Solution Approach 

Cognizant’s Tools solution is designed to achieve an end state that integrates three key components of the tooling landscape, namely
Service Assurance, Service Management and Service Automation. This core tooling capability is supplemented by a comprehensive reporting solution. 

In order to achieve the above stated objective in the most cost efficient manner, Cognizant will use existing available tools where possible
while bringing additional products to replace tools owned by incumbent that will not be available or fill the gaps in the current environment. The deployment of tools is planned in full synchronization with the data center migrations. This will
ensure availability of full functionality tools platform for the data center management teams enabling them to work with effective collaboration while at the same time ensuring that there is no impact to the existing services – irrespective of
these being delivered form the existing or new data centers. 

  

					
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 Final 

 The key improvements brought about by the Cognizant solution are: 

 

	 	•	 	Consolidation of multiple tools providing similar functionality in to single too wherever possible 

  

	 	•	 	Full integration of all system monitoring in to a single-pane-of-view event manager acting as Manager of Managers 

  

	 	•	 	Automation of ticket generation in to ServiceNow ITSM based on filtered and qualified alerts 

  

	 	•	 	Integration of tools to a reporting engine enabling automated dashboard based reporting. 

Solution consideration 

Scope of monitoring solution are based on following component 
  

	 	•	 	100 transactions for Business applications 

  

	 	•	 	50 URL monitoring 

  

	 	•	 	System monitoring includes 2400 Primary and 675 Fail-over servers 

  

	 	•	 	1250 Network Devices 

  

	 	•	 	Citrix Application instance—194 

  

	 	•	 	MS SQL Database instance- 65 Active and 30 Failover 

  

	 	•	 	MS Active directory instance- 5 Active and 5 Failover 

  

	 	•	 	Oracle Database instance—320 Active and 100 Failover 

  

	 	•	 	Weblogic Application instance—400 Active and 210 Failover 

  

	 	•	 	BizTalk Server instances—15 Active and 10 Failover 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-104		Health Net / Cognizant Confidential

 Final 
  

 Tool Landscape 

Cognizant’s enterprise monitoring tools solution which has immense flexible and scalable architecture to support strategic requirement.
Below diagram provides the overall Tools logical architecture. 
  
  

 
 Figure: Tools Landscape 

Following table provides the details of various tools that will be deployed for monitoring application and infrastructure services. 

 

					
	 Technology
	  	 Availability Monitoring
	  	Performance Monitoring
(Used for Capacity Mgmt.)
	 Business
 Applications
	  	HP BSM – BPM	  	HP Service Health Reporter
			
	URLs	  	HP SiteScope	  	HP Service Health Reporter
			
	Operating System	  	HP OML	  	HP Service Health Reporter
			
	Network Device	  	HP NNMi	  	HP Service Health Reporter
			
	Physical Server	  	Cisco UCS manager	  	
			
	vSphere	  	vCenter	  	HP OM VSPI and vCenter
			
	Storage	  	Hitachi Tuning Manager	  	Hitachi Tuning Manager

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-105	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Technology
	  	 Availability Monitoring
	  	Performance Monitoring
(Used for Capacity Mgmt.)
	NetBackup	  	 Symantec NetBackup

OpsCenter
	  	Symantec NetBackup
			
	 Virtual Disk
 Libraries
	  	Delta View manager	  	Sepaton
			
	 Tape Disk
 Libraries
	  	Blue scale	  	Spectra logic
			
	VCloud Enterprise	  	Cloud 360	  	Cloud 360
			
	Database	  	 Oracle Enterprise
 Manager (OEM) 12c
	  	Oracle Enterprise Manager
 (OEM) 12c

 Note: Current Sniffer Solution (NAM 2320) is applicable to the Data Center. For the remote sites, the
expectation is that the incumbent will continue to support those sites with the existing Sniffer available at those sites. During Phase 2 LLD discussions and Remote Site Support transition process, additional sniffer requirement for these Sites will
be assessed and planned 

  

					
	SOW#4 (Information Technology) Ex A-3-2	  	A-3-2-106	  	Health Net / Cognizant Confidential

 Final 
  

 High Level ESA Tools Solution 

The figure below depicts the representation of the overall tools integration and IT user’s operation model 

 
  
 

 
 Figure: Operation Model 

 

	 	•	 	HP tools will be integrated with HP Omi using built-in adaptors and other monitoring tools will be integrated with HP Omi through SNMP traps 

 

	 	•	 	All the events from individual monitoring tools will be directed to HP Omi (MoM) 

  

	 	•	 	Performance data from HP OML and HP NNM will be directed to HP Service Health Reports (includes SPI performance report) 

  

	 	•	 	Cognizant’s IT operations team will leverage HP Service Health Reporter to analyze Operating System, Database, Applications, Virtualization and Network performance 

 

	 	•	 	HP Service Health report has a capability to capture historical data for a year to perform trend analysis 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-107		Health Net / Cognizant Confidential

 Final 
  

 Proposed Tools Architecture for Federal Network 

 
  
 

 
 Figure: Tools Architecture – Federal Network 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-108		Health Net / Cognizant Confidential

 Final 
  

 Proposed Tools Architecture for Commercial Network 

 
  
 

 
 Figure: Tools Architecture – Commercial Network 

Proposed Tools Architecture for Development 
  

 
 Figure: Tools Architecture—Development 

  

					
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 Final 
  

 3.1.11.2. Service Deliverables 

 

	 	•	 	Implementation of business applications from an end user perspective using HP Business Service Management – BPM module (Federal, Commercial and Development) 

 

	 	•	 	System and application monitoring using HP Operation Manager for Linux (Federal, Commercial and Development) 

  

	 	•	 	Following Application specific monitoring are part of Systems monitoring (Federal, Commercial and Development) 

  

	 	•	 	Oracle Enterprise Manager Cloud Control 12c, with plug-ins installed to monitor other database technologies and to implement Oracle 12c as standard 

 

	 	•	 	Database monitoring using HP OM MS SQL and Oracle Database SPI 

  

	 	•	 	Citrix monitoring using HP OM Citrix SPI 

  

	 	•	 	Weblogic Application monitoring using HP OM Weblogic SPI 

  

	 	•	 	TIBCO monitoring using HP OM TIBCO SPI 

  

	 	•	 	IIS and BizTalk server monitoring using HP OM MS Enterprise Server SPI 

  

	 	•	 	Virtualization monitoring using HP OM VSPI (vSphere) 

  

	 	•	 	Network availability and performance monitoring using HP Network Node Manager and iSPI (Federal, Commercial and Development) 

  

	 	•	 	Gathering and consolidation of system, network performance and business applications metrics using HP Service Health Reporter (Federal, Commercial and Development) 

 

	 	•	 	Centralized Event Integration using HP OMi for element management systems or domain tools (HP OML, HP NNMi, Citrix Edge sight, Hitachi Tuning Manager, Sepaton, Spectra logic, Symantec NetBackup, Cloud360, Cisco UCS
manager and vCenter) 

  

	 	•	 	Event Correlation and Analysis tool (HP OMi) integration with IT Service Management (ServiceNow) using Applink adapter 

  

	 	•	 	IT Operation End user Training in HP BSM 

 3.1.11.3. Steady State Support Deliverables

  

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery
 Location
	  	 •    Onsite —Health Net Offices

 
 •    Offshore –
Bangalore

  

					
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 Final 
  

 Tools Support Services 

Tools support services will be provided in accordance with the procedures documented in the SOPs and will include the following: 

 

			
			 •    Support tools environment

		
			 •    Configure and troubleshooting agents in new environment

		
	 Tools Support

Team
		 •    Monitoring and tuning the alert parameters

		  

•    Analysis, reduction event correlation, suppress duplicate alerts

		
			 •    Report preparation and analysis

		
			 •    Automatic trouble ticket generation for error conditions

 3.1.11.4. Assumptions 

The following are the assumptions considered under monitoring tools: 
  

	 	•	 	Proposed effort are limited to out of box implementation and no customization 

  

	 	•	 	Separate Element Managers and Event Correlation analysis solutions for Federal and Commercial network 

  

	 	•	 	Prototype for each monitoring components will be configured in development stage 

  

	 	•	 	Assuming VMware environment is designed with Vmotion for HA 

  

	 	•	 	Solution designed in High availability for Commercial network considering the inventory distribution 

3.1.11.5. Dependency 
 The
following are the dependencies considered under monitoring tools: 
  

	 	•	 	Active Directory support team’s involvement is required to integrate Active Directory and Key monitoring tools like HP SHR, HP OMi (but not limited to) to manage the user access 

3.1.11.6. Risk and Mitigations 
  

	 	•	 	Non availability of Health Net locations to deploy synthetic monitoring probes 

  

					
	SOW#4 (Information Technology) Ex A-3-2		A-3-2-111		Health Net / Cognizant Confidential

 Final 
  

 3.1.12. VoIP 

3.1.12.1. Solution Approach 
 Guiding
Principles 
 The VoIP program strategy is being designed around certain key principles as mentioned below, which aims to minimize the business impact,
and improve efficiency of the Voice solution. The Cognizant’s solution is balanced and aligned to meet Health Net’s goals and objectives. 
  

	 	•	 	The target architecture to be designed needs to accommodate the existing solution, capacity and future growth 

  

	 	•	 	The program strategy to be designed with minimal service disruption to Health Net customers as well as internal IT users during and after the exercise 

 

	 	•	 	To meet regulatory / non-regulatory and Federal compliance requirements 

  

	 	•	 	The design shall incorporate disaster recovery solution 

  

	 	•	 	The assessment phase will be comprehensive and designed to understand the known, and account for unknown details of the current landscape. 

 

	 	•	 	Opportunities to improve the efficiency of the VoIP environment in terms of cost, open, secure, and easy to use, to improve productivity, efficiency and end user experience. 

Cognizant proposes to host VoIP infrastructure in Health Net’s location (Woodland hills, Rancho Cordova) using Cisco UCS C series servers to meet the
Health Net Federal and commercial requirements. 
 Solution highlights 
  

	 	•	 	Redundant Cisco Unified Communications system for approx. 9,000 end users and ready for future expansion. 

  

	 	•	 	Capable to provide centralized SIP trucking for long distance 

  

	 	•	 	Cisco Unity Connection voicemail for approximately 10000 end users 

  

	 	•	 	CER platform for enhanced E911 compliance. 

  

	 	•	 	Local fallback (SRST) for 911 and outbound calling during WAN failures 

  

	 	•	 	Monitoring with cisco prime collaboration. 

  

	 	•	 	Ability to integrate with the 3rd party applications over industry standard protocols. 

  

	 	•	 	Phase out the existing voice infrastructure and legacy PBX system 

  

	 	•	 	Ability to interact with existing Contact Center 

  

	 	•	 	Capable to provide logical separation for Federal and Commercial verticals. 

  

	 	•	 	Cognizant managed Services with 24x7 dedicated support model 

  

					
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 Final 
  

 Solution approach starts with a detailed assessment followed by design, build, pilot, migration and testing
phase. During the design phase all the foundational UC dependencies, site specific design requirements and final high level design will be agreed upon. The server infrastructure will be built in Woodland Hills and Rancho Cordova locations,
followed by UC implementation phase will begin. Prior to cutting over any Health Net site, Cognizant will run a pilot phase and will test call functionality with test phones and temporary directory numbers at the customer provided site. Voicemail
functionality, including unified messaging and survivable remote site telephony will be tested as well. After successful completion of pilot phase the implementation of all other Health Net sites will be started according to the scheduled migration
plan. 
 The following sections detail VoIP architecture solutions. 
  

 
 Figure: High Level Architecture 

Target state Architecture 
 Based on business and
technical requirement the following solution components are proposed. 
  

	 	•	 	CUCM 1 Cluster (Rancho and Woodland) 

 8000 (Basic Users) + Diverse Users 

 

	 	•	 	Publisher (1) 

  

	 	•	 	2 MOH and 2 TFTP servers 

  

	 	•	 	Subscribers for Call Processing (8) 

  

					
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 Final 
  

	 	•	 	Unity Cluster (pub, sub) 

  

	 	•	 	Jabber servers 

  

	 	•	 	CER Cluster (1 publisher 1 subscriber) (9500 users) 

  

	 	•	 	CUBEs (centralized SIP trunk for Long Distance) 

  

	 	•	 	Remote TDM Sites Voice gateways (2911 and 2951)/SRST 

  

	 	•	 	Analog Gateway (500 analog connections) 

  

	 	•	 	7942 (4000) and 7962 (1000) phones 

  

	 	•	 	Centralized SIP Trunk : As per Cognizant understanding at this phase ,centralized PRI terminating at Rancho and Woodland will be migrated to SIP trunks with geographical redundancy and remote sites digital trunks will
be replaced to SIP trunks at later stage under. 

 Monitoring Tool 

Cisco Prime Collaboration helps enable rapid installation and maintenance of Cisco Unified Communications and Cisco Telepresence components as well as the
provisioning of users and services. Cisco Prime Collaboration also provides historical reporting of key performance indicators and enables IT network managers to analyze trends for capacity planning, resource optimization, and quality of service.

 3.1.12.2. Service Deliverables 

Below section details the deliverables: 
  

	 	•	 	Design, Build and Support CUCM infrastructure 

  

	 	•	 	Refresh the Existing VoIP Platform 

  

	 	•	 	Migrate the TDM phone to VoIP 

  

	 	•	 	Implement the Monitoring tools 

 3.1.12.3. Steady State Support Deliverables 

 

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated onsite / offshore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support – Offshore/Onsite (Non-federal) with on
call
  
 •    24X7
Onshore support
  

•    8x5 dedicated support – Onsite (Federal) with the rest on call

		
	 Delivery
 Location
	  	 •    Onsite —Health Net Offices

 
 •    Offshore –
Bangalore / Coimbatore

  

					
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 Final 
  

 L1 Services will be provided in accordance with the procedures documented in the SOPs and will include the
following: 
  

			
			 •       Perform incident analysis

		
			 •       Perform initial troubleshooting to determine the nature of the issue

		
			 •       Fault monitoring of Unified Communication Manager (Up-Down Status
monitoring)

		
			 •       Create ticket and log all troubleshooting steps performed

		
			 •       Performance statistics monitoring of Unified Communication Manager

		
			 •       Escalate unsolved issue to Level -2

		
	L1 Team		 •       Trunk link issues—Co-ordination efforts with vendors

		
			 •       Extension assignment—MACD for phones

		
			 •       Configuring Feature Access Codes

		
			 •       Configuring Authorization codes

		
			 •       Maintaining the Extension and Trunk inventory

		
			 •       Basic Trunk trouble shooting (D-Channel status check)

		
			 •       Direct call handling from Health Net – Service request

		
			 •       Daily Check list monitoring for Site

 Level 2 Services 
 L2
Services will be provided in accordance with the procedures documented in the SOPs and will include: 
  

			
			 •       Perform intermediate issue analysis and resolution

		
			 •       Configuring Trunks—T1-E1, Analog, IP

		
			 •       Respond to critical monitoring alerts

		
			 •       Generate articles and issue resolution scripts

		
			 •       Configuring Dial-peers

		
			 •       Hunt group configurations

		
	L2 Team		 •       Escalate unsolved ticket to L3 team or appropriate technology owner

		
			 •       Configuring L2/L3 QOS at Communication Manager, Gateways and LAN/WAN
devices

		
			 •       Troubleshooting PSTN, Inter Trunk calls issues

		
			 •       Troubleshooting endpoints/gateways/gatekeeper registration

		
			 •       Analyzing the performance logs for any errors or degradation of service

		
			 •       Maintain Unified Communications architecture maps and relevant documents

  

					
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			 •       Working with OEM/3rd party vendors for problem resolution and break fix
resolutions

		
			 •       Access rights (TACACS etc.)

		
			 •       Project configuration and deployment rollout assistance

		
			 •       Prepare documentation of known errors and KEDB

 Level 3 Services 
 All
unknown / new errors and problems will be resolved by L3 VoIP Support group. This team will work with Vendors when required. 
  

			
		
			 •       Maintains network architecture documentation

		
			 •       Perform advanced issue analysis and resolution

		
			 •       Perform maintenance and environment upgrades

		
			 •       Addressing high severity issues and service outages

		
			 •       Maintain the configurations and configuration backup

		
			 •       Performing Communication Manager upgrades and fixing bugs in co-ordination with
TAC

		
			 •       Capacity Management—Providing recommendations and suggestions

		
			 •       Historical trend analysis / Performance analysis

		
	L3 Team		 •       Unified Communications Planning

		
			 •       Advanced problem troubleshooting with detailed root cause analysis

		
			 •       Advanced Unified Communications Design Assistance

		
			 •       HA and DR Support

		
			 •       Root cause analysis for Communication Manager issues

		
			 •       Ensuring 3rd party vendor contracts and warranties are up-to-date and renewed in
time

		
			 •       Service Level Management

 3.1.12.4. Assumptions 

The following are the assumptions considered under VoIP: 
  

	 	•	 	Existing TDM configuration details, extension, feature reports and integration configurations will be provided by existing vendor/Health Net. 

 

	 	•	 	Existing CUCM configuration details, extension, feature reports and integration configurations will be provided by existing vendor. 

  

	 	•	 	Network configuration such as DHCP, Subnets, Routing, QoS, VLAN, Port configuration, etc. will be provided by existing vendor. 

  

					
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	 	•	 	ACD/ IVR integration details to be provided by existing vendor. Cognizant has not factored any effort or hardware requirement for the integration. 

 

	 	•	 	Total 2500 VoIP and 5500 TDM users 

  

	 	•	 	Existing VoIP sites will use same voice gateways, VG224, ATA and IP Phones. 

  

	 	•	 	Total of < 500 users would be using jabber 

  

	 	•	 	Adequate bandwidth is available at Health Net Offices and branch locations to support voice traffic. Additional bandwidth / QoS requirement will be provided after the Assessment phase. 

 

	 	•	 	Health Net has the required VPN solutions compatible for teleworkers end devices e.g jabber client or 79XX phones and no additional Cisco HW/SW needed for this secure connectivity 

 

	 	•	 	Adequate bandwidth is available between Woodland Hills and Rancho Cordova to Health Net MPLs. 

  

	 	•	 	Any new item or requirement identified during assessment phase shall be estimated separately on mutual agreement with Cognizant and Health Net. 

3.1.12.5. Dependency 
 The
proposed solution depends on the accuracy of the required information like: 
  

	 	•	 	Enterprise dial plan development (proposed by Cognizant after discovery phase) 

  

	 	•	 	Site specific DID number to be ported / repointed schedule. 

  

	 	•	 	Site survey and site readiness 

  

	 	•	 	Analog needs 

  

	 	•	 	Access Layer Cabling 

  

	 	•	 	Network health 

  

	 	•	 	Incumbent vendors availability for Network configuration changes and testing (L2/L3 QoS ) 

3.1.12.6. Risk and Mitigations 
 Below
tables describes the various risks and their mitigation. 
  

					
	 Risk type
	  	 Risk
	  	 Mitigation Plan

	Licenses	  	 Non-availability of
 Software and
their
 Licenses
	  	 •    Cognizant will explicitly highlight the pre-requisites in relation to
Software for executing the project before the start of the project
  

•    Cognizant has considered adequate licenses based on the count given during the
RFP/requirement understanding

  

					
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	 Risk type
	  	 Risk
	  	 Mitigation Plan

	Dependency	  	 Delay in User        

inputs
	  	 •    Health Net to assist in getting adequate user inputs to enable timely resolution of issues

			
	Documentation	  	Site documents are not detailed or not updated	  	 •    Early identification of documentation required

 
 •    Documenting all
information from direct interactions with SMEs, System administrators and end users for problem areas and Common user requirements
  

•    Utilize best practice checklists to capture knowledge that is not documented

 
 •    Recording site
changes since document update date
  

•    Perform a detailed system analysis and site surveys for site specific configuration and
customization and document it

 3.1.13. Thin Client 

3.1.13.1. Solution Approach 
 Guiding
Principles 
 Thin Client implementation is a transformation program which will transform the Health Net End user computing devices to from Laptops and
Desktops to Thin Clients. 
  

	 	•	 	Assessment phase will be comprehensive and designed to understand the known, and account for unknown details of the current landscape. 

 

	 	•	 	Opportunities to improve the efficiency of the Desktop environment in terms of cost, open, secure, and easy to use, to improve productivity, efficiency and end user experience. 

Solution highlights 
 Cognizant proposes to use Thin
client which will connect to the Citrix Xen Desktops for end users. Cognizant currently assumes a total of 3300 users can be migrated to Thin client platform, this will be validated during the assessment phase. 

Thin Client rollout will be a phased approach as described below. 

A. Assessment Phase 
  

	 	•	 	Identify end users work function and form functional groups 

  

	 	•	 	Identify Thin client devices which meets end user needs 

 B. Pilot Phase 

 

	 	•	 	Rollout Thin client for identified pilot groups 

 C. Build Phase 

 

	 	•	 	Rollout plan Thin Client to identified users based on Department, location and user functions 

  

					
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 D. Implementation Phase 

 

	 	•	 	Deploy Thin clients to end users based on roll out plan 

  

	 	•	 	Support users migrated to Thin client 

 3.1.13.2. Service Deliverables 

Below section details the deliverables: 
  

	 	•	 	Design and build the Thin client environment 

  

	 	•	 	Implement and rollout Thin client to end users 

  

	 	•	 	Support end user issues post migration to Thin Client 

  

	 	•	 	Hand off to steady state support team 

 3.1.13.3. Assumptions 

The following are the assumptions considered under Thin Cilent 
  

	 	•	 	Health Net end users primary use physical laptops/desktops 

  

	 	•	 	Citrix XD VDI to be provisioned for use with Thin client 

  

	 	•	 	Sites with less than 100 users are referred as Remote sites and will be considered Thin client only sites 

  

	 	•	 	Other locations will be combo sites with Desktops, Laptops & Thin clients as applicable 

  

	 	•	 	Any new item or requirement identified during assessment phase shall be estimated separately on mutual agreement with Cognizant and Health Net. 

3.1.13.4. Dependency 

Below are the dependencies from Health Net for the Thin Client implementation 

 

	 	•	 	VMWare, Windows and Citrix Xen Desktop licenses for building the infrastructure to host VDI 

  

	 	•	 	Network bandwidth between Centennial/Phoenix and Health Net locations-Rancho Cordova, Woodland Hills, other remote locations to accommodate the VDI traffic 

 

	 	•	 	Procurement of Thin client devices by Health Net for roll out 

  

	 	•	 	Health Net end user function and computing requirements 

  

					
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 3.1.14. Service Desk 

3.1.14.1. Solution Approach 

Cognizant will logically separate the Federal and Commercial service desk and will use ServiceNow ITSM tool. 

 

	 	•	 	As the Transition waves will go live, Cognizant will start picking up the respective support using ServiceNow ITSM tool. 

  

	 	•	 	By the end of the Transition, Cognizant will use ServiceNow ITSM tool and will go live for end users covering both ITO and BPaaS groups of end users 

 

			
	 Use case
	  	 Specifications & Activities

	Service Desk    	  	 •    Single and first point of contact for all IT issues

		
		  	 •    Taking calls and handling incidents or service requests

		
		  	 •    Log all incidents / service request details, allocate categorization and prioritization
codes

		
		  	 •    First line investigation and diagnosis

		
		  	 •    Escalate incidents / service requests

		
		  	 •    Inform users of progress, impending changes or outages

		
		  	 •    Track open, escalated issues to closure

		
		  	 •    Maintain regular communication to stakeholders during the incident lifecycle

		
		  	 •    Run Book automation

 Solution Consideration 
  

	 	•	 	Logically separated Service Desk the Federal and commercial users 

  

	 	•	 	Federal Service Desk will be handled from Phoenix, AZ 

  

	 	•	 	Commercial Service desk services from Manila , Philippines 

  

	 	•	 	Separate IVR queue for Federal/Commercial queries/ issues 

  

	 	•	 	Sized for 13800 contacts (calls/email/web request) per month with 20% for Federal and 80% for commercial 

  

	 	•	 	90% of the Contacts are during the Weekdays and 10% during weekends. 

  

	 	•	 	Average call handling time (AHT) is 6mins 

  

	 	•	 	Call Abandon rate is < 5% 

  

	 	•	 	Users dial the In-country Toll Free / Toll number and Health Net identification Code to reach the service desk agents. 

  

					
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 Figure: Delivery Model – Service Desk 

Ticket Flow 
 Cognizant sees the interaction of our
delivery team with the following Health Net 3rd party vendors for day to day operations: 
  

	 	•	 	End User device leasing vendor 

  

	 	•	 	Various Software/ hardware /applications/ tools vendors 

 Cognizant is well versed with working with multiple
such stakeholders across engagements and will employ the best practices evolved over the years. The following is the typical incident management process when 3rd party vendor is involved. 

  

					
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 Figure: Ticket Handling 

 
 Considering the multitude of vendors, Cognizant will also look at a model in which the
individual vendor tickets are tracked to closure by the incident managers. 
 VIP User Handling 

If an Incident compromises the availability or delivery of an enterprise service to Health Net’s VIP users, whether or not such service is subject to a
service level, the Incident may, on the instruction of nominated users be classified as having a “high” urgency. Cognizant service desk will have a group of agents who will be specially trained to handle Health Net VIP users. Also the
ServiceNow ticketing tool will be configured and customized to identify Health Net VIP users. The scope of support will be end to end ownership of calls/incidents. Cognizant will obtain the VIP list during the Transition stage and start
acclimatizing its resources on the users, processes, involved support groups, etc. 
 Cognizant Voice Integration Solution 

Cognizant has a well-established Global Shared Voice infrastructure framework which is used for providing Service Desk support to various customers by
leveraging our MPLS cloud. Cognizant will leverage the same infrastructure to deliver Service Desk support to Health Net. 

  

					
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 Cognizant’s voice infrastructure consists of Avaya Multivantage PBX as an ACD switch and AT&T EVPN
Network for connectivity. It also includes IVR and Avaya S8700 as the media server for the ACD functioning with communication manager ver. 2.0 loaded with the elite call center features. 

Cognizant will leverage the existing external (Toll Free) number for Health Net users to contact the Service Desk. Health Net users can dial the external
numbers which will get routed to the nearest Avaya Gateway. We will manage and ensure that all end-user calls are successfully routed to the closest Cognizant POP. 
  

	 	•	 	All calls coming in from Health Net locations will be collected and routed to the nearest ACD (via the nearest POP). 

  

	 	•	 	From there, the calls will be internally routed to the Service Desk located in different Cognizant proposed premises. 

  

	 	•	 	There is a Customer Specific Code (CIC) for accessing IVR/ACD by end users calling Service Desk. 

  

	 	•	 	Cognizant has high availability voice architecture and calls will be delivered to the nearest Avaya GW. 

  

 
 

 
 Figure: Call flow for Internal and External User 

  

					
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 Call Routing Procedure 

Initially the call will connect to Cognizant’s Root IVR. Based on the Customer Identification Code (CIC), the authentication call will be directed to the
Health Net specific IVR. The ACD configuration call will also be delivered to Cognizant’s agents across locations. The following shows the process through which the customer will connect to Cognizant’s Service Desk agents: 

 

	 	•	 	End customer will dial internal or external numbers 

  

	 	•	 	Select the Customer Identification Code for authentication (CIC code) 

  

	 	•	 	Call will be directed to Health Net specific IVR 

  

	 	•	 	Based on the IVR options end user will reach Cognizant’s Service Desk agents 

 Advantages of
Cognizant’s Shared Voice Infrastructure 
  

	 	•	 	Authentication is based on CIC, which is customizable 

  

	 	•	 	Cost effective setup 

  

	 	•	 	Additional locations can be on-boarded with minimal setup 

 3.1.14.2. Service Deliverables

 Service deliverables for the service desk are the service desk solutions for BPaaS and ITO users. 

3.1.14.3. Steady State Support Deliverables 

Below section details the steady state support deliverables. 
  

			
	 Solution
	  	 Description

	 Solution
 Highlights
	  	 •    A dedicated onsite / near shore delivery team performing all in-scope activities

		
	 Support
 Coverage
	  	 •    24x7 dedicated support – Near shore ( Commercial)

 
 •    24x7 dedicated
support – Onsite (Federal)

		
	 Delivery
 Location
	  	 •    Onsite —Phoenix(US)

 
 •    Near-shore –
Manila;

 Support Services will be provided in accordance with the procedures documented in the SOPs and will include the following:

  

			
		
	Support services (L1) 	  	 •    First point of contact for end users

 

	  	 •    Accept inquiries—telephone calls/e-mail/web-based from end
users
  

	  	 •    Provide Level 1 problem resolution for all applications/systems and
hardware
  

	  	 •    Attempt to resolve incoming calls during first customer contact

 

	  	 •    Notify appropriate management and escalate according to escalation matrix

  

					
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			 •    Record the history of the problem in the problem tracking system

 
 •    Update the problem
ticket and communicate the status to users
  

•    Follow up with users after resolution to close out the service request

 
 •    Monitor progress of
incident resolution by third parties and update ticket status

		
	Support services (L2 )		 •    Respond to, investigate, and resolve incidents initiated as a result
of monitoring alarms at monitored sites
  

•    Resolve incidents escalated from Level 1 or escalate to Level 3 if unresolved

 
 •    Act as liaison to
OEMs and other third-parties
  

•    Monitor the implementation of the patches and upgrades and communicate to the user
community as required
  

•    Make updates to the CMDB once the Change Request is completed

 
 •    Collect and report
monthly data on incoming call statistics and ticket volumes

		
	Support services (L3 )		 •    Fulfill incident resolution activities for assigned incidents

 
 •    Coordinate with
Level 4 support or the OEM to resolve the incident when necessary
  

•    Provide resolution to problems as part of problem management, working together with
Level 4 support when necessary
  

•    Document and maintain processes, standards, methods and procedures and continuously look
for improvements
  

•    Investigate and address customer concerns or complaints regarding provision of the
services
  
 •    Report
issues to customer management
  

•    Providing general assistance to Level 1 and Level 2 analysts

 3.1.14.4. Assumptions 

The following are the assumptions considered under service desk: 
  

	 	•	 	Leverage Health Net proposed ITSM tool ServiceNow for ticketing 

  

	 	•	 	Outbound calls volumes <= 20% of overall contact volume 

  

	 	•	 	Support shall be provided in English language 

  

	 	•	 	Out of the total contacts 75% of contacts are assumed to be by phone, 22% by Email and only 3% of contacts by chat 

  

	 	•	 	Service desk team shall use ServiceNow ticketing tool for incident recording. 

  

					
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 3.1.14.5. Dependency 

The following are the dependencies considered under service desk: 
  

	 	•	 	ServiceNow ITSM tool implementation 

 3.2. ITO Service Delivery 

Cognizant has configured an end to end ITO solution for supporting its applications by hosting the infrastructure as well as managing the services and the
assets. The overall delivery will be ITIL framework based providing improved operational services. Cognizant will deploy dedicated team will comprise of Federal and Commercial resources. While Commercial resources will not be shared to Federal, the
Federal resources will be shared to Commercial in order to realize efficiencies depending on the nature of activities to be performed. In this model, Cognizant will execute majority of the tasks from an offshore location, while activities requiring
an Onsite physical presence to support the federal environment will be executed from the Onsite locations (Health Net facilities for Desk side support, Federal and Commercial environments, both will be supported from Onsite). ITO Services (such as,
remote infrastructure services) will be delivered primarily from Cognizant’s Offshore delivery centres in India. All Cognizant’s Federal resources are US citizens and will undergo a clearance by NACLC. The Data Centre will be certified for
DIACAP and NIST controls. 

  

					
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 Below diagram depicts the Target Operating Model and Cross Functional Services. 

 
  
 

 
 Figure: Target Operating Model and Cross Functional Services 

The following table details the association of Cognizant’s affiliates, subcontractors and managed third parties. 

 

					
	 Affiliates,

Subcontractors and

Managed Third
Parties
	  	 Services Provided
	  	 Locations

	AT & T	  	 •    P2P and MPLS Link Management
	  	
			
	Cisco	  	 •    Server Hardware Maintenance Support

 
 •    Network Devices
Maintenance Support
	  	NA

  

					
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	 Affiliates,
 Subcontractors
and
 Managed Third

Parties
	  	 Services Provided
	  	Locations
	Hitachi	  	 •    SAN, HDI & NAS Maintenance Support

 
 •    Sepaton , Tape
Library Maintenance Support
	  	NA
			
	HP	  	 •    HP Tools

 
 Software Maintenance Support
	  	NA
			
	Latisys	  	 •    Datacenter Colo services

 
 •    Facility
Services
	  	Centennial
			
	WWT	  	 •    Professional services for VoIP implementation

 
 •    Hardware
procurement and physical
  
 Logistics, Integration and
deploying
	  	Centennial
and
Phoenix

 3.2.1. Delivery Location and Organization 

 

	 	•	 	Commercial IT Service Desk location is based out of Manila, Philippines. 

  

	 	•	 	Primary Onsite Delivery locations will be based out of Health Net’s Rancho Cordova and Cognizant’s Global Delivery Centre in Phoenix (Federal IT Service Desk). 

 

	 	•	 	Primary Offshore Delivery locations will be based out of Cognizant’s Global Delivery Centres Bangalore (India) and Coimbatore (India) locations. 

The following table details the Service Delivery locations. 
  

							
	 Location
	  	 Primary

Location
	  	Backup/
Failover
Location	  	 Services/Platform

	Health Net Onsite Location	  	

	  		  	 •    Primary Onsite Delivery Centre

	Rancho Cordova, USA	  	  	  	  

•    L1, L2 & L3 support for Foundation Services & Use cases

  

					
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	 Location
	  	 Primary
Location
	  	 Backup/
Failover
Location
	  	 Services/Platform

	 Health Net Onsite Location
 Woodland Hills,
USA
	  		  	

	  	 •    Backup/failover Onsite Delivery Centre

 
 •    L1, L2 & L3
support for Foundation Services & Use cases

				
	 Cognizant Location
 Phoenix, USA
	  	

	  		  	 •    Secondary Onsite Delivery Centre

 
 •    DC Hosting and
DR
  
 •    Facility
Service
  
 •    24/7
Service Desk for Federal

				
	 Latisys Location
 Centennial, USA
	  	

	  		  	 •    Latisys DC Hosting

 
 •    Facility
Service

				
	 Cognizant Location
 Manila,
Philippines
	  	

	  		  	 •    24/7 Service Desk for Commercial

				
	 Cognizant Location
 Cebu,
Philippines
	  		  	

	  	 •    24/7 Service Desk for Commercial

				
	 Cognizant Location
 Bangalore, India
	  	

	  	

	  	 •    Primary Location Services

 
 •    Primary Offshore
Delivery Centre
  

•    L2 & L3 support for Foundation Services & Use cases

 
 •    Backup Location
Services
  
 •    L1
support for Foundation Services & Use cases

				
	 Cognizant Location
 Coimbatore,
India
	  	

	  	

	  	 •    Primary Location Services

 
 •    Secondary Offshore
Delivery Centre
  

•    L1 support for Foundation Services & Use cases

 
 •    Backup Location
Services
  
 •    L2
& L3 support for Foundation Services & Use cases

  

					
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 The global overview of the delivery locations is as shown below: 

 
  
 

 
 Figure: Onsite and Offshore Global Delivery Centres 

  

					
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 Final 
  

 The network connections are as shown below: 

 
  
 

 
 Figure: Network Connectivity Diagram 

  

					
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 Organization 

Below diagram illustrates the organizational structure for this Health Net engagement. 

 
  
 

 
 Figure: Organizational Structure 

3.2.2. Service Management 

The ITO environment will follow the support process of an ITIL framework with greater participation in operations and governance directly
interacting with Health Net. Both the ITO and BPaaS services are built upon common foundation layer and there wills be similarity in terms of the support processes involved (ITIL). Cognizant’s approach is to move services delivered to Health
Net to a more standardized, process- based delivery model, thereby enabling consistency in approach. One of the major components of the solution which will drive consistency in operations and cross-functional processes will be the Cognizant Service
Management Office (SMO). Cognizant’s ITIL Process Framework is based on ITIL V3 framework and ISO 20000 standards which comprise of the ITSMF and ISO 9000 requirements for IT infrastructure projects. The Quality System provides a comprehensive
process framework with standard procedures, guidelines, templates and checklists as depicted in the following sections addressing various service offerings. It covers all aspects of Cognizant’s Service Support and Service Delivery. 

  

					
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 Cognizant will be submitting Integrated Service Process and Service Integration
Documentations for Health Net Review to avoid redundancy and to ensure the completeness of its services across all Service Towers (BPaaS, IO and AO). 

Business Continuity/Disaster Recovery: Cognizant will establish a BCP function to provide the following key capabilities designed to meet regulatory and
customer requirements for uninterrupted service and effective strategies for backup and restoration: 
  

	 	•	 	Inventory all applications and identify Restore Time Objectives (RTO) and Recovery Point Objectives (RPO). 

  

	 	•	 	Ensure appropriate procedures and infrastructure is in place to meet all identified objectives. 

  

	 	•	 	Perform BCP/DR risk assessments. 

  

	 	•	 	Document all BCP and DR plans. 

  

	 	•	 	Periodically test all documented plans. 

  

	 	•	 	Perform root cause analysis and remediation of all identified issues in the event of an outage. 

  

	 	•	 	Ensure appropriate backup processes are operating properly. 

  

					
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 EXHIBIT A-3-3 

BPAAS SOLUTION 
 TABLE OF CONTENTS

  

							
	 1. BPAAS EXECUTIVE SUMMARY
		 	1	  
		
	 2. SCOPE DEFINITION
		 	3	  
			
	 2.1.
		In-Scope Assets		 	3	  
			
	 2.2.
		In-Scope Services		 	3	  
			
	 2.3.
		Out-Of-Scope and Scope Exclusions		 	4	  
		
	 3. SOLUTION DESCRIPTION
		 	4	  
			
	 3.1.
		BPaaS – Product Management		 	4	  
			
	 3.1.1.
		 Cognizant’s ProdIgy Product Development Life Cycle
		 	5	  
			
	 3.1.2.
		 Product Requirements Intake
		 	6	  
			
	 3.1.3.
		 Product Definition and Planning
		 	7	  
			
	 3.1.4.
		 Product Legal and Compliance Management
		 	8	  
			
	 3.1.5.
		 Product Elaboration and Testing Phase
		 	9	  
			
	 3.1.6.
		 Product Training
		 	10	  
			
	 3.1.7.
		 Client Image Management
		 	10	  
			
	 3.1.8.
		 Product Professional Services
		 	10	  
			
	 3.1.9.
		 Product Roll out
		 	11	  
			
	 3.1.10.
		 Product Support
		 	11	  
			
	 3.1.11.
		 Third Party Licenses
		 	11	  
			
	 3.1.12.
		 Asset Transition to GA
		 	12	  
			
	 3.2.
		BPaaS—Infrastructure		 	12	  
			
	 3.2.1.
		 Servers
		 	12	  
			
	 3.2.2.
		 Storage
		 	13	  
			
	 3.2.3.
		 Backup
		 	14	  
			
	 3.2.4.
		 Middleware
		 	15	  
			
	 3.2.5.
		 BPaaS Application Migration
		 	15	  
			
	 3.3.
		BPaaS—Disaster Recovery (DR)		 	16	  
			
	 3.3.1.
		 DR Strategy and Approach
		 	16	  
			
	 3.3.2.
		 Business Continuity Planning (BCP)
		 	16	  
			
	 3.4.
		BPaaS Service Delivery		 	16	  
			
	 3.4.1.
		 Service Delivery Integration
		 	16	  
			
	 3.4.2.
		 Delivery Location and Organization
		 	17	  
			
	 3.4.3.
		 Service Management
		 	18	  
			
	 3.5.
		Security, Compliance and Controls		 	18	  

  

					
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 1. BPaaS EXECUTIVE SUMMARY 

Understanding Health Net’s immediate need to reduce its General and Administrative cost (G&A) due to Healthcare Reform- MLR Implications, Cognizant
proposes Business Process as a Service (BPaaS) solution that caters to this need. 
 This document addresses the IT Solutions that will be delivered as part
of BPaaS. The Health Net and Cognizant partnership will focus on supporting growth and achieving optimal G&A operating expense ratio. The proposed BPaaS Solution will help Health Net to move from a high fixed-cost, capital intensive model to a
variable, consumption-based cost structure. This approach will enable a predictable G&A profile (combined Cognizant and Health Net internal reductions) through a full utility back office model, priced using PMPM model. The PMPM cost will be
dependent on the membership volume. BPaaS model will also reduce Health Net’s platform investment without compromising regulatory risk while providing additional scalability and capability for growth. 

Cognizant understands Health Net’s business environment by virtue of its long-standing relationship and exposure to Health Net’s IT and business
processes. This document provides an overview of the scope of IT services, solution approach for Product Development, Infrastructure Management, and Service delivery with security and compliance controls. Leveraging Cognizant’s comprehensive
business process management expertise, this proposed BPaaS solution outlines process harmonization, optimal organization design and change management, and offering transformational benefits to meet Health Net’s objective on this proposal. 

Scope of Services 
 Cognizant will provide all IT services
to Health Net in a unified BPaaS model with improved control over capability and increasing capacity. The overall scope includes management, support and hosting of BPaaS assets, which is aligned to Scope Operating Model established in documents
SOW 4 IT Services Ex A-1 Scope Model, SOW 4 IT Services Ex A-1-1 Process Definitions and SOW 4 IT Services Ex A-1-2 Element Definitions. 
  

	 	•	 	Product Management and Development of all BPaaS Application Assets (APA – Schedule F – Bill of Sale) 

  

	 	•	 	BPaaS Asset Production Support and Customization Support 

  

	 	•	 	Infrastructure Management of Deployed BPaaS Assets, that includes 

  

	 	•	 	Data Center Hosting Services 

  

	 	•	 	Network Management 

  

	 	•	 	Infrastructure Server, Middleware and Database Management 

  

	 	•	 	Capacity Planning and Capacity Management. 

  

	 	•	 	Service Desk Support 

 BPaaS Product Management 

For providing solutions, Cognizant will be acquiring the identified and agreed Health Net applications. The Health Net application assets will be the base
version of building BPaaS General Availability (GA) version. Cognizant’s strategy is to modernize the BPaaS Assets for immediate Health Net needs and generalize it to meet the Product “General Availability” standards. BPaaS assets
that are acquired from Health Net will be managed by Cognizant’s Healthcare Product Management group and will be responsible for all product transformation with the agenda to keep the assets commercially viable and competitive in the market.
Our key focus areas will be 

  

					
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	 	•	 	Meeting all State, Federal and other contractually obligated compliance requirements. 

  

	 	•	 	Implementing all Health Net Specific Enhancements to enhance operational efficiency. 

  

	 	•	 	Extending Product ability to Support new Healthcare Product that arises due to Market demands. 

  

	 	•	 	Create and Manage Product Development Roadmap to Convert the procured assets to “Product” that are technically and commercially viable to implement for other Healthcare Payers 

At all times, Cognizant Product Management team will keep Health Net Informed on all the Key decisions that will be made on improving the Asset capabilities.

 BPaaS Infrastructure Management 
 As part of BPaaS
Service Delivery, Cognizant will be providing all the required Infrastructure services for the BPaaS Assets. 
 As of today all identified BPaaS assets
(Health Net Applications) are deployed in IBM, Data Center at Boulder, CO. As per the ITO Phase I & ITO Phase 2 infrastructure design, Infrastructure Foundation Services that will be established on Cognizant DC for Health Net will be common to
BPaaS assets and Health Net retained applications. Foundation Services of Infrastructure will include Data Center Service Management, Network Service Management, HN Link Services, Server and Database Management and Service Desk. Cognizant will put
strong Governance in place to manage both the BPaaS asset and non BPaaS assets at same service levels to ensure that the product delivered as part of BPaaS Services are in line or exceeding the Health Net retained application standards. BPaaS
Infrastructure solution will have 80% or more Virtualized infrastructure with Optimized tools monitoring the infrastructure. 
 BPaaS Service Delivery

 Cognizant will be establishing Transition Management Office, Healthcare product Management Team and Service Management Office as part of Service
Delivery. The primary focus of Cognizant’s Transition Management team is to plan, oversee, spearhead and coordinate all transition activities to assure minimal disruption in Service Delivery, Perform effective Organizational Change Management
and Knowledge Retention while managing delivery of the end state keeping triple constraints (Schedule, Scope and Budget) intact. 
 In the steady state, the
TMO activities will be fully transitioned into Service Management Office for managing Operations and IT service delivery. Cognizant will follow the ITIL framework based on “dedicated” service delivery with 24x7 support model. During the
BPaaS planning phase, Cognizant will work with Health Net to refine Organization model and Governance structure to meet specific Health Net needs. Cognizant core principles in establishing Governance will include: 

 

	 	•	 	End-to-End Ownership of Service Levels – ensures accountability and compliance for all functional areas. Audit oversight for objective review of SLA outcomes 

Security Compliance and Controls 
 In order to ensure the
effective delivery of Information Security, Cognizant will partner with Health Net to ensure appropriate management of all security functions in the delivery of the BPaaS solution. 

  

					
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Security management will be a collaborative approach with Health Net driving the overall security strategy, setting security policies and standards and providing information security governance.
Cognizant will build a security execution strategy in line with the direction provided by the Health Net security leadership. Additionally, Cognizant will designate key functional leaders to interact with Health Net leadership and ensure seamless
operation. The details of Cognizant security solution are documented in “HN-CTS SOW4 IT Services Ex A-3-6 BPaaS Non-BPaaS Security Solution”. 

2. SCOPE DEFINITION 
 2.1. In-Scope
Assets 
 Health Net and Cognizant teams accepted the list of systems that will be taken over by Cognizant as BPaaS Asset based on the
following guiding principles. 
  

	 	•	 	All Health Net IP and Third Party Business applications, Licenses, Infrastructure Licenses that are required to support following Business Operations Under P5 Program 

 

	 	•	 	Membership Management 

  

	 	•	 	Call Center Management 

  

	 	•	 	Print and Output Management 

  

	 	•	 	Claims Processing 

  

	 	•	 	Medical Management Intake 

  

	 	•	 	Multi-Functional Systems – System Supporting P5 Business Operations and non P5 Business Operations 

  

	 	•	 	Membership systems 

  

	 	•	 	Medical management systems 

  

	 	•	 	Print and Output Management 

  

	 	•	 	Claims Systems 

  

	 	•	 	Contact center optimization 

 The detailed list of assets that will be taken over by Cognizant are defined
in APA – Schedule F – Bill of Sale. The referred asset tracking information document contains list of Asset and non-Asset Details, Asset Details with IP information and Asset Details with underlying Infrastructure License mapping.
Cognizant clearly understands any asset that will be taken over, which has Health Net Branding cannot be generalized for its product needs, such systems are Identified and classified. All BPaaS Services provided to HNT from Cognizant DC will be
based on dedicated Infrastructure and it will not be shared with other customers. 
 2.2. In-Scope Services 

Under BPaaS Service Delivery Model, Cognizant’s teams will be responsible for providing all the necessary IT Functions that are required for supporting
Health Net. 
 IT Functions within BPaaS Service Delivery includes: 
  

	 	•	 	Business Requirement Gathering and Assessment 

  

	 	•	 	Product Roadmap Definition 

  

	 	•	 	Enterprise, System and Domain Architecture Management 

  

	 	•	 	Product Design and Development 

  

					
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	 	•	 	Product Testing 

  

	 	•	 	Product Release Management 

  

	 	•	 	Product Deployment 

  

	 	•	 	Product Support 

  

	 	•	 	Infrastructure Management – Compute, Storage, Network, DR and BCP 

  

	 	•	 	Infrastructure Software and Currency Management 

  

	 	•	 	Service Desk 

  

	 	•	 	Integration Service Management 

  

	 	•	 	Data Asset Security 

  

	 	•	 	Project Management and Program Management. 

  

	 	•	 	Architecture Support for HN Retained Systems. 

 Infrastructures for BPaaS Asset will be hosted in Primary and
Secondary Data Centers that were chosen by Health Net. As HN retained applications and Cognizant BPaaS assets are going to be deployed in same datacenters, foundation layers will be common to both IT and Infrastructure Services. Cost of Management
of Foundation Services that is common will be shared between Health Net Retained Applications and BPaaS Assets. Details of Product Management from Requirement through Delivery and implementation are described as part of the Solution Approach 

2.3. Out-Of-Scope and Scope Exclusions 

Application and Infrastructure Support for assets that are classified in APA – Schedule F – Bill of Sale as HN Retained application and all
branding related work such as Marketing content, Digital products, images, videos, pdf’s, Site Branding, Site Contents, User Experience, Training 

3. SOLUTION DESCRIPTION 
 3.1. BPaaS –
Product Management 
 Cognizant will leverage its proprietary tried and tested ‘ProdIgy’ product engineering framework for
the management of BPaaS assets 
  
 

 

  

					
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 ProdIgy stands for Product Innovation and Engineering MethodoloGY is a
full-fledged framework for managing product development from Inception to Optimization ProdIgy framework is designed based on the below fundamentals: 
  

	 	•	 	Agile and Iterative methodologies for product development 

  

	 	•	 	A set of processes and guidelines to ensure all critical product development activities are accomplished 

  

	 	•	 	A set of ready to use proprietary tools, templates and checklists designed to help achieve repeatability, consistency and greater product quality 

With a vision of 
  

	 	•	 	Shorten time to market and product development cycles 

  

	 	•	 	Lower cost of development while maintaining high quality standards 

  

	 	•	 	Keeping it compliant to the statutory and regulatory needs 

 ProdIgy is designed to provide timely delivery of
varying product development feature requirements. As part of developing the Podigy framework all design, development, testing and release management standards will be established and will be used as reference through out the lifecycles. The
established standards will be reviewed yearly to accomadate the new learnings. 
 3.1.1. Cognizant’s ProdIgy Product Development
Life Cycle 
 The customized Product Development Life Cycle covering the various stages is described in the figure below 

 
 

 

  

					
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 3.1.2. Product Requirements Intake 

As part of BPaaS product development Cognizant envisions requirements from the following 4 teams 

 

	 	1.	Cognizant BPaaS Product Management group: 

 Cognizant’s Product Management group
will be responsible for all product transformation with the agenda to keep the systems commercially viable and competitive in the market. The Product Management group will comprise of product experts as well as Health Net specific customization and
integration specialist. Cognizant’s product management group will address Health Net specific strategic, operational and market needs and to also address challenges shared with Cognizant by Health Net. The internal Cognizant groups will feed
operational, market and Health Net needs and challenges through knowledge management, analytics and industry defined best practices to define the strategic roadmap 
  

	 	2.	Market Research Team: 

 Cognizant will conduct quarterly user group meetings to gather
requests for feature enhancements. The Cognizant BPaaS Product Management Group will work closely with Cognizant Market Research team and Cognizant Operations team to gather the requirements from Industry experts and also from HC governance bodies
to address the future roadmap 
  

	 	3.	Cognizant Information Security Office: 

 Cognizant Information Security office for Health
Net and Healthcare will work with Cognizant Global Information Security- Legal wing team to provide compliance requirements that are mandated by the healthcare regulatory agencies like Center for Medicare and Medicaid Services (CMS), Health and
Human Services (HHS), Health Insurance Portability and Accountability Act (HIPPA), Health and Human Services (HHS), Office of the National Coordinator for Health Information Technology (ONC) and Office of Civil Rights (OCR) 

 

	 	4.	Health Net: 

 Health Net specific requirements are those that are provided by Health Net
for any focused needs as mentioned below 
  

	 	•	 	Health Net’s product market demand (E.g.: Enhancement needed to enter new geographies or Enhancements needed to introduce new products/LOBs ( ASO)) 

 

	 	•	 	Health Net specific Compliance and Security requirements 

  

	 	•	 	Brand Management related requirements 

  

	 	•	 	Non BPaaS asset integration requirements 

 Being the Most Favored Customer (MFC) for Cognizant,
Health Net requirements will be handled via a defined methodology as described below 
  

	 	•	 	For any specific business reason/need Health Net will approach Cognizant with the specific product functionality needs 

  

	 	•	 	Such needs will be made through a project brief which will contain the priority of the need-Low, Medium and High 

  

					
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	 	•	 	On receiving the need, Cognizant will turnaround with the requirements as per the terms established in the Master Service Agreement (MSA) and/or MSA Schedules/Exhibits. 

 

	 	•	 	Once both Cognizant and Health Net agree upon the requirement priority, the request will be forwarded to the Governance committee to get the funding allocation 

 

	 	•	 	On approval from the Governance Committee, Cognizant will proceed to the next phase of the Product Development Life Cycle. 

3.1.3. Product Definition and Planning 

Using the requirements gathered from Intake, Product Definition and Planning will be carried out in three steps. 

 

	 	1.	Product Definition: 

 Product Definition Phase focuses on handling the Product
Requirements and providing a Roadmap. It consists of the below mentioned sub-steps 
  

	 	•	 	Define user stories 

  

	 	•	 	Identify features from user stories and create consolidated feature list (product backlog) 

  

	 	•	 	Evaluate and prioritize features (business value and costs) 

  

	 	•	 	Define Product Design Principles and Coding Standards. 

  

	 	•	 	Define product NFRs 

  

	 	•	 	Document product requirements (product backlog + NFRs) 

  

	 	•	 	Develop product roadmap—key product releases, supporting platforms and markets 

  

	 	•	 	Parameters that are considered while defining the product roadmap: 

  

	 	•	 	Setting the timeline 

  

	 	•	 	Release prioritization process 

  

	 	•	 	Establishing the work streams 

  

	 	•	 	Work out the high-level activities within each work stream 

  

	 	•	 	Add labels for areas of high risk 

  

	 	•	 	Mark out the key milestones 

  

	 	2.	Product Release Plan 

 Product release will be managed in conjunction with the product
release roadmap. Cognizant product management team will establish release calendar for major, minor, patch/hot fix and client image management. The release schedule of the BPaaS asset will be established to all of Cognizant’s clients. 

Any releases that are required for critical needs will be addressed based on client requirements in the required date as negotiated. 

There are 4 kinds of releases that happen 
  

			
	 Release
	  	 Description

	Major	  	A major release contains several significant features or an architectural change

  

					
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	 Release
	  	 Description

	Minor	  	A minor release contains one significant feature or several small ones
		
	Hotfix/Patch	  	A hotfix is any update to fix or improve the performance or address specific needs
		
	 Client Image
 Management
	  	Client specific requirements are those that are very specific to Health Net needs

 Cognizant will provide the release notes which will consist of – what is new in the release, previous
release notes, focus of the release, compatibility and deployment methodology and issues resolved with this release 
 Cognizant will use a
standard scheme by which anyone can tell the release type simply by looking at the version number 
  

	 	•	 	x.0.0.0—The first number signifies major version release of the product 

  

	 	•	 	0.x.0.0—The second number signifies the minor version release of the product 

  

	 	•	 	0.0.x.0—The third number signifies the hot fix/patch update of the product 

  

	 	•	 	0.0.0.x—The fourth number signifies the client image release of the product 

  

	 	3.	Product Support Plan: 

 Product Support planning phase focuses on the support
requirements and approach post implementation phase. It identifies roles that needs to be involved and guides development of other required deliverables, as well as indicates assumption and risks. It covers the feature list and how the current
release is different to the previous one, any change in technology or modifications to the current stack, addresses the question as to how to revamp the support team 
  

	 	•	 	Identify the support groups that participate in the production support process and their roles 

  

	 	•	 	Plan for any coordination needs between production support, knowledge management, and release planning 

  

	 	•	 	Establish early life support timeframe and required stabilization criteria 

  

	 	•	 	Create a production support matrix of common scenarios and their escalation paths 

  

	 	•	 	Determine any staff communication and documentation needs for early life support 

  

	 	•	 	Create a final readiness assessment for early life support and production support 

  

	 	•	 	Plan for a post-transition review of the approach development and implementation process and outcomes and evaluate all for effectiveness. 

Product SDLC Phases start after product concept, roadmap, release and support plan is approved by Product Governance Team 

3.1.4. Product Legal and Compliance Management 
 Once the
product roadmap and product release requirements are finalized by the Product Governance team, Product Compliance Management team will review all the requirements that are planned for a release and will provide feedback (add/delete/modify
requirements) on the same to ensure that the Product meets the compliance and security needs that are mandated by Federal and State Regulatory boards. 

  

					
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 Product compliance management may conduct Legal review with Customer Legal departments to
ensure that they are aligned with the solutions derived to meet compliance standards 
 3.1.5. Product Elaboration and Testing Phase

 The Product Elaboration and Test phase starts off with project initiation 

 

	 	1.	Product Project Initiation: 

 Project Initiation Phase focuses on defining Product
Charter and Project Plan. It consists of the below mentioned sub-steps 
  

	 	•	 	Prepare Product Story Board (business objectives, Critical Success Factors, scope, timelines, Cost Benefit analysis, governance etc.) 

 

	 	•	 	Prepare project plan 

  

	 	2.	Product Architecture and Design: 

 Product Architecture and Design Phase focuses on
defining Product Architecture and High Level Design. It consists of the below mentioned sub-steps 
  

	 	•	 	Define product architecture (architectural goals, various views, framework, technology platform selection etc.) 

  

	 	•	 	Define high level design 

  

	 	•	 	Define user experience strategy 

  

	 	•	 	Establish design and coding standards 

  

	 	3.	Product Testing Approach 

 Product Testing Approach Phase focuses on defining or
modifying the Product Acceptance Test Plan and High Level Test Strategies. It consists of the below mentioned sub-steps 
  

	 	•	 	Define/Modify product acceptance test approach, test plan, acceptance criteria etc. 

  

	 	•	 	Define/Modify product performance test strategy 

  

	 	4.	Sprint 0: 

 Sprint 0 Phase focuses on preparing for product development in sprints (env.
set ups). It consists of the below mentioned sub-steps 
  

	 	•	 	Develop Sprint 0 plan 

  

	 	•	 	Set up development environment 

  

	 	•	 	Set up test environment 

  

	 	•	 	Conduct Sprint 0 review meeting 

  

	 	5.	Sprint Execution (1..N): 

 Development of every product release happens in multiple
sprints. Each sprint focuses on designing, developing and certifying by feature. It consists of the below mentioned sub-steps 
  

	 	•	 	Sprint plan is created before starting sprint execution 

  

	 	•	 	Each sprint execution will involve design by feature, code by feature and certify by feature 

  

					
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	 	•	 	Sprint integration testing is conducted to certify all features included in sprint 

  

	 	•	 	Sprint performance testing is conducted to ensure meeting performance requirements 

  

	 	•	 	Sprint regression testing to ensure features covered in current and all previous sprints 

  

	 	•	 	Sprint acceptance testing is done and user, ops and installation guides evolve over sprints 

  

 
 3.1.6. Product Training 

Cognizant will provide the product manual and provide user demo for all the product releases. Learning requirements over and beyond this would
not be handled by Cognizant as part of this contract 
 However, Specific request for learning requirements such as creation of learning
materials will be provided by Cognizant as an add-on service. Once Cognizant team receives such request, Product Training team will work with client to understand their requirements for creating the Product training contents. 

3.1.7. Client Image Management 

For each customer there may be specific requirements and it may apply for their business models only, such requirements will developed as add
on with the core products and will be e released to the specific client. The build and release management will be managed for specific client and will be released to them as Custom Images. All Health Net Specific requirements like Health Net
branding will be managed through Client Image Processes 
 3.1.8. Product Professional Services 

As part of the product management team, there would be a product professional services team which would comprise of product experts and
integration specialists. The professional services team would help the client on implementation services, integration services with other systems, consulting services, interaction with 3rd party systems and productized services like managing IP.

  

					
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 3.1.9. Product Roll out 

 

	 	•	 	Once the integration services are taken care of, next step deals with the Product deployment which is concerned with deploying the versioned release. This is based on whether the product is a GA (Generally Available)
release or customized release 

  

	 	•	 	GA Releases will be certified by the internal product team post which there would be a pilot testing phase before deploying to the client environment 

 

	 	•	 	The Health Net custom releases are certified by Cognizant to be deployed in HNT environment following HNT TCoE guidelines. 

  

	 	•	 	It consists of the following steps 

  

	 	•	 	Test Plan Strategy Development 

  

	 	•	 	Test Plan Preparation 

  

	 	•	 	Test Execution 

  

	 	•	 	Defect Fixing 

  

	 	•	 	Client Security Requirement 

  

	 	•	 	Certify product package for market release 

  

	 	•	 	Conduct market retrospection for product feedback 

  

	 	•	 	Update product backlog based on customer feedback 

 3.1.10. Product Support 

 

	 	•	 	Product support focuses on providing necessary support for product defects, enhancements, upgrades and customizations post launch of product. The product support revolves around defined scope, resources, organizational
structure, system availability, and support expectations for production support. Cognizant’s standard offering for the product support is as described below 

  

	 	•	 	First line (L1) application/product support for initial review and response to customer service requests and escalation of unresolved issues to technical support specialists 

 

	 	•	 	Second line (L2) technical support through product specialists and subject matter experts for the provision of comprehensive diagnostic and root cause analysis and Incident resolution 

 

	 	•	 	Third line (L3) escalation support through product development engineers for the provision of Problem resolution and corrective maintenance releases 

 

	 	•	 	Cognizant will deliver services via a 24 X 7 support model through a dedicated team. This team will receive incident requests from the helpdesk / service desk via ticketing system. The detailed explanation of each of
the services involved is provided in the Service Management section 

 3.1.11. Third Party Licenses 

For first two years, Cognizant will be utilizing Health Net Licenses for Providing Services to Health Net. From year three onwards Cognizant
will be deploy its own License or will reimburse License Cost back to Health Net. 
 The List of Third Party Application, Infrastructure
Middleware, Database and Operating System that are required for Supporting assets are called out in APA – Schedule F – Bill of Sale. Cognizant will purchase any additional or new licenses that are required for providing BPaaS
Services 

  

					
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 3.1.12. Asset Transition to GA 

Cognizant vision is to convert the assets to “Generally Available” (COTS) products. The GA/GTM version will be built upon the Health
Net version; which will be modernized into suite of Healthcare solutions based on market needs. Converting the assets into Product provides ability for Cognizant team to Market the Product. Cognizant will follow structured steps for converting the
assets to the Marketable Product. 
  

	 	•	 	Address all compliance projects 

  

	 	•	 	Consolidate all the LoB into single Platform 

  

	 	•	 	Externalize Health Net Specific Contents 

  

	 	•	 	Remove all Health Net Specific Hard codes 

  

	 	•	 	Migrate Asset Integrations to Acceptable Standards or SOA Architecture 

  

	 	•	 	Decommission any Third Party Applications by building the functionalities in unified Assets 

Once the assets ready for “Plug and Play”, first General Availability version will be released, timing for each assets to gain
“GA” status will vary and is subjected to Product Development team discretion 
 3.2. BPaaS—Infrastructure 

Under BPaaS, Cognizant will be responsible for Infrastructure Services that provides scalability for Business Operations. Following sections will provide the
details of Infrastructure that will be deployed for BPaaS Assets 
 3.2.1. Servers 

The Server’s to support BPaaS is physically part of IO Sliver plus ITO solution (IO Sliver 2), but is logically separated in three
categories BPaaS, Corp IT, and Federal. This section will only address the portion broken out to support BPaaS environment. For technical diagrams or details please refer to “HN-CTS SOW4 IT Services Ex A-3-2 Solution Description—ITO Phase
II” solution document for details like Rack layout, Architecture design and configuration information. 
  

					
	 Charge Components
	  	 Unit Of Measure
	  	 Servers

	AIX Physical	  	Per Image	  	4
			
	AIX Virtual	  	Per Image	  	21
			
	Solaris Physical	  	Per Image	  	12
			
	Solaris Virtual	  	Per Image	  	156
			
	Windows/Linux Physical	  	Per Image	  	264
			
	Windows/Linux Virtual	  	Per Image	  	784

  

					
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 3.2.1.1. Solution Approach 

Cognizant will deliver a logically separated solution for our approach please see exhibit “HN-CTS SOW4 IT Services Ex A-3-2 Solution
Description—ITO Phase II” for details on our solution. 
 Open VMS-HP Integrity Platform 

Cognizant will procure HP Intel Itanium (latest i4) blade based on C7000 Chassis (similar platform as Boulder DC) for hosting most business
critical OpenVMS BPaaS Asset. The OpenVMS version 8.4 will be used for BPaaS standup. As per HP press release, Open VMS Licensing and Support will be moved to VSI, Cognizant is watching the market developments and it will take appropriate decision
on OpenVMS Version and Hardware Requirements as situation demands. Prioritization of the project will be based on the timeline for migration and cost benefit analysis. 

The HP Integrity hardware details for Centennial and Phoenix are as follows. 

 
 

 
 Connectivity Details for HP Integrity-Open VMS 

 

	 	•	 	8 Network interface per Chassis – 10 Gbps for LAN connectivity (with redundancy) 

  

	 	•	 	2 Management Interface – 1 Gbps for Management 

  

	 	•	 	8 HBA per Chassis – 8 Gbps for SAN connectivity 

 3.2.2. Storage 

Storage Requirements for identified BPaaS assets that are being migrated from incumbent data centers to the newly built DC’s are fulfilled
by upgrading the Storage Infrastructure at both Denver and Phoenix DC. Storage Management Tools will be deployed for monitoring and notifications. Logical Separation of Storage infrastructure for BPaaS and Commercial applications will be maintained.

  

					
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 The below details the Storage requirement for the BPaaS application and DR 

 

					
	 Charge Components
	  	Storage (TB)	 
	 Centennial Storage
	  	 	1180	  
	 Phoenix Storage
	  	 	506	  
	 DR Storage (Phoenix)
	  	 	50	  
		  	  
	  
	 
	 Total Storage
		 	1736	  
		  	  
	  
	 

  

	*	Note: Detailed design on the Storage Infrastructure at Centennial and Phoenix is available in the “ HN-CTS SOW4 (IT) Ex A-3-A (Solution Desc)“Solution Document and HN-CTS SOW4 IT Services Ex
A-3-2 Solution Description—ITO Phase II” Solution Document. 

 3.2.3. Backup 

The backup Infrastructure for BPaaS will leverage the solution built in IO Sliver and ITO. Cognizant will logically separate the BPaaS solution
to support Health Net. Cognizant will ensure the data are backed up and retained as per HNT Record Management specifications. 
  

	*	Note: Detailed design on the Backup Infrastructure at Centennial and Phoenix is available in the “HN-CTS SOW4 (IT) Ex A-3-A (Solution Desc)” Solution Document and HN-CTS SOW4 IT Services Ex A-3-2
Solution Description—ITO Phase II: Solution Document. 

 3.2.3.1. Solution Approach

 Cognizant will build backup pools to support BPaaS, which will be logically separated from backup pools using dedicated backup
Network. Following upgrades or addition will be made to back environment for supporting BPaaS asset data backup. 
  

	 	•	 	66 Tape drives will be added. 

  

	 	•	 	SpectraLogic Tape Library will be upgraded for additional slots (2300 for Centennial and 1900 for Phoenix). 

Additional NetBackup Media Servers will be installed to handle the increased backup load. 

 

	 	Backup	environment 

  

	 	1.	Backup Software: 

 For the detailed design, configuration documentation
please refer to “HN-CTS SOW4 IT Services Ex A-3-2 Solution Description—ITO Phase II” solution document for initial build-out, and HN-CTS SOW4 IT Services Ex A-3-2 Solution Description—ITO Phase II solution
document. 

  

					
	SOW#4 (Information Technology) Ex A-3-3		A-3-3-14		Health Net / Cognizant Confidential

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 Following table outlines, number of tape drives and slots that will be deployed BPaaS
Infrastructures (Sepaton and NetBackup) 
  

							
	 Location
	  	 Unit Of Measure
	  	 Environment
	  	 BPaaS

	Centennial and Phoenix	  	Tape drive	  	Spectra logic	  	74
				
	Centennial and Phoenix	  	Tape Slot	  	Spectra Logic	  	3250
				
	Centennial and Phoenix	  	TB	  	Speaton	  	600
				
	Centennial and Phoenix	  	%	  	Netbackup	  	65%

  

	 	2.	Backup Overview—Primary DC (Centennial) and Secondary DC (Phoenix) 

Cognizant will be expanding backup solution to protect the BPaaS assets by scaling up the backup solution in Centennial DC and Phoenix DC as
follows. 
  

	 	•	 	Additional NBU Media Servers will be added to the backup infrastructure. 

  

	 	•	 	Expand the Sepaton Storage by adding SRE nodes and controller to provide additional Backup Storage 

Expand the SpectraLogic Tape Library by adding Slots and LTO-6 FC Tape Drives 

3.2.4. Middleware 

3.2.4.1. Solution Approach 

Cognizant will stand up middleware application servers, as per the current application infrastructure requirements. Cognizant will be following
build and deploy strategy to stand up the middleware services in the new datacenters. Following table provides the number of instances of Middleware services that will be deployed for BPaaS assets. 

 

			
	 Technology
	  	 No of Instances

	WebLogic 7.0, 8.1, 8.1.5, 9.1, 9.2, 10.0.1, 11gR1	  	200
		
	IIS 5.x, 6.x, 7.x	  	100
		
	Weblogic Aqualogic (Enterprise Service Bus)	  	12

 As part of BPaaS technology road map assessment, TIBCO applications will be migrated to WebLogic gradually.

 3.2.5. BPaaS Application Migration 

For Application migration approach and details please refer to the Transition Manual. 

  

					
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 3.3. BPaaS—Disaster Recovery (DR) 

Cognizant has a robust and proven Disaster Recovery /Business Continuity Plan (DR/BCP) that ensures that services offered to Health Net are protected in the
event where any of our service locations becomes inoperable, or any other issues requiring us to move the work elsewhere. 
 The BCP reiterates our
commitment to delivering the highest quality solution using the Onsite/Offshore model, and protecting Health Net from service continuity risks. Our business continuity plans are based on the need to protect professional staff, computing
infrastructure, and intellectual property in order to help Health Net remain in business through any contingency; that includes provisions to ensure the mobility of professional skills along with fully redundant communications backbones and
computing infrastructures. 
 As part of providing BPaaS Services, Cognizant will work with Health Net DR and BCP team to build Health Net Specific DR
and BCP Plan. 
 Cognizant is ISO 27001 certified company- the authority that mandates stringent and tested Business Continuity Planning and Disaster
Recovery operations. Cognizant’s Business Continuity Plan will present the process and procedures to be followed if project activities are affected by a disaster or interruption. 

3.3.1. DR Strategy and Approach 

For details please refer to the “HN-CTS SOW4 IT Services Ex A-3-2 Solution Description—ITO Phase II” solution document 

3.3.2. Business Continuity Planning (BCP) 

For details please refer to the “HN-CTS SOW4 IT Services Ex A-3-2 Solution Description—ITO Phase II” solution document. 

3.4. BPaaS Service Delivery 
 The Section
describes the approach towards setting up of the BPaaS environment as well as the operational aspects of BPaaS service delivery model. 
 Cognizant has
configured an integrated BPaaS solution for supporting its applications by hosting the infrastructure as well as managing the services and the assets. The overall delivery will be ITIL framework based providing improved operational services. 

Cognizant’s Integrated Service Process and Service Integration Documentations for Health Net are documented in HN-CTS SOW4 IT
Services Exhibit A-3-4 Solution Description—People/Process. 
 3.4.1. Service Delivery
Integration 
 The overall solution strategy configured is now being split into support for BPaaS and ITO applications. The segregation
has been done based on the core towers and the overlying applications. Cognizant envisages a roadmap in which the BPaaS services will be dedicated to Healthnet for a period of 24 months. As more customers are on-boarded onto this framework,
Cognizant will look at further segregation of the offering to ensure there is no dependency on Health Net. 

  

					
	SOW#4 (Information Technology) Ex A-3-3		A-3-3-16		Health Net / Cognizant Confidential

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 3.4.2. Delivery Location and Organization 

Cognizant’s offshore facilities will be connected among each other and with the Health Net network through robust network infrastructure
– consisting of fail-over links and backup lines to handle traffic in times of disasters, more fully set forth below. Robust infrastructure and strong inter-connectivity among these facilities will ensure high operational coordination and the
consistency of services in these centers. Cognizant will provide the Services from its dedicated onsite (California, USA) and offshore (India, Philippines) facilities. The following elements of Cognizant’s operating model ensure high level of
coordination, quality and distribution of work across multiple locations: 
  

	 	•	 	Work will be distributed across multiple delivery facilities, but each individual project will be handled by a single location – to ensure a high level of coordination and planning for the respective project

  

	 	•	 	Cognizant will decide on the location best suited to execute this project by considering parameters such as required skills, available pools of resources, suitability of operating timings in the specific locations,
benefits of scale etc. For example, projects that require a talent pool with niche skills or knowledge will be operated out of locations that specialize in such skills or knowledge, as long as such projects do not have interdependencies with other
projects in the engagement 

 Delivery Location 

The services to Health Net will be delivered from the following global delivery centers: 

 

							
	 Location
	  	Primary
Location	  	Backup /
Failover
Location	  	 Services/Platform

	 Health Net Onsite

Location

Rancho Cordova, USA
	  	

 	  		  	 •    Primary Onsite Delivery Centre

 
 •    L1, L2 & L3
support for Foundation Services & Use cases

				
	 Health Net Onsite

Location

Woodland Hills, USA
	  		  	

 	  	 •    Backup/failover Onsite Delivery Centre

 
 •    L1, L2 & L3
support for Foundation Services & Use cases

				
	 Cognizant Location

Phoenix, USA
	  	

 	  		  	 •    Secondary Onsite Delivery Centre

 
 •    DC Hosting and
DR
  
 •    Facility
Service

				
	 Latisys Location

Centennial, USA
	  	

 	  		  	 •    Latisys DC Hosting

 
 •    Facility
Service

				
	 Cognizant Location

Manila, Philippines
	  	

 	  		  	 •    24/7 Service Desk for Commercial

				
	 Cognizant Location

Cebu, Philippines
	  		  	

 	  	 •    24/7 Service Desk for Commercial

				
	 Cognizant Location

Bangalore, India
	  	

 	  	

 	  	 •    Primary Location Services

 
 •    Primary Offshore
Delivery Centre
  

•    L2 & L3 support for Foundation Services & Use cases

  

					
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	 Location
	  	Primary
Location	 	  	Backup /
Failover
Location	 	  	 Services/Platform

		  				  				  	 •    Backup Location Services

 
 •    L1 support for
Foundation Services & Use cases

				
	 Cognizant Location

Coimbatore, India
	  	 	

 	  	  	 	

 	  	  	 •    Primary Location Services

 
 •    Secondary Offshore
Delivery Centre
  

•    L1 support for Foundation Services & Use cases

 
 •    Backup Location
Services
  
 •    L2
& L3 support for Foundation Services & Use cases

 3.4.3. Service Management 

The BPaaS environment will follow the support process of an ITIL framework with greater participation in operations and governance
–directly interacting with Health Net. Both the ITO and BPaaS services are built upon common foundation layer and there will be similarity in terms of the support processes involved (ITIL). Cognizant’s approach is to move services
delivered to Health Net to a more standardized, process- based delivery model, thereby enabling consistency in approach. One of the major components of the solution which will drive consistency in operations and cross-functional processes will be
the Cognizant Service Management Office (SMO). Cognizant’s ITIL Process Framework is based on ITIL V3 framework and ISO 20000 standards which comprise of the ITSMF and ISO 9000 requirements for IT infrastructure projects. The Quality System
provides a comprehensive process framework with standard procedures, guidelines, templates and checklists as depicted in the following sections addressing various service offerings. It covers all aspects of Cognizant’s Service Support and
Service Delivery. 
 Cognizant will be submitting Integrated Service Process and Service Integration Documentations for Health Net
Review to avoid redundancy and to ensure the completeness of its services across all Service Towers (BPaaS, IO and AO) 
 3.5.
Security, Compliance and Controls 
 The details of security compliance and controls are described in the Security
Solution document HN-CTS SOW4 IT Services Ex A-3-6 BPaaS Non-BPaaS Security Solution. 

  

					
	SOW#4 (Information Technology) Ex A-3-3	  	A-3-3-18	  	Health Net / Cognizant Confidential

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 EXHIBIT A-3-4 

IT PROCESS SOLUTION 
 TABLE OF CONTENTS

  

									
	 1.
		SERVICE AND SUPPORT OVERVIEW		 	1	  
			
	 2.
		TARGET OPERATING MODEL		 	1	  
				
			2.1		Service Delivery Model		 	1	  
				
			2.2		Operation Maturity Framework		 	9	  
			
	 3.
		SERVICE DELIVERY PROCESS		 	11	  
				
			3.1		ITIL/ITSM Processes		 	11	  
				
			    3.1.1		Incident Management		 	11	  
				
			    3.1.2		Problem Management		 	18	  
				
			    3.1.3		Configuration Management		 	22	  
				
			    3.1.4		Release Management		 	26	  
				
			    3.1.5		Change Management		 	29	  
				
			    3.1.6		Capacity Management		 	34	  
				
			    3.1.7		Asset Management		 	37	  
				
			    3.1.8		SLA Reporting		 	43	  
				
			    3.1.9		Knowledge Management		 	47	  
				
			    3.1.10		Service Request Management		 	50	  
				
			    3.1.11		Patch Management		 	54	  
				
			    3.1.12		Software Currency		 	56	  
				
			    3.1.13		Project Life-cycle Management		 	58	  
			
			    3.1.14 Infrastructure Testing		 	62	  
				
			    3.1.15		COLO Service for Third Party in Data Center		 	65	  
			
	 4.
		CONTINUAL SERVICE IMPROVEMENT		 	67	  

  

					
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 1. Service and Support Overview 

Health Net environment will be supported with services aligning to processes compliant with ITIL v3 framework. Cognizant’s approach is to move services
delivered to Health Net to a more standardized, process- based delivery model, thereby enabling consistency in approach. Cognizant will ensure that its service delivery is aligned to ITIL v3 service definitions and also ensure process compliance in
all aspects of service delivery. One of the major components of the solution which will drive consistency in operations and cross-functional processes will be the Cognizant Service Management Office (SMO). 

Cognizant’s ITIL Process Framework is based on ITIL V3 framework and ISO 20000 standards which comprise of the ITSMF and ISO 9000 requirements. The
Quality System provides a comprehensive process framework with standard procedures, guidelines, templates and checklists as depicted in the following sections addressing various service offerings. It covers all aspects of Cognizant’s Service
Support and Service Delivery. 
 2. Target Operating Model 

2.1 Service Delivery Model 
 Cognizant’s services are
modeled in alignment with the results of the Health Net’s scope validation workshop to ensure efficiency, process improvements, documented and controlled processes, metrics management and business value expansion. Cognizant will use its global
delivery Onsite-Offshore outsourcing model comprising of a dedicated team to support Health Net. This dedicated team will comprise of Federal and Non-Federal resources. While Non-Federal resources will not be shared to Federal, the Federal resources
will be shared to Non-Federal in order to realize efficiencies depending on the nature of activities to be performed. In this model, Cognizant will execute majority of the tasks from an offshore location, while activities requiring an Onsite
physical presence to support the federal environment will be executed from the Onsite locations (Datacenters and Heath Net facilities). IT Services will be delivered primarily from Cognizant’s offshore delivery centers in India. All
Cognizant’s Federal resources are US citizens and will undergo a clearance from NACLC. 
  
 

 

  

					
	SOW#4 (Information Technology) Ex A-3-4		A-3-4-1		Health Net / Cognizant Confidential

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	SOW#4 (Information Technology) Ex A-3-4		A-3-4-2		Health Net / Cognizant Confidential

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 The high level activities performed by L1, L2 and L3 teams are described below: 

 

			
	 Team
	  	 Activities

	L1 Team	  	 •    First point of contact for end users for all use cases services

 
 •    Accept
inquiries—telephone calls/e-mail/web-based from end users for all use cases services
  

•    Provide Level 1 problem resolution for all applications/systems and hardware based on
standard SOPs
  

•    Notify appropriate management and escalate according to the escalation matrix

 
 •    Record the history
of the problem in the problem tracking system
  

•    Update the problem ticket and communicate the status to users

 
 •    Follow up with
users after resolution to close out the service request
  

•    Monitor progress of incident resolution by third parties and update ticket
status

		
	L2 Team	  	 •    Respond to, investigate, and resolve incidents initiated as a result
of monitoring alarms at monitored sites
  

•    Resolve incidents escalated from Level 1 or escalate to Level 3 if unresolved

 
 •    Act as liaison to
Cognizant OEMs and other third-parties
  

•    Monitor the implementation of patches and upgrades and communicate to the user community
as required
  

•    Make updates to the CMDB once the Change Request is completed

 
 •    Collect and report
monthly data on incoming call statistics and ticket volumes

		
	L3 Team	  	 •    Fulfill incident resolution activities for assigned incidents

 
 •    Coordinate with OEM
to resolve the incident when necessary
  

•    Provide resolution to problems as part of problem management, working together with OEM
when necessary
  

•    Document and maintain processes, standards, methods and procedures and continuously look
for improvements
  

•    Investigate and address Health Net concerns or complaints regarding provision of the
services
  
 •    Report
issues to Health Net management
  

•    Provide general assistance to Level 1 and Level 2 analysts

  

	 	•	 	Cognizant proposes to deploy Level 1 and L2/L3 for both Federal and Non-Federal. This team will provide support related to L1, L2 and L3 for all the use cases 

 

	 	•	 	Federal support would be provided from an Onsite location 

  

	 	•	 	Level 1 and L2/L3 team will constitute of Cognizant IT support and Service Management for cross functional services 

  

	 	•	 	In a typical situation, the incident workflow will be as follows: 

  

	 	•	 	End user will call the existing service desk provider. The service desk agents will raise the ticket in the ticketing tool with all the details like detailed incident description, severity, person contact details. The
ticket will be allocated to the Cognizant L1 team 

  

	 	•	 	Primary responsibility of Level 1 team will be to handle all the backend related and operational issues and provide Level 1 resolution 

 

	 	•	 	Unresolved issues by Level 1 team will be escalated to the appropriate Level 2/Level 3 IT use case team. This will ensure that tickets are assigned and acknowledged by the right team 

 

  

					
	SOW#4 (Information Technology) Ex A-3-4	  	A-3-4-3	  	Health Net / Cognizant Confidential

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	 	•	 	Each use case will have analysts reporting to a lead and support teams will be structured with Level 2 analysts and Level 3 specialists 

 

	 	•	 	Once a ticket is assigned to the Level 2 team, the analyst will perform an analysis and resolve the problem. All issues requiring specialist help will be forwarded to the concerned Level 3 teams. Level 3 teams will
analyze the issues and provide appropriate resolution. Cognizant teams will also update the Knowledge Base (Health Net existing KEDB) with any new issues/ processes 

 

	 	•	 	Cognizant’s Service Delivery enabling functions will work with the service delivery organization to provide best in class services to Health Net. Cognizant will leverage its Operations Maturity teams to ensure
continuous process improvement and provide productivity benefits to Health Net. Cognizant’s IT Centers of Excellence/Technical Architects will enable Health Net in the adoption of industry best practices. The overall solution model envisioned
by Cognizant is depicted below: 

  
 

 

  

					
	SOW#4 (Information Technology) Ex A-3-4		A-3-4-4		Health Net / Cognizant Confidential

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 Following are the key components as identified in our Service Delivery Model 

Support for all the use cases related to Federal and Non Federal can be provided by Federal support team depending on their availability whereas support for
all use cases related to Federal will be provided only by Onsite Federal support team. Tickets from the Health Net’s service management tool (ServiceNow) will flow to Cognizant’s L1 team for Federal Support based at Onsite and Non-Federal
Support based at Offshore. 
 The L2/L3 team for Federal Support will be based at Onsite and L2/L3 team for Non-Federal support will be based at Offshore.
Federal support team would also support Non-federal environment based on their capacity and availability. 
 Database Services has a dependency with the
existing Boulder Datacenter service provider since the services resides on the service provider’s assets, while all other use cases will be on Cognizant’s Datacenter. Any incident related to databases that involves infrastructure that
belongs to the existing Boulder Datacenter service provider would be managed differently compared to other use cases since there is a dependency with the existing Boulder Datacenter service provider for the service. Cognizant would follow the
existing ITSM processes of the existing Boulder Datacenter service provider related to Database Services to be delivered as part of the knowledge transition. 

L2 / L3 Support Layer 
 This layer will be responsible for
service restoration and maintenance and to enable productivity improvements: 
  

	 	•	 	Level 2: Activities include providing resolution and restoring services in case of incidents escalated by Level 1 and resolve any user queries/clarifications. The primary objective will be to ensure stability of
the operations environment and associated business processes in addition to the availability of applications and infrastructure components 

  

	 	•	 	Level 3: Will resolve complex incidents and perform proactive trend analysis to identify the bottlenecks (root cause of recurring incidents, availability and performance issues) and implement permanent fixes in
consultation with Health Net. The primary objective will be to enable proactive service delivery, provide operational efficiencies through automation, enrich knowledge database and ensure reliability of the operational environment 

  

					
	SOW#4 (Information Technology) Ex A-3-4		A-3-4-5		Health Net / Cognizant Confidential

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 Ticket Flow Diagram 
  

 
 Tools Implementation 

Cognizant’s Tools solution is designed to achieve an end state that integrates three key components of the tooling landscape, namely Service Assurance,
Service Management and Service Automation. This core tooling capability is supplemented by a comprehensive reporting solution. In order to achieve these objectives in the most cost efficient manner, Cognizant will use existing Health Net tools where
possible while bringing additional products to replace tools owned by the existing Boulder Datacenter service provider that are not be available and to fill the gaps in the current environment. The deployment of these tools is planned during the
data center migration. This will ensure the full functionality of the data center management team’s tools platform to enable them to work with effective collaboration and no impact to existing services. The key improvements brought about by the
Cognizant solutions are: 
  

	 	•	 	Consolidation of multiple tools providing similar functionality in to single tool wherever possible 

  

	 	•	 	Full integration of all system monitoring to a single-pane-of-view event manager acting as Manager of Managers 

  

	 	•	 	Automation of ticket generation in to ServiceNow ITSM based on filtered and qualified alerts 

  

	 	•	 	Enhancement of ITSM functionality through implementation of additional modules such as Asset Management, Knowledge Management and Service Level Management. 

 

	 	•	 	Implementation of integrated Asset Management and CMDB solution which is in turn fully integrated with ITSM solution. 

  

					
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	 	•	 	Introduction of Service Automation functionality that can be leveraged for achieving provisioning and de-provisioning of virtual instances, runbook automation, tracking compliance and software release and distribution.

  

	 	•	 	Integration of tools to a reporting engine enabling automated dashboard based reporting. 

 Service
Management Office 
 The proposed Service Management Office (SMO) provides managing use case, IT cross-functional services in an Onsite-Offshore model.
Shown below are the key functions that the SMO performs and the benefits that Health Net will derive from them. 
  
 

 
 The SMO will have the overall accountability for all service related issues/escalations. Some of the key process areas that
SMO will govern include: 

  

					
	SOW#4 (Information Technology) Ex A-3-4		A-3-4-7		Health Net / Cognizant Confidential

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	 Process Areas
	  	 Key Responsibilities

	Incident Management	  	 •    Manage Major Incidents (Severity 1s), Critical Situations and
Disasters involving breakdown of business processes – Convene and chair incident management calls, coordinate with delivery managers and technical support teams (if needed) for faster incident resolution

 
 •    Communicate timely
and accurate information to key stakeholders (IT and Business) –Cognizant, Health Net, 3rd Parties and existing Boulder datacenter service provider
  

•    Manage 3rd party interactions during critical situations

 
 •    Own the Incident
from creation to closure irrespective of the internal or external technical support team’s involvement
  

•    Ensure appropriate communication to the user community on critical Incidents.

 
 •    Initiate Problem
Management process for performing Root cause analysis and to come up with possible permanent fixes to eliminate recurring incidents.

		
	 Change and Release
 Management
	  	 •    Cognizant will own the change and release management processes

 
 •    Cognizant will
convene and chair Change Advisory Board
  

•    Ensure all changes are approved before implementation

 
 •    Cognizant will
maintain the forward schedule of changes and release calendar
  

•    Ensure appropriate communication to the user community before deployment of releases

 
 •    Conduct post
implementation review for major changes
  

•    Maintain a Release Acceptance framework to ensure proper handoff between project and
steady state support teams

		
	Capacity Management	  	 •    Develop/Enhance/Verify process guidelines for Capacity and
Availability Management functions and train the teams on the respective processes
  

•    Manage and Lead Configuration, Capacity and Availability Management functions

 
 •    Establish and
document thresholds with approval from Health Net
  

•    Monitor trends and thresholds

 
 •    Engage with Health
Net when thresholds are reached

		
	Service Level Management	  	 •    Health Net will define service levels using their baselines and
business needs of their requirements.
  

•    Health Net will define Business Level SLAs and Cognizant will manage and govern
them

		
	Vendor Management	  	 •    Regular interaction with Cognizant’s 3rd Party Vendors

 
 •    Vendor Performance
Management
  

•    Define and Manage OLAs with Cognizant’s 3rd Party Vendors for End to End SLA
Management

  

					
	SOW#4 (Information Technology) Ex A-3-4	  	A-3-4-8	  	Health Net / Cognizant Confidential

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 In addition to the process areas mentioned in the table above, SMO will own and improve other operational
processes across use cases and Cross-Functional services like incident problem management, knowledge management, critical-situation management and configuration management. 

2.2 Operation Maturity Framework 
 Cognizant will
implement its proven “Operation Maturity” (OM) Delivery Framework starting from the current mode of operations. This framework is based on measuring and managing of a number of KPIs and metrics that will be reported transparently to Health
Net and will lay the foundation for robust operations delivery and drive continual improvements. 
 OM framework will provide direction to run the
operations by having the overall service delivery for Health Net monitored, measured and reported on an ongoing basis through specific, measurable and transparent parameters along with a clear roadmap for Continuous Service Improvement and
Transformation. Cognizant will work with Health Net to ensure we capture any additional metrics that may be important to Health Net’s performance indicators. 

The OM Index, which is a measure of the service delivery excellence of a process, is divided into 6 parameters 

 

	 	•	 	Stability 

  

	 	•	 	Compliance 

  

	 	•	 	Continuous Service Improvement 

  

	 	•	 	Customer Experience 

  

	 	•	 	Customer Specific Requirements 

  

	 	•	 	Automation 

 “Operations Maturity Index” measures various dimensions like Stability, Compliance,
Customer Experience, Continual Service Improvement, Customer CSF & Automation Maturity 
 Automation- Enhance capabilities in various ESM
tools and technologies, Service Automation, Task Automation. It measures 13 parameters on Process Optimization, Minimization of Manual effort, Mistake Proofing etc. 

  

					
	SOW#4 (Information Technology) Ex A-3-4		A-3-4-9		Health Net / Cognizant Confidential

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 Example of an Operations Maturity Index – Standard 

 

									
	 OPERATIONS MATURITY INDEX
-Standard

	 Sl

No
	  	 Parameter / Scale
	 	 Weightage
	 	 Scoring
	 	 Weighted

Scoring

	1	  	Stability	 	35%	 	2.20	 	0.77
					
	2	  	Compliance	 	10%	 	2.80	 	0.28
					
	3	  	CSI	 	15%	 	4.00	 	0.60
					
	4	  	Customer Experience	 	5%	 	3.50	 	0.18
					
	5	  	Customer Specific requirements	 	5%	 	3.00	 	0.15
					
	6	  	Automation	 	30%	 	0.00	 	0.00
				
		  	OMI	 	100%	 	1.98
				
		  	                Calculated OMI	 		 	1.98

  

					
	SOW#4 (Information Technology) Ex A-3-4	  	A-3-4-10	  	Health Net / Cognizant Confidential

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 Using these indices in conjunction with Cognizant’s metrics culture, OM team will drive process
standardization, optimization and Continuous Service Improvements in every facet of managed services delivery for Health Net. 
 Cognizant IO Program
solution document details the proposed tools for availability and performance in section : 2.2.5 Monitoring Tools. 
 3. Service Delivery Process

 The processes described below will be followed for Phase 1 Scope and for any future scope changes that Cognizant undertakes for Health Net. 

3.1 ITIL/ITSM Processes 
 3.1.1 Incident Management

 Goals and Objectives 
 The objective of the
Incident Management Process is to restore normal service operation as quickly as possible and minimize the impact to business operations, thus ensuring that the service quality and availability is maintained. 

An Incident is defined as any event which is not a part of the standard operation of a service and which causes, or may cause, an interruption to, or a
reduction in, the quality of the service. 
 The Incident Management activities will include: 

 

	 	•	 	Incident detection and recording 

  

	 	•	 	Classification and initial support 

  

	 	•	 	Investigation and diagnosis 

  

	 	•	 	Resolution and recovery 

  

	 	•	 	Incident ownership, monitoring, tracking and closure 

 Cognizant’s Incident Management team will restore
normal services within the defined SLAs agreed and to minimize the impact to business operations. Incidents will be categorized and prioritized according to the SLA definition in the SLA schedule. 

  

					
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 Final 
  

 Incident Management Process Flow 

 
 

 
  

	 	•	 	Incident detection and recording by Cognizant L1 team/ Service Desk 

  

	 	•	 	Record basic details of the incident as required by Service Desk tool. Some of these details will be obtained from Health Net end user as the complaint is submitted 

 

	 	•	 	Alert specialist support group(s) as necessary ; for federal issues, the Onsite team will be alerted 

  

	 	•	 	Classification and initial support 

  

	 	•	 	Classifying Incidents 

  

	 	•	 	Matching against Known Errors and Problems 

  

	 	•	 	L1 will inform the Problem Management team of the existence of new problems and of unmatched or multiple Incidents 

  

	 	•	 	Assessment of impact and urgency, and thereby defining priority 

  

	 	•	 	Incident Categorization 

  

					
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	 	•	 	Application—Service not available, Application bug 

  

	 	•	 	Hardware—Automatic alert, Printer issues 

  

	 	•	 	Service Request—forgotten passwords 

  

	 	•	 	Assessing related configuration details (daily verification) 

  

	 	•	 	Providing initial support (assess incident details, find quick resolution) 

  

	 	•	 	Closing the Incident or routing to a specialist support group, and informing the User(s) 

  

	 	•	 	Investigation and diagnosis 

  

	 	•	 	Assessment of incident details 

  

	 	•	 	Collection and analysis of all related information, and resolution (Including any work-around) or route to the next level of support 

 

	 	•	 	Engagement of existing Boulder database service provider, AO, software/hardware vendors or other 3rd parties as needed to participate in the investigation 

 

	 	•	 	Resolution and recovery 

  

	 	•	 	Resolve the Incident using the solution/work-around or, alternatively to raise a Request For Change (RFC) tickets 

  

	 	•	 	Take recovery actions 

  

	 	•	 	Incident closure 

  

	 	•	 	Details of action taken to resolve the incident are concise and readable 

  

	 	•	 	The resolution is agreed upon by Health Net end users/ affected teams 

  

	 	•	 	All details applicable to this incident are recorded 

  

	 	•	 	Ownership, monitoring, tracking and communication 

  

	 	•	 	Monitor Incidents 

  

	 	•	 	Escalate Incidents 

  

	 	•	 	Inform User 

 Roles and Responsibilities: Incident Management 

 

			
	 Roles
	  	 Responsibility

	Health Net	  	 •    Reporting all incidents to the Service Desk

 
 •    Responding to
requests for additional information in a timely fashion
  

•    Reporting their related incidents to the Service Desk

 
 •    Responding in
assisting with resolution in a timely fashion
  

•    Confirming that issue has been resolved

		
	Level 1 Support	  	 •    Identifying incidents and be first point of contact for incidents
reported by Service Desk. Diagnose, escalate, and resolve based on documented processes and procedures. Responsible for:
  

•    Recording, classification, prioritization and routing of incidents

 
 •    Resolving incident
using Level 1 SOP’s, knowledge base articles and experience
  

•    Tracking progress of incidents by accurate and timely recording of incident status and
of work notes
  

•    Ongoing communication of progress to the users

 
 •    If incident can be
resolved by Level 1 team, then:
  

•    Documenting resolution of incident to ensure that this is clear and understandable by
the user

  

					
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	 Roles
	  	 Responsibility

		  	 •    Ensuring the user is satisfied with the resolution

 
 •    Confirming
classification of the incidents request to improve management information and aid future incident matching
  

•    Responsible for incident investigation, diagnosis and recovery within the defined
service levels.
  

•    Where appropriate, assign incident to Level 2 or 3.

 

	Level 2 Support	  	 •    Providing first point of escalation, guidance and instructions to
Level 1 support to diagnose and resolve the incident. Take assignment of incidents where subject matter expertise and experience is required for diagnosis. Responsible for:
  

•    Providing business/functional support

 
 •    Responsible for
incident investigation, diagnosis and recovery within the defined service levels
  

•    Providing Health Net updates, as required

 
 •    Escalating
incidents, as required
  

	Level 3 Support	  	 •    Making changes to components or where a complex resolution is
required, for example, code change, hardware replacement or vendor support. Responsible for:
  

•    Providing technical support

 
 •    Responsible for
incident investigation, diagnosis and recovery within the defined service levels
  

•    Providing Health Net updates, as required

 

	Team Leader	  	 •    Ensuring the team complies with documented processes including the
Queue Management process and ensuring the team meets the required Service Levels. Responsible for:
  

•    Ensuring the Queue management is performed within the team

 
 •    Providing the
tools, training and support required by team members to perform their tasks
  

•    Monitoring team performance and accountable for SLA breaches within the team

 

	 Incident
 Manager
	  	 •    Managing and supporting incidents and urgent service requests either
personally or via the Service Desk, to ensure successful completion and user satisfaction. Responsible for:
  

•    Monitoring efficiency and effectiveness of the Incident Management process

 
 •    Providing periodic
touch base with technical team /s for the exact status of the incident
  

•    Providing updates to key Health Net/Cognizant stakeholders

 
 •    Providing
escalation management for incidents arising from end users/stakeholders

  

					
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	 Roles
	  	 Responsibility

		  	 •    Generating Incident Management performance reports

 
 •    Managing
improvements within the Incident Management process
  

•    Assisting the team with the Major Incident and Problem Management
processes

  

					
	 Incident Management Services Roles and Obligations
	  	Cognizant	  	Health Net
	 Interface and coordinate with the Service Desk and Health Net for Incident Management Services activities and take ownership of end to
end Incident Resolution
	  	X	  	
			
	 Establish Incident classification by priority based on business case
	  		  	X
			
	 Establish Incident workflow, escalation, communication and reporting processes that help to achieve SLAs
	  	X	  	
			
	 Review and approve Incident classification, prioritization and workflow, communication, escalation and reporting processes
	  	X	  	
			
	 Manage entire Incident lifecycle including detection, escalation, diagnosis, Health Net status reporting, repair and recovery
	  	X	  	
			
	 Ensure Incident Resolution activities conform to defined Change Management procedures
	  	X	  	
			
	 Daily/Weekly review of the state of open Incidents and the progress being made in addressing the incidents
	  		  	X
			
	 Identify possible enhancement opportunities for improved operational performance and potential cost savings based on results of
Incident Resolution activities
	  	X	  	X
			
	 Review and approve projects to implement enhancement opportunities
	  	X	  	X
			
	 Implement approved projects to implement enhancement opportunities
	  	X	  	X

  

					
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 Critical Situation (Critical Incident) Incident Management 

Cognizant will follow the critical incident management process* as per ITIL standards. The overall process flow is summarized below: 

 
 

 
  

	*	The above critical incident process is applicable to both prod and non-prod critical systems 

  

					
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 Roles and Responsibilities: Critical Incident Team 

 

			
	 Roles
	  	 Responsibility

	 Team Members
	  	 •    Accept assigned ticket during business Hours and off-business
hours
  
 •    Inform
Operations Team about bridge opening details
  

•    Start troubleshooting of the incident if the issue is in scope

 
 •    Provide technical
expertise and ensure correctness of incident troubleshooting and impact assessment
  

•    Refer knowledge base and resolve incident as quickly as possible

 
 •    Work on alternate
solutions and discuss the solution with product vendor and Health Net
  

•    Follow the process documentation

 
 •    Update the ticket
with status regularly every 30 minutes as to notify stake holders.
  

•    Co-ordinate with vendors and ensure timely response

 
 •    Prepare the RCA :
share with Health Net and update the approved RCA in ServiceNow

		
	 Critical Incident / Problem

Manager
	  	 •    Control the escalation and involve appropriate individuals/teams as
required to speed up the resolution
  

•    Inform the program manager about the incident in details and the ETR

 
 •    Notify the Onsite
team about the opening of Critical Incident bridge
  

•    Program Manager will provide the Critical Incident bridge information to all the
Critical Incident stakeholders
  

•    Ensure timely (every 30 Min.) and accurate information is being updated until the
incident is resolved
  

•    Handle any escalations during the incident

 
 •    Provide necessary
guidance and support to the team
  

•    Bring in 3rd party vendor/partner/ CoE for expert inputs towards resolution

 
 •    Interact with
operations team to assess the impact and current status
  

•    Coordinate RCA review with all stake holders

 
 •    Prepare Major
Incident Report (RCA) and share it with the Critical Incident stakeholders

		
	 Other Members
	  	 •    Health Net program manager to be informed periodically by the
Critical Incident manager or delivery manager about the progress and resolution of incident
  

•    Cognizant application team to provide inputs on the criticality and business impact of
the incident

 While the table above describes a critical situation scenario, in case of outage situations, the Service Desk will create an
automated response in the IVR for end users to keep them informed of the on-going critical outage and also send out a mailer to the effected employees. 

  

					
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 3.1.2 Problem Management 

Goals and Objectives 
 The goal of Problem Management is to
minimize the adverse impact of incidents and problems have on the business processes and to prevent incidents from reoccurring. Problem Management is both a reactive and proactive process that identifies the root cause for one or more incidents. The
reactive approach to Problem Management looks at identifying the root cause of incidents, while the proactive method looks to prevent incidents from occurring in the first place by identifying and solving problems. 

  

					
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 Problem Management Process Flow 

 
 

 
 Problem Management Flow for Health Net 

 

	 	•	 	Problem identification and Recording 

  

	 	•	 	If there was an incident with considerable impact that has been solved, Problem Manager should immediately register a problem to investigate root cause 

 

	 	•	 	During trend analysis number of incidents with similar symptoms may be discovered 

  

	 	•	 	Someone discovers a source of potential problems 

  

	 	•	 	If an incident is closed with the code “Work Around” 

  

	 	•	 	If a problem is forwarded from another domain 

  

	 	•	 	Classification (Involves collection of data so that problem can be categorized and prioritized) 

  

	 	•	 	What are the related incidents? 

  

	 	•	 	How urgently the problem needs to be solved? 

  

					
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	 	•	 	Assign Resources 

  

	 	•	 	Categorization and Prioritization of a problem enables the appropriate resources to be assigned. This ensures that problems are handled efficiently and effectively. 

 

	 	•	 	Investigation and Diagnosis 

  

	 	•	 	To detect the underlying cause of one or more incidents 

  

	 	•	 	Provide workarounds for incidents related to problem 

  

	 	•	 	Records of recent changes to be interrogated because these may provide clues as to the cause 

  

	 	•	 	Establish Known Error 

  

	 	•	 	Identified known error is recorded in KEDB 

  

	 	•	 	The error is routed to Error control process 

 Throughout the process the Problem Manager has a responsibility
to track and monitor progress and quality as well as to provide necessary reports. 
 Proactive Problem Management 

 

	 	•	 	Identifying and resolving Problems and Known Errors before Incidents occur 

  

	 	•	 	Trend analysis 

  

	 	•	 	Targeting of preventive action 

 Roles and Responsibilities: Problem Management 

 

			
	 Roles
	  	 Responsibility

	 Critical Incident / Problem

Manager
	  	 •    Reviewing the efficiency and effectiveness of problem control
process
  

•    Managing problem support team (L2/L3 teams)

 
 •    Monitoring the
effectives of problem management process and making recommendations for improvements
  

•    Develop and publish RCA reports

 
 •    Identifying
problems (by analyzing Incident data etc.)

  

					
	 Problem management Services Roles and Obligations
	  	Cognizant	  	Health Net
	 Problem Identification, recording and Classification
	  	X	  	
			
	 Categorization and Prioritization of a problem
	  	X	  	
			
	 Investigation and Diagnosis to provide workarounds
	  	X	  	
			
	 Identified known error is recorded in KEDB
	  	X	  	
			
	 Conduct proactive trend analysis to identify recurring Problems and providing
RCA Services trend analysis reporting to Health
Net
	  	X	  	
			
	 Track and report on all Severity Level 1 and 2 Incidents and provide associated consequences
	  	X	  	
			
	 Recommend solutions to address recurring Problems or failures
	  	X	  	
			
	 Review and approve solutions to address recurring Problems or failures
	  		  	X
			
	 Identify root cause of Severity Level 1 and 2 Incidents and recommend appropriate Resolution action
	  	X	  	

  

					
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	 Problem management Services Roles and Obligations
	  	Cognizant	  	Health Net
	 Review and approve solutions to address Severity Levels 1 and 2 Incidents
	  		  	X
			
	 Provide status report detailing the root cause of and procedure for correcting recurring Problems and Severity Levels 1 and 2 Incidents
until closure as determined by Health Net
	  	X	  	

 Root Cause Analysis (RCA) 

One of the most critical steps in Problem Management process is the root cause analysis (RCA) which would ensure either correct diagnosis of the incident
leading to right solution. RCA will be done for Severity 1 and Severity 2 tickets only. The severity of the incidents as Severity 1 or Severity 2 will be defined as below: 
  

					
	 Severity Level
	  	 Definition
	  	 Response Required

	 1
 Critical
	  	 A serious fault prevents a business
 critical
process from being performed and there is no workaround available for the problem.
	  	 Cognizant will commence work to
 resolve the
problem immediately. Work shall continue uninterrupted until a suitable workaround is implemented.

			
	 2
 High
	  	 A high percentage of Users are
 affected and a
fault or workaround prevents a business process from being performed satisfactorily.
	  	 Cognizant will commence work to
 resolve the
problem immediately and shall continue within normal business hours until a suitable workaround is implemented.

  

	 	•	 	Delivery Manager is responsible to ensure timely completion of RCA report 

  

	 	•	 	Root cause analysis is mandatory for all Critical Situations 

  

	 	•	 	Root Cause Analysis will done using techniques like Ishikawa diagrams, and brainstorming sessions. The inputs will be data and information from incident management team as well as metrics book and problem call log form

  

	 	•	 	Capture the inputs from all the stakeholders after the root cause is identified within the agreed time. 

  

	 	•	 	Wherever applicable, get in touch with the 3rd party involved to ensure that the cause and solution is collaboratively closed 

  

	 	•	 	The draft RCA report should be reviewed with all the stake holders with in agreed time frame after problem resolution 

  

	 	•	 	RCA document will be available at common shared location 

  

	 	•	 	The RCA report should clearly capture lessons learned and action items 

  

	 	•	 	The final RCA report after review with all stakeholders to be and formally accepted by Health Net within agreed timelines 

  

	 	•	 	RCA will be initiated within 24 hrs. of Severity 1 or Severity 2ticket being closed 

  

					
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 For all resolutions which are not dependent on any 3rd party vendors, RCA will be submitted to Health Net
within 5 days from Severity 1 or Severity 2 ticket closure. As per Heath Net CTS – Exhibit B-1 (Service Level Metrics) document Section 6.5 Root cause Analysis Completion, in the event of a critical service level failure due to the
performance failure of an OEM vendor (e.g., Hitachi, Cisco, Telco, IBM), Cognizant may be excused from this critical level failure. Incident Manager will submit a Change/Project Request for implementing the solution/fix for the problem as documented
in the RCA approved by Health Net. 
 3.1.3 Configuration Management 

Goals and Objectives 
 Cognizant identifies Configuration
Management Process as a pivotal process for all the other processes (especially the Service Support). Configuration Management is important as it is considered central and supportive to other ITIL processes where it provides information. All
in-scope hardware/software inventory/version would be maintained in ServiceNow as well as in an MS excel spread sheet. 
 The objective of the configuration
management process will be to: 
  

	 	•	 	Provide IT Management with greater control over the IT Assets of the organization. 

  

	 	•	 	Provide accurate information to other ITIL processes. 

  

	 	•	 	Maintain a reliable Configuration Management Database (CMDB) 

 The Configuration Management Process will include
the following activities 
  

	 	•	 	Designing the Configuration Management Database 

  

	 	•	 	Identifying and establishing the configuration item (CI) 

  

	 	•	 	Taking inventory of the hardware and software assets and assigning a CI 

  

	 	•	 	Documenting the As-is configuration of the systems and assigning a CI 

  

	 	•	 	Providing access to the CI 

  

	 	•	 	Changing the CI 

  

	 	•	 	Reporting CI changes 

  

	 	•	 	Reviewing CI regularly 

  

					
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 Configuration Management Process Flow 

 
 

 
 Configuration Management Flow and its Interaction with other processes 

Configuration Management Planning 
 Cognizant’s
Configuration Management plan will encompass: 
  

	 	•	 	Related policies, standards and processes that are specific to the support group 

  

	 	•	 	Configuration Management roles and responsibilities 

  

	 	•	 	CI (Configuration Item) naming conventions 

  

	 	•	 	The schedule and procedures for performing Configuration Management activities: configuration identification, control, status accounting, configuration audit and verification 

 

	 	•	 	Interface control with third parties, e.g. Change Management, suppliers 

  

	 	•	 	Configuration Management systems design, including scope and key interfaces 

 Configuration Identification

  

	 	•	 	CIs are the components used to deliver a service. The CIs include hardware, software, documentation and SLAs 

  

	 	•	 	Identify the relationship between CIs and the attributes for every CI (allocating identifiers and version numbers for CIs, labeling each item, and entering it on the Configuration management database (CMDB))

  

					
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 Control of CIs 
  

	 	•	 	Strict configuration control will ensure that only authorized and identifiable CIs are recorded in the Configuration management Database (CMDB) upon receipt. 

 

	 	•	 	Cognizant will use ServiceNow 

  

	 	•	 	The CMDB will be updated as and when there will be a change in the environment using the authorized change management cycle. 

Configuration Status Accounting 
 Status reports should be
produced on a regular basis, listing, for all CIs under control, their current version and change history. Status accounting reports on the current, previous and planned states of the CIs should include: 

 

	 	•	 	Unique identifiers of constituent CIs and their current status, e.g. ‘under development’, ‘under test’, ‘live’ 

 

	 	•	 	Configuration baselines, Releases and their status (Base lining is done during the initial state of set up of CMDB which is on a year to year basis. It would help us to identify the amount of changes performed and
correlate them to the impact created positively or negatively. Baseline in Configuration management is done with help of standard tools.) 

  

	 	•	 	Latest software item versions and their status for a system baseline/application 

  

	 	•	 	The person responsible for status change, e.g. from ‘under test’ to ‘live’ 

  

	 	•	 	Change history/audit trail 

  

	 	•	 	Open problems /RFCs 

 Configuration Verification and Audits 

Configuration audits would be considered during the following times: 
  

	 	•	 	Shortly after implementation of a new Configuration Management system 

  

	 	•	 	Before and after major Changes 

  

	 	•	 	Before a software release or installation to ensure that the environment is as performing as expected 

  

	 	•	 	Following recovery from disasters and after a ‘return to normal’ (this audit should be included in contingency plans) 

  

	 	•	 	In response to the detection of any unauthorized CIs 

  

	 	•	 	Quarterly audits 

 All processes within ITIL have links with configuration Management or retrieve information
from the Configuration Management Database. 

  

					
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 Roles and Responsibilities: Configuration Management 

 

			
	 Roles
	  	 Responsibility

	Configuration Manager	  	 •    Performs audits and establish baselines.

 
 •    Selects, assigns
responsibilities to, and trains the configuration management staff.
  

•    Establishes CMDB policies, including CI-naming conventions.

 
 •    Oversee the
day-to-day operations of the process.
  

•    Produces and distributes management reports.

 
 •    Provides change
owner with a baseline report for assessing the impact of a release.
  

•    Updates the CMDB with all changes to the target environment when both the pilot and the
full release have been completed.
  

•    Conduct audits and reconcile the CMDB

  

					
	 Configuration Management Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	 Establish Configuration Management Database (CMDB), in accordance with Health Net requirements
	  	X	  	
			
	 Review and approve all configurations and CMDB (critical and business impact)
	  		  	X
			
	 Review and approve all configurations and CMDB (non-critical)
	  	X	  	
			
	 Enter/upload configuration data into the CMDB
	  	X	  	
			
	 Establish automated process Interfaces to Incident and Problem management, Change management, DR, technical support, maintenance and
asset management processes
	  	X	  	
			
	 Establish appropriate authorization controls for modifying configuration items and verify compliance with software licensing
	  	X	  	
			
	 Ensure Configuration Management processes are consistent across all infrastructure(e.g., development, test and production)
	  	X	  	
			
	 Establish process for verifying the accuracy of configuration items, adherence to Configuration Management process and identifying
process deficiencies
	  	X	  	
			
	 Track and flag configurations that are not in conformance with Health Net-defined standards and requirements (e.g., exceptions
list)
	  	X	  	

  

					
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 Final 
  

 3.1.4 Release Management 

Goals and Objectives 
 The goal of the Release Management
process is to ensure the planning, design, build, configuration and testing of software and hardware systems to create a set of Release components for the service production environment. Testing (operational and service readiness), planning,
preparation and scheduling of the Release is done by the Project/Build team before handing off to Steady State. 
 This procedure applies to all changes
that require software and /or a hardware release. The Release Management process ensures that, both process oriented and technical aspects of a release are planned and standardized: 

 

	 	•	 	Plan releases in line with requirements resulting from approved changes 

  

	 	•	 	Plan technology refresh of the environment is in line with Health Net technology plan, Health Net release calendar and ensure that the IT changes are implemented in a controlled manner to minimize the impact on Health
Net application releases 

  

	 	•	 	Cognizant IT support team under this process will deploy the entire release request submitted to them by the application support group like code promotion. Where the release would have some impact on the exiting
environment, Cognizant IT team would follow the change management process. Cognizant IT team will work closely with all application team to understand the impact (if any) and take necessary precautionary measure/s and keep Health Net informed

  

	 	•	 	To design and implement efficient procedures for the distribution and installation of changes to IT systems 

  

	 	•	 	Develop implementation and rollback plans for approved changes that will be included in the release 

  

	 	•	 	Build effective release modules for the deployment of the changes to production 

  

	 	•	 	To ensure that hardware and software being changed is traceable, secure and that only correct, authorized and tested versions are installed 

 

	 	•	 	To ensure that master copies of all software are secured in the Definitive Software Library (DSL),hardware spares are stored in Definitive Hardware Store(DHS) and the details are updated in asset management tool
(ServiceNow) 

  

	 	•	 	Cognizant support team will deploy the release in line with structured implementation guidelines 

 Release
Management Process Flow 
 Cognizant has put in place a release management team who will work closely with change management and configuration management
teams of Cognizant and Health Net to ensure that the changes are implemented as per the release schedule. The frequency and type of releases will be determined mutually between the Cognizant release manager and Health Net during the course of
engagement. 

  

					
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 Release Management Process 

Cognizant understands that the current infrastructure hosted in the Datacenter has a usable life of over 3 years, where at that time we will review the need
the for a technology refresh. This provides us with a unique opportunity to review and enhance the overall environment at the same time as the refresh. 

Cognizant would look to follow the principles below when considering transformation 
  

	 	•	 	Software currency roadmap 

  

	 	•	 	Future Growth plan 

  

	 	•	 	Out-of-support technology 

  

	 	•	 	Compliance 

  

	 	•	 	Cost reduction 

  

	 	•	 	Standardization 

 Typical activities that Cognizant will perform during tech refresh process are: 

 

	 	•	 	Conduct services and activities associated with the technology refresh to modernize the IT infrastructure on a continual basis 

  

	 	•	 	Establish, implement, and manage plans, policies and procedures regarding continual technical improvement and publish to Health Net 

  

	 	•	 	Maintain the Technology Refresh Plan for all the Infrastructure/Software currency in line with the approved technology plan 

  

	 	•	 	Design, Build, upgrade, replace and test hardware and software components with appropriate new technology 

Roles and Responsibilities: Release Management Process 
  

					
	 Release Management Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	 Administer the version control system as it relates to Release Management of Health Net applications
	  	X	  	
			
	 Establish Release Management plans for major releases
	  	X	  	
			
	 Review Release Management details with Health Net and alter as appropriate (e.g., back out plan, go/no go decision)
	  	X	  	
			
	 Ensure Release Management Services processes are consistent across all environments (e.g., development, test and production)
	  	X	  	

  

					
	SOW#4 (Information Technology) A-3-4	  	A-3-4-28	  	Health Net / Cognizant Confidential

 Final 
  

 3.1.5 Change Management 

Goals and Objectives 
 The Change Management process is
used to ensure that standardized methods and procedures are used for the efficient and prompt handling of all changes. The Change Management process is designed to minimize the impact of change-related incidents on service quality, and consequently
improve the day-to-day operations of the organization. 
 The change management process will perform the following activities:- 

 

	 	•	 	Recording the change requests 

  

	 	•	 	Accepting the change request 

  

	 	•	 	Classifying the change requests 

  

	 	•	 	Building and Testing the change 

  

	 	•	 	Implementing the change 

  

	 	•	 	Evaluating the business impact of the change 

 Change Management Process Flow 

Cognizant will follow an extensive ITIL based change management process. Cognizant will utilize ServiceNow to run the Change Management process after receiving
change tickets. The change management process will be run along with Cognizant application team to ensure that all changes are approved after validation of application impact. Cognizant will implement the changes in the Health Net environment as per
the process below: 

  

					
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 Change Management Process Flow 

  

					
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 The Change Advisory Board (CAB) will consist of Health Net and Cognizant members and will take all decisions
on planned and emergency changes. The CAB will be formed during the transition phase and will continue into the steady state of the engagement. The CAB will perform the following activities but not limited to: 

 

	 	•	 	Reviews respective agenda and details of each RFC on the agenda prior to each CAB meeting based on Report distributed 

  

	 	•	 	Approves/disapproves or requests more information for each RFC 

  

	 	•	 	Assess Emergency Changes (for example outage due to hardware failure, as required) 

  

	 	•	 	Participates in scheduling and coordination of change schedule 

  

	 	•	 	Ensures all changes are properly assessed and evaluated 

  

	 	•	 	Participates in Change Management process review and evaluation (efficiency and effectiveness of Change Management) 

  

	 	•	 	Review all opened RFCs 

  

	 	•	 	Other necessary tasks to complete the change 

 The CAB consists of the following members from Cognizant: 

 

	 	•	 	Change Manager 

  

	 	•	 	Incident Manager 

  

	 	•	 	Delivery Manager 

  

	 	•	 	Application support team 

  

	 	•	 	Use case Lead 

 Health Net will be represented by: 

 

	 	•	 	Health Net Operations Team 

 Emergency Change Management 

Any service interruption that is identified as high impact, where the number of users affected or systems or services that are critical to the organization are
involved, must be attended to immediately. The resolution of the problem must be accomplished quickly, and will adhere to the following emergency process flow. 

  

					
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 The procedure to be followed is the following: 
  

	 	•	 	An urgent meeting of the ECAB (Emergency Change Approval Board) will be held 

  

	 	•	 	If it is difficult for the ECAB to meet or if it occurs over a weekend or during a holidays a decision is needed from the change manager to postpone the problem resolution 

As the priority objective in the event of emergency changes is to restore service, it may be needed for the associated processes to follow an out of sequence
process order from the normal case (i.e. the CMDB is recorded and the associated documentation completed after the change has been made). 
 However, it is
essential that when the emergency change is closed, the change information is recorded as it would be in the case of a normal change. If not, future changes may result in incompatibilities, incorrectly recorded configurations, etc. and could give
rise to new incidents and problems. 
 Emergency changes are covered in the SLA document and it would be based on a Severity 1/ Severity 2 situation. The
number of emergency changes with regards to total number of infrastructure changes should not exceed 10% in a month. 

  

					
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 Roles and Responsibilities: Change Management 

 

			
	 Roles
	  	 Responsibility

	Change Manager	  	 •    Accepts, filters, and classifies RFCs.

 
 •    Obtains required
authorization for the change.
  

•    Plans and coordinates the implementation of the change.

 
 •    Reviews implemented
RFCs to ensure the objective was met.
  

•    Assembles CAB for emergency RFCs.

 
 •    Generates change
management reports.

  

					
	 Change and Release Management Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	 Participate in weekly CAB meetings
	  	X	  	X
			
	 Establish Change classifications (impact, severity, risk) and Change authorization process, including a list of contacts authorized to
request Changes to scope by level of authority and any updates thereto
	  	X	  	X
			
	 Document and classify proposed Changes to the CAB, including required risk impact, test plans and back out plans of those
Changes
	  	X	  	
			
	 Develop and maintain a schedule of planned Changes and provide to Health Net for review as required
	  	X	  	
			
	 Determine Change logistics
	  	X	  	
			
	 Communicate and coordinate recommended Changes with all affected parties
	  	X	  	
			
	 Schedule and conduct Change and Release Management meetings to include review of planned Changes and results of Changes made
	  	X	  	
			
	 Provide and continually maintain Change Documentation
	  	X	  	
			
	 Authorize and approve scheduled Changes or alter the schedule of any or all Change requests
	  	X	  	X
			
	 Notify Health Net and other Third Parties of Change timing and impact
	  	X	  	
			
	 Implement Change and adhere to detailed release plans
	  	X	  	
			
	 Modify and update systems and documentation impacted by implemented Changes (e.g., CMDB, Asset Management System, Service catalog (if
applicable), DR plan, SOP)
	  	X	  	
			
	 Verify that Change met objectives and Resolve negative impacts from the Change
	  	X	  	
			
	 Monitor Changes and report results of Changes and impacts and provide single portal access to reports and associated logs
	  	X	  	
			
	 Manage Change communication with Health Net and Third Parties as required
	  	X	  	

  

					
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	 Change and Release Management Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	 Perform quality control activities and approve Change results
	  	X	  	X
			
	 Secure and maintain master copies of all in-scope Software versions in a secured Software library and update CMDB
	  	X	  	
			
	 Implement and document out-of-CAB-cycle changes related to the Infrastructure components
	  	X	  	

 3.1.6 Capacity Management 

Goals and Objectives 
 The goal of capacity management is
to optimize the capability of the IT infrastructure in order to deliver a cost-effective and sustained level of availability that enables the business to satisfy its objectives. The goal of capacity management is to continuously optimize existing
and future IT resource demands and supply. Based on this optimizing goal, the capacity management process maintains a capacity plan and initiates requests for change that may result in environmental updates or new facilities. 

The activities include: 
  

	 	•	 	Monitoring the infrastructure components to ensure the agreed-upon service levels are reached 

  

	 	•	 	Analyzing the data monitored from the previous activity and creating trends to establish baselines 

  

	 	•	 	Tuning the systems based on the established baselines 

  

	 	•	 	Implementation of new or changed capacity 

  

	 	•	 	Influencing the demand for capacity. This activity provides important inputs into both the capacity plan and service level agreements 

 

	 	•	 	Gathering and updating technical, business, and other information relevant to the Capacity Management database 

Capacity Management Process Flow 
 Cognizant will adopt a
structured process for capacity management to ensure that the current and future needs of the business with respect to IT infrastructure are provided cost effectively by understanding the performance trends of existing infrastructure and business
needs in line with the technology changes in the industry. This will be discussed with Health Net periodically in monthly governance meetings. Cognizant will gather all the necessary inputs to the capacity plan from incident information from
incident management, CMDB and performance management tools. (Refer to the tools section for more details). 

  

					
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 Capacity Management Process is broken down into following sub-processes 

Business Capacity Management—Typical strategic activities to plan and implement business requirements in a timely manner are: 

 

	 	•	 	Ensure that future business requirements are planned and implemented in time 

  

	 	•	 	Understand Health Net’s capacity requirements including business demands which can be brought forward at the governance meetings with the Health Net Program Manager 

 

	 	•	 	Design new services or make recommendations for procuring hardware and software, where performance and /or Capacity are needed 

  

	 	•	 	Propose service design targets to SLM that can be monitored 

  

	 	•	 	Provide SLM with information, any analysis done to the SLA breaches 

  

	 	•	 	Use the current resource utilization data to trend, forecast or model the future requirements. Consider business inputs, plans outlining new services, any improvements and growth envisaged in existing services while
forecasting for future requirements 

 Service Capacity Management—Typical tactical activities to performed to compliance with
service level agreements 
  

	 	•	 	Monitor applications and business processes and understand resource consumption patterns and cycles to ensure SLAs are met 

  

	 	•	 	Record, analyze and report the data 

  

	 	•	 	Ensure data is collected, services are modeled, and normal service level trends are maintained 

  

	 	•	 	If service related incidents / problems are raised pertaining to Capacity, evaluate the issues and provide necessary inputs 

  

	 	•	 	Raise RFCs pertaining to service capacity through formal Change Management Process 

  

	 	•	 	Establishing acceptable capacity thresholds 

 Resource Capacity Management—Typical operational
activities to manage the capacity and performance of individual components within the infrastructure in a timely fashion are 
  

	 	•	 	Monitor, measure and record utilization details for all the individual components within the infrastructure; this will be discussed at monthly PMR meetings and appropriate action will be agreed upon 

 

	 	•	 	Analyze the collected data and prepare utilization reports and exception reports 

  

	 	•	 	Whenever exceptions (threshold , SLA breach) occur take short-term or immediate actions (disk clean-up, fine tuning, etc.) to meet business requirements 

 

	 	•	 	Provide solutions to resolve any incidents, problems pertaining to capacity. If any change is necessary implement using the RFC process 

 

	 	•	 	Establishing acceptable capacity thresholds 

  

	 	•	 	Obtain Health Net approval for procuring additional capacity 

 As this is an ongoing activity, each capacity
management request would logically follow a well-defined process to maintain consistency. As a result of the capacity plans, there can be a trigger to the change management process and subsequently to procurement process. Both these activities will
involve the discussion and approval from Health Net before an actual change can be made. Also based on the future growth forecast of Health Net, Cognizant will jointly work to frame the capacity plan. The high level approach is outlined below: 

  

					
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 Capacity Management 

Roles and Responsibilities: Capacity Management 
  

			
	 Roles
	  	 Responsibility

	 Capacity Manager
	  	 •    Forecasting future service capacity requirements

 
 •    Providing
consulting expertise for the review and creation of any external contracts that include capacity clauses
  

•    Use of modeling tools and other capacity planning techniques

 
 •    Changing the batch
schedule
  

•    Capturing metrics and creating performance reports

 
 •    Submitting RFCs for
schedule changes
  

•    Ensuring high availability (24x7)

  

					
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	 Capacity Management Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	Establish and continually maintain a comprehensive Capacity Management planning process	  	X	  	
			
	Review and approve Capacity Management planning process	  		  	X
			
	Develop capacity plans that meet Health Net demand and growth projection and SLRs	  	X	  	
			
	Review and approve capacity plans	  		  	X
			
	Define future capacity requirements and define thresholds	  		  	X
			
	Participate in all capacity planning reviews	  		  	X
			
	Assess capacity impacts to all technology when adding, removing or modifying services	  	X	  	
			
	Continually monitor IT resource usage to enable proactive identification of capacity issues	  	X	  	
			
	Recommend Changes to capacity to improve service performance and/or reduce costs	  	X	  	
			
	Assess impact/risk and cost of capacity Changes	  	X	  	

 3.1.7 Asset Management 

Goals and Objectives 
  

	 	•	 	Prolonging asset life and aiding in the decision to rehabilitate/repair/replacement assets through an efficient and quick method 

  

	 	•	 	Meeting Health Net demands with a focus on system sustainability 

  

	 	•	 	Meeting service expectations and regulatory requirements 

  

	 	•	 	Improving response to emergencies 

  

	 	•	 	Maintain License Compliancy for Hardware and Software 

 Asset Management Process 

The following activities would be performed under the asset management that would be provided by Cognizant: 

 

	 	•	 	Tracking and Reporting 

  

	 	•	 	Assets hosted and managed in cognizant datacenters 

  

	 	•	 	Ensure auditable control of all end points (deployed, stock, repair, quarantine, legal hold) 

  

	 	•	 	Identify location of end points using a Unique ID 

  

	 	•	 	Update Asset management tool (ServiceNow) 

  

	 	•	 	Report generation 

  

	 	•	 	Asset Purchasing Management 

  

					
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	 	•	 	Includes all the purchase activities only for Cognizant’s data center equipment 

  

	 	•	 	Asset management tools Manage ServiceNow would be used to track PO management for the Cognizant data center equipment only (this is an offline and manual activity ) 

 

	 	•	 	Cognizant would provide monthly procurement forecast report to Heath Net as part of Desktop/Laptop refresh activity 

  

	 	•	 	Stock Management 

  

	 	•	 	Hold and Manage stock, transfer stock between sites 

  

	 	•	 	Order and receive/ dispatch equipment 

  

	 	•	 	Disposal 

  

	 	•	 	Health Net would identity the EUC component (desktops, scanners, printers, etc.) that are to be decommissioned (such as end of lease equipment, complete hardware break down, etc.) 

 

	 	•	 	Cognizant would co-ordinate with existing Health Net contracted vendor for the asset disposal for recycling 

Note: High level Depot activities and responsibilities are detailed in the Health Net IO Program Solution documents in the
Section 2.3.3.2 
  

	 	•	 	Support Repair Activities 

  

	 	•	 	Diagnosis, warranty and non-warranty repairs 

  
 

 
 Asset Management Workflow 

The ARC/RRC billing will be tied into asset management process through the ServiceNow tool which would be utilized to have up to date inventory of assets to
enable the unit price model. 

  

					
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 Asset Tracking and Reporting 

Cognizant’s solution principles for managing asset data and achieving high quality include a comprehensive approach to asset management and tracking.
Asset data in the asset database is created and maintained as the result of notifications from lifecycle activities, these data are continuously validated against what is found on the estate by manual audits or other trusted data sources (e.g. 3rd
party contract schedules). Using asset data updates from change management and underpinning with a robust validation process typically results in data accuracy above 95%. 

Cognizant Asset Tracking and reporting Team, which will be a part of the SMO, will actively investigate all data exceptions to discover the true status of
each asset. Cognizant will be responsible for maintaining the asset data and accountable for its accuracy. Cognizant will have an Asset and Procurement Manager to be accountable for the maintenance of the data. This role will be based at Onsite. A
team of Asset Management resources to perform data cleansing and processing will be located at Offshore to provide the service. 
  

 
 Asset Management Team 

Cognizant will be responsible for ensuring that the Asset processes for all activities for which they are responsible are fully integrated with the asset
lifecycle management processes, and will also work with Health Net to review the processes which impact asset lifecycle management and make recommendations 

  

					
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for improvements necessary to enable the maintenance of high quality asset data. Cognizant would use ServiceNow to Track and report Hardware, software inventory and ensure software license
compliance for assets hosted and managed in Cognizant Datacenters. ServiceNow is a web-based IT Asset Management (ITAM) tool that helps to monitor and manage assets. 

Asset Purchasing Management 
 The Procurement service will
interface with asset management service, to check inventory levels before initiating new purchase orders. Cognizant will use ServiceNow for offline reporting of the asset inventory. The re-ordering levels will be decided during due diligence phase.
Cognizant’s vendor management team will be responsible for management of the procurement and interaction with Health Net/ Cognizant’s 3rd party vendor. Shown below is the process flow to be followed for asset procurement: 

  

					
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 Procurement Management Process 

  

					
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 End User Asset Management Services 

Cognizant will provide End point provisioning, re-provisioning and decommissioning Service by a service request/IMAC request to add and remove
standard end Points to/from the Health Net environment. This service will be delivered in an Onsite-Offshore model, where the Offshore team will service activities such as image deployment, user migration, active directory updates, and the Onsite
team will coordinate with desk side teams and stock management teams for the execution of the “touch services” associated with the service requests. CMDB and inventory/asset system updates will be in line the asset management functions.
The process will be managed by coordinators from the key primary sites and Cognizant Offshore delivery centers. Hardware stock management will be driven by dedicated procurement coordinators in key primary hub sites (sites which have high density of
devices) and Onsite teams located in other primary sites. The service will closely work with the asset management service for managing stock assets, and utilize CMDB updates and asset/inventory management platform of Cognizant for stock tracking and
reporting. 
 Desk side Services also includes depot service as part of the solution. Cognizant assumes Health Net would provision Secured
room/warehouse to maintain Spares/inventory for EUC devices at identified locations. 
 Typical high level activities performed by depot
support team would entail the following: 
  

	 	•	 	Depot Support will maintain the inventory of spares/ in order to facilitate desktop/laptop/printers part replacement for sites under its administration area 

 

	 	•	 	Depot Support will receive/maintain the inventory of New desktop/laptop to install new system or replace existing PC for the users 

  

	 	•	 	Dispatching Parts and Repairing devices by replacing parts 

  

	 	•	 	Depot Support Location would assist in imaging and build services for Laptops/Desktops which are not pre-built by the OEM. 

  

	 	•	 	Depot Support will provision Laptops/Desktops to support home users for any quick replacements 

 Roles and
Responsibilities: Asset Management 
  

					
	 Asset Management Services Roles and Obligations
	  	 Cognizant
	  	 Health Net

	 Provide an Asset Management System, processes and procedures for all Health Net hardware and Software.
	  	X	  	
			
	 Manage lifecycle of all in-scope Assets from requisition ordering, inventory, installation, preventative maintenance to
disposal
	  	X	  	

  

					
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	 Asset Management Services Roles and Obligations
	  	 Cognizant
	  	 Health Net

	 Provide Health Net inquiry and reporting access into the Asset Management System for all Assets including data access via a real-time
access reporting portal in exportable and analyzable format and ad hoc and recurring (e.g., monthly) reports
	  	X	  	
			
	 Input, maintain, update, track and report all in-scope Assets throughout the Asset lifecycle (i.e. acquisition to retirement)
	  	X	  	
			
	 Continually maintain the accuracy of the data of Assets in the Asset Management System according to SLRs
	  	X	  	
			
	 Update Asset records related to all Change activities (e.g., Install/Move/Add/Change/Disposal (IMACD) activities, Break/Fix activities,
enterprise reorganization and Change Management activities)
	  	X	  	
			
	 Provide, and upon Health Net approval, implement remediation plans for Asset Management System deficiencies
	  	X	  	
			
	 Review and approve physical Asset inventory reports and remediation plans of the Asset Management System
	  		  	X
			
	 Reporting the end-of-life assets/technology obsolesce
	  	X	  	
			
	 Tech Refresh
	  	X	  	X

 3.1.8 SLA Reporting 

Goals and Objectives 
  

	 	•	 	To present a clear, concise, and measurable description of service levels to Health Net 

  

	 	•	 	Proactive SLA Monitoring and Alerts to keep IT in Control 

  

	 	•	 	Real-time status and SLA trends over time 

  

	 	•	 	Management Reports based on services being monitored and reported to all stakeholders 

  

					
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 SLA Reporting Overview 

Cognizant will implement several controls and measures that will assure consistent quality of services are delivered to Health Net. Cognizant’s approach
to project and engagement reporting is based on accuracy, transparency and timeliness. 
 Cognizant will implement a rigorous Service Level Management
(ITIL) process to improve IT service quality via constant Monitoring and Reporting/Reviewing to meet Health Net business objectives. As part of monitoring, reporting and reviewing the following activities will be conducted: 

 

	 	•	 	Monitoring SLA / KPIs using dashboard, alerts and reports 

  

	 	•	 	Reporting, both scheduled and ad-hoc 

  

	 	•	 	Disagreements and queries review, and resolution using corrections and exceptions 

 Our Cognizant proposed HP
service Health Reporter provides cross-domain reporting of the availability and performance metrics for the IT infrastructure elements and enabling these metrics to be directly related to the business services. HP Service Health Reporter will be
tightly integrated with HP OMW and HP NNMi to collect the performance data to be saved in PMDB (Performance Management database). This enables to storing the reporting long term trend analysis and cross domain analysis. HP SHR comes with a
comprehensive out of box reports which helps technical SME to use the tool quickly. 
 As part of Periodic Review Process, the following activities will be
conducted: 
  

	 	•	 	Review SLAs and KPIs with Health Net periodically 

  

	 	•	 	Publish and review achievements with the aid of standard reports 

 Health Net will receive a set of standard
reports that can include performance, utilization, and availability reports. These reports are scheduled and are provided to the client on a monthly basis. 

  

					
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 Sample Reports 
  

 

  

					
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 Roles and Responsibilities: SLA Reporting 
  

					
	 SLA Reporting Services Roles and Obligations
	  	 Cognizant
	  	Health Net
	Define Service Level Monitoring and Reporting Services requirements and policies	  		  	X
			
	Define SLRs	  		  	X
			
	Report on SLR performance and improvement results	  	X	  	
			
	Coordinate SLR monitoring and reporting with designated Health Net representative and Third Parties	  	X	  	
			
	Measure, analyze, and provide management reports on performance relative to SLRs	  	X	  	
			
	Develop and deliver SLR improvement plans where required	  	X	  	

  

					
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 3.1.9 Knowledge Management 

Goals and Objectives 
 The key goal of various initiatives
in knowledge management is to provide tactical support to enable improvements in the use and effectiveness of the knowledge base. The following are the detailed objectives: 
  

	 	•	 	Productivity benefits and cost reduction 

  

	 	•	 	Improved resolution time and effort 

  

	 	•	 	Provide potential to expand and grow 

  

	 	•	 	Encourage free flow of ideas leading to insight and innovation 

  

	 	•	 	Foster a collaborative culture 

  

	 	•	 	Facilitate better, more informed decision 

  

	 	•	 	Increase Health Net satisfaction 

  

	 	•	 	Continuously collect, store, manage and update explicit and tacit knowledge 

 Cognizant will develop a
knowledge repository for Health Net right from the beginning of the engagement. During the transition phase, Cognizant would document all its learning from the Health Net environment, standard operating procedures (SOPs), processes etc. and place
them in the repository. This repository would form the basis of how the support would be provided to Health Net during the steady state. During steady state, Cognizant would document and collect all the information related to process improvement,
issue resolution, etc. These documents would also become part of the repository. 
 With the help of knowledge repository, Cognizant’s support teams
will be better equipped to handle the user queries and asking them the right questions to understand their issues / requirements. 

  

					
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 Knowledge Management Process 
  

 
  

	 	•	 	Knowledge Process Manager creates a new article, either directly on the Knowledge form or from an incident or problem (one of the functions performed by CSI/Transformation Architect) 

 

	 	•	 	Administrator adds roles to the article, if appropriate, and changes the workflow state to Review 

  

	 	•	 	Knowledge Process Manager verifies that the article is not a duplicate and edits the content, as necessary 

  

	 	•	 	Administrator changes the Workflow field to Published 

  

	 	•	 	Article is available to appropriate users through the knowledge portal and search 

 All of Cognizant’s
support resources would undergo training on using the knowledge repository. This training would specify: 
  

	 	•	 	The kind of questions to be asked to triage the problem at the first level 

  

					
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	 	•	 	Steps to be taken to narrow down the cause. E.g., if the user reports that he cannot send/receive mails, the analyst would narrow down the problem using a series of questions to identify if it’s a network issue, a
mailbox size issue or an exchange server issue 

  

	 	•	 	Resolution methodology 

 Upon receiving the call, the L1 team will identify the problem. During identification,
the L1 team would check if there is any solution / workaround available in the repository. If available, the L1 team will solve the issue and close the ticket. Otherwise, the analyst would escalate it to the proper support team. The use of
repository thus would increase the efficiency of the analysts in resolving the issues. The reports on the KEDB usage will be retrieved monthly. 
  

 
 Typically, in any engagement, the knowledge base is initially small. The First level resolution team will forward most of
the issues it receives to Level 2 / Level 3 teams due to limited information in the repository. The Level 2 / Level 3 experts will resolve the incident and add their learning / solutions in the knowledge repository. As the engagement progresses, the
knowledge repository is filled with information specific to issue resolution. After some time, the First level resolution desk will start resolving more issues, thus increasing the First Call Resolution (FCR) % and decreasing the turnaround time to
solve these issues. 

  

					
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 Roles and Responsibilities: Knowledge Management 

 

			
	 Roles
	  	 Responsibility

	CSI/Transformation Architect	  	 •    Ensure that the KM process supports the Technical Support team,
Support Groups, End Users and the other processes
  

•    Preparing management reports and ensuring Knowledge Article reviews

 
 •    Reviewing monthly
management metrics and taking action where necessary to ensure compliance, governance, and continued process maturity
  

•    Knowledge monitoring and interaction to other processes

 
 •    Making
recommendations for Process Improvement Plans

 3.1.10 Service Request Management 

Goals and Objective 
 The Service Request Processes manage
submission and handling of all requests for service to ensure: 
  

	 	•	 	Service requests are properly logged 

  

	 	•	 	Service requests are properly routed 

  

	 	•	 	Service request status is accurately reported 

  

	 	•	 	Queue of unfulfilled requests is visible and reported 

  

	 	•	 	Service requests are properly prioritized 

  

	 	•	 	Solution provided meets the requirements specified by the user 

  

					
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 Service Request Process Flow 

 
 

 
  

	 	•	 	Perform the same functions and will have the same responsibilities for Service Requests as required for Incident Management, including: 

 

	 	•	 	Monitor, identify, integrate and resolve requests in Health Net’s environment, in accordance with the Service Levels 

  

	 	•	 	Provide Health Net’s representative with the estimated resource or cost impacts of Service Requests 

  

	 	•	 	Participate in Health Net’s IT Project process where applicable for the Services including but not limited to: participate in Project planning meetings, solution design sessions, provide timely estimates for
resources or cost impact of Service Requests, contribute knowledge and expertise, including information based on “lessons learned” and experience with similar technologies used with the Cognizant’s other customers. 

  

					
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	 	•	 	Provide support for Service Requests, including interfacing with the Health Net entity initiating the Service Request and providing support for the following: the documentation standards; production task list and run
sheet updates; informing day-to-day staff of the changes to the environment; and support for Health Net’s coordination and acceptance of any Service Request deliverables 

 

	 	•	 	Escalate unresolved requests according to Health Net procedures. Health Net has the right to escalate at any time it deems necessary to meets its operational needs 

 

	 	•	 	Address all Service Requests promptly after receipt; monitor, control, and report on each request until complete or otherwise resolved 

 

	 	•	 	Provide a mechanism for expedited handling of Service Requests identified to Cognizant by Health Net as a high priority 

  

	 	•	 	Track and manage all Service Requests from Authorized Users 

  

	 	•	 	Fulfill Service Requests by working with service management teams, Business owners, and Third-Party Vendor(s) 

  

	 	•	 	Liaise with Change Management to ensure that Service Requests follow the Change Management Process for Standard Changes and Requests For Changes (RFCs). 

 

	 	•	 	Liaise with Access Management to ensure that Service Requests follow the Access Management Process for access to a service. 

  

	 	•	 	Verify the request is fulfilled to Health Net user’s satisfaction prior to closing the ticket. If not fulfilled correctly, re-open the original ticket (user does not need create a new ticket) 

 

	 	•	 	Provide regular reporting identifying tasks, present current status reports and identify potential bottlenecks and problems. Cognizant will also notify user promptly of any problems that might affect the expected
fulfillment date. In addition, Cognizant will provide user Service Request status reports on a monthly basis or as needed, including statistics on number of outstanding requests and planned completion dates, number of requests received for the
current month, number of requests completed for the current month, and average time to complete requests (e.g., current month, year-to-date) 

Roles and Responsibilities: Service Request Management 
  

			
	 Role
	  	 Responsibilities

	Service Request Manager	  	 •    Develop task lists for the more complex and most common Assistance
Service Requests. For example, a new employee needs active directory id and email account (Server Group), New PC (PC Group). These task lists will be set in CRM for the related service and used to provide more detail in each case

 
 •    Monitor request
queue to ensure all requests are being handled
  

•    Make final decision on priority of items in the request queue

 
 •    If necessary, make
decision on which resources need to be involved in fulfilling the request

  

					
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	 Role
	  	 Responsibilities

		  	 •    Review service task lists for request fulfillment to ensure policy
compliance, value tasks for service being rendered, and for any vulnerabilities or risks
  

•    Perform post-implementation review to ensure that all services are functioning properly
and all documentation is complete
  

•    If issues arise during the service delivery, review service task list compliance or
improvement needs
  

•    Monitor adherence to the agreed upon SLAs/KPIs for Service Request
resolution

  

					
	 Service Request Management Roles and Obligations
	  	 Cognizant
	  	Health Net
	Initiate Service Request	  	X	  	X
			
	Creation of new SRs	  	X	  	X
			
	modification of existing SRs	  	X	  	
			
	Accept Request from Health Net	  	X	  	
			
	Determine whether this request is a request for assistance or change	  	X	  	
			
	Prioritize SR’s in the queue	  	X	  	
			
	Select next SR to be worked on	  	X	  	
			
	Implement technical solution	  	X	  	
			
	Verify solution with Health Net	  	X	  	
			
	Close case	  	X	  	
			
	Develop checklists to be followed for Service Requests	  	X	  	
			
	Verify checklists are being utilized for SR’s	  	X	  	
			
	Develop task lists for SR’s to be utilized by Service Desk	  	X	  	

  

					
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 3.1.11 Patch Management 

Goals and Objectives 
 Patch management is the process of
controlling the deployment and maintenance of interim software releases to production environments. It aims to ensure all patches required for system functionality and security. Patch Management also ensures the successful completion of patches
without any failure. 
 The objective of the Patch Management procedure is to define a standard method based on the best practices available in the industry
to carry out the installation of all patches. 
 Considering the criticality of the patch management process, Cognizant will ensure that there is seamless
integration of the release management and change management process. To achieve this, Cognizant has configured a dedicated release manager to drive successful patch implementation in the environment. 

Patch Management helps maintain: 
  

	 	•	 	Operational efficiency 

  

	 	•	 	Effectiveness 

  

	 	•	 	Overcome security vulnerabilities 

  

	 	•	 	Stability of production environment 

  

					
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 Patch Management Process 

The following activities would be performed under patch management workflow provided by Cognizant: 

 
 

 
 Patch Management Workflow 

 

	 	•	 	Notification is received from OEMs in advance of the normal release period 

  

					
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	 	•	 	Release manager identifies the criticality of the patches 

  

	 	•	 	Classify the criticality type of path as either a routine path or a project path and patches to be made available for testing 

  

	 	•	 	Test the patches and perform impact analysis 

  

	 	•	 	Deploy the patches to the test environment 

  

	 	•	 	Once successful, RM raises the change request for patch deployment to production 

  

	 	•	 	Health Net approves patch deployment recommendations and Cognizant initiates patch deployment 

 Roles and
Responsibilities: Patch Management 
  

					
	 Patch Management Services Roles and Obligations
	  	Cognizant	  	Health Net
	 Patch Validation
	  	X	  	
			
	 Patch Criticality Definition
	  	X	  	
			
	 Patch Testing and Impact Analysis
	  	X	  	
			
	 Patch Production Deployment
	  	X	  	
			
	 Patch Failure machines Remediation
	  	X	  	
			
	 Patch Update Reports
	  	X	  	
			
	 Update CMDB
	  	X	  	
			
	 Approval of patch deployment recommendations
	  		  	X

 3.1.12 Software Currency 

Goals and Objectives 
 Cognizant’s asset management
team will administer Health Net’s license and currency management. This team will be entrusted with tracking the currency of IT software/entities such as Operating System, Database, Servers, Network and Routers etc. The asset management team
coordinates with OEM for any updates. The update is driven by the following: 

  

					
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	 	•	 	The particular software is EOL ( End of Life) 

  

	 	•	 	OEM mandated critical updates 

  

	 	•	 	Application driven changes 

 This will help in: 

 

	 	•	 	Inventory tracking 

  

	 	•	 	Usage metering 

  

	 	•	 	License harvesting 

  

	 	•	 	Compliance verification 

 Software Currency Management Process 

Cognizant will use ServiceNow to track and report software inventory and ensure software license compliance. It is a web-based IT Asset Management (ITAM) tool
that helps to monitor and manage assets. 
 Cognizant will have regular meetings with Health Net on the importance of the changes and the implementation
plan based on Health Net’s technology refresh plan and application release calendar. Once Health Net approves the change, Cognizant will follow the change management process to implement the change including testing and UAT deployment and
finally production deployment. For application driven software updates, there will be a comprehensive testing plan to ensure all critical applications run without downtime. The software currency for Health Net would be managed at N-1 level for most
of the software and at N-2 level which has dependency on other release activities like application upgrade etc. (N-OEM Vendor major release versions). 

Roles and Responsibilities: Software Currency Services 
  

					
	 Software Currency Services Roles and Obligations
	  	Cognizant	  	Health Net
	 Provide an Asset Management System, processes and procedures for all Health Net Software
	  	X	  	
			
	 Manage lifecycle of all in-scope software Assets from inventory tracking, usage metering to compliance verification
	  	X	  	
			
	 Provide Health Net inquiry and reporting access for all software Assets including data access via a real-time access reporting portal
in exportable and analyzable format and ad hoc and recurring (e.g., monthly) reports
	  	X	  	
			
	 Testing the updates and deployment in production
	  	X	  	
			
	 Review and approve physical Asset inventory reports and remediation plans of Asset Management System
	  		  	X

  

					
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 3.1.13 Project Life-cycle Management 

Goals and Objectives 
 A “Project” is a discrete
unit of non-recurring work that generally requires startup, planning, execution, and completion with a definite start date and finish date. 
 The goal of
Cognizant’s Project Life-cycle Management is to integrate our industry’s operational and functional expertise in IT management and our deep Health Net experience and insight to ensure successful project implementation and value
realization. Effective project process management includes strategies, tactics, and tools for managing the design, development and delivery processes and for controlling key factors to ensure that Health Net’s infrastructure matches their
expectations and business functions. 
 The planning and execution of in-flight projects are based on Cognizant’s proven experience and will be
modified to meet Health Net -specific requirements. Some of the critical factors to be considered during the analysis of the in-flight projects are: the current stage of the project or enhancement timelines, business priorities, size, dependencies
between in-flight projects, etc. 
 Cognizant understands that in-flight projects will run alongside the Transition phase of this engagement. For such
projects Cognizant will mutually agree on a roadmap to take over project execution from Health Net if feasible. The project timelines and its impact to the Transition will also be evaluated and agreed upon by both parties. 

  

					
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 High Level Project Lifecycle Process Flow 

Cognizant will adopt a Project Lifecycle process flow to ensure that the current and future needs of Health Net with respect to IT are provided cost
effectively. 
 Health Net would send out a BARR document through their project team that would include the Health Net’s IT requirements to
Cognizant’s Account team. Cognizant’s Account and IO team would follow Health Net’s requirements based on the Health Net’s approved BARR document. Once the requirements are understood and agreed upon in terms of the scope and
capabilities, Cognizant’s IO and Account team would proceed with initiation of the project. The project life cycle framework in-place would be used and the Cognizant team would work with all the stake holders involved to plan and get the
necessary approvals and budget to deliver the project within the stipulated timeline as per the agreed terms and conditions. This diagram below depicts the high level project lifecycle process flow: 

 
 

 
 Project Lifecycle Process flow 

  

					
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	 	•	 	Analysis of the high level business requirement for the project 

  

	 	•	 	Preparation of project schedule, project design and project management plan 

  

	 	•	 	Project Estimation and technical solution provided by Cognizant for Health Net’s approval 

  

	 	•	 	Build/Implement the project deliverables 

  

	 	•	 	Test the build environment and report to Health Net 

  

	 	•	 	User Acceptance test by Health Net IT team 

  

	 	•	 	Sign off by Health Net for the successful completion of the project 

 Project Lifecycle Methodology 

This Project Lifecycle Methodology to be followed will be mutually agreed by Cognizant and Health Net. This will be based on the current Health Net Project
Management processes and Cognizant’s standard project lifecycle methodology during the start of the engagement. The diagram below shows Cognizant’s project lifecycle methodology: 

  

					
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 Cognizant’s Standard Project Lifecycle Methodology 

Roles and Responsibilities: Project Process Management 
  

			
	 Roles
	  	 Responsibility

	Project Process Manager	  	 •    End to end management of project requests

 
 •    Coordination with
Health Net for all approvals related to the project

  

					
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	 Roles and Obligations
	  	Cognizant	  	Health Net
	 Initiate Project Request
	  	X	  	X
			
	 Prepare Project Process Plan and Design
	  	X	  	
			
	 Review and approve Project Management Plan and Design
	  		  	X
			
	 Pilot Testing
	  	X	  	X
			
	 User Acceptance Testing
	  		  	X
			
	 Approval of UAT/Test Phase Successful Completion
	  		  	X

 The above process flows and diagrams are for better understanding of the functions. In the event of a conflict between the
solution and the scope model, the scope model document will be referred. 
 3.1.14 Infrastructure Testing 

Goals and Objectives 
 Infrastructure testing depends on
the nature of the change and the impact to the infrastructure. The objectives of Infrastructure Testing lifecycle which Cognizant has planned for Health Net are as outlined below: 

 

	 	•	 	Infrastructure impact assessment 

  

	 	•	 	Creation of test scenarios and test cases 

  

	 	•	 	Validation of infrastructure and environment parameters using the test cases 

  

	 	•	 	Testing the functionalities of infrastructure and environment components 

  

	 	•	 	Validating that the Infrastructure and environments confirm to Health Net defined standards 

  

  

					
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 Infrastructure Test Life-cycle Management Process Flow 

Cognizant will follow a sequential and phased approach to the Infrastructure Testing requirement for approved Infrastructure projects (non-BAU). The Testing
Lifecycle that will be followed by the Cognizant team for each phase will provide Health Net the necessary understanding of our approach. Cognizant will leverage Health Net’s existing test case management tool for its infrastructure testing
case management. The number of licenses which will be required will be mutually decided at the appropriate time. 
  
 

 
 Requirement Understanding Phase 

In this phase the Business Requirement document, Design Documents and migration plans for the proposed Infrastructure change is shared with the team.
Cognizant, in collaboration with Health Net’s team, will analyze the documents to identify the infrastructure impacts and risks. The Cognizant team will conduct assessment sessions with Health Net and migration teams/vendors in order to
validate the understanding and the impact assessment. 

  

					
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 Test Planning Phase 

In this phase the Cognizant team will develop a Test Plan document which will describe how the testing will be carried out based on the approach specified in
the test strategy. The test plan document will contain a detailed plan for testing the parameters as defined in the checklist along with the project phase schedule and timelines. 

Test Case Design Phase 
 In this phase the Cognizant team
will prepare detailed Test Cases based on the scenarios identified. There may be multiple test cases created for one test scenario. The Test Cases will contain Description, Pre-condition, Design Steps, and Expected Results for the test scenarios.
The Test Cases will be then shared for review, approval and sign-off by the Health Net team. 
 Test Environment Check (Smoke Testing) 

The objective of this phase is to ensure that the test environment is ready for the Cognizant team to execute the tests. 

In this phase the Cognizant team will perform an initial check of the test environment which will include network connectivity to the Onsite Health Net
environment, validating the server log in credentials, etc. In case any test in this phase fails, further tests will not be carried out by the Cognizant team. 

Test Execution 
 The Cognizant team will implement a
2-pass approach in co-ordination with Health Net during the execution phase which is described below: 
 Pass 1: Test Cases defined in the Test Case
Design phase will be executed in this pass in order to identify any deviation and defects, and will be logged accordingly 
 Pass 2: Typically
consists of retesting of all deviation and defects that are found in Pass 1 and relevant regression testing if applicable. 
 Test Closure 

At the end of all the test phase, Cognizant team will produce a Test closure Memo which will have details on 

 

	 	•	 	The actual testing conducted against the scope 

  

	 	•	 	List of outstanding defects with the assessment 

  

	 	•	 	Details on required business dispensation for any deviation from entry / exit criteria 

  

	 	•	 	List of all the defects raised during the execution with status and comments 

  

	 	•	 	Certification note on whether the infrastructure/environment is in a state to go to next test phase 

  

					
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 3.1.15 COLO Service for Third Party in Data Center 

Goals and Objectives 
 This section details the process for
Co-locating Health Net contracted third party vendor’s IT infrastructure in the datacenter. 
 Cognizant would host these IT infrastructures in
Terremark’s Centennial datacenter and Cognizant’s Phoenix DC. More details on Datacenter service is detailed in Health Net IO program solution document. There is requirement to host third party’s asset in the Datacenter and the
following is the process that will be followed (to be refined during the course of the engagement): 
  

	 	•	 	Third party vendor would share the infrastructure details of the component to be hosted in DC such as 

  

	 	•	 	New requirement like application to be hosted and associated infrastructure and security controls if any 

  

	 	•	 	Configuration details—number of devices/racks , dimensions , power utilization , network details 

  

	 	•	 	Duration of hosting, hands and feet support requirements 

  

	 	•	 	Cognizant would perform capacity assessment regarding the required network bandwidth, MPLS link connectivity, floor space etc. 

  

	 	•	 	Datacenter team would design, rack and stack the equipment , install cable and other activities in consultation with the vendor 

  

	 	•	 	Depending on Health Net’s contractual agreement with the Third party vendor, charge back for the Co-locating service would be directly with the third party vendor or with Health Net 

Roles and Responsibilities: 
  

							
	 Co-locating Services
	  	 Cognizant/DC team
	  	 Vendor
	  	 Health Net

	 New hosting requirement in Datacenter
	  		  		  	X
				
	 Co-locating requirements for the asset
	  		  	X	  	
				
	 Assessment and Capacity management
	  	X	  	X	  	X
				
	 Professional services for racking and stacking in DC
	  	X	  		  	
				
	 Security assessment
	  	X	  		  	X
				
	 Change management process
	  	X	  		  	X

  

					
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	 Management service for the new requirement
		X		X		
				
	 Datacenter services such hands and feet support
		X				
				
	 Charge back for the co-locating services
		X				X
				
	 Termination of service
				X		X
				
	 Asset Disposal
						

  

					
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 4. Continual Service Improvement 

Cognizant has substantial experience in bringing about continuous improvements for large engagements. We have also developed a structured continuous
improvements framework to assist us to drive efficient and effective continuous improvement themes. This framework focuses on a set of parameters which Cognizant believes are instrumental in bringing about continuous improvement opportunities. 

 
 

 
 Cognizant will leverage the Operations Maturity (OM) Delivery Framework and Transformation Program Office (TPO) to identify
service improvements that can add value to Health Net. As a part of its OM Delivery framework, Cognizant will drive Continuous Service Improvement across the engagement through a proven methodology which will include Service Improvement Plans
(SIPs), Business Excellence projects (BizEx) and Service Transformation Programs (STPs), as depicted in the illustration below: 

  

					
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 During the stabilization phase of the Steady State support, Cognizant will analyze the feasibility of conducting service
improvement initiatives within Health Net’s environment, in order to improve the efficiency of the delivered services. During the course of the engagement, Cognizant will drive to suggest and execute more SIPs and STPs in Health Net
environment. 
 Cognizant will consider several input parameters to initiate Continuous Service Improvement requests as listed below: 

 

	 	•	 	Health Net Governance Review 

  

	 	•	 	Internal and Health Net Brainstorming 

  

	 	•	 	Escalation 

  

	 	•	 	Health Net Customer Satisfaction Survey 

  

	 	•	 	Voice of Process (this encompasses complaints or escalations, performance trends, voice of employees, business process mapping, technology improvements, automation opportunities, right sizing and skilling, service level
reports, process deficiencies and performance metrics) 

  

	 	•	 	Value Stream Mapping 

  

	 	•	 	CSI Catalogue – Operations, Technology and Automation Track (as depicted in the diagram above) 

 Cognizant
has a repository of successfully implemented Continuous Service Improvement initiatives which have been categorized into Operations, Technology and Automation. This repository has been built from our experience with other projects and will help us
in driving benefits to this engagement. 

  

					
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 Based on the input parameters several improvement initiatives will be streamlined and forwarded for internal
scrutiny. The initiatives will be then thoroughly screened and studied by the Delivery Managers and the OM team. The initiatives that are successfully screened will then be forwarded to Health Net for approval. Based on Health Net’s approval,
continuous improvement themes will then be approved for implementation within Cognizant. 
 Cognizant’s engagement once in Steady state will be
scoped-in for Transformation and Kaizen by default. Post transition, theme identification and CSI scope assessment will be completed one month after steady state. Such assessments will culminate into a transformation roadmap which Cognizant will
jointly prepare with Health Net. This transformation roadmap will then be presented to Health Net’s governing body for review, prioritization and approval before initiating the improvement plans. Depending upon project theme, suitable
methodology will be applied for project execution (Six Sigma DMAIC, Lean Technology, Transformation, automation). During internal practice level quarterly governance apart from review discussions, new project/themes will be included. These meetings
will revisit the transformation roadmap to identify the status of progress made. Brainstorming sessions with Delivery team Onsite and Offshore and process teams will be held on a quarterly basis. This encourages identification and addition of themes
throughout the year and not just at the beginning of the year. This also ensures that there is no predefined cap on the number of themes which will be implemented in a year to achieve the objectives of the transformation roadmap. The
CSI/transformation themes which involve CAPEX are planned separately from OPEX themes and will be implemented in parallel to OPEX initiatives with prior approval from Health Net and the same will be charged to Health Net accordingly. 

Our Continuous Service Improvements will focus on six key areas of this engagement as depicted below: 

Delivery Management, OM and TPO teams will together identify service improvements initiatives across these areas based on the engagement requirements and pain
points: 
  
 

 

  

					
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 EXHIBIT A-3-5 

[RESERVED] 

  

					
	SOW#4 (Information Technology) Exhibit A-3-5		 		Health Net / Cognizant Confidential

 SOW 4 Ex A-3-6 

EXHIBIT A-3-6 

NON-BPAAS SECURITY SOLUTION 

*** 
 [Represents 52 pages of material
pursuant to a request for confidential treatment under Rule 24b- 2 of the Securities Exchange Act of 1934 which has been filed separately with the Securities and Exchange Commission] 

 Final 
  

 EXHIBIT B 

IT SERVICE LEVELS 
  

	1.	CONTENT 

 This Exhibit B provides the Service Levels for the IT Services. It consists of
this document and the following: 
 Exhibit B-1: Service Level Metrics 

Exhibit B-2: Critical Services 

Exhibit B-3: Resolvable Call Categories 

Exhibit B-4: Service Request Completion Times 

Exhibit B-5: Procurement Request Completion Times 

Exhibit B-6: Reports 
  

	2.	APPLICABILITY 

 The Service Levels in this Exhibit B measure Supplier’s performance
of all IT Services, including those in support of BPaaS Services and Non-BPaaS IT Services, except as expressly provided otherwise below. 
  

	2.1	BPaaS Exclusions 

 The following Service Levels shall not apply to infrastructure used
solely in support of the BPaaS Services: 
 ##2-3: Production and Non-Production Server Availability 

##3-4: SAN and NAS Availability 

#5: Database Availability 

  

					
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 #6: Production Batch Job Scheduling 

#11: Production Server Backups 

#12: Production Server Recovery 

#13: Disaster Recovery Synchronization 

#15: Installation of Standard Servers 

#32: Capacity Reporting 
  

	2.2	Projects and Testing 

 The Service Levels in Rows 40 through 43 and 71 through 73 shall
apply to all Discretionary Projects and all Infrastructure Projects. 
  

	3.	DEFINITIONS 

  

			
	 Term
	  	 Definition

	Accurate Asset Data Field	  	A data field for an in-scope hardware asset is an “Accurate Asset Data Field” if the data elements in the asset configuration records in the CMDB for the in-scope hardware assets are complete and accurate, including with
respect to: (i) asset tag; (ii) serial number; (iii) asset location (site location / building only); (iv) product manufacturer; (v) product category (e.g., laptop, desktop, server); (vi) product model; and (vii) asset owner or user;.
		
	Accurate Inventory Records	  	The asset-level records in Health Net’s hardware inventory database that are complete and accurate. A record is not complete and accurate if: (i) an asset is missing from the database; (ii) the database includes an asset that
does not exist in Health Net’s environment; or (iii) Health Net can demonstrate any other inaccuracy in the database with respect to any asset.
		
	Actual Uptime	  	The aggregate number of hours during the Scheduled Uptime in any calendar month during which the applicable equipment, software, network devices, services, or Health Net Data are Available for Use.
		
	Availability	  	The extent to which such Equipment, Software, network devices, Services and Health Net Data are actually Available for Use.

  

					
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	 Term
	  	 Definition

	Available for Use	  	 The ability of equipment, software, network devices, services, or Health Net Data (and all applicable functionality) to

be accessed and used by Health Net and all of its applicable end users in accordance with normal operations (including, as applicable, equipment and software
specifications and committed levels of service), and without degradation of performance.

		
	Batch Processing Completion Time	  	The time of day at which the last data bit of the output of a completed processing job is Available for Use.
		
	Critical Service	  	Each of the services listed in Exhibit B-2.
		
	Priority 1 Incident (Critical)	  	 Critical application(s), service(s) or business function(s) is/are down resulting in complete work stoppage for 25 or more users and no work
around is available. Failure to resolve will impact Compliance, Government Mandates and Deliverables. Has potential for negative financial impact to HN.
  

Coding in Remedy: Problem Priority 1
  

Coding in Service Now: Sev 1; Vital

		
	Priority 2 Incident (High)	  	 Slow response or degraded performance to critical application(s), service(s) or business function(s) resulting in partial work stoppage
impacting 25 users or complete work stoppage impacting between 5 and 25 users. Failure to resolve will impact Compliance, Government Mandates and Deliverables. Critical Production Batch job failure. Failure to resolve issues will impact critical
business function(s) with the potential for negative financial risks to HN.
  
 Coding in
Remedy: Problem Priority 2
  
 Coding in Service Now: Sev 2;
Critical

  

					
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	 Term
	  	 Definition

	Priority 3 Incident (Moderate)	  	 Complete work stoppage for one to five associates. Unable to perform vital business function(s) and no business work around is available.
Failure to resolve will have potential for lost productivity and/or negative financial impact to HN. Non -production environment down.
  

A VIP outage. A VIP outage is an incident that impacts VIP work flow and minimizes ability to perform at maximum potential for a predefined VIP.

 
 Coding in Remedy: Incident Priority 1

 
 Coding in Service Now: Sev 3; High

		
	Priority 4 Incident	  	 Slow response or degraded performance for non-critical application(s), service(s) or business function(s) resulting in partial work stoppage
for one to five users. No business work around in place. Failure to resolve will impact user’s ability to perform some job functions. Non-Critical Batch job failure.
  

Coding in Remedy: Incident Priority 2
  

Coding in Service Now: Sev 4; Moderate

		
	Priority 5 Incident (Low)	  	 Software or hardware malfunctions with low business impact. Non-critical application(s), service(s) or business function(s) is/are slow or
degraded with temporary work around in place.
  
 Coding in Remedy: Problem Priority 3,
Incident Priority 3, Problem Priority 4
  
 Coding in Service Now: Sev 5;
Low

		
	Procurement Request	  	A Health Net-approved request for Supplier to order any Equipment, Software, network devices, or other material used to provide the Services.

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-4	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Term
	  	 Definition

	Procurement Request Completion Time	  	The elapsed time between (i) Supplier’s receipt of a Procurement Request (or, if a later scheduled start time provided by Health Net, such scheduled start time), and (ii) the time Supplier successfully completes such
Procurement Request (e.g., the Procurement Request is satisfied and the corresponding Services are fully functional and ready for use by the user who made the Procurement Request, and such user agrees the Procurement Request has been satisfactorily
completed (or if the user is unavailable, Supplier has provided notification to the user following an agreed notification process)).
		
	Response Time	  	For any Incident, the elapsed time between (i) the earlier of the moment that an Incident is reported (by an end user, monitoring log or other automated alert) or the moment that Supplier otherwise becomes aware of such Incident,
and (ii) the moment the relevant Supplier Personnel is assigned such Incident Ticket and Health Net is notified.
		
	Restoration Time	  	For any Incident, the elapsed time between (i) the earlier of the moment that an Incident is reported (by an end user, monitoring log or other automated alert) or the moment that Supplier otherwise becomes aware of such Incident;
and (ii) the moment that the affected Equipment, Software, network device, or Service is restored to normal operations in accordance with applicable Service Levels and specifications.
		
	Root Cause Analysis Report	  	A completed analysis or action plan for root cause remediation that: (i) identifies, in a level of detail and at a level of accuracy that is reasonably complete under the circumstances, the actual root cause(s) of a Severity 1
Incident or Severity 2 Incident, and (ii) describes the means by which Supplier proposes to address such root cause(s) of such Incident (including appropriate measures to prevent recurrence of such problems and minimize risks to Health Net). For the
avoidance of doubt, a Root Cause Analysis determines the analysis performed by Supplier and not the remediation Services themselves
		
	Scheduled Uptime	  	With respect to a Service Level, the time during which the applicable corresponding Equipment, Software, network devices, Services or Health Net Data for which Supplier is responsible are scheduled to be Available for Use during the
applicable Measurement Period. Mutually agreed scheduled maintenance windows shall be documented in the Procedures Manual. Scheduled Uptime is 24x7 or as defined in AO Contract unless mutually agreed
otherwise.

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-5	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Term
	  	 Definition

	Successful Change	  	A Change (i) for which the performed actions described in the Change request are completed within the agreed upon change window; (ii) with no errors or deficiencies; (iii) that has been properly authorized by Health Net; (iv) that
is executed in accordance with the agreed Change management process; and (v) that does not result in the opening of a Ticket for a Priority 1, 2 or 3 Incident.
		
	Patch	  	A patch is a piece of software designed to update a computer program or its supporting data, to fix or improve it. This includes fixing security vulnerabilities and other bugs, and improving the usability or performance.

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-6	  	Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-1 

Service Level Metrics 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 	Primary Compute	 		 		 		 		 		 		 		 	
										
	1	 	Critical Service Availability	 	 Measures the Availability of each Critical Service listed in Exhibit B-2.

 
 The Scheduled Uptime for each Critical Service is 24x7 (excluding scheduled maintenance
windows approved by Health Net) except as otherwise documented by Health Net in Exhibit B-2.
	 	 (a) Average Availability of the Critical Services in each Group in Exhibit B-2 shall be greater than:

 
 - 99.9% for each Tier 1 Group

 
 - 99.5% for each Tier 2 Group; and

 
 - 99.0% for each Tier 3 Group;

 
 and
  

(b) Availability of each Critical Service in Exhibit B-2 shall be greater than:
  

- 98.9% for Critical Services within a Tier
	 	 Availability of each Critical Service (as measured in Remedy) = (Minutes in Month – P1/P2 full outage ticket minutes during Scheduled
Uptime – 50%* P1/P2 partial outage or slowness ticket minutes during Scheduled Uptime) / (Minutes in Month)
  

Availability of each Critical Service (as measured against Service Now) = (Minutes in Month – Severity 1 ticket minutes during Scheduled Uptime – 50%
Severity 2 ticket minutes during Scheduled Uptime – 5% Severity 3 ticket minutes during Scheduled Uptime) / (Minutes in Month)
	 	Initially Remedy and then Service Now upon implementatio n within Health Net	 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-7	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 	 1 Group
  

- 99.0% for Critical Services within a Tier 2 Group; and
  

- 98.0% for Critical Services within a Tier 3 Group
	 	 Minutes in Month = number of minutes in the calendar month – scheduled downtime minutes

 
 This metric measures the Availability of all components within the scope of
Supplier’s responsibility that affect an end user’s ability to access and use a Critical Service without material degradation (including network, server, server O/S and services).
	 		 		 		 		 	
										
	2	 	Production Server Availability	 	 Measures the Availability of each individual Server Image in Health Net’s production server environment.

 
 Scheduled Uptime for each Server Image is 24x7 (excluding scheduled maintenance windows
approved by Health Net)
	 	>99.90%	 	 Availability of each Server Image = (Actual Uptime / Scheduled Uptime) x 100

 
 Each Server and O/S must be Available for Use by end users in order for a Server Image to
be “Available”
	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-8	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	3	 	Non- Production Server Availability	 	 Measures the Availability of each individual Server Image in Health Net’s non- production server environment.

 
 Scheduled Uptime for each Server Image is 24x7 (excluding scheduled maintenance windows
approved by Health Net)
	 	>99.00%	 	 Availability of each Server Image = (Actual Uptime / Scheduled Uptime) x 100

 
 Each Server and O/S must be Available for Use by end users in order for a Server Image to
be “Available”
	 		 	A	 	Y	 	Monthly	 	
										
	4	 	SAN Availability	 	 Measures the Availability of the Health Net storage area network (e.g., Hitachi VSP/SAN Switch).

 
 Scheduled Uptime for this metric is 24x7 (excluding scheduled maintenance windows approved
by Health Net).
	 	>99.999%	 	SAN Availability of = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-9	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	5a	 	NAS Availability (Redundant)	 	 Measures the Availability of the network attached redundant storage supporting Health Net business operations (e.g., Hitachi HUS/HCP
and HDI where deployed in a redundant configuration).
  
 Scheduled Uptime for this metric
is 24x7 (excluding scheduled maintenance windows approved by Health Net).
	 	>99.99%	 	NAS Availability of = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	5b	 	NAS Availability (Non- Redundant)	 	 Measures the Availability
 of the network
attached non redundant storage supporting Health Net business operations (e.g., Hitachi HDI Caching Device at HNT branch office).
  

Scheduled Uptime for this metric is 24x7 (excluding scheduled maintenance windows approved by Health Net).
	 	>99.00%	 	NAS Availability of = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-10	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	6	 	Database Availability	 	 Measures the Availability of each database instance within the Health Net environment.

 
 Scheduled Uptime for this metric is 24x7 (excluding scheduled maintenance windows approved
by Health Net).
	 	> 99.90%	 	Database instance Availability of = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	7	 	Production Batch Job Scheduling	 	Measures the percentage of scheduled batch jobs listed in Procedures Manual that (a) are initiated on-time and (b) have a Batch Processing Completion Time on or before the corresponding time provided in Procedures Manual.	 	 (a) > 98% of Critical Batch Jobs; and
  

(b) > 90% of Non-Critical Batch Jobs.
	 	Total scheduled batch jobs that are initiated on-time with on-time Batch Processing Completion Time / total scheduled batch jobs in the month.	 		 	A	 	N	 	Monthly	 	
										
	8	 	Web Online Application Response Time	 	Measures the online response time for all online applications (Extranet, Web Based & eCommerce-based applications on production Unix, Linux & Windows platforms) Online response time measurements will be	 	 (a) > 95% Home page and content pages load in 3 seconds or less; and

 
 (b) > 95% Application/Transactional pages load in 5
	 	Online transactions completed within required timeframe / Total online transactions x 100	 	Apache	 	C	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-11	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 	based on a representative set of specific named pages for each site. Health Net will designate between 30 and 60 pages per site for the measurement.	 	seconds or less	 		 		 		 		 		 	
										
	9	 	Speed of Messaging	 	Measures the speed of messages delivered within Health Net’s infrastructure (i.e., server to server messaging)	 	Average message delivered in less than 10 seconds	 	Aggregate number of seconds to deliver all messages / # of messages delivered x 100	 	GSX tool metric named, “Internal Average Mail Delivery Time”	 	A	 	N	 	Monthly	 	
										
	10	 	 Patches and
 Upgrades Delivered on Time
	 	Measures the number of patches and upgrades delivered to machines that are Available for Use within the required timeframes (timeframes will be defined by the parties in Phase 1)	 	>97%	 	Number of patches and upgrades delivered within the required timeframes / total number of patches and upgrades x 100	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-12	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	11	 	Production Server Backups	 	 Measures the percentage of server backups completed on or before the mutually agreed completion time (timeframes will be defined by the
parties in Phase 1).
  
 Unless parties agree otherwise Supplier will perform incremental
daily backup and full weekly backup of programs and data on storage internally and externally attached to all compute systems.
	 	>99%	 	Number of server back-ups completed on-time / total number of server back-ups required x 100	 		 	A	 	N	 	Monthly	 	
										
	12	 	Production Server Backup Recovery	 	Measures the number of backup recovery requests from Health Net completed on or before the completion time specified in the Procedures Manual.	 	>99%	 	% Production Server Backup Recovery = (Number of backup recovery requests completed successfully within the completion time specified in the Procedures Manual / Total number of backup recovery requests) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-13	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	13	 	Disaster Recovery Synchroniza tion (i.e., data center to data center replication time)	 	 Measures the percentage of time in which data center replications occurs in <6 hours

 
 Scheduled Uptime for this metric is 24 x 7
	 	100%	 	All data center replications must complete in less than 6 hours	 		 	A	 	N	 	Monthly	 	
										
	14	 	Audit and Compliance	 	Measures the time to respond to requests for information about the Services or service delivery environment required to support an audit of Health Net (including internal, customer, and external audits)	 	100% within 72 hours (or other time as the parties may agree in writing)	 	All audit requests must be fulfilled on-time	 		 	A	 	N	 	Monthly	 	
										
	15	 	Installation of Standard Server / Images	 	Measures the time to install a standard Server Image (i.e., single instance of an operating system with standard backup, encryption, monitoring, and packages)	 	>98% within 7 Business Days	 	Number of Standard Images installed successfully within 5 Business Days / Requested number of Standard Images to be installed) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-14	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 	Managed Network	 		 		 		 		 		 		 		 	
										
	16	 	WAN Network Availability (Redundant)	 	Measures the Availability of the LAN at locations with redundancy. Scheduled uptime is 24x7.	 	>99.99%	 	WAN Availability = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	17	 	WAN Network Availability (Non- Redundant)	 	Measures the availability of the LAN at locations without redundancy. Scheduled uptime is 24x7.	 	>99.00%	 	WAN Availability = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	18	 	LAN Network Availability (Redundant)	 	Measures the Availability of the LAN at locations with redundancy. Scheduled uptime is 24x7.	 	>99.99%	 	LAN Availability = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	19	 	LAN Network Availability (Non- Redundant)	 	Measures the Availability of the LAN at locations without redundancy. Scheduled uptime is 24x7.	 	>99.00%	 	LAN Availability = (Actual Uptime / Scheduled Uptime) x 100	 		 	A	 	N	 	Monthly	 	
										
	20	 	Voice Availability	 	Measures the Availability of the voice network. Scheduled uptime is 24x7.	 	>99.14%	 	 Availability of voice network = (Actual Uptime / Scheduled Uptime) x 100

 
 Voice Services are Available for Use only if (A) all end users have a dial-tone and are
able to place calls; (B) calls from
	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-15	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 		 	the end user are routed to the proper extensions and according to engineered routes; and (C) the end user are able to access their respective voicemail box and use other applicable voice network functionality (e.g., conferencing,
call forwarding).	 		 		 		 		 	
										
		 	Service Operations	 		 		 		 		 		 		 		 	
										
	21	 	First Call Resolution	 	 Measures the percentage of Resolvable Calls that are resolved during the initial telephone conversation (excluding password resets and
unlocks).
  
 “Resolvable Calls” means the call types listed in Exhibit
B-3
	 	>90%	 	 Number of Resolvable Calls resolved during the first call / total Resolvable Calls received

 
 Password resets and unlocks are excluded from this calculation.
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-16	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	22	 	Average Speed of Answer	 	Measures average speed for a live agent to answer calls to the Service Desk	 	< 20 seconds by live agent 100% of the time	 	Total minutes of wait time in a Service Desk queue before an end user speaks to a Service Desk agent / total calls to Service Desk that are answered by a live agent.	 		 	A	 	N	 	Monthly	 	
										
	23	 	Call Abandonment	 	Measures the percentage of calls (i) that are not answered by the Service Desk within twenty five (20) seconds of the moment that the end user selects an option to speak with a Service Desk representative, and (ii) that are
subsequently terminated by the end user prior to being routed	 	< 6%	 	Number of calls that enter the Service Desk queue and “hang up” / total calls that enter the Service Desk queue	 		 	A	 	Y	 	Monthly	 	
										
	24	 	Ticket Routing	 	Measures the percentage of tickets routed to more than three owners.	 	< 10%	 	Number of tickets that are routed to a resolver group and actually resolved by that group / total number of tickets routed for resolution.	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-17	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	25	 	Service Desk and End User Satisfaction (Quarterly Measurement)	 	 (a) Measures satisfaction of Health Net end users and other third parties who interact with Supplier’s Service Desk (measured on a
per-contact basis)
  
 (b) Measures satisfaction of Health Net end users and other third
parties who interact with Supplier’s deskside support services.
	 	 (a) > 91.5%
  

and
  

(b) > 91.5%
	 	 a) Number of end users surveyed giving a “Satisfied” or “Very Satisfied” rating / total number of Survey responded end
users survey (1/3 of end users will be survey each year)
  
 and

 
 b) Number of end users surveyed giving a “Satisfied” or “Very
Satisfied” rating / total number of Survey responded end users survey (1/3 of end users will be survey each year)
	 		 	A	 	Y	 	Quarterly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-18	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	26	 	Privileged Access Admin Compliance	 	Measures the percentage of days in a month in which Supplier delivers an accurate consolidated report comprising eleven SOX system-related artifacts that, together, validate whether Supplier has granted or deactivated privileged
access to SOX systems within the prescribed timeframe, which is currently 72 hours.	 	> 93%	 	 Number of daily reports delivered each day before

20:00 PST with accurate information / total number of days in a month.
  

Delivery of the Privileged Access Artifacts is executed by posting the daily reports to the Global Bridge Service (GBS), where Health Net Compliance and Legal
teams can pull the reports for daily validation.
  
 This metric requires delivery of a
consolidated report consisting of the following eleven artifacts once daily (365 days/year) to Health Net no later than 20:00 PT where the artifacts illustrate the complete and accurate activity of the 24-hour performance period (00:01 - 23:59 PT)
from the immediately preceding day: (i) SOX Daily Scorecard; (ii) Daily
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-19	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 		 	Privileged ISRs; (iii) Daily MEF3 Files; (iv) Daily Event logs; (v) Daily SOX Private ID Check; (vi) Vault Check-in/Check-out; (vii) Compare Report; (viii) Vault inventory; (xi) Daily Check Follow-up; (x) Exception MEF Backwards
check report for Windows systems only; (xi) Final Daily Scorecard Report for prior reporting period.	 		 		 		 		 	
										
	27	 	Privileged Access Reconciliati on	 	Measures Supplier’s reconciliation of all errors and omissions within the privileged access artifacts that are completed within 24 hours of Health Net’s notification of errors or omissions	 	 (a) All but 1 error/omission reconciled within 24 hours when there are

< 9 errors or omissions in a month; and
  

(b) >90% of errors or omissions reconciled within 24 hours when there are 10 or more errors/omissions in the month.
	 	 (a) All reconciliations measured to confirm no more than one extends more than 24 hours; and

 
 (b) Total reconciliations within 24 hours / Total reconciliations required.
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-20	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	28	 	BAU Access Admin	 	 (a) Measures the percentage of non-privileged BAU access admin requests involving 10 or fewer end users that are completed within 5 Business
Days
  
 BAU requests are any AA requests other than Privilege Access requests, Emergency
IDs, Supplier requests, and requests fulfilled by Health Net or Third Parties engaged by Health Net to provide Access Administration services.
  

and
  

b) Fulfillment of BAU ISR requests that are not completed within 5 business days must be completed within 6 to 10 business days.
	 	 (a) >91%
  

(b)100%
	 	 (a) Number of non-privileged requests completed within 5 business days / total non-privileged requests

 
 (b) Number of non-privileged requests completed within 6-10 business days / total
non-privileged requests not completed within 5 business days
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-21	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	29	 	Access Administrati on - User-ID Termination – Activities in support of complete removal of IDs associated with a terminated associate.	 	 (a) Measures the effectiveness of deleting user-id’s and account access based on an ISR Delete request for a terminated associate. IDs
to be removed from Network, Active Directory, Remote Access Lotus Notes and application IDs such as Macess, ABS, VMS, Mainframe, MC400, Remedy, SAP, eBuyer, etc.
  

(b) Remediation within 5 Business Days
	 	 100% - Network ID & Lotus Notes
  

>95% - Others Systems
	 	 (a) Number of user accts not deleted in month as verified by application, system and AD user lists not to exceed 0 (zero).

 
 (b) IDs found still active must be removed within 5

Business Days of notice.
  

NOTE: This will require addition of a new flag in ISR AA requests to identify requests for terminated associate. Otherwise will be labor intensive as each ISR
with a Delete request will need to be examined for Delete type.
	 	ISR System	 	A	 	N	 	Monthly	 	
										
	30	 	Access Administrati on –Emergency ID Termination	 	 Measures the turn-around- time for ID deactivation for emergency termination requests from Health Net Organization

Effectiveness. ISR Termination Request need to be backed up with a phone call to the Service Desk.
	 	100% of Emergency ID Termination requests completed within 30 Minutes of request	 	Number of Emergency ID Requests completed within 30 minutes divided by total number of Emergency ID requests.	 	ISR System + afterhours request handled via Priority 1 incident ticket	 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-22	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	31	 	Access Administrati on – Open Inventory	 	 Measures the number of ISRs that are in Open Request statuses during normal BAU operation days.

 
 Exclusions Include : Mass ISR Submission for any major business event such as Transition
during Phase
  
 2. Open Enrollment staffing increases and other events of similar scope
are not a major business events.
	 	The average number of Under Review and Open Request statuses each day shall be < 400 during the month.	 	(Number of days the Under Review and Open Request ISR count is 400 or less divided by the total number of days in the calendar month) multiplied by 100%.	 	ISR System	 	A	 	Y	 	Monthly	 	
										
	32	 	Capacity Reporting	 	 Measures the reporting of Capacity Events to Health Net
  

A “Capacity Event” occurs anytime storage utilization or CPU utilization or other identified capacity constraint crosses a configured threshold that
represents the normal operating parameters designed for the system.
	 	 (a) At least 98% of Capacity Events reported within 1 Business Day; and

 
 (b) 100% of Capacity Events reported within 4 Business Days
	 	 (a) % Capacity Reporting = (Number of Capacity Events reported within 1 Business Day / Total number of Capacity Events during the measured
period) x 100
  
 (b) No Capacity Reports reported more than 4 Business Days after

occurrence
	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-23	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 	 Cross
 Tower
	 		 		 		 		 		 		 		 	
										
	33	 	Incident Response - Priority 1-2	 	Measures the Response Time for Priority 1 Incidents and Priority 2 Incidents	 	 (a) > 95% of Priority 1 Incidents within 15 minutes; and
  

(b) > 98% of Priority 2 Incidents within 120 minutes
	 	 (a) Number of Priority 1 Incidents with Response Time < 15 minutes / total number of Priority 1 Incidents; and

 
 (b) Number of Priority 2 Incidents with Response Time < 2 hours / total number
of Priority 2 Incidents
	 		 	A	 	Y	 	Monthly	 	
										
	34	 	Incident Response - Priority 3-4	 	Measures the Response Time for Priority 3 Incidents and Priority 4 Incidents	 	 (a) > 98% of Priority 3 Incidents within 2 business hours; and

 
 (b) > 98% of Priority 4 Incidents within 4 Business Hours
	 	 Number of Priority 3 Incidents with Response Time < 2 hours / total number of Priority 3 Incidents; and

 
 (b) Number of Priority 4 Incidents with Response Time < 4 hours / total number
of Priority 4 Incidents;
	 		 	A	 	Y	 	Monthly	 	
										
	35	 	Incident Response - Priority 5	 	Measures the Response Time for Priority 5 Incidents	 	> 90% of Priority 5 Incidents within 2 Business Days	 	Number of Priority 5 Incidents with Response Time < 2 Business Days / total number of Priority 5 Incidents	 		 	C	 	Y	 	Monthly	 	0

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-24	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	36	 	Incident Resolution - Priority 1-2	 	Measures the Restoration Time for Priority 1 Incidents and Priority 2 Incidents	 	 (a) > 95% within 4 hours for Priority 1 Incidents; and
  

(b) > 98% within 8 hours for Priority 2 Incidents
	 	 (a) % Priority 1 Restoration Time = (Number of Priority 1 Incidents with Restoration Time < 4 hours / Number of Priority 1
Incidents reported) x 100; and
  
 (b) % Priority 2 Restoration Time = (Number of Priority
2 Incidents with Restoration Time < 8 hours / Number of Priority 2 Incidents reported) x 100
	 		 	A	 	Y	 	Monthly	 	
										
	37	 	Incident Resolution - Priority 3-4	 	Measures the Restoration Time for Priority 3 Incidents and Priority 4 Incidents	 	 (a) > 98% within 1 Business Day for Priority 3 Incidents; and

 
 (b) > 98% within 2 Business Days for Priority 4 Incidents
	 	 (a) % Priority 3 Restoration Time = (Number of Priority 3 Incidents with Restoration Time < 1 Business Days / Number of Priority 3
Incidents reported) x 100;
  
 and

 
 (b) % Priority 4 Restoration Time = (Number of Priority 4 Incidents with Restoration Time
< 2 Business Days / Number of Priority 4 Incidents reported) x 100
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-25	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	38	 	Incident Resolution- Priority 5	 	Measures the Restoration Time for Priority 5	 	>85% within 4 Business Days for Priority 5 Incidents	 	% Priority 5 Restoration Time = (Number of Priority 5 Incidents with Restoration Time < 2 Business Days / Number of Priority 5 Incidents reported) x 100	 		 	C	 	Y	 	Monthly	 	0
										
	39	 	Root Cause Analysis Completion	 	Measures the time in which Root Cause Analysis Reports for Priority 1 and Priority 2 Incidents are completed	 	>98% within 5 Business Days following the incident	 	% Root Cause Analysis Completion = (Number of Root Cause Analysis Reports provided by Supplier within 5 Business Days / Total number of Root Cause Analysis Reports that are required to be completed by Supplier) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-26	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	40	 	Project Intake, Design and Estimation Turnaround Time	 	 (a) Project Estimates will be provided to Health Net within 5 Business Days of Supplier’s acceptance of a Project Brief;

 
 and
  

(b) A detailed project plan (in sufficient detail to attach to a Work Order) for each Project shall be provided to Health Net within 5 Business Days of the
date Health Net approves a Project
  
 Estimate and requests the project plan for each
such Project.
  
 Project Estimate and Project Brief shall be defined in the Project
Framework
	 	100%	 	 (a) Project Estimate Percentage = (# Brief’s provided to HN within 5 Business Days of acceptance / total Brief’s accepted) *
100%
  
 and
  

(b) Project Time to Schedule percentage = (# project plans provided to HN within 5 Business Days of estimate approval /total # of estimate approvals)* 100%

 
 Project Managers keep log of request date and receive date.
	 	Planview, plus some manual calculations.	 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-27	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	41	 	On-Budget Completion of Projects	 	 Measures the percentage of project milestones delivered within 10% of the estimated costs provided in the approved Work Order.

 
 The Cost Components of a project are the following 6 items: (i) Hardware costs; (ii) ARC
charges; (iii) Project pool hours; (iv) Software license required for CTS to provide; (v) Software license required for HN to provide; (vi) 3rd party expenses (contracting, subcontracting)
	 	>95%	 	 Delivery of projects to budget = (count of project milestones delivered within >= 90% of budget

and <= 110%) / (number of project milestones reached)
	 		 	A	 	N	 	Monthly	 	
										
	42	 	On-Time Completion of Projects	 	Measures the percentage of Project milestones delivered within 10% of estimated delivery date provided in each Work Order.	 	>95%	 	 Milestone Delivery Percentage = (Number of Business Days required to reach the milestone measured from signing of work order/ (Number of
Business Days projected to reach the milestone as stated in the Work Orders).
	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-28	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 		 	Percentage of Project Milestones delivered within 10% of estimated delivery date = (Number of milestones reached within a Milestone Delivery Percentage of 90% - 110%) / (Number of milestones projected by approved Work Orders to be
reached in the month) *100	 		 		 		 		 	
										
	43	 	Quality of Project Deliverables	 	 Measures the quality of Supplier deliverables and artifacts, which will be measured as a percentage of the time a deliverable does not meet
its specifications three (3) times or more.
  
 All comments must be provided as part of
initial delivery.
	 	>99%	 	 (Number of Deliverables delivered experiencing less than 3 notices of deficiencies / Total number of Deliverables) *100.

 
 Each project artifact will be delivered and submitted to Health Net for acceptance. This
metric measures the percentage of project artifacts that Health Net rejects 3 or more times.
  

Project artifacts will include documents provided at each stage of the project lifecycle, including (i) brief
	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-29	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 		 	assessments; (ii) requirements Work Orders; (iii) technical system designs; (iv) build, test, implement Work Orders; (v) IT change management plans; and (vi) revised Work Orders.	 		 		 		 		 	
										
	44	 	Service Request Completion	 	Measures the percentage of Service Requests completed within the timeframe provided in Exhibit B-4	 	>95% within the time required by Exhibit B-4	 	 Number of Service Requests completed on-time / Number of Service Requests) x 100. In addition, any Service Request not delivered on- time
will result in a ticket being opened as a Priority 2 Incident.
  
 Exhibit B-4 will be a
list of standard service requests and corresponding completion times.
  
 “Service
Request” means a set of standardized IT requests that are smaller than projects and are mutually agreed to be made available for users to request via a standardized process and tool.
	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-30	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	45	 	Procurement Management	 	Measures the percentage of Procurement Requests completed within the corresponding Procurement Request Completion Time provided in Exhibit B-5	 	>95%	 	 Number of Procurement Requests completed within the corresponding Procurement Request Completion Time / Number of Procurement Requests) x
100.
  
 Exhibit B-5 will be a list of standard procurement requests and corresponding
completion times.
	 		 	A	 	Y	 	Monthly	 	
										
	46	 	Change Execution	 	Measures the percentage of Successful Changes.	 	>98.5%	 	% Change Execution = (Number of Successful Changes / Number of Changes required) x 100	 		 	A	 	N	 	Monthly	 	
										
	47	 	Unauthorized Change Records	 	Measures the percentage of Changes that were implemented without authorization	 	100%	 	No unauthorized changes in a month.	 		 	A	 	N	 	Monthly	 	
										
	48	 	Methodology Compliance Change Management	 	The number of Change Records performed in accordance with applicable change management polices (“Compliant Changes”) for the month.	 	>98%	 	Percentage of Changes in Compliant = (Compliant Changes / Total Changes ( x 100	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-31	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	49	 	Asset Configuratio n Accuracy	 	Measures the percentage of Accurate Asset Data Fields compared to the total number of asset configuration data fields that are sampled during the measured period in the Health Net environment	 	>98%	 	 % Asset Configuration Accuracy = (Number of Accurate Asset Data Fields / Total number of asset data fields sampled) x 100.

 
 Example: Each asset data field represents one (1) count in the total sample
population. For example: if 100 assets are sampled and each asset contains 5 asset data fields, then the sample population is 500. Each data element missed counts as 1 error. With 500 data fields sampled and 25 misses = 5% error or 95%
accuracy.
	 		 	A	 	N	 	Monthly	 	
										
	50	 	Asset Inventory Accuracy	 	Measures the percentage of complete and Accurate Inventory Records compared to the total number of assets in the Health Net environment	 	>98%	 	% Asset Inventory Accuracy = (Number of Accurate Inventory Records / Total number of assets in the Health Net environment) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-32	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

	51	 	Reporting Delivery	 	Measures the number of final, complete, and accurate reports delivered by Supplier by the required reporting delivery date	 	98% of reports listed in Exhibit B-6 are accurate and delivered by the required delivery date (“Reporting Delivery Date”)	 	% Reporting Delivery = (Number of reports delivered by Supplier by the Reporting Delivery Date / Number of reports required to be delivered to Health Net) x 100. In addition, any report that is not delivered by the Reporting
Delivery Date shall result in a Ticket being opened as a Priority 2 Incident.	 		 	A	 	N	 	Monthly	 	
										
		 	Desktop	 		 		 		 		 		 		 		 	
										
	52	 	IMAC Completion	 	 Measures the IMAC completion times in the Health Net end user environment

 
 Excludes
  

• Office movement
 • Refresh of end user

  devices
  

*IMAC volume over150 per month will be excluded from measurement
	 	 (a) >95% of IMACs completed within three (3) Business Days for all end users in any location (other than VIP Users);

 
 (b) >95% of IMACs completed within two (2) Business Days for VIP Users who are
not in a Dedicated Location at the time of the IMAC Request; and
	 	% IMAC Completion = (Number of IMACs completed within the applicable timeframe / Total number of IMACs completed) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-33	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 	 (c) >95% of IMACs completed within one (1) Business Day for VIP Users who are located in a Dedicated Location at the time of the
IMAC Request.
  
 “Dedicated Location” means any location where Supplier
provides an on-site deskside support resource.
	 		 		 		 		 		 	
										
	53	 	Application Image Development – COTS Application	 	 Measures the percentage of
 Package Requests
completed within 10 Business Days of request
  
 “Package Request” means a
request by Health Net to package an application for deployment to physical and virtual desktops.
	 	>98%	 	% Application Image Development – COTS Application = (Number of Package Requests completed within 10 Business Days / Number of Package Requests) x 100	 		 	A	 	N	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-34	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 	Testing	 		 		 		 		 		 		 		 	
										
	54	 	 Testing Effectiveness
	 	Measures the Testing Failure rate at Integration Test and UAT phases	 	 The Testing Failure Rate shall be less than or equal to the percentage set forth below for each of the following Testing Phases:

(i) Integration Testing <10%
 (ii) User Acceptance Testing
<3%
	 	 “Testing Failure Rate” means the percentage of Critical Tests during a Testing Phase that fail to meet applicable success criteria,
calculated in accordance with the following formula: Testing Failure Rate (for each Testing Phase) = (# of Critical Tests Failures / Total # Critical Tests) * 100
  

“Critical Test” means a test case designated by Health Net as Critical during development of the testing plan for a particular Deliverable.
	 		 	A	 	N	 	Monthly	 	
										
	55	 	Testing Coverage	 	Measures the Requirements Coverage Percentage for business and technical requirements	 	 The Requirements
 Coverage Percentage for each
Deliverable shall be greater than or equal to (a) 100% for business requirements and (b) 98% for technical
	 	“Requirements Coverage Percentage” means, for each Deliverable, the percentage of business or technical requirements, as applicable, for such Deliverable that have been mapped to a specific Test Case prior to delivery
to	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-35	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 	requirements.	 	 Health Net for UAT, calculated in accordance with the following formula:

 
 Requirements Coverage Percentage = (# business or technical requirements, as applicable,
mapped to Test Cases / total # business or technical requirements, as applicable) * 100%.
  

“Test Case” has the meaning given in the Health Net PDLC.
	 		 		 		 		 	
										
	56	 	Testing Completeness Percentage	 	Measures the Testing Completeness Percentage for each Deliverable.	 	>98%	 	“Testing Completeness Percentage” means the percentage of Test Cases actually executed by Supplier Personnel, excluding Test Cases that could not be executed because of production environment or data dependencies outside
Supplier’s control or Health Net’s suspension or cancellation of requirements, calculated in accordance with the following formula:	 		 	A	 	Y	 	Monthly	 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-36	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	 	 Service

Area
	 	 Description
	 	 Service Level

Metric
	 	 Formula
	 	 Measurement

Tools /

Process
	 	 Code
	 	 Continuous
Improvement
	 	 Measurement

Period
	 	 Weighting

Factor

		 		 		 		 	Testing Completeness Percentage = (# Test Cases executed / total # Test Cases) * 100%	 		 		 		 		 	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-37	  	Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-2 

Critical Services 
 The following are the
Critical Services and Critical Services Groups referenced in Exhibit B-1. 
 Scheduled Uptime will be 24x7 or defined in AO Contract or defined within 90
days of Effective Date for each Critical Service unless provided otherwise below. Health Net (in its sole discretion) will document Scheduled Uptime for each Critical Service during Phase 1. 

 

			
	 Group 1 Critical Services: Security and Critical Infrastructure Support

Categorization: Tier 1
	  	Scheduled Uptime
	 VPN
	  	
	 Citrix – XenApp
	  	
	 VDI (Citrix – Xendesktop)
	  	
	 Active Directory
	  	
	 Service Now
	  	
	 Asset Management/Remote Data Wipe
	  	
	 Vulnerability Scanner
	  	
	 Network Access Control (NAC)
	  	
	 Data Loss Prevention (DLP)
	  	
	 Server and SAN Encryption (all storage types in the entire data center and MERs)
	  	
	 Security Tools Management Consoles
	  	
	 File Integrity Monitoring
	  	
	 Endpoint agents
	  	
	 Anti-Virus and Anti-Malware
	  	
	 Host DLP
	  	
	 URL Filtering
	  	
	 Host Intrusion Prevention
	  	
	 Firewalls
	  	
	 Workstation Encryption
	  	
	 Security Information Event Manager (SIEM)
	  	
	 Intrusion Detection/Prevention (IDS/IPS)
	  	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-38	  	Health Net / Cognizant Confidential

 Final 
  

			
	 Two Factor Authentication
	  	
	 Vulnerability Scanning (IAVA, URL/Web, STIG/CIS)
	  	
	 Web Reporting
	  	
	 Web Inspection/Filtering
	  	
	 DDoS protection
	  	
	 Event Log Management Systems
	  	
	 Server Anti-Virus
	  	
	 Asset/Endpoint Management
	  	
	 Web Application Firewall (WAF)
	  	
	 Workstation Policies Unix/Linux STIC and CIS Scans
	  	
		
	 Group 2 Critical Services: Commercial Services Visible to Members, Providers, Brokers and Employers in
Real Time

Categorization: Tier 1
	  	 
	 Healthnet.com – Consumers
	  	
	 Healthnet.com – Providers
	  	
	 Healthnet.com – Members
	  	
	 Healthnet.com – Employer
	  	
	 Healthnet.com – Brokers
	  	
	 Healthnet.com – Admin
	  	
	 Members.MHN.com
	  	
	 MHN.COM – Providers
	  	
	 MHN.COM – Members
	  	
	 MHNGS.COM – MFLC
	  	
	 MHNGS.COM – Providers
	  	
	 Pega – OMNI
	  	
	 UNITY COMMERCIAL
	  	
	 UNITY/ATLANTES MHN
	  	
	 CSI-WR
	  	
	 ABS – KNOWLEDGE BASE
	  	
	 ABS – MEMBERSHIP
	  	
	 ABS – GROUPS
	  	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-39	  	Health Net / Cognizant Confidential

 Final 
  

			
	 ABS – POLICYHOLDER
	  	
	 ABS – CAPITATION
	  	
	 ABS – PROVIDERS
	  	
	 ABS – CLAIMS
	  	
	 ABS – AUTHORIZATION
	  	
	 ABS – BILLING
	  	
	 ABS – BROKER
	  	
	 ABS – FEE SCHEDULE
	  	
	 ABS – BENEFITS
	  	
	 ABS – ACCUMULATOR
	  	
	 ABS – PROVIDER CONTRACTS
	  	
	 ABS – PRICING
	  	
	 Pega – DOFR
	  	
	 MACESS
	  	
	 ACD
	  	
	 IVR
	  	
	 AMES
	  	
		
	 Group 3 Critical Services: Federal Services Visible to Members, Providers and Government Customer in

Real Time
 Categorization: Tier 1
	  	 
	 DMDC B2B Gateway
	  	
	 CareRadius
	  	
	 CareRadius – Care Affilate
	  	
	 CareRadius – Adjudication Rules
	  	
	 EDI (includes Care Affiliate Civilian EDI, Spin Systems MTF EDI and BizTalk MTF EDI)
	  	
	 PGBA FHP3 Enterprise Extender (Enrollment / Premium Billing)
	  	
	 COMM (OCoE- Federal)
	  	
	 FSB
	  	
	 HNFS.com – MTF
	  	
	 HNFS.com – Providers
	  	
	 HNFS.com – Bene
	  	

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-40	  	Health Net / Cognizant Confidential

 Final 
  

			
	 HNFS.com – SSO and SAML integration with DMDC for DS Logon on all environments.
		
	 HNFS.com – es.hnfs.com Spanish translation site
		
	 Map Info / Spectrum
		
	 Pega – OMNI
		
	 ACD
		
	 Health Net IVR (non PGBA, e.g. United after hours)
		
	 DMDC Web applications
		
	 PGBA IVR
		
	 Right Fax Federal
		
	 CCS
		
		
	 Group 4 Critical Services: Commercial Vital Services Impacting Associates and Business
Processes
 (includes services shared between Commercial and Federal)

Categorization: Tier 2
		
	 Lotus Notes
		
	 Instant Messaging
		
	 Good Technology
		
	 Right Fax – Commercial
		
	 File Server Services
		
	 Print Services
		
	 Call Center Workforce Management
		
	 HN Connect
		
	 MAGIC
		
	 MDM
		
	 OCOE
		
	 PAOS
		
	 Pega – MARS
		
	 Pega – KIM
		
	 Pega – Prime
		
	 Pega – FD2
		
	 Pega – Staffer
		
	 Pega – 51-100
		

  

					
	SOW#4 (Information Technology) Exhibit B		B-41		Health Net / Cognizant Confidential

 Final 
  

			
	 Alfresco
		
	 LOTUS DATABASE APPLICATIONS
		
	 SAP
		
		
	 Group 5 Critical Services – Federal Vital Services Impacting Associates and Business
Processes
 Categorization: Tier 2
		
	 AutoCoder
		
	 Interqual
		
	 Quantum
		
	 Hall Mailing and Fulfillment
		
	 JIVE
		
	 Zavanta
		
	 Call Center Enterprise Manager
		
	 PGBA ConnectDirect (NDM)
		
	 Fastrieve
		
		
	 Group 6 Critical Services: Commercial Non-real time, Reporting and Lower Impact Services

Categorization: Tier 3
		
	 HR Link
		
	 My Archive
		
	 PSAS
		
	 PETRS
		
	 ODW
		
	 ADW
		
	 KBASE
		
	 SALSA
		
	 SBG
		
	 CDS
		
	 EDI
		
	 EFT
		
	 FTP (external supporting EDI)
		
	 BRCC
		
	 BUSINESS OBJECTS
		

  

					
	SOW#4 (Information Technology) Exhibit B		B-42		Health Net / Cognizant Confidential

 Final 
  

			
	 EIS
		
	 Informatica
		
	 RRS
		
	 WFA (Waste, Fraud and Abuse - STARS and STARSSentinel)
		

  

					
	SOW#4 (Information Technology) Exhibit B		B-43		Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-3 

Resolvable Call Categories 
 The call
categories below are subject to the First Call Resolution SLA. 
  

							
	 Category
	  	 Type
	  	 Item
	  	 Category Type Item

	 SOFTWARE
 DESKTOP
	  	NETWORK DRIVE	  	NETWORK MAPPING	  	 SOFTWARE DESKTOP NETWORK DRIVE NETWORK

MAPPING

	 SOFTWARE
 APPLICATION
	  	MC400	  	FTP-RUMBA	  	SOFTWARE APPLICATION MC400 FTP-RUMBA
	 SOFTWARE
 APPLICATION
	  	AMEX	  	CONNECTIVITY	  	SOFTWARE APPLICATION AMEX CONNECTIVITY
	HELP DESK	  	PHONE SUPPORT	  	DEAD AIR	  	HELP DESK PHONE SUPPORT DEAD AIR
	HELP DESK	  	PHONE SUPPORT	  	INFORMATION	  	HELP DESK PHONE SUPPORT INFORMATION
	HELP DESK	  	PHONE SUPPORT	  	STATUS CALL	  	HELP DESK PHONE SUPPORT STATUS CALL
	HELP DESK	  	PHONE SUPPORT	  	TRAINING	  	HELP DESK PHONE SUPPORT TRAINING
	HELP DESK	  	PHONE SUPPORT	  	TRANSFER CALL	  	HELP DESK PHONE SUPPORT TRANSFER CALL
	HELP DESK	  	PHONE SUPPORT	  	WRONG NUMBER	  	HELP DESK PHONE SUPPORT WRONG NUMBER
	HELP DESK	  	MEETING PLACE	  	ADD PORTS	  	HELP DESK MEETING PLACE ADD PORTS
	HELP DESK	  	MEETING PLACE	  	CANCEL MEETING	  	HELP DESK MEETING PLACE CANCEL MEETING
	HELP DESK	  	MEETING PLACE	  	QUESTION	  	HELP DESK MEETING PLACE QUESTION
	HELP DESK	  	MEETING PLACE	  	SCHEDULE MEETING	  	HELP DESK MEETING PLACE SCHEDULE MEETING
	HELP DESK	  	EMAIL SUPPORT	  	INFORMATIONAL	  	HELP DESK EMAIL SUPPORT INFORMATIONAL
	HELP DESK	  	EMAIL SUPPORT	  	 REQUESTED MORE
 INFORMATION
	  	 HELP DESK EMAIL SUPPORT REQUESTED MORE

INFORMATION

	DISK SPACE	  	 QUOTA
 EXTENSION
	  	HOME DRIVE	  	DISK SPACE QUOTA EXTENSION HOME DRIVE
	DISK SPACE	  	DATA RESTORE	  	COMMON DRIVE	  	DISK SPACE DATA RESTORE COMMON DRIVE
	DISK SPACE	  	DATA RESTORE	  	HOME DRIVE	  	DISK SPACE DATA RESTORE HOME DRIVE
	ACCOUNT/ACCESS	  	SHOWCASE	  	PROFILE ERROR	  	ACCOUNT/ACCESS SHOWCASE PROFILE ERROR

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-44	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Category
	  	 Type
	  	 Item
	  	 Category Type Item

	ACCOUNT/ACCESS	  	PQM	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS PQM NOT ABLE TO ACCESS
	ACCOUNT/ACCESS	  	MEETING PLACE	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS MEETING PLACE NOT ABLE TO ACCESS
	ACCOUNT/ACCESS	  	HN CONNECT	  	PROFILE ERROR	  	ACCOUNT/ACCESS HN CONNECT PROFILE ERROR
	ACCOUNT/ACCESS	  	HEALTHNET.COM	  	PROFILE ERROR	  	ACCOUNT/ACCESS HEALTHNET.COM PROFILE ERROR
	ACCOUNT/ACCESS	  	CCS	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS CCS NOT ABLE TO ACCESS
	ACCOUNT/ACCESS	  	CCM	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS CCM NOT ABLE TO ACCESS
	ACCOUNT/ACCESS	  	BURGESS	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS BURGESS NOT ABLE TO ACCESS
	ACCOUNT/ACCESS	  	AMEX	  	 NOT ABLE TO
 ACCESS
	  	ACCOUNT/ACCESS AMEX NOT ABLE TO ACCESS
	PRINTER	  	NETWORK	  	 QUEUE
 MANAGEMENT
	  	PRINTER NETWORK QUEUE MANAGEMENT
	PRINTER	  	NETWORK	  	MAP PRINTER	  	PRINTER NETWORK MAP PRINTER
	PRINTER	  	LOCAL	  	 QUEUE
 MANAGEMENT
	  	PRINTER LOCAL QUEUE MANAGEMENT
	PRINTER	  	LOCAL	  	MAP PRINTER	  	PRINTER LOCAL MAP PRINTER
	ACCOUNT/ACCESS	  	CITRIX	  	 CREATE/CLEAR
 PROFILE
	  	ACCOUNT/ACCESS CITRIX CREATE/CLEAR PROFILE
	ACCOUNT/ACCESS	  	CITRIX	  	CLEAR SESSION	  	ACCOUNT/ACCESS CITRIX CLEAR SESSION
	 SOFTWARE
 APPLICATION
	  	LOTUS NOTES	  	CONFIGURATION	  	SOFTWARE APPLICATION LOTUS NOTES CONFIGURATION

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-45	  	Health Net / Cognizant Confidential

 Final 
  

							
	 Category
	  	 Type
	  	 Item
	  	 Category Type Item

	 SOFTWARE
 APPLICATION
	  	LOTUS NOTES	  	HOW TO/TRAINING	  	 SOFTWARE APPLICATION LOTUS NOTES HOW

TO/TRAINING

	 SOFTWARE
 DESKTOP
	  	SCCM	  	ADD OBJECTS	  	SOFTWARE DESKTOP SCCM ADD OBJECTS
	ACCOUNT/ACCESS	  	ABS	  	APP RE-INSTALL	  	ACCOUNT/ACCESS ABS APP RE-INSTALL
	 SOFTWARE
 APPLICATION
	  	LOTUS NOTES	  	IM – CONFIGURATION	  	 SOFTWARE APPLICATION LOTUS NOTES IM -

CONFIGURATION

  

					
	SOW#4 (Information Technology) Exhibit B	  	B-46	  	Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-4 

Service Request Completion Times 

[Service Request Completion Times will be documented in this Exhibit B-4 or in the Procedures Manual within 90 days following the Effective
Date.] 

  

					
	SOW#4 (Information Technology) Exhibit B		B-47		Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-5 

Procurement Request Completion Times 

[Procurement Request Completion Times will be documented in this Exhibit B-5 or in the Procedures Manual within 90 days following the
Effective Date.] 

  

					
	SOW#4 (Information Technology) Exhibit B		B-48		Health Net / Cognizant Confidential

 Final 
  

 Exhibit B-6 

Reports 
 [Reports
covered by this Service Level (which shall include all reports Supplier is required to provide under the Agreement unless the parties agree otherwise) will be documented in this Exhibit B-6 within 90 days following the Effective Date.] 

  

					
	SOW#4 (Information Technology) Exhibit B		B-49		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT D 

KEY SUPPLIER PERSONNEL 
 Subject to
Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions filled by the individuals listed in the table below. 

 

			
	 Key Supplier Position
	  	 Initially Approved Individual

	IT Vendor Mgmt	  	TBD
	Application Development Director	  	TBD

  

			
	 Key Supplier Position
	  	 Initially Approved Individual

	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***
	ABS SME/Support	  	***

  

					
	SOW#4 (Information Technology) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms and
Conditions, this Schedule H identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth below. 

 

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved

Subcontractor
	  	Address	  	Functions
	 ***
	  		  	

  

					
	SOW#4 (Information Technology) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

 Final 
  

 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #5 (QUALITY ASSURANCE SERVICES) 

  

					
	SOW#5 (Quality Assurance)		 		Health Net / Cognizant Confidential

 Final 
  

 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #5 (QUALITY ASSURANCE SERVICES) 

This Statement of Work #5 (Quality Assurance Services), dated November 21, 2014, but effective as of November 2, 2014
(“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #5 (Quality Assurance Services) is entered into and shall be governed by the terms of that certain Amended and Restated
Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #5 (Quality Assurance Services) replaces and supersedes in all respects the Statement of
Work #5 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #5 (Quality Assurance Services) describes
the Quality Assurance Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Quality Assurance Services) to this SOW #5 (Quality Assurance Services), and sets forth certain terms and conditions
relating to them, including, among other things: 
  

	 	(a)	The scope of the Quality Assurance Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; 

  

	 	(d)	The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

	1.2	Structure 

 This SOW #5 (Quality Assurance Services) is comprised of this cover
document and the following Exhibits: 
  

					
	 Table 1: Exhibits to SOW #5
(Quality Assurance Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	 1
	  	Exhibit A (Services)	  	Describes the scope of the Quality Assurance Services.

  

					
	SOW#5 (Quality Assurance)	  	2	  	Health Net / Cognizant Confidential

 Final 
  

					
	 Table 1: Exhibits to SOW #5
(Quality Assurance Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	2	  	Exhibit A-1 (Solution Description)	  	 Describes Supplier’s solution for the provision of the Quality Assurance Services and includes as exhibits:

 
 •    Exhibit A-1-1
(Approved Service Delivery Centers)
 •    Exhibit A-1-2 (Service Delivery
Configuration at the Completion of Phase 2)

			
	4	  	Exhibit A-3 (Organizational Chart)	  	Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW #5 (Quality Assurance Services).
			
	6	  	Exhibit B-1 (Operational SLAs)	  	Identifies the Operational Service Levels applicable to the Quality Assurance Services.
			
	7	  	 Exhibit D (Key
 Supplier
Positions)
	  	Identifies the Key Supplier Positions applicable to the Quality Assurance Services.
			
	8	  	Exhibit H (Subcontractors)	  	Identifies the Subcontractors approved by Health Net to provide certain of the Quality Assurance Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #5 (Quality Assurance
Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #5 (Quality Assurance Services) is
hereby made a part of, and is subject to and governed by, the Agreement. This SOW #5 (Quality Assurance Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW#5 (Quality Assurance)	  	3	  	Health Net / Cognizant Confidential

 Final 
  

 IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #5 (Quality
Assurance Services) to be signed and delivered by its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

									
	 Health Net, Inc.
				Cognizant Healthcare Services, LLC
					
	By:		 				By:		 
					
	Print Name:		 				Print Name:		 
					
	Title:		 				Title:		 
					
	Date:		 				Date:		 

  

					
	SOW#5 (Quality Assurance)		 		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A 

QUALITY ASSURANCE SERVICES 
  

	1	INTRODUCTION 

  

	1.1	General 

  

	 	(a)	In general terms, the “Quality Assurance (QA) Services” are the Functions associated with the post transaction auditing and reporting of finalized accuracy results (including the resolution of
error disputes) for Claims, Membership, Appeals & Grievances, Contact Center Provider Dispute Resolution (PDR) Correspondence, Configuration, and Contact Center work for all geographies and lines of business requested by Health Net.

  

	 	(b)	The Quality Assurance Services are more fully described in Section 3, and include the Cross Functional Services described in Section 3 of Schedule A (Cross Functional Services) and the Functions
included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Quality Assurance Services. For clarity, this includes
Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 (Managed Third Party Contract Services) of Schedule A (Cross Functional Services). Supplier shall
perform the Quality Assurance Services, except for those Functions that are expressly identified as retained Health Net responsibilities in Section 2 below. For purposes of clarity, the Party that is assigned responsibility for a Function as
per the designations in Section 2 is also responsible for the Embedded Processes applicable to that Function. 

  

	 	(c)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Quality Assurance Services to be performed by Supplier include all Functions performed
by or associated with the roles in the Quality Assurance Organization Chart set forth in Exhibit A-3 (QA Organization Chart), all of which are either being transferred to Supplier or displaced by Supplier roles as a result of the execution of
this Statement of Work. Such Functions will be deemed to be part of the Quality Assurance Services to be performed by Supplier as if expressly set forth in this Statement of Work. 

 

	 	(d)	In addition to the retained Health Net responsibilities expressly identified in this Exhibit A (Quality Assurance Services), and in addition to and without limiting Health Net’s rights under the Terms and
Conditions, Health Net may perform quality reviews and audits of Supplier’s performance of the Quality and Assurance Services in accordance with the Terms and Conditions. For the avoidance of doubt, Health Net is not obligated to perform any
level of such quality reviews and activities, except to the extent required by applicable Law. 

 Supplier shall generate and
provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is no longer required, (ii) such other operational
reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and evolutions of the Quality Assurance Services during the term
of this Statement of Work. 

  

					
	SOW#5 (Quality Assurance) Exhibit A		A-1		Health Net / Cognizant Confidential

 Final 
  

	1.2	Definitions 

  

	 	(a)	“Book of Business (BKB) Audit” means audits performed to represent overall performance for a specific line of business and region for a given work area (e.g., Claims, Membership, etc.)

  

	 	(b)	“Client Business Area” means the functional area that receives Quality Assurance Services (e.g. Claims, Membership, etc). 

 

	 	(c)	“External Employer Group Audit” means the planning and project management and oversight of on-site audits by Employer Groups. 

 

	 	(d)	“Focused/Ad Hoc Audit” means audits outside BKB Audits or Regulatory Audits as requested by the work area or another Health Net department. 

 

	 	(e)	“Regulatory (Mock) Audit” means audits performed for specific elements and universe sets as a Regulator (e.g., CMS, DMHC, etc.) would audit. 

 

	 	(f)	“Sox/IPC Audit” means the fulfillment of SOX and IPC audit requirements. 

  

	 	(g)	“Uphold” means to keep the original error finding after reviewing a dispute from the Client Business Area. 

 

	2	RESPONSIBLE PARTY 

 The following table sets forth the responsible party for the Quality
Assurance Services. 
  

													
	 	  	 	  	 	  	 	  	Resp. Party
	 Process /
Function
ID
	  	 Process/Function Name / Description
	  	Health Net
Department	  	Line of
Business
(LOB)	  	Region	  	Supplier	  	Health
Net
	QA1	  	Quality Assurance Services	  		  		  		  		  	
	QA1.1	  	SOX/IPC	  	All	  	All	  	All	  		  	
	QA1.1.1	  	SOX/IPC Compliance	  	All	  	All	  	All	  	X	  	
	QA1.1.2	  	SOX/IPC Control Approval	  	All	  	All	  	All	  		  	X
	QA1.2	  	Book of Business Auditing	  	All	  	All	  	All	  	X	  	
	QA1.3	  	Regulatory (Mock) Auditing	  	Claims,
Membership,
Appeals &
Grievances	  	All	  	All	  	X	  	
	QA1.4	  	Focused/Ad Hoc Auditing	  	All	  	All	  	All	  	X	  	

  

					
	SOW#5 (Quality Assurance) Exhibit A	  	A-2	  	Health Net / Cognizant Confidential

 Final 
  

													
	 	  	 	  	 	  	 	  	Resp. Party
	 Process /
Function
ID
	  	 Process/Function Name / Description
	  	Health Net
Department	  	Line of
Business
(LOB)	  	Region	  	Supplier	  	Health
Net
	QA1.5	  	External Employer Group Audits	  	Claims,
Membership,
Contact
Center,
Appeals &
Grievances	  	Commercial	  	All	  		  	
							
	QA1.5.1	  	 External Employer Group
 Auditing
Services
	  	Claims,
Membership,
Contact
Center,
Appeals &
Grievances	  	Commercial	  	All	  	X	  	
							
	QA1.5.2	  	 External Employer Group
 Auditing
Oversight
	  	Claims,
Membership,
Contact
Center,
Appeals &
Grievances	  	Commercial	  	All	  		  	X
							
	QA1.6	  	Audit Oversight and Review	  	All	  	All	  	All	  		  	X
	QA1.7	  	Audit Support Services	  	All	  	All	  	All	  	X	  	
	QA1.8	  	Quality Assurance Policy Services	  	All	  	All	  	All	  	X	  	

  

	3	QUALITY ASSURANCE SERVICES 

  

	3.1	SOX/IPC 

  

	 	(a)	“Sox/IPC Compliance” are the Functions associated with performing all audit and reporting in compliance with regulatory SOX and IPC controls, including the following activities:

  

	 	(i)	Intake and satisfy various SOX/IPC requests from Internal Audit and other parties within/outside of Health Net; and 

  

	 	(ii)	Manage and satisfy monthly and quarterly SOX/IPC requests. 

  

	 	(b)	“Sox/IPC Control Approval” are the Functions associated with reviewing and approving new/amended SOX/IPC controls. 

 

	3.2	Book of Business (BKB) Auditing 

  

					
	SOW#5 (Quality Assurance) Exhibit A	  	A-3	  	Health Net / Cognizant Confidential

 Final 
  

 “BKB Auditing” are the Functions associated with the monthly
sampling, auditing, and reporting results on a post transactional basis for BKB Audits, including the following activities: 
  

	 	(a)	Randomly sample universe, with a statistically valid sample size, using a stratified sampling rule set from a universe provided by the Client Business Area; 

 

	 	(b)	Validating the universe prior to sampling to ensure the appropriate universe was sampled; 

  

	 	(c)	Audit (on a post transaction basis) various work types for the listed Client Business Areas, in accordance with Client Business Area provided policies and procedures, inclusive of compliance to any regulations;

  

	 	(d)	Notify Processor Associates and their Supervisor of any errors within the established turnaround times; 

  

	 	(e)	Manage the dispute process for any errors being disputed by the Client Business Area; 

  

	 	(f)	Finalize and publish final error findings and overall accuracy scores on a monthly basis within the established turnaround times; 

  

	 	(g)	Maintenance, upgrades, and development of audit tools and databases including but not limited to Microsoft Access and Lotus Notes and Excel; 

 

	 	(h)	Fulfill custom ad hoc report requests from the BKB auditing universe; 

  

	 	(i)	Manage and maintain intake process and system for new and adjusted audit requests; (j) Fulfill audit requirements from a SOX/IPC perspective; 

 

	 	(k)	On at least an annual basis, perform sample size an alysis and universe stratification; and 

  

	 	(l)	Based on audit findings, make recommendations to business areas for policy and procedure creation/updates and/or process change/improvement. 

 

	3.3	Regulatory (Mock) Auditing 

 “Regulatory Mock Auditing”
are those Functions associated with the monthly sampling, auditing, and reporting results for Regulatory (Mock) Audits, including the following activities: 
  

	 	(a)	Randomly sample universe based on regulatory criteria using a sampling rule set from a universe provided by the Client Business Area; 

 

	 	(b)	Validating the universe prior to sampling to ensure the appropriate universe was sampled; 

  

	 	(c)	Audit (on a post transaction basis) various regulatory elements for the listed Client Business Areas, in accordance with Client Business Area provided policies and procedures, inclusive of compliance to any regulations;

  

	 	(d)	Manage the dispute process for any errors being disputed by the Client Business Area; 

  

	 	(e)	Finalize and publish final error findings and overall accuracy scores on a monthly basis within the established turnaround times; 

  

					
	SOW#5 (Quality Assurance) Exhibit A		A-4		Health Net / Cognizant Confidential

 Final 
  

	 	(f)	Maintenance, upgrades, and development of audit tools and databases including but not limited to Microsoft Access and Excel; 

  

	 	(g)	Collect Corrective Action Plan (CAP) responses from Client Business Areas for elements which fail for the given month; 

  

	 	(h)	Manage and maintain intake process and system for new and adjusted audit requests; (i) Fulfill audit requirements from a SOX/IPC perspective; and 

 

	 	(j)	Based on audit findings, make recommendations to business areas for policy and procedure creation/updates and/or process change/improvement. 

 

	3.4	Focused/Ad Hoc Auditing 

 “Focused/Ad Hoc Auditing” are those
Functions associated with the sampling, auditing, and reporting results on a post transactional basis for Focused/Ad Hoc Audits, including the following activities: 
  

	 	(a)	Randomly sample universe based on criteria using a sampling rule set from a universe provided by the Client Business Area; 

  

	 	(b)	Validate the universe prior to sampling to ensure the appropriate universe was sampled; 

  

	 	(c)	Audit (on a post transaction basis) specific focused elements for the listed Client Business Areas, in accordance with Client Business Area provided policies and procedures, inclusive of compliance to any regulations;

  

	 	(d)	Manage the dispute process for any errors being disputed by the Client Business Area; 

  

	 	(e)	Finalize and publish final error findings and overall accuracy scores based upon an established turnaround time; 

  

	 	(f)	Creation of audit tools including but not limited to Excel and Microsoft Access databases; 

  

	 	(g)	If CAP’s are required, collect Corrective Action Plan (CAP) responses from Client Business Areas for elements which fail for the given audit time period; 

 

	 	(h)	Fulfill custom ad hoc report requests from the focused / ad hoc auditing universe; 

  

	 	(i)	Manage and maintain intake process and system for new and adjusted audit requests; (j) Fulfill audit requirements from a SOX/IPC perspective; and 

 

	 	(k)	Based on audit findings, make recommendations to business areas for policy and procedure creation/updates and/or process change/improvement. 

 

	3.5	External Employer Group Audits 

  

					
	SOW#5 (Quality Assurance) Exhibit A		A-5		Health Net / Cognizant Confidential

 Final 
  

	 	(a)	“External Employer Group Auditing Services” are those Functions associated with the planning, scheduling, auditing, and project management of on-site External Employer Group Audit requests,
including the following activities: 

  

	 	(i)	Audit Employer Group requested audit universe; 

  

	 	(ii)	Provide systems training and systems oversight for Employer Group Auditors; and 

  

	 	(iii)	Provide Subject Matter Experts during the on-site audit. 

  

	 	(b)	“External Employer Group Oversight” are those Functions associated with overseeing the External Employer Group Auditing Services, including the following activities: 

 

	 	(i)	Receive and plan External Employer Group Audit request; and 

  

	 	(ii)	Respond to External Employer Group Audit finalized findings. 

  

	3.6	Audit Oversight and Review 

 “Audit Oversight and Review” are
those Functions associated with the overall management and oversight of the Quality Assurance Services, including the following activities: 
  

	 	(a)	Audit-the-Supplier Auditor; 

  

	 	(b)	Regular review of audit methodologies, strata, sampling, processes, and sample sizes; 

  

	 	(c)	Approve universe and sample size analysis; 

  

	 	(d)	External Employer Audit Management; and 

  

	 	(e)	Review and consultation of new audits and review requested changes to current audits. 

  

	3.7	Audit Support Services 

 “Audit Support Services” means those
Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group), including
the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with regulators. 

  

	3.8	Quality Assurance Policy Services 

  

					
	SOW#5 (Quality Assurance) Exhibit A		A-6		Health Net / Cognizant Confidential

 Final 
  

 “Quality Assurance Policy Services” means those Functions associated
with the development and implementation of “Health Net Quality Assurance Policies,” which are the Health Net Policies as defined in Schedule P (Health Net Policies) governing or pertaining to the Quality Assurance
Services, more specifically, the conduct of Health Net’s Quality Assurance Services. 
 Below are some examples of selected Quality
Assurance Policy Services Functions, which include descriptions of the manner in which such Functions are currently performed by Health Net. The examples are illustrative only: 

 

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Quality Assurance Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Quality Assurance Policies;

  

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

 

	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Quality Assurance Services and participate in operational implementation and/or affected system
changes of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net Quality Assurance Policies and submit them to the relevant Health Net and Supplier stakeholders for
review, comment and approval; 

  

	 	(d)	Prepare updated versions of Health Net Quality Assurance Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Quality Assurance Policies and access to Health Net personnel to such communications and training; and 

 

	 	(f)	Implement Heath Net-approved Health Net Quality Assurance Policies by Supplier Personnel involved in the performance of the Quality Assurance Services. 

  

					
	SOW#5 (Quality Assurance) Exhibit A		A-7		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

QUALITY ASSURANCE 

SOLUTION DESCRIPTION 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1 

QUALITY ASSURANCE SOLUTION DESCRIPTION 

TABLE OF CONTENTS 
  

					
	 1. INTRODUCTION
		 	1	 
		
	 2. DEFINITIONS AND INTERPRETATION
		 	1	 
		
	 2.1 Defined Terms
		 	1	 
		
	 3. SOLUTION OVERVIEW
		 	1	 
		
	 3.1 High-level Service Delivery Architecture and Configuration
		 	1	 
		
	 3.2 Service Delivery Model
		 	2	 
		
	 3.3 Business-Process-as-a-Service
		 	2	 
		
	 4. CHANGES TO SUPPLIER’S SOLUTION
		 	3	 
		
	 5. SOLUTION DESCRIPTION
		 	3	 
		
	 6. OPERATING MODEL
		 	4	 
		
	 6.1 Resource Mix
		 	4	 
		
	 6.2 Location
		 	5	 
		
	 6.3 Operating Hours
		 	7	 
		
	 6.4 Operations
		 	7	 
		
	 6.5 Resource Profile
		 	8	 
		
	 6.6 IT Systems
		 	10	 
		
	 6.7 Onshore Requirements
		 	13	 
		
	 6.8 Service Performance Management
		 	13	 
		
	 7. KEY ASSUMPTIONS
		 	13	 
		
	 8. RISKS
		 	13	 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1-i		Health Net / Cognizant Confidential

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 EXHIBIT A-1 

QUALITY ASSURANCE 

SOLUTION DESCRIPTION 
  

	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work #5 –
Quality Assurance (this “Statement of Work”). Whereas Exhibit A (Quality Assurance Services) describes the Functions which Supplier is responsible for performing under this Statement of Work. This Exhibit
A-1(Quality Assurance Solution Description) describes the means by which and the manner in which Supplier will perform those Functions. This document includes an overview of Supplier’s service delivery architecture
–including a depiction on a global map of the geographic configuration and delivery architecture of Supplier’s Solution (as it will exist at the completion of Phase 2). This geographical depiction also identifies all Service Delivery
Centers of Supplier (and its Affiliates and other Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how they will be interconnected to each other and to Health
Net’s IT Environment. It then provides additional descriptive information about each of the principal components of Supplier’s Solution. 

This Exhibit A-1 (Quality Assurance Solution Description) includes the following attachments, which are incorporated herein by
reference: 
 Exhibit A-1.1 Approved Service Delivery Centers 

Exhibit A-1.2 Service Delivery Configuration at the Completion of Phase 2 

 

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings set forth below unless otherwise specifically defined in the body of this document. Additionally any capitalized term used but not defined in this Exhibit A-1 (Quality Assurance Solution Description) will have the meaning indicated
in Schedule W (Glossary). 
  

			
	 Defined Term
	  	 Meaning

	“Solution”	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work.

  

	3.	SOLUTION OVERVIEW 

  

	3.1	High-level Service Delivery Architecture and Configuration 

 This section provides an
overview of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service Delivery Centers) provides additional information about each of the Service
Delivery Centers Supplier will use to provide the Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if
operations at any primary Service Delivery Center are disrupted or disabled. 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-1	  	Health Net / Cognizant Confidential

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 Figure 1 

*Dates represent end date of each transition wave. 
  

 
 Supplier’s Solution will be implemented in 3-4 waves as depicted in Figure 1 above with some of the
work gradually moving to the Offshore locations of Chennai and Bangalore in India and Manila in the Philippines. The estimated end state for the Quality Assurance Services is expected by September 2017. 

 

	3.2	Service Delivery Model 

 This section provides an overview of the commercial delivery
model that the Supplier will utilize in providing the Services under this Statement of Work. As described in Exhibit H (Quality Assurance Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform the Services
under this Statement of Work. The Supplier Personnel performing the Services will be located in Rancho Cordova, CA; Woodland Hills, CA; San Rafael, CA; Huntington Beach, CA; Chennai, India; and Manila, Philippines. 

 

	3.3	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work
will be provided under a ‘Business- Process-as-a-Service’ delivery model—i.e., as a fully integrated vertical service in which Supplier is responsible for providing all the associated resource / service layers (facilities, IT
infrastructure, tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’. Supplier will be
responsible for performing the Quality Assurance Services set forth in Exhibit A (Quality Assurance Services). 

  

					
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 At the end of the Transition, Supplier is targeting for 50% of the FTE work to be Offshore.
Refer to Section 6 (Operating Model) for details on Onshore/Offshore mix, delivery locations, and processes. 
  

	4.	CHANGES TO SUPPLIER’S SOLUTION 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Quality Assurance Solution). That said, Supplier is charged with responsibility for the adequacy of its
Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Quality Assurance Solution), should prove inadequate at any point during the Statement of Work Term for Supplier to perform and deliver the
Services in accordance with the obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in
accordance with such obligations. All such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such
changes at its own cost and expense except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 
  

	5.	SOLUTION DESCRIPTION 

 Supplier’s solution is built on the following foundational
aspects: 
 Delivery Solution: 
  

	 	•	 	Quality Focus – Supplier’s primary focus will be to maintain seamless continuity of Services. For all processes migrated Offshore, the focus will be to first ensure adherence to regulatory compliance
and quality. 

  

	 	•	 	Support ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides a Supplier Personnel to Supervisor and Manager ratio at Offshore and Onshore as described in Section 0.

  

	 	•	 	Continuous Improvement—Supplier will appoint dedicated Six Sigma and Process Excellence resources during the Term to identify sustainable improvement opportunities. *** 

Knowledge Retention: 
  

	 	•	 	Domain Experts – Supplier will invest in dedicated management staff with previous quality and compliance experience. 

  

	 	•	 	Health Net Training Academy – Supplier will have in place a dedicated Health Net Training Academy tasked with the mandate of building/maintaining a knowledge repository, updating training and process
documentation, providing training to new hire Supplier Personnel and providing higher level training to experienced resources for Quality Assurance operations. Supplier will periodically conduct training to keep Supplier Personnel up-to date on
regulatory, process and system changes. 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1-3		Health Net / Cognizant Confidential

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 Solution Location: 

Supplier will deliver the Quality Assurance Services from the United States, India and the Philippines. Exhibit A-1.1 (Supplier
Facilities) lists the locations of the Supplier Service Delivery Centers for the Quality Assurance Services. 
  

	6.	OPERATING MODEL 

 The operating model for Quality Assurance Services defines the service
delivery blueprint and key aspects of service delivery. The operating model also describes how the Services will be delivered in a scalable global environment. 

*** 
  

	6.1	Resource Mix 

 Supplier will leverage its global operating model to deliver the Quality
Assurance Services. Supplier has considered the following criteria to define its Onshore/Offshore strategy: 
  

	 	•	 	Regulatory requirements 

  

	 	•	 	Availability of skills at Offshore locations 

  

	 	•	 	Health Net Offshore restrictions 

 Roles identified to move Offshore will continue to be
responsible for the same tasks and activities that were previously performed Onshore. 
 The Onshore/Offshore resource mix for Quality
Assurance Services is listed below in Table 1. 
 Table 1 
  

											
	 Function
	  	Estimated End State
	 	  	Onshore
%	 	  	Offshore
%	 	  	Location
	Quality Assurance	  				  				  	
	Membership & CCC Correspondence	  	 	***	  	  	 	***	  	  	W,R,Ch,B
	Claims	  	 	***	  	  	 	***	  	  	W,R,Ch,B
	MHN- Claims, A&G and Configuration	  	 	***	  	  	 	***	  	  	W,S,Ch,B
	Claims and A&G Analyzing/Reporting	  	 	***	  	  	 	***	  	  	W, Ch,B
	Business Analysis	  				  				  	
	CCC/MHN Calls	  	 	***	  	  	 	***	  	  	W,R,H,Ch,B
	Reports	  	 	***	  	  	 	***	  	  	W,Ch,B
	Reports/Configuration/Benefits Load Audits	  	 	***	  	  	 	***	  	  	W, Ch,B
	Total (A+B+C+D)	  	 	***	  	  	 	***	  	  	

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-4	  	Health Net / Cognizant Confidential

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	 Legends

	Location	  	Code
	Woodland Hills (US)	  	W
	Rancho Cordova (US)	  	R
	San Rafael	  	S
	Chennai (India)	  	Ch
	Bangalore (India)	  	B
	Manila (Philippines)	  	M
	Huntington Beach	  	H

  

	 	•	 	The above percentages are approximate estimates. 

  

	 	•	 	The above plan will be finalized as part of the process assessment that will take place during the Transition as described in Transition Manual, with agreement between Health Net and Supplier. 

 

	 	•	 	The estimated end state is expected by September 2017. 

  

	 	•	 	Only those roles mandated by Health Net or where skills are not available Offshore will be Onshore. 

  

	 	•	 	As shown in Table 1, while a process can span across 5 locations there will be no role within a process which will span across more than 2 locations. 

 

	6.2	Location 

 Supplier will deliver the in-scope Services from US, India and Philippines
based locations. The delivery location strategy has been carefully planned considering following criteria: 
  

	 	•	 	Health Net mandated Offshore staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-5	  	Health Net / Cognizant Confidential

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	 	•	 	Regulatory limitations 

  

	 	•	 	Business continuity 

 Supplier will deliver specific Quality Assurance Functions as set forth in
Table 2 as follows: 
 Table 2 
  

					
	 Function
	  	 Delivery Location

	 	  	 US
	  	India
	Membership and CCC Correspondence	  	Rancho Cordova, Woodland Hills	  	Bangalore/Chennai
	Claims	  	Rancho Cordova, Woodland Hills	  	Bangalore/Chennai
	MHN – Claims, A&G and Configuration	  	Rancho Cordova, Woodland Hills, San Rafael	  	Bangalore/Chennai/Manila
	Claims and A&G analysis/reporting	  	Woodland Hills	  	Bangalore/Chennai
	CCC/MHN calls	  	Rancho Cordova, Huntington Beach	  	Bangalore/Chennai
	Reports / Business Analysis	  	Woodland Hills	  	Bangalore/Chennai

 The teams across locations in US, India and Philippines will interact on an ongoing basis to ensure effective
planning, monitoring and tracking of QA processes, activities and requirements. The following are the key activities that will be performed at each location: 
  

	 	•	 	Forecasting – identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	•	 	Capacity Planning – ensuring staffing in place can manage the forecasted volumes 

  

	 	•	 	Monitor Productivity – An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	•	 	Reallocation based on productivity – An ongoing exercise to track and shift work , based on transaction and volumes, within teams and individuals to ensure desired productivity 

  

					
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	 	•	 	Monitor Quality and SLAs—An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

The organization structure has been functionally designed in a manner that facilitates effective operations across locations. This model
ensures that workflow is effective in real time facilitating tactical monitoring. 
  

	6.3	Operating Hours 

 Supplier will at minimum replicate the operating hours currently
adhered to by Health Net’s Quality Assurance organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Quality Assurance Services will regularly require Supplier Personnel
to perform additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Quality Assurance Services. 

Supplier will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of operations is within the scope of the Quality Assurance Services. 

Within the regular Hours of Operations listed below, Supplier will have staff work according to defined shift schedules. However, Supplier will
make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the
Agreement. 
 Table 3 
  

			
	 Sub function
	  	 Weekday—Hours of Operations

(PST)

	 Quality Assurance
	  	
	 Membership and CCC Correspondence
	  	08:00 am to 17:00 pm
	 Claims
	  	08:00 am to 17:00 pm
	 MHN – Claims, A&G and Configuration
	  	08:00 am to 17:00 pm
	 Claims and A&G analysis/reporting
	  	08:00 am to 17:00 pm
	 Business Analysis
	  	
	 CCC/MHN calls
	  	08:00 am to 17:00 pm
	 Reports
	  	08:00 am to 17:00 pm

  

	6.4	Operations 

 Supplier approach to managing operations is as follows: 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-7	  	Health Net / Cognizant Confidential

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	 	•	 	Operational Focus: 

 Team leaders and supervisors take part in team
huddles, floor walks, daily performance reviews, daily supplier personnel communication plan and customer calibration sessions 
  

	 	•	 	Performance Management: 

 Measure and manage associate performance through
data and service dashboards 
  

	 	•	 	Span of Control: 

 Supplier will provide for the following span of control:

  

	 	•	 	***Health Net Training Academy: 

 Supplier will establish a dedicated
Health Net Training academy for management of training content and delivery of training programs. Supplier will establish a Knowledge Management Portal for management and easy access to training content, desktop procedures and P&Ps. The Health
Net Training Academy will work closely with the Training operations and facilitate necessary training. Training material will be continuously updated based on System and process updates. 

 

	 	•	 	Team Huddle: 

 Supplier’s team leads will conduct daily team meetings
for individual processes to share any critical updates, provide feedback and communicate lessons learned, and plan for the day. 
  

	 	•	 	Quality: 

 Supplier will implement Health Net mandated specific quality and
compliance programs in its delivery model for managing and achieving Service Levels. Supplier will analyze audit findings to determine root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings,
prevalent trends in errors, root causes and preventive actions will be discussed and implemented. 
  

	 	•	 	Continuous Improvement: 

 Supplier will have a dedicated Process Excellence
(PEX) team consisting of Six Sigma resources for Health Net Quality Assurance functions to optimize performance and handoffs in Health Net Quality Assurance processes while continuously improving standardization. 

 

	 	•	 	Rewards and Recognition: 

 Supplier will recognize the efforts of its best
performers using stack ranking and will reward them through a structured reward and recognition program that aligns with quality and productivity objectives. The rewards and recognition will be applicable for both Onshore and Offshore teams. The
specific criteria for the awards will be decided by the Supplier operations leads depending on the specific behavior and/or results to be achieved. 
  

	6.5	Resource Profile 

 Supplier has a very well defined methodology for recruitment and
selection of candidates at the Offshore locations. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper
qualifications and experience in order to ensure a “best-fit” for Health Net. These resources will be seeded from Health Net operations. 

The table below is an illustration of indicative requirements for Offshore staffing and the minimum qualifications required to be selected for
Quality Assurance Services. 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1-8		Health Net / Cognizant Confidential

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	Audit Analyst – Claims	  	 
	 Qualification & Experience
	  	 Selection Process

	 Graduates with four to five (4-5) years’ experience with Health Net Healthcare claims adjudication and audit processes

 
 Six Sigma/Lean exposure of at least two (2) years
	  	 Aptitude test
 Domain/ Operations Interview

HR Interview for Cultural fitment
 Medical and background
check

  

			
	Audit Analyst – Membership	  	 
	 Qualification & Experience
	  	 Selection Process

	 Graduates with four to five (4-5) years’ experience with Health Net membership / financial reconciliation process auditing
experience
  
 Six Sigma/Lean exposure of at least two (2) years
	  	 Aptitude test
 Domain/ Operations Interview

HR Interview for Cultural fitment
 Education and Professional
Background check

  

			
	Audit Analyst – Configuration	  	 
	 Qualification & Experience
	  	 Selection Process

	 Graduates with four to five (4-5) years’ experience with Health Net Healthcare Configurations and benefits coding process auditing
experience
  
 Six Sigma/Lean exposure of at least two (2) years
	  	 Aptitude test
 Domain/ Operations Interview

HR Interview for Cultural fitment
 Education and Professional
Background check

  

			
	Audit Analyst – A&G	  	 
	 Qualification & Experience
	  	 Selection Process

	 Graduates with two to three (2-3) years’ experience with Health Net Healthcare & A&G processes

 
 Six Sigma/Lean exposure of at least two (2) years
	  	 Aptitude test
 Domain/ Operations Interview

HR Interview for Cultural fitment
 Education and Professional
Background check

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-9	  	Health Net / Cognizant Confidential

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	 Audit Analyst – Contact Center

Qualification & Experience
	  	 Selection Process

	 Graduates with two to three (2-3) years’ experience with Health Net Healthcare & Contact Center

 
 Six Sigma/Lean exposure of at least two (2) years
	  	 Aptitude test
 Domain/ Operations Interview

HR Interview for Cultural fitment
 Education and Professional
Background check

  

			
	Supervisors	  	 
	 Qualification & Experience
	  	 Selection Process

	 Graduate with six to eight (6-8) years’ experience in Healthcare Industry specifically in respective in-scope process

 
 Two (2) years of Supervisory experience leading teams of at least thirty to forty
(30-40) associates
  
 Leadership and communication skills
	  	 Communication skills screening
 Domain/
Operations Interview
 HR Interview for Cultural fitment

Education and Professional Background check

  

			
	Audit /BA Manager	  	 
	 Qualification & Experience
	  	 Selection Process

	 MBA with eight to ten (8-10) years’ experience Excellent communication and leadership skills

 
 Seven to nine (7-9) years of overall BPO experience with at least six (6) years
leading a process in a Healthcare BPO.
	  	 Initial screening of profiles by recruitment team

Interview with Business Leader/ HR Manager
 Technical/
Communication ability Interview
 Screening for leadership ability and cultural fit

Education and Professional Background check

  

	6.6	IT Systems 

 The following systems will be used by Supplier for delivery of Quality
Assurance Services. 
  

	
	 IT Applications/Platforms

	 Claims Application Platforms

	 ABS

	 Qcare

	 FileNet

	 MHN

	 Viant/Multiplan

	 DRG Grouper

  

					
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	 IT Applications/Platforms

	 Multiple Shared Drives

	 Microsoft Access data bases

	 Enrollment and Billing Applications / Platforms

	 Genelco

	 ABS

	 MACESS

	 Symphony

	 SAP

	 Salesforce

	 Showcase (Data Warehouse Query Tool)

	 CSI

	 Monarch

	 Check deposit software

	 CMS MARX

	 Callidus

	 FindApps

	 Callidus

	 Appeals and Grievance Applications / Platforms

	 MAGIC

	 MACESS

	 CSI

	 OMNI

	 PRIME

	 ABS

	 Qcare

	 UNITY

	 PAOS

	 API

	 RightFax

	 A&G Database

	 Configuration Applications

	 ABS Dev and Prod

  

					
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	 IT Applications/Platforms

	 Qcare

	 Viant

	 FileNet

	 Burgess

	 MHN

	 DRG Grouper

	 Alfresco

	 BRCC

	 PSA Archive

	 Inventory Management Database

	 Symphony

	 Contact Center Applications

	 MAGIC

	 MACESS

	 CSI

	 OMNI

	 PRIME

	 ABS

	 Qcare

	 UNITY

	 PAOS

	 API

	 RightFax

	 QA Services Specific tools/databases

	 ACL 9.1

	 Lotus Notes Findings Database

	 Multi User Audit Forms/Databases (Microsoft Access 2010

	 Error Database

	 Aspect (Call Recorder)

	 Qfiniti (Call Recorder)

	 AQ Recorder (Call Recorder)

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1-12	  	Health Net / Cognizant Confidential

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	6.7	Onshore Requirements 

 Section 6 sets forth the Quality Assurance Services roles
that Supplier is required to retain Onshore. Supplier will at all times provide the Quality Assurance Services in accordance with Schedule Y (Offshore Prohibitions and Requirements). 

 

	6.8	Service Performance Management 

 Supplier will provide and implement the quality
assurance procedures that are necessary to perform the Quality Assurance Services in accordance with the Service Levels, reporting formats and frequency. 

Approach 
 Supplier will
use a statistically valid sample size for auditing 
 Tools 

Supplier will use quality analysis using tools including: 
  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

	7.	KEY ASSUMPTIONS 

  

	 	1)	Any work request received directly at Health Net in non-digital format will be batched and sent by Supplier to the scanning/imaging service provider for conversion into digital format. However for regulatory
requirements Onshore Supplier Personnel will scan the documents in the United States. 

  

	 	2)	The Onshore-Offshore mix will be validated during detailed Transition planning as set forth in the Transition Manual. 

  

	 	3)	All Services will be provided in English language only. 

  

	8.	RISKS 

 Additional risks, if any will be identified and shared during Transition as part
of the Processes Assessment exercise. 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1-13		Health Net / Cognizant Confidential

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 EXHIBIT A-1.1 

APPROVED SERVICE DELIVERY CENTERS 
 The
Service Delivery Centers at (or from) which Supplier is authorized to perform the Services under this Statement of Work are listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform certain
aspects of the Services, their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.1 (Approved Service Delivery Centers). 

Supplier will provide sufficient coverage for the Quality Assurance Services by leveraging its global delivery network. A list of holidays across delivery
locations will be mutually agreed with Health Net to ensure that there is no impact on operations. 
 Onshore Service Delivery Centers 

 

																					
	 Primary

Location
	 	 Type of

Facility
	 	 Hours of

Operation
	 	 Functions /
Services
	 	Languages
Supported	 	 Key

Platform /

Systems
	 	
Back-up /

Fail-over

Location
	 	Facility
Operator	 	Facility
Owner	 	Date
Placed
in
Service	 	Multi-
client
Site
(Y/N)?
	Rancho Cordova	 	Office Building	 	Please refer to Section 6.3	 	Quality Assurance	 	English	 	Please refer to Section 0 for list of platform/systems	 	 Woodland
 Hills
	 		 		 		 	
											
	Woodland Hills	 	Office Building	 	Please refer to Section 6.3	 	Quality Assurance	 	English	 	Please refer to Section 0 for list of platform/systems	 	 Rancho
 Cordova
	 		 		 		 	
											
	San Rafael	 	Office Building	 	Please refer to Section 6.3	 	Quality Assurance	 	English	 	Please refer to Section 0 for list of platform/systems	 	 Woodland
 Hills
	 		 		 		 	
											
	Huntington Beach	 	Office Building	 	Please refer to Section 6.3	 	Quality Assurance	 	English	 	Please refer to Section 0 for list of platform/systems	 	 Rancho
 Cordova
	 		 		 		 	

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1.1-1	  	Health Net / Cognizant Confidential

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 Near-shore Service Delivery Centers 

Supplier will not use any Near-shore Service Delivery Centers to perform the Quality Assurance Services. 

Offshore Service Delivery Centers 
  

																					
	 Primary

Location
	 	 Type of

Facility
	 	 Hours of

Operation
	 	 Functions /
Services
	 	 Languages

Supported
	 	 Key Platform /
Systems
	 	 Back-up /
Fail-over
Location
	 	 Facility

Operator
	 	 Facility

Owner
	 	 Date

Placed
 in

Service
	 	 Multi-

client
 Site

(Y/N)?

	 Cognizant Technology Solutions, Carr Tower, Ramanujan IT SEZ, Taramani, Rajiv Gandhi Salai, Taramani, Chennai

600113
	 	 Office
 Building
	 	Please refer to Section 6.3	 	 Quality
 Assurance
	 	English	 	Please refer to Section 0 for list of platform/systems	 	 Cognizant Technology Solutions, SEZ—2

Manyata Embassy Business Park,
 Bangalore

- 560045
	 	Supplier	 	 Third
 Party
	 	2012	 	Y
											
	 Cognizant Technology Solutions, SEZ - 2
 Manyata
Embassy Business Park,
 Bangalore - 560045
	 	 Office
 Building
	 	Please refer to Section 6.3	 	 Quality
 Assurance
	 	English	 	Please refer to Section 0	 	Cognizant Technology Solutions, Carr Tower, Ramanujan IT SEZ, Taramani, Rajiv Gandhi Salai, Taramani, Chennai 600113	 	Supplier	 	 Third
 Party
	 	 F2 -
 2008

F3 -
 2013

G4 -
 2012
	 	Y

  

					
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	 Primary

Location
	 	 Type of

Facility
	 	 Hours of

Operation
	 	 Functions /
Services
	 	 Languages

Supported
	 	 Key Platform /
Systems
	 	 Back-up /
Fail-over
Location
	 	 Facility

Operator
	 	 Facility

Owner
	 	 Date

Placed
 in

Service
	 	 Multi-

client
 Site

(Y/N)?

	 One World
 Square Building, Unit A, Mckinley Hill,
Fort Bonifacio, Taguig City, Philippines
	 	Office Building	 	Please refer to Section 6.3	 	Quality Assurance	 	English	 	Please refer to Section 0	 	Cognizant Technology Solutions, 4th & 5th Floor, Paseo Centre Building, Roxas corner, Makati City 1277	 	Supplier	 	Third Party	 	2013	 	Y

  

					
	SOW#5 (Quality Assurance) Exhibit A-1	  	A-1.1-3	  	Health Net / Cognizant Confidential

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 EXHIBIT A-1.2 

SERVICE DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 

Set out below is a description of Supplier’s ‘To-Be’ Solution for the Quality Assurance Services as it will be configured at the completion of
Phase 2. The tactical To Be solution will be mutually defined during the Transition, below is an illustrative technology environment: 
  

 

  

					
	SOW#5 (Quality Assurance) Exhibit A-1		A-1.2-1		Health Net / Cognizant Confidential

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 EXHIBIT A-3 

QUALITY ASSURANCE ORGANIZATION CHART 

  

					
	SOW#5 (Quality Assurance) Exhibit A-3		 		Health Net / Cognizant Confidential

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 EXHIBIT A-3 

QUALITY ASSURANCE ORGANIZATION CHART 
 This
Exhibit A-3 (Quality Assurance Organization Chart) contains organization charts showing, at a specific recent point in time prior to the Effective Date, the positions (including both filled and currently open positions) that represent the
Health Net organizational unit(s) whose Functions are being outsourced to Supplier under this Statement of Work. This document is included as part of this Statement of Work as a supplemental means of depicting the Functions that comprise the Quality
Assurance Services for which Supplier is assuming responsibility from Health Net under this Statement of Work. It is not included for the purpose of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s
Charges for the Quality Assurance Services. Any changes in the organization charts between the Agreement’s Effective Date and the BPaaS Services Commencement Date shall not be interpreted to represent a change in the scope of the Quality
Assurance Services in the absence of Health Net specifically adding or removing Functions from Exhibit A (Quality Assurance Services) of this Statement of Work. 

  

					
	SOW#5 (Quality Assurance) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

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	SOW#5 (Quality Assurance) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

  
 

 

  
 

 

 Final 
  

 EXHIBIT B-1 

QUALITY ASSURANCE SERVICE LEVEL METRICS 
  

	1.	QUALITY ASSURANCE OPERATIONAL LEVELS 

 All Service Levels are subject to the Service
Level Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement and the Exhibits thereto. 
  

																	
	 Category /

Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improve
	 A&G Audits
 (% of production)
	 	Total number of audits completed against goal.	 	Monthly	 	 A&G Audit Database and
 Reporting
Tool
	 	100% of Statistically Valid Sample as calculated by HN as of the Effective Date with a minimum count of 690 for CA, 238 for OR, and 323 for AZ.	 	Yes	 	TBD	 	A	 	Y
									
	 A&G Audit the Auditor (Regulatory Element %

accuracy)
	 	 The percentage of correctly audited regulatory elements.
  

(count of elements)—(count of elements with error) / (count of elements )
	 	Monthly	 	A&G ATA Database and Reporting Tool	 	 98% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N
									
	A&G Audit the Auditor (Internal Element % accuracy)	 	 The percentage of correctly audited internal elements.
  

(count of elements)—(count of elements with error) / (count of elements)
	 	Monthly	 	 A&G ATA Database and
 Reporting Tool
	 	 98% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N

  

					
	SOW#5 (Quality Assurance) Exhibit B-1	  	B-1-1	  	Health Net / Cognizant Confidential

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	 Category /

Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improve
	Claims Audits (% of production)	 	Total number of audits completed against goal.	 	Monthly	 	 Claims Audit
 Database and

Reporting Tool
	 	100% of Statistically Valid Sample as calculated by HN as of the Effective Date with a minimum count of 8,704 for CA, 1,328 for OR, and 2,779 for AZ.	 	Yes	 	TBD	 	A	 	Y
									
	Claims Audit the Auditor (Payment % accuracy)	 	 The percentage of correctly audited claims (without any payment error).

 
 (count of audits)—(count of audits with error) / (count of audits )
	 	Monthly	 	 Claims ATA
 Database and

Reporting Tool
	 	 98% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N
									
	Claims Audit the Auditor (Financial % Accuracy)	 	 The percentage of correctly audited claims (without any financial error).

 
 (total $ processed) – (absolute $ in error) / (total $ processed)
	 	Monthly	 	 Claims ATA
 Database and

Reporting Tool
	 	 99% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N
									
	Claims Audit the Auditor (Procedural % accuracy)	 	 The percentage of correctly audited claims (without any procedural error).

 
 (count of audits)—(count of audits with error) / (count of audits )
	 	Monthly	 	Claims ATA Database and Reporting Tool	 	 98% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N

  

					
	SOW#5 (Quality Assurance) Exhibit B-1	  	B-1-2	  	Health Net / Cognizant Confidential

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	 Category /

Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improve
	Membership Audits* (% of production)	 	Total number of audits completed against goal.	 	Monthly	 	Membership Audit Database and Reporting Tool	 	 – CA/OR
 – AZ 100% of Statistically
Valid
 Sample as calculated by HN as of the Effective Date with a minimum count of 10,777 for CA and OR, and 1,546 for AZ.
	 	Yes	 	TBD	 	A	 	Y        
									
	Membership Audit the Auditor (% accuracy)	 	 The percentage of correctly audited transactions.
  

(count of audits)—(count of audits with error) / (count of audits)
	 	Monthly	 	Membership ATA Database and Reporting Tool	 	 98% - CA
 98% - OR

98% - AZ
	 	Yes	 	TBD	 	C	 	N
									
	BKB Audit Reports Timeliness	 	Publish finalized audit reports by the 5th business day	 	Monthly	 	BA Team Database and Reporting Tool	 	baseline consideration	 	Yes	 	TBD	 	C	 	N
									
	 Regulatory Audit Reports
 Timeliness
	 	Publish finalized audit reports (complete with CAP responses) by the 12th calendar day	 	Monthly	 	BA Team Database and Reporting Tool	 	baseline consideration	 	Yes	 	TBD	 	C	 	N
									
	Ad Hoc Report Requests	 	Provide ad hoc report requests by the agreed upon timeline provided by Health Net and/or an External Entity such as a Regulator, Employer Group, etc.	 	Ad hoc	 	BA Team Database and Reporting Tool	 	baseline consideration	 	Yes	 	TBD	 	C	 	N
									
	CCC BKB Call Audit production (% of production)	 	Total number of audits completed against goal.	 	Monthly	 	CCC Audit Database and Reporting Tool	 	100% of Statistically Valid Sample as calculated by HN as of the Effective Date	 	Yes	 	TBD	 	C	 	N

  

					
	SOW#5 (Quality Assurance) Exhibit B-1	  	B-1-3	  	Health Net / Cognizant Confidential

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	 Category /

Name
	 	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improve
	CCC BKB Call Audit the Auditor (% Accuracy)	 	 The percentage of correctly audited transactions.
  

(count of audits) – (count of audits with error) / (count of audits)
	 	Monthly	 	CCC ATA Database and Reporting Tool	 	98%	 	Yes	 	TBD	 	C	 	N
									
	 CCC BKB
 Commercial Correspondence
Production
	 	Total number of audits completed against goal.	 	Monthly	 	 CCC Corr Audit
 Database and

Reporting Tool
	 	TBD	 	Yes	 	TBD	 	C	 	N
									
	 CCC BKB
 Commercial Correspondence Audit the
Auditor (% Accuracy)
	 	 The percentage of correctly audited transactions.
  

(count of audits) – (count of audits with error) / (count of audits)
	 	Monthly	 	 CCC Corr ATA
 Database and

Reporting Tool
	 	98%	 	Yes	 	TBD	 	C	 	N
									
	CCC BKB SHP Correspondence Production	 	Total number of audits completed against goal.	 	Monthly	 	 CCC Corr Audit
 Database and

Reporting Tool
	 	TBD	 	Yes	 	TBD	 	C	 	N
									
	CCC BKB SHP Correspondence Audit the Auditor (% Accuracy)	 	 The percentage of correctly audited transactions.
  

(count of audits) – (count of audits with error) / (count of audits)
	 	Monthly	 	 CCC Corr ATA
 Database and

Reporting Tool
	 	98%	 	Yes	 	TBD	 	C	 	N
									
	Configuration Production	 	Total number of audits completed against goal.	 	Monthly	 	 Configuration
 Audit Database and Reporting
Tool
	 	TBD	 	Yes	 	TBD	 	C	 	N
									
	Configuration Audit the Auditor (% Accuracy)	 	 The percentage of correctly audited transactions.
  

(count of audits) – (count of audits with error) / (count of audits)
	 	Monthly	 	 Configuration
 ATA Database and Reporting
Tool
	 	 baseline
 consideration
	 	Yes	 	TBD	 	C	 	N

  

					
	SOW#5 (Quality Assurance) Exhibit B-1	  	B-1-4	  	Health Net / Cognizant Confidential

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 EXHIBIT D 

KEY SUPPLIER PERSONNEL 
 Subject to
Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions filled by the individuals listed in the table below. 

 

			
	 Key Supplier Position
	  	 Initially Approved Individual

	Mgr Quality Assurance	  	TBD
	Mgr Business Analysis	  	TBD

  

					
	SOW#5 (Quality Assurance) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

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 EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms and
Conditions, this Schedule H (Subcontractors) identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth
below. 
  

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	 ***
	  		  	

  

					
	SOW#5 (Quality Assurance) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

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 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #6 (APPEALS AND GRIEVANCES SERVICES) 

  

					
	SOW#6 (Appeals and Grievances)		 		Health Net / Cognizant Confidential

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 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #6 (APPEALS AND GRIEVANCES SERVICES) 

This Statement of Work #6 (Appeals and Grievances Services), dated November 21, 2014, but effective as of November 2, 2014
(“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #6 (Appeals and Grievances Services) is entered into and shall be governed by the terms of that certain Amended and
Restated Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #6 (Appeals and Grievances Services) replaces and supersedes in all respects
the Statement of Work #6 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #6 (Appeals and Grievances Services)
describes the Appeals and Grievances Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Appeals and Grievances Services) to this SOW #6 (Appeals and Grievances Services), and sets forth certain
terms and conditions relating to them, including, among other things: 
  

	 	(a)	The scope of the Appeals and Grievances Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; 

  

	 	(d)	The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

	1.2	Structure 

 This SOW #6 (Appeals and Grievances Services) is comprised of this
cover document and the following Exhibits: 
  

					
	 Table 1: Exhibits to SOW #6
(Appeals and Grievances Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	Exhibit A (Services)	  	Describes the scope of the Appeals and Grievances Services.

  

					
	SOW#6 (Appeals and Grievances)	  	1	  	Health Net / Cognizant Confidential

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	 Table 1: Exhibits to SOW #6
(Appeals and Grievances Services)

	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	2	  	 Exhibit A-1 (Solution

Description)
	  	 Describes Supplier’s solution for the provision of the Appeals and

Grievances Services and includes as exhibits:
  

•    Exhibit A-1-1 (Approved Service Delivery Centers)

 
 •    Exhibit A-1-2
(Service Delivery Configuration at the Completion of Phase 2)

			
	3	  	Exhibit A-3 (Organizational Chart)	  	Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW #6 (Appeals and Grievances Services).
			
	4	  	Exhibit B-1
(Operational SLAs)	  	Identifies the Operational Service Levels applicable to the Appeals and Grievances Services.
			
	5	  	 Exhibit D (Key
 Supplier
Positions)
	  	Identifies the Key Supplier Positions applicable to the Appeals and Grievances Services.
			
	6	  	Exhibit H
(Subcontractors)	  	Identifies the Subcontractors approved by Health Net to provide certain of the Appeals and Grievances Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #6 (Appeals and
Grievances Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #6 (Appeals and Grievances Services) is
hereby made a part of, and is subject to and governed by, the Agreement. This SOW #6 (Appeals and Grievances Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW#6 (Appeals and Grievances)	  	2	  	Health Net / Cognizant Confidential

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 IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #6 (Appeals
and Grievances Services) to be signed and delivered by its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

									
	Health Net, Inc.				Cognizant Healthcare Services, LLC
					
	By:		 				By:		 
					
	Print Name:		 				Print Name:		 
					
	Title:		 				Title:		 
					
	Date:		 				Date:		 

  

					
	SOW#6 (Appeals and Grievances)		 		Health Net / Cognizant Confidential

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 EXHIBIT A 

APPEALS AND GRIEVANCES SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	General 

  

	 	(a)	In the most general terms, the Appeals and Grievances (A&G) Services are Functions associated with the intake, processing, resolution and archiving of Appeals and Grievances received from Members or
their representatives through all Channels for all regions and Lines of Business requested by Health Net including: 

  

	 	(i)	Documenting and tracking all Appeals and Grievances in the appropriate system of record and adherence with to all Health Net, regulatory, compliance and business standards applicable to all Products, Regions and Line of
Business; and 

  

	 	(ii)	Ensuring quality of work while meeting required timelines. 

  

	 	(b)	The Appeals and Grievances Services are more fully described in this Exhibit A-1 (Appeals and Grievances Services), and include the Cross Functional Services described in Section 3 of Schedule A (Cross
Functional Services) and the Functions included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Appeals and Grievances
Services. For clarity, this includes Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 of Schedule A (Cross Functional Services). Supplier shall perform
the Appeals and Grievances Services, except for those Functions that are expressly identified as retained Health Net responsibilities in Section 2 below. For purposes of clarity, the Party that is assigned responsibility for a Function as per
the designations in Section 2 is also responsible for the Embedded Processes applicable to that Function. 

  

	 	(c)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Appeals and Grievances Services to be performed by Supplier include all Functions
performed by or associated with the roles in the Appeals and Grievances Organization Chart set forth in Exhibit A-3 (Appeals and Grievances Organization Chart) except where specifically excluded in this Statement of Work, all of which are
either being transferred to Supplier or displaced by Supplier roles as a result of the execution of this Statement of Work. Such Functions will be deemed to be part of the Appeals and Grievances Services to be performed by Supplier as if expressly
set forth in this Statement of Work. 

  

	 	(d)	In addition to the retained Health Net responsibilities expressly identified in this Exhibit A (Appeals and Grievance Services), and in addition to and without limiting Health Net’s rights under the Terms
and Conditions, Health Net reserves the right to perform quality reviews and audits of Supplier’s performance of the Appeals and Grievances Services when and to the extent it desires in its sole discretion. For the avoidance of doubt, Health
Net is not obligated to perform any level of such quality reviews and activities, except to the extent required by applicable Law. 

  

					
	SOW#6 (Appeals and Grievances)		A-1		Health Net / Cognizant Confidential

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	 	(e)	Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is
no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and
evolutions of the Appeals and Grievances Services during the term of this Statement of Work. 

  

	1.2	Definitions 

 The following definitions will apply to the Appeals and Grievances
Services: 
  

	 	(a)	“Acknowledgement Letter” means an acknowledgement letter sent by Health Net to a Member either (i) upon Health Net’s receipt of an Appeal or Grievance; or (ii) upon the escalation
of an Appeal to another level of review in the Appeals process. 

  

	 	(b)	“Adverse Benefit Determination” means any denial, reduction, termination, or failure to provide a payment or service (in whole or in part) when related to: (i) the determination of benefits
available under the Plan, (ii) the determination of a member’s eligibility under the Plan, (iii) the application of utilization review and pre-authorization provisions, (iv) the application of experimental or investigational
exclusions, (e) a determination that a benefit is not a covered benefit, or (v) the imposition of a preexisting condition exclusion, source-of-injury exclusion, network exclusion, or other limitation on otherwise covered benefits. The
failure to make a payment in whole or in part includes any instance where a plan pays less than the total amount of expenses submitted with regard to a claim, including a denial of part of the claim due to the terms of a plan or health insurance
coverage regarding copayments, deductibles, or other cost sharing requirements. Adverse Benefit Determination also includes any rescission of coverage, which are defined as a cancellation or discontinuance of coverage that has retroactive effect,
except to the extent it is attributable to a failure to timely pay required premiums or contributions towards the cost of coverage. 

  

	 	(c)	“Appeal” means any oral or written request submitted by a member, their physician, or other member authorized representative pursuant to which such Member disagrees with a Health Net decision
regarding (i) an initial adverse determination, (ii) the denial of a claim (in whole or in part), or (iii) other denial of coverage for service, as referenced in “Adverse Benefit Determination.” 

 

	 	(d)	“Appeals Levels 1, 2 or 3” or “Levels” means those Appeals or Grievances that (i) have reached either Level 1, Level 2 or Level 3 in the Appeals and Grievance
process; and (ii) are not Expedited Appeals. 

  

	 	(e)	“Congressional/Legislative Complaint” means a written or oral expression of dissatisfaction regarding the Plan and/or Provider, including quality of care concerns, and shall include a complaint,
dispute, request for reconsideration or Appeal made by an enrollee or the enrollee’s representative to a congressional or other legislative office. 

  

	 	(f)	 “Expedited Review” means the review of an urgent care issue, initiated orally or in writing by the member acting as a prudent
layperson or a practitioner acting on the member’s behalf, involving an imminent and serious threat to the health of the member, including severe pain, potential loss of life, limb or major bodily function. In addition, a

  

					
	SOW#6 (Appeals and Grievances)		A-2		Health Net / Cognizant Confidential

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“claim involving urgent care” includes any claim for medical care or treatment with respect to which the application of the time periods for making non-urgent care determinations:
(i) could seriously jeopardize the life or health of the member or the ability of the member to regain maximum function, or (ii) in the opinion of a physician with knowledge of the member’s medical condition, would subject the member
to severe pain that cannot be adequately managed without the care or treatment that is the subject of the claim. 

  

	 	(g)	“Grievance” means a grievance submitted by or on behalf of a Member pursuant to which such Member expresses dissatisfaction with any aspect of the manner in which health care services are
provided under a Plan. 

  

	 	(h)	“Member Inquiry” means a request made by a Member for clarification of a benefit or product, or request for information with respect to eligibility, where no expression of dissatisfaction, no
initial determination, previously made decision, or denial was made. Where the Plan is unable to distinguish between a Grievance or an inquiry, it will be considered a Grievance. 

 

	 	(i)	“Member Warning” means the process of initiating involuntary transfers of members to another Primary Care Physician (PCP) or contracting Participating Physician Group (PPG) or the termination of
members from a Health Net plan under certain circumstances. 

  

	 	(j)	“Potential Quality Issue (PQI)” means any potential or suspected deviation from expected performance, clinical care or outcome identified by an associate and/or the Plan’s Providers and
practitioners which cannot be determined or be justified without additional review that has been. 

  

	 	(k)	“Pre-Service Appeal” means a request to change an adverse determination for care or services that the organization must approve in whole or in part, in advance of the Member obtaining care or
services. 

  

	 	(l)	“Post-Service Appeal” means a request to change an adverse determination for care or services that the Member has received. 

 

	2.	RESPONSIBLE PARTY 

  

											
	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.1	  	Intake Services	  	X	  		  	All	  	All
	AG1.2	  	 Standard Appeals Processing

Services
	  		  		  	All	  	All
	AG1.2.1	  	 Performing Member and/or Provider Outreach
	  	X	  		  		  	
	AG1.2.2	  	 Submitting request for information
	  	X	  		  		  	
	AG1.2.3	  	 Completing investigations
	  	X	  		  		  	
	AG1.2.4	  	 Performing real time case

file updates
	  	X	  		  		  	
	AG1.2.5	  	 Making Benefit

Determinations (favorable)
	  	X	  		  		  	

  

					
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	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.2.6	  	 Routing Cases for clinical review/determination
	  	X	  		  		  	
	AG1.2.7	  	 Clinical Review/Determination
	  		  	X	  		  	
	AG1.2.8	  	 Routing recommendations on adverse benefit determinations
	  	X	  		  		  	
	AG1.2.9	  	 Adverse Benefit Determinations
	  		  	X	  		  	
	AG1.2.10	  	 Sending requiring correspondence
	  	X	  		  		  	
	AG1.2.11	  	 Addressing and resolving all concerns
	  	X	  		  		  	
	AG1.2.12	  	 Closing Cases
	  	X	  		  		  	
	AG1.3	  	Process Grievances Services	  		  		  	All	  	All
	AG1.3.1	  	 Performing Member and/or Provider Outreach
	  	X	  		  		  	
	AG1.3.2	  	 Submitting request for information
	  	X	  		  		  	
	AG1.3.3	  	 Completing investigations
	  	X	  		  		  	
	AG1.3.4	  	 Performing real time case file updates
	  	X	  		  		  	
	AG1.3.5	  	 Making Benefit Determinations (favorable)
	  	X	  		  		  	
	AG1.3.6	  	 Routing Cases for clinical review/determination
	  	X	  		  		  	
	AG1.3.7	  	 Clinical Review/Determination
	  		  	X	  		  	
	AG1.3.8	  	 Routing recommendations on adverse benefit determinations
	  	X	  		  		  	
	AG1.3.9	  	 Adverse Benefit Determinations
	  		  	X	  		  	
	AG1.3.10	  	 Sending requiring correspondence
	  	X	  		  		  	
	AG1.3.11	  	 Addressing and resolving all concerns
	  	X	  		  		  	
	AG1.3.12	  	 Closing Cases
	  	X	  		  		  	
	AG1.4	  	Expedited Review Services	  		  		  	All	  	All
	AG1.4.1	  	 Performing Member and/or Provider Outreach
	  	X	  		  		  	
	AG1.4.2	  	 Submitting request for information
	  	X	  		  		  	
	AG1.4.3	  	 Completing investigations
	  	X	  		  		  	
	AG1.4.4	  	 Performing real time case file updates
	  	X	  		  		  	
	AG1.4.5	  	 Making Benefit Determinations (favorable)
	  	X	  		  		  	

  

					
	SOW#6 (Appeals and Grievances)	  	A-4	  	Health Net / Cognizant Confidential

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	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.4.6	  	 Routing Cases for clinical review/determination
	  	X	  		  		  	
	AG1.4.7	  	 Clinical Review/Determination
	  		  	X	  		  	
	AG1.4.8	  	 Routing recommendations on adverse benefit determinations
	  	X	  		  		  	
	AG1.4.9	  	 Adverse Benefit Determinations
	  		  	X	  		  	
	AG1.4.10	  	 Sending requiring correspondence
	  	X	  		  		  	
	AG1.4.11	  	 Addressing and resolving all concerns
	  	X	  		  		  	
	AG1.4.12	  	 Closing Cases
	  	X	  		  		  	
	AG1.5	  	Inquiries Services	  	X	  		  	 Commercial
 and

Medicare
	  	 CA
 (Comm) All (Medicare);
Inquiries
 for
 Medicaid, AZ, OR, and WA are
handled within the Contact Center tower

	AG1.6	  	Member Warnings Services	  	X	  		  	 Commercial
 and

Medicare
	  	 CA
 (Comm) All (Medicare); Member
Warnings for Medicaid, AZ, OR, and WA
 are handled within the Contact Center tower

	AG1.7	  	Potential Quality Issue (PQI) Services	  		  		  	All	  	All
	AG1.7.1	  	 Performing Provider Outreach
	  	X	  		  		  	

  

					
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	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.7.2	  	 Submitting request for information
	  	X	  		  		  	
	AG1.7.3	  	 Compiling case
	  	X	  		  		  	
	AG1.7.4	  	 Submitting to Clinical for validation
	  	X	  		  		  	
	AG1.7.5	  	 Completing investigations
	  	X	  		  		  	
	AG1.7.6	  	 Performing real time case file updates
	  	X	  		  		  	
	AG1.7.7	  	 Closing Cases
	  	X	  		  		  	
	AG1.7.8	  	 Validating Presence of a PQI Issue
	  		  	X	  		  	
	AG1.7.9	  	 Performing Peer Review or associated corrective actions
	  		  	X	  		  	
	AG1.8	  	External Review Services	  	X	  		  	Commercial	  	 AZ, OR, and WA,
 CA

	AG1.9	  	State Fair Hearings Services	  		  		  	Medicaid	  	AZ and CA
	AG1.9.1	  	 Tracking and logging case details
	  	X	  		  		  	
	AG1.9.2	  	 Sending all required correspondence
	  	X	  		  		  	
	AG1.9.3	  	 Attending the hearing as requested by Health Net
	  	X	  		  		  	
	AG1.9.4	  	 Effectuating determination
	  	X	  		  		  	
	AG1.9.5	  	 Legal Review
	  		  	X	  		  	
	AG1.10	  	Independent Review Entity (IRE)	  		  		  	Medicare	  	All
	AG1.10.1	  	 Tracking and logging case details
	  	X	  		  		  	
	AG1.10.2	  	 Sending all required correspondence
	  	X	  		  		  	
	AG1.10.3	  	 Providing support services to Health Net to report to regulators
	  	X	  		  		  	
	AG1.10.4	  	 Approving reports and submitting to IRE
	  		  	X	  		  	
	AG1.10.5	  	 Performing effectuations
	  	X	  		  		  	
	AG1.11	  	Administrative Law Judge Services	  		  		  	Medicare	  	All
	AG1.11.1	  	 Tracking and logging case details
	  	X	  		  		  	
	AG1.11.2	  	 Sending all required correspondence
	  	X	  		  		  	
	AG1.11.3	  	 Providing support services to Health Net to report to regulators
	  	X	  		  		  	

  

					
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	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.11.4	  	 Approving reports and submitting to ALJ
	  		  	X	  		  	
	AG1.11.5	  	 Performing effectuations
	  	X	  		  		  	
	AG1.11.6	  	 Legal Review
	  		  	X	  		  	
	AG1.12	  	Medicare Appeals Council (MAC)	  		  		  	Medicare	  	All
	AG1.12.1	  	 Tracking and logging case details
	  	X	  		  		  	
	AG1.12.2	  	 Sending all required correspondence
	  	X	  		  		  	
	AG1.12.3	  	 Providing support services to Health Net to report to regulators
	  	X	  		  		  	
	AG1.12.4	  	 Approving reports and submitting to MAC
	  		  	X	  		  	
	AG1.12.5	  	 Performing effectuations
	  	X	  		  		  	
	AG1.12.6	  	 Legal Review
	  		  	X	  		  	
	AG1.13	  	Small Claims Cases Services	  		  		  	All	  	All
	AG1.13.1	  	 Preparing the position statement
	  	X	  		  		  	
	AG1.13.2	  	 Tracking and logging case details
	  	X	  		  		  	
	AG1.13.3	  	 Working with Health Net’s

retained legal representation
	  	X	  		  		  	
	AG1.13.4	  	 Sending all required correspondence
	  	X	  		  		  	
	AG1.13.5	  	 Performing effectuations
	  	X	  		  		  	
	AG1.13.6	  	 Attending hearings
	  		  	X	  		  	
	AG1.13.7	  	 Legal Review
	  		  	X	  		  	
	AG1.14	  	Investigation Support Services	  	X	  		  	All	  	All
	AG1.15	  	MHN Provider Disputes Services	  	X	  		  	MHN	  	All
	AG1.15.1	  	 Performing Provider Outreach
	  	X	  		  		  	
	AG1.15.2	  	 Submitting request for information
	  	X	  		  		  	
	AG1.15.3	  	 Completing investigations
	  	X	  		  		  	
	AG1.15.4	  	 Performing real time case file updates
	  	X	  		  		  	
	AG1.15.5	  	 Making Benefit Determinations (non-clinical)
	  	X	  		  		  	
	AG1.15.6	  	 Routing Cases for clinical review/determination
	  	X	  		  		  	
	AG1.15.7	  	 Clinical Review/Determination
	  		  	X	  		  	
	AG1.15.8	  	 Sending requiring correspondence
	  	X	  		  		  	

  

					
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	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 Resp. Party
	  	 LOB
	  	 Region

	  	  	 Supplier
	  	 HN
	  	 	  	 
	AG1.15.9	  	 Addressing and resolving all concerns
	  	X	  		  		  	
	AG1.15.10	  	 Closing Cases
	  	X	  		  		  	
	AG1.16	  	Oversight of Exempt Grievance Process Services	  	X	  		  	All	  	All
	AG1.17	  	Administrative Payments Services	  		  		  	All	  	All
	AG1.17.1	  	 Monitoring and Trending
	  	X	  		  		  	
	AG1.17.2	  	 Coaching and retraining associates
	  	X	  		  		  	
	AG1.17.3	  	 Conducting monthly SOX control audits
	  	X	  		  		  	
	AG1.17.4	  	 Approving administrative payments exceeding dollar amount thresholds
	  		  	X	  		  	
	AG1.17.5	  	 Creating delegation of authority matrix
	  		  	X	  		  	
	AG1.18	  	SOX Reconciliation Process	  		  		  	All	  	All
	AG1.18.1	  	 Weekly review of cases
	  	X	  		  		  	
	AG1.18.2	  	 Researching and tracking findings
	  	X	  		  		  	
	AG1.18.3	  	 Monitoring and Trending
	  	X	  		  		  	
	AG1.18.4	  	 Coaching and retraining associates
	  	X	  		  		  	
	AG1.18.5	  	 Conducting required SOX control audits
	  	X	  		  		  	
	AG1.18.6	  	 Reviewing audit results and monitoring performance
	  		  	X	  		  	
	AG1.19	  	Translation Services	  	X	  		  	All	  	All
	AG1.20	  	Executive Response Unit (ERU)	  	X	  		  	All	  	All
	AG1.21	  	Audit Support Services	  	X	  		  	All	  	All
	AG1.22	  	Appeals and Grievances Policy Services	  	X	  		  	All	  	All

  

	3.	APPEALS AND GRIEVANCES SERVICES 

  

	3.1	Intake Services 

  

	 	(a)	“Intake Services” are the Functions associated with performing front end processing of correspondence to determine the correct work stream pursuant to Health Net criteria, including the
following activities: 

  

	 	(i)	Screening incoming correspondence from all Channels to identify and prioritize all cases that may meet criteria for Expedited Review; and 

  

					
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	 	(ii)	Triaging incoming correspondence from all Channels, pursuant to the criteria specified by Health Net, including data capture, classification, documentation, Acknowledgement Letters, case assignment, and misroute
processing. 

  

	3.2	Standard Appeals Processing Services 

 “Standard Appeals Processing
Services” are the Functions associated with processing all of Appeals within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory, and/or contractual requirements, including the following
activities: 
  

	 	(a)	Processing all Pre-Service Appeals and Post-Service Appeals, including the following activities: 

  

	 	(i)	Performing Member and/or Provider outreach; 

  

	 	(ii)	Submitting request for information; 

  

	 	(iii)	Completing investigations as dictated by the circumstances surrounding the case; 

  

	 	(iv)	Performing real time case file updates; 

  

	 	(v)	Making benefit determinations (favorable); 

  

	 	(vi)	Routing cases requiring clinical review/determination to Health Net; 

  

	 	(vii)	Clinical Review/Determination; 

  

	 	(viii)	Routing recommendations on adverse benefit determinations to Health Net 

  

	 	(ix)	Adverse Benefit Determinations; 

  

	 	(x)	Sending required correspondence; 

  

	 	(xi)	Addressing and resolving all concerns; and 

  

	 	(xii)	Closing cases; 

  

	3.3	Process Grievances Services 

 “Process Grievances Services” are
the Functions associated with processing all Grievances within the prescribed or required timeframes in adherence to Health Net policies and procedure, regulatory, and/or contractual requirements, including the following activities: 

 

	 	(a)	Performing Member and/or Provider outreach; 

  

	 	(b)	Submitting request for information; 

  

	 	(c)	Completing investigations; 

  

	 	(d)	Performing real time case file updates; 

  

	 	(e)	Performing benefit determinations (favorable); 

  

					
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	 	(f)	Routing cases requiring clinical review/determination to Health Net; 

  

	 	(g)	Clinical Review/Determination; 

  

	 	(h)	Routing recommendations on adverse benefit determinations to Health Net 

  

	 	(i)	Adverse Benefit Determinations; 

  

	 	(j)	Sending required correspondence; 

  

	 	(k)	Addressing and resolving all concerns; and 

  

	 	(l)	Closing cases. 

  

	3.4	Expedited Review Services 

 “Expedited Review Services” are the
Functions associated with resolving all expedited cases within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements including the following activities: 

 

	 	(a)	Submitting case for front end review; 

  

	 	(b)	Performing Member and/or Provider outreach; 

  

	 	(c)	Submitting request for information; 

  

	 	(d)	Completing investigations; 

  

	 	(e)	Performing real time case file updates; 

  

	 	(f)	Performing benefit determinations (favorable); 

  

	 	(g)	Routing cases requiring clinical review/determination to Health Net; 

  

	 	(h)	Clinical Review/Determination; 

  

	 	(i)	Routing recommendations on adverse benefit determinations to Health Net 

  

	 	(j)	Adverse Benefit Determinations; 

  

	 	(k)	Sending required correspondence; 

  

	 	(l)	Addressing and resolving all concerns; and 

  

	 	(m)	Closing cases. 

  

	3.5	Inquiries 

 “Inquiries” are the Functions associated with
responding to all written inquiries within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

  

					
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	 	(a)	Performing Member outreach; 

  

	 	(b)	Completing investigation; 

  

	 	(c)	Performing real time case file updates; 

  

	 	(d)	Sending required correspondence; 

  

	 	(e)	Addressing all resolve all actionable items; and 

  

	 	(f)	Closing cases. 

  

	3.6	Member Warnings Services 

 “Member Warnings Services” are the
Functions associated with completing all Member Warning cases within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

 

	 	(a)	Performing Member and/or Provider outreach; 

  

	 	(b)	Assigning warning Levels; 

  

	 	(c)	Processing based on assigned Levels; 

  

	 	(d)	Completing investigation; 

  

	 	(e)	Processing real time case file updates; and 

  

	 	(f)	Sending required correspondence. 

  

	3.7	Potential Quality Issue (PQI) Services 

 “Potential Quality Issue
Services” are the Functions associated with developing all PQI within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following
activities: 
  

	 	(a)	Performing Provider outreach; 

  

	 	(b)	Submitting request for information; 

  

	 	(c)	Compiling case; 

  

	 	(d)	Submitting to Clinical for validation; 

  

	 	(e)	Completing investigations; 

  

	 	(f)	Performing real time case file updates; 

  

	 	(g)	Closing cases; 

  

	 	(h)	Validating presence of a Potential Quality Issue; and 

  

					
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	 	(i)	Performing Peer Review or associated corrective Actions. 

  

	3.8	External Review Services 

 “External Review Services” are the
Functions associated with review of an adverse determination conducted pursuant to an applicable state external review process by an independent review organization, including the following activities: 

 

	 	(a)	Tracking and logging case details; 

  

	 	(b)	Sending all required correspondence; 

  

	 	(c)	Providing support services to Health Net to report to regulators, as required; 

  

	 	(d)	Performing effectuations on all cases where the external review entity overturns Health Net’s decision; and 

  

	 	(e)	For California External Review Services, working with Regulatory Affairs to provide support for all cases and ad hoc requests as necessary. 

 

	3.9	State Fair Hearings Services 

 “State Fair Hearings Services” are
the Functions associated with review of an adverse determination by an Administrative Law Judge, including the following activities: 
  

	 	(a)	Tracking and logging case details; 

  

	 	(b)	Sending all required correspondence; 

  

	 	(c)	Attending the hearing as requested by Health Net; 

  

	 	(d)	Effectuating the determination on all cases where the administrative law judge overturns Health Net’s decision; and 

  

	 	(e)	Performing legal review. 

  

	3.10	Independent Review Entity (IRE) (Maximus) Services 

 “Independent Review
Entity (IRE) (Maximus) Services” are the Functions associated with a review of an adverse determination conducted pursuant to an applicable state external review process by an independent review organization, including the following
activities: 
  

	 	(a)	Tracking and logging case details; 

  

	 	(b)	Sending all required correspondence; 

  

	 	(c)	Providing support services to Health Net to report to regulators, as required; 

  

	 	(d)	Approving reports and submitting to IRE, if applicable; and 

  

	 	(e)	Performing effectuations on all cases where the IRE overturns Health Net’s decision. 

  

					
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	3.11	Administrative Law Judge (ALJ) Services 

 “Administrative Law Judge
Services” are the Functions associated with processing a review of an adverse determination conducted pursuant to CMS regulations, including the following activities: 

 

	 	(a)	Tracking and logging case details; 

  

	 	(b)	Sending all required correspondence; 

  

	 	(c)	Providing support services to Health Net to report to regulators, as required; 

  

	 	(d)	Approving reports and submissions to the ALJ, if applicable; 

  

	 	(e)	Performing effectuations on all cases where the administrative law judge overturns Health Net’s decision; and 

  

	 	(f)	Performing legal review. 

  

	3.12	Medicare Appeals Council (MAC) Services 

 “Medicare Appeals Council (MAC)
Services” are the Functions associated with a review of an adverse determination conducted pursuant to CMS regulations, including the following activities: 
  

	 	(a)	Tracking and logging case details; 

  

	 	(b)	Sending all required correspondence; 

  

	 	(c)	Providing support services to Health Net to report to regulators, as required; 

  

	 	(d)	Approving reports and submissions to the MAC, if applicable; 

  

	 	(e)	Performing effectuations on all cases where the MAC overturns Health Net’s decision; and 

  

	 	(f)	Performing legal review. 

  

	3.13	Small Claims Cases Services 

 “Small Claims Cases Services” are
the Functions associated with responding to small claims filed against Health Net in a court of law, including the following activities: 
  

	 	(a)	Preparing the position statement; 

  

	 	(b)	Tracking and logging case details; 

  

	 	(c)	Working with Health Net’s retained legal representation, as necessary; 

  

	 	(d)	Sending all required correspondence; 

  

	 	(e)	Performing effectuations on all cases where the court overturns Health Net’s decision; 

  

					
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	 	(f)	Attending hearings; and 

  

	 	(g)	Performing legal review. 

  

	3.14	Investigation Support Services 

 “Investigation Support Services”
are the Functions associated with providing support services in the investigation of complaints, concerns, audit, and oversight activity from regulators and other entities (e.g., CMS, CTMs, HICS, ERU, SIU, Privacy Office, OID, ADOI, DMHC, DHCS, OIC,
WIC, NCQA, URAC, Attorney General, Congressional and Legislative Complaints Cal Viva, Cal Optima, etc.), including the following activities: 
  

	 	(a)	Preparing case files; 

  

	 	(b)	Researching and responding to concerns; and 

  

	 	(c)	Performing Member and/or Provider outreach. 

  

	3.15	MHN Provider Disputes Services 

 “MHN Provider Dispute Services”
are the Functions associated with processing all cases within the prescribed or required timeframes in adherence to Health Net policies and procedures, regulatory and/or contractual requirements, including the following activities: 

 

	 	(a)	Provider outreach; 

  

	 	(b)	Submitting request for information; 

  

	 	(c)	Complete investigation; 

  

	 	(d)	Real time case file updates; 

  

	 	(e)	Benefit determinations (non-clinical); 

  

	 	(f)	Routing cases requiring clinical review/determination to Health Net; 

  

	 	(g)	Clinical Review/Determination; 

  

	 	(h)	Sending required correspondence; 

  

	 	(i)	Address and resolve all concerns; and 

  

	 	(j)	Case closure. 

  

	3.16	Oversight of Exempt Grievance Process Services 

 “Oversight of Exempt
Grievance Process Services” are the Functions associated with maintaining management level oversight for the Contact Center Exempt and Oral Grievance Services, including the following activities: 

 

	 	(a)	Facilitating and keeping a record of monthly review meetings; 

  

					
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	 	(b)	Reviewing and approving Contact Center Policies related to Appeals and Grievances; and 

  

	 	(c)	Providing feedback to Contact Center management related to areas for improvement. 

  

	3.17	Administrative Payments Services 

 “Administrative Payments
Services” are the Functions associated with performing administrative payments in accordance with the regulatory, SOX requirements and Health Net policies and procedures, including the following activities: 

 

	 	(a)	Monitoring and trending administrative payments to identify areas of opportunity; 

  

	 	(b)	Coaching and retraining associates as necessary to drive down administrative payment volumes; 

  

	 	(c)	Conducting monthly SOX control audits; 

  

	 	(d)	Approving administrative payments exceeding dollar amount thresholds; and 

  

	 	(e)	Creating a delegation of authority matrix that includes retained authority at Health net for Administrative Payment approvals based on certain dollar amount thresholds. 

 

	3.18	SOX Reconciliation Processes 

 “SOX Reconciliation Process” are
the Functions associated with performing reconciliation activities in accordance with the regulatory, SOX requirements and Health Net policies and procedures, including the following activities: 

 

	 	(a)	Performing at a minimum a weekly review of cases on the exceptions reports; 

  

	 	(b)	Researching and tracking findings; 

  

	 	(c)	Monitoring and trending performance against SOX standards; 

  

	 	(d)	Coaching and retraining associates as necessary; 

  

	 	(e)	Conducting required SOX control audits; and 

  

	 	(f)	Reviewing audit results and monitoring performance. 

  

	3.19	A&G Translation Services 

 “A&G Translation Services” are
those Functions associated with interfacing with Health Net’s translation vendor to have all communications translated in accordance with regulatory, contractual and/or Health Net policies and procedures, including the following activities:

  

	 	(a)	Coordinating with Health Net’s translation vendor to have documentation (e.g. member correspondence and provider records) translated; and 

 

	 	(b)	Coordinating with Health Net’s translation vendor to have language assistance provided to non-English speaking members as needed during member contact. 

  

					
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	3.20	Executive Response Unit (ERU) 

 “Executive Response Unit” or
“ERU” are the Functions associated with resolving complaints and inquiries received by the Health Net Executive Team via social media, phone, and email Channels as identified in the Policy and Procedure document including
researching and resolving Better Business Bureau inquiries and internal Compliance inquiries. This Service is Offshore-restricted and must be performed Onshore. 
  

	3.21	Audit Support Services 

 “Audit Support Services” means those
Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group), including
the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with regulators. 

  

	3.22	Appeals and Grievances Policy Services 

 “Appeals and Grievances Policy
Services” means those Functions associated with the development and implementation of “Health Net Appeals and Grievances Policies,” which are the Health Net Policies as defined in Schedule P (Health Net
Policies) governing or pertaining to the Appeals and Grievances Services, more specifically, the conduct of Health Net’s Appeals and Grievances Services. 

Below are some examples of selected Appeals and Grievances Policy Development Services Functions, which include descriptions of the manner in
which such Functions are currently performed by Health Net. The examples are illustrative only: 
  

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Appeals and Grievances Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Appeals and Grievances Policies;

  

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

  

					
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	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Appeals and Grievances Services and participate in operational implementation and/or affected
system changes of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net Appeals and Grievances Policies and submit them to the relevant Health Net and Supplier stakeholders
for review, comment and approval; 

  

	 	(d)	Prepare updated versions of Health Net Appeals and Grievances Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Appeals and Grievances Policies and access to Health Net personnel to such communications and training; and

  

	 	(f)	Implement Heath Net-approved Health Net Appeals and Grievances Policies by Supplier Personnel involved in the performance of the Appeals and Grievances Services. 

  

					
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 EXHIBIT A-1 

APPEALS AND GRIEVANCES 

SOLUTION DESCRIPTION 

  

					
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 EXHIBIT A-1 

APPEALS AND GRIEVANCES SOLUTION DESCRIPTION 

TABLE OF CONTENTS 
  

									
	1.		 INTRODUCTION
		 	1	  
	2.		 DEFINITIONS AND INTERPRETATION
		 	1	  
			     2.1
		Defined Terms		 	1	  
	3.		 SOLUTION OVERVIEW
		 	1	  
			     3.1
		High-level Service Delivery Architecture and Configuration		 	1	  
			     3.2
		Service Delivery Model		 	2	  
			     3.3
		Business-Process-as-a-Service		 	2	  
	4.		 CHANGES TO SUPPLIER’S SOLUTION
		 	3	  
	5.		 SOLUTION DESCRIPTION
		 	3	  
	6.		 SCOPE OF SERVICES
		 	4	  
	7.		 OPERATING MODEL
		 	4	  
			     7.1
		Resource Mix		 	4	  
			     7.2
		Location		 	8	  
			     7.3
		Operating Hours		 	10	  
			     7.4
		Operations		 	11	  
			     7.5
		Resource Profile		 	13	  
			     7.6
		Voice Solution		 	16	  
			     7.7
		IT Systems		 	16	  
			     7.8
		Third Party Tools		 	17	  
			     7.9
		Regulatory On-shore Requirements		 	17	  
			     7.10
		Service Performance Management		 	17	  
			     7.11
		Mailing Correspondence Onshore		 	17	  
			     7.12
		In-Person Filing Requirement		 	18	  
			     7.13
		Receiving Member and Member Representative Calls		 	18	  
	8.		 KEY ASSUMPTIONS
		 	18	  
			 EXHIBIT A-1.1
		 	1	  
			 EXHIBIT A-1.2
		 	1	  

  

					
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 EXHIBIT A-1 

APPEALS AND GRIEVANCES 

SOLUTION DESCRIPTION 
  

	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work #6
(Appeals and Grievances) Services (this “Statement of Work”). Whereas Exhibit A (Appeals and Grievances Services) describes which Functions Supplier is responsible for performing under this Statement of
Work, this Exhibit A-1 (Appeals and Grievances Solution Description) describes the means by which and the manner in which Supplier will perform those Functions. This document contains an overview of Supplier’s service
delivery architecture, a depiction of which is – displayed on a global map containing the geographic configuration and delivery architecture of Supplier’s Solution (as it will exist at the completion of Phase 2, identifying all Service
Delivery Centers of Supplier (and its Affiliates and other Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how these components will be interconnected to
each other and to Health Net’s IT Environment. It also provides additional descriptive information about each of the principal components of Supplier’s Solution. 

This Exhibit A-1 (Appeals and Grievances Solution Description) includes the following attachments, which are incorporated herein by
reference: 
 Exhibit A-1.1 Approved Service Delivery Centers 

Exhibit A-1.2 Service Delivery Configuration at the Completion of Phase 2 

 

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings set forth below unless otherwise specifically defined in the body of this document. Additionally any capitalized term used but not defined in this Exhibit A-1 (Appeals and Grievances Solution Description) will have the meaning
indicated in Schedule W (Glossary). 
  

			
	 Defined Term
	  	 Meaning

	“Solution”	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work.

  

	3.	SOLUTION OVERVIEW 

  

	3.1	High-level Service Delivery Architecture and Configuration 

 This section provides an overview of the
geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service 

  

					
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 Delivery Centers) provides additional information about each of the Service Delivery
Centers Supplier will use to provide the Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if operations at any
primary Service Delivery Center are disrupted or disabled. 
  
 

 
 Figure 1 
  

	*	Dates represent end date of each transition wave. 

 Supplier’s Solution will be
implemented in 2 waves as depicted in Figure 1 above with some of the work moving to the Offshore locations of Manila and Cebu in Philippines, and the Tempe work would move to Supplier’s Phoenix AZ location. 

 

	3.2	Service Delivery Model 

 This section provides an overview of the commercial delivery
model that the Supplier will utilize to provide the Services under this Statement of Work. As described in Exhibit H (Appeals and Grievances Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform the
Services under this Statement of Work. 
  

	3.3	Business-Process-as-a-Service 

 The Services to be provided under this Statement of Work
will be provided under a ‘Business- Process-as-a-Service’ delivery model—i.e., as a fully integrated vertical service in which Supplier is responsible for providing all the associated resource / service layers (facilities, IT
infrastructure, tools, application software, labor, infrastructure and applications operations and support, and performance of the associated business processes); and Health Net is purchasing ‘business outcomes’ (e.g., fully resolved
grievance or appeal). Supplier will be responsible for performing the Appeals and Grievances Services set forth in Exhibit A (Appeals and Grievances Services). 

  

					
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	4.	CHANGES TO SUPPLIER’S SOLUTION 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Appeals and Grievances Solution). That said, Supplier is charged with responsibility for the adequacy of its
Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Appeals and Grievances Solution), should prove inadequate at any point during the Statement of Work Term for Supplier to perform and deliver the
Services in accordance with the obligations of the Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in
accordance with such obligations. All such changes are to be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such changes
at its own cost and expense except in those cases (if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 
  

	5.	SOLUTION DESCRIPTION 

 Supplier’s solution is built on the following foundational
aspects: 
 Delivery Solution: 
  

	 	•	 	Quality Focus – Supplier’s primary focus will be to maintain seamless continuity of Services while ensuring regulatory and contractual compliance requirements. For all processes migrated Offshore, the
focus will be on ensuring adherence to compliance and quality. 

  

	 	•	 	Support ratio – To enable focused monitoring and feedback, Supplier’s delivery model provides Personnel to Supervisor and QA ratio Onshore and Offshore as described in Section 7.4 of this exhibit.

  

	 	•	 	Continuous Improvement – Supplier will appoint dedicated Six Sigma resources during the Term of the contract to identify sustainable improvement opportunities. The typical ratio will be 1 Six Sigma resource
for every 150 Supplier Personnel FTEs. 

 Knowledge Retention: 

 

	 	•	 	Domain Experts – Supplier will invest in staff (existing and hired) with previous Healthcare experience for key functions including Operations, Transition, Training, Quality and Compliance.

  

	 	•	 	Health Net Training Academy –Supplier’s dedicated Health Net Training Academy will be tasked with the mandate of building a Knowledge repository during Phase 2. During phase 3, the Training Academy will
be involved in maintaining the Knowledge repository, updating training and process documentation, providing training to new hire Supplier personnel and providing higher level training to experienced resources for Appeals and Grievances Operations.
Supplier will periodically conduct training to keep Supplier personnel up-to date on regulatory, process and system changes. Supplier will provide ongoing/refresher training 

  

					
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 as per the updates received from Health Net and will conduct assessments to ensure that there
are no knowledge gaps. Refresher training will be conducted based on Quality audit scores for Supplier Personnel. 
 Solution Location:

  

	 	•	 	Supplier will deliver Appeals and Grievances from Service Delivery Centers in the US and Philippines. Exhibit A-1.1 (Approved Service Delivery Centers) describes the On-shore, near-shore and Offshore Service
Delivery Centers that Supplier will use to deliver the A&G Services. 

  

	6.	SCOPE OF SERVICES 

 In addition to the Appeals and Grievances services described in
Exhibit A (Appeals and Grievances Services); 
  

	 	1.	Supplier will research, respond, track and report privacy related incidents 

  

	 	2.	Supplier will also train and educate the team on HIPAA Privacy and Security 

  

	 	3.	Supplier’s Appeals and Grievances operations team will provide necessary information to sales team 

  

	 	4.	For RFP support, Supplier Appeals and Grievances operations team will provide opinion and operational data points 

  

	 	5.	Supplier will provide necessary operational information for new vendor on-boarding and existing vendor renewals. Health Net will be responsible for vendor negotiations and contract execution. 

Supplier Personnel for A&G Services will be dedicated only to Appeals and Grievances Operations. 

 

	7.	OPERATING MODEL 

 The operating model for Appeals and Grievances operations defines the
service delivery blue print and key aspects of service delivery. The operating model also describes how the A&G Services will be delivered for each functional process area in a scalable global environment. 

Supplier will maintain twenty-two (22) FTEs Onshore to satisfy the requirements set forth in Schedule Y (Offshore Restrictions and
Prohibitions). Any other resources staffed Onshore will be due to a lack of skill availability at the Supplier’s Offshore Service Delivery Centers. 
  

	7.1	Resource Mix 

 Supplier will leverage its global operating model to deliver the A&G
Services. Supplier has considered the following criteria to define its Onshore/Offshore strategy: 
  

	 	•	 	Regulatory requirements 

  

					
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	 	•	 	Availability of skills at Offshore locations 

  

	 	•	 	Health Net Offshore restrictions 

  

	 	•	 	Consideration for work load to resource ratio 

  

	 	•	 	HR constraints (i.e. PTO, illness, injury, etc.) 

 Processes requiring voice support will be
delivered out of US and Philippines. Roles identified to move offshore (Supervisors/coordinators/sr. coordinators) will continue to be responsible for current tasks and activities being performed onshore. 

The Onshore/Offshore resource mix for A&G Services is listed below in Table 1. 

 

							
	 Sub Function
	  	Resource Mix Estimate*
	  	Final State
	  	Onshore %	 	Offshore %	 	Delivery
Location
	 Appeals and Grievances Management Team (VP)
	  	100%	 	0%	 	R
	 Director
	  	100%	 	0%	 	W
	 Program Manager
	  	100%	 	0%	 	W
	 Senior Coordinator
	  	0%	 	100%	 	M, Cb
	 Analyst
	  	0%	 	100%	 	M, Cb
	 Admin III
	  	0%	 	100%	 	M, Cb
	 Manager – Appeals
	  	0%	 	100%	 	M, Cb
	 Business Analyst
	  	0%	 	100%	 	M, Cb
	 Supervisor A
	  	0%	 	100%	 	M, Cb
	 HMO Appeals, PPO Appeals, Benefit Determinations, Dental Appeals (Commercial)
	  	0%	 	100%	 	M, Cb
	 Supervisor B
	  	100%	 	0%	 	W, P
	 AZ Medicare Grievances, Medicaid Appeals and Grievances
	  	33%	 	67%	 	W, P, M, Cb
	 Supervisor C
	  	0%	 	100%	 	M, Cb
	 Intake (Screen and Triage), Audit, Final Letter Review, Admins Inquiry, Member
	  	0%	 	100%	 	M, Cb

  

					
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	 Warnings
						
	 Associate
		0%		100%		M, Cb
	 Associate – Remote
		0%		100%		M, Cb
	 Supervisor D
		0%		100%		M, Cb
	 Maximus, ALJ, MAC, Medicare Appeals, Cal Medi Connect Appeals Dental Appeals (Medicare)
		8%		92%		W, P, M, Cb
	 Supervisor E
		0%		100%		M, Cb
	 Benefit Determination EXR Appeals & Grievances (all)
		0%		100%		M, Cb
	 Manager – Grievances
		100%		0%		W, P
	 Business Analyst
		100%		0%		W, P
	 PQI
		100%		0%		W, P
	 Supervisor F
		100%		0%		W, P
	 State Fair Hearings
		100%		0%		W, P
	 Supervisor G
		0%		100%		M, Cb
	 HMO and PPO Standard and EXR Grievance, Dental Grievances (Commercial)
		0%		100%		M, Cb
	 Supervisor H
		0%		100%		M, Cb
	 Medicare Grievance, Dental Grievances (Medicare)
		0%		100%		M, Cb
	 Supervisor I
		0%		100%		M, Cb
	 SHP Appeals and Grievances, Cal Medi Connect Grievances, Dental Appeals and Grievances (SHP)
		0%		100%		M, Cb
	 Supervisor J
		100%		0%		R
	 CTM (Retained Organization)
		100%		0%		R

  

					
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	 HICS (Retained Organization)
	  	100%	 	0%	 	W
	 Supervisor K
	  	0%	 	100%	 	M, Cb
	 MHN for MHN Business, Member and Provider Appeals
	  	0%	 	100%	 	M, Cb
	 Supervisor L
	  	100%	 	0%	 	W
	 Executive Response Unit
	  	100%	 	0%	 	W

 Table 1 
  

			
	 Legends

	 Locations
	  	Code
	 Woodland Hills (US)
	  	W
	 Rancho Cordova (US)
	  	R
	 Tempe (US)
	  	Te
	 San Rafael (US)
	  	S
	 Telecommuting (US)
	  	T
	 Manila (Philippines)
	  	M
	 Cebu (Philippines)
	  	Cb
	 Phoenix (US)
	  	P

 Key Note: 
  

	 	•	 	*The above percentages are approximate estimates at this point 

  

	 	•	 	The above plan will be finalized during the Process Assessment Phase as described in the Transition Manual, with agreement between Health Net and Supplier. 

 

	 	•	 	The estimated end state is expected by March 2017 

  

	 	•	 	As shared in Section 6 above, only those roles mandated by Health Net or where skills are not available offshore, will be onshore 

 

	 	•	 	As shown in Table 1, while a process can span across 4 locations there will be no role within a process which will span across more than 2 locations 

 

	 	•	 	Support for the AZ and OR/WA Appeals & Grievances processes (as currently provided under the existing agreement between Supplier and Health Net) from Supplier’s delivery center in Chennai, India. Changes
to the current solution will be documented through the Change Management process 

  

					
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	7.2	Location 

 Supplier will deliver Appeals and Grievances Services from the US and
Philippines. Exhibit A- 1.1 (Approved Service Delivery Centers) has details of the proposed locations. The delivery location strategy has been carefully planned considering multiple criteria as follows: 

 

	 	•	 	Health Net mandated onshore staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

	 	•	 	Regulatory limitations 

  

	 	•	 	Business continuity 

  

					
	 Sub Function
	  	Delivery Location
	 	  	US	  	Philippines
	 Appeals and Grievances Management Team (VP)
	  	US	  	
	 Director
	  		  	
	 Program Manager
	  	US	  	
	 Senior Coordinator
	  	US	  	
	 Analyst
	  	US	  	
	 Admin III
	  	US	  	
	 Manager – Appeals
	  		  	
	 Business Analyst
	  	US	  	
	 Supervisor A
	  		  	
	 HMO Appeals, PPO Appeals, Benefit Determinations, Dental Appeals (Commercial)
	  	US	  	Manila
	 Supervisor B
	  		  	
	 AZ Medicare Grievances, Medicaid Appeals and Grievances
	  	US	  	
	 Supervisor C
	  		  	
	 Intake (Screen and Triage), Audit, Final Letter Review, Admins Inquiry, Member Warnings
	  	US	  	Manila
	 Associate
	  	US	  	
	 Associate – Remote
	  	US	  	
	 Supervisor D
	  		  	
	 Maximus, ALJ, MAC, Medicare Appeals, Cal Medi Connect Appeals Dental Appeals (Medicare)
	  	US	  	Manila
	 Supervisor E
	  		  	

  

					
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	 Benefit Determination EXR Appeals & Grievances (all)
		US		Manila
	 Manager – Grievances
				
	 Business Analyst
		US		
	 PQI
		US		
	 Supervisor F
				
	 State Fair Hearings
		US		
	 Supervisor G
				
	 HMO and PPO Standard and EXR Grievance, Dental Grievances (Commercial)
		US		Manila
	 Supervisor H
				
	 Medicare Grievance, Dental Grievances (Medicare)
		US		Manila
	 Supervisor I
				
	 SHP Appeals and Grievances, Cal Medi Connect Grievances, Dental Appeals and Grievances (SHP)
		US		
	 Supervisor K
				
	 MHN for MHN Business, Member and Provider Appeals
		US		Manila
	 Supervisor L
				
	 Executive Response Unit
		US		

 Table 2 

During Phase 2, resources working on AZ Medicare Grievances will continue to be based out of Tempe, AZ. Post Phase 2, Supplier will evaluate
the operating model and will have the right to relocate resources to its other onsite US locations including Woodland Hills and Phoenix. 

The below Figure 2 illustrates how teams across locations in US and Philippines, will typically interact on an ongoing basis to ensure
effective planning, monitoring and tracking of Appeals and Grievance processes, activities and requirements 
  

	 	1.	Forecasting – Identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	2.	Capacity Planning- Ensure staffing in place can manage the forecasted volumes 

  

	 	3.	Monitor Productivity- An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	4.	Reallocation based on productivity – An ongoing exercise to track and shift work, based on transaction and volumes, within teams and individuals to ensure desired productivity 

 

	 	5.	Monitor Quality and SLAs - An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

Figure 2 

  

					
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 The organization structure has been functionally designed in a manner that facilitates
effective operations across locations. The model ensures that workflow is effective in real time facilitating tactical monitoring. 

Figure 3 
  

	7.3	Operating Hours 

 Supplier will at minimum replicate the operating hours adhered to by
Health Net’s Appeals and Grievances organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Appeals and Grievances Services will regularly require Supplier Personnel to
perform additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Appeals and Grievances Services. 

Supplier will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of operations is within the scope of the Appeals and Grievances Services. 

Within the regular Hours of Operations listed below, Supplier will have staff work according to defined shift schedules. However, Supplier will
make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to meet regulatory requirements, Compliance and Service Level metrics and other requirements of the
Agreement. 
 The operating hours for the A&G Services are given below. 

 

			
	 Sub Function
	  	Hours of Operations
(PST)
	 Director
	  	
	 Program Manager
	  	06:00 am to 08:00 pm
	 Senior Coordinator
	  	06:00 am to 08:00 pm
	 Analyst
	  	06:00 am to 08:00 pm
	 Admin III
	  	06:00 am to 08:00 pm

  

					
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	 Manager – Appeals
		06:00 am to 08:00 pm
	 Business Analyst
		06:00 am to 08:00 pm
	 Supervisor A
		06:00 am to 08:00 pm
	 HMO Appeals, PPO Appeals, Benefit Determinations, Dental Appeals (Commercial)
		06:00 am to 08:00 pm
	 Supervisor B
		06:00 am to 08:00 pm
	 AZ Medicare Grievances, Medicaid Appeals and Grievances
		06:00 am to 08:00 pm
	 Supervisor C
		06:00 am to 08:00 pm
	 Intake (Screen and Triage), Audit, Final Letter Review, Admins Inquiry, Member Warnings
		06:00 am to 08:00 pm
	 Associate
		06:00 am to 08:00 pm
	 Associate – Remote
		06:00 am to 08:00 pm
	 Supervisor D
		06:00 am to 08:00 pm
	 Maximus, ALJ, MAC, Medicare Appeals, Cal Medi Connect Appeals Dental Appeals (Medicare)
		06:00 am to 08:00 pm
	 Supervisor E
		06:00 am to 08:00 pm
	 Benefit Determination EXR Appeals & Grievances (all)
		06:00 am to 08:00 pm
	 Manager – Grievances
		06:00 am to 08:00 pm
	 Business Analyst
		06:00 am to 08:00 pm
	 PQI
		06:00 am to 08:00 pm
	 Supervisor F
		06:00 am to 08:00 pm
	 State Fair Hearings
		06:00 am to 08:00 pm
	 Supervisor G
		06:00 am to 08:00 pm
	 HMO and PPO Standard and EXR Grievance, Dental Grievances (Commercial)
		06:00 am to 08:00 pm
	 Supervisor H
		06:00 am to 08:00 pm
	 Medicare Grievance, Dental Grievances (Medicare)
		06:00 am to 08:00 pm
	 Supervisor I
		06:00 am to 08:00 pm
	 SHP Appeals and Grievances, Cal Medi Connect Grievances, Dental Appeals and Grievances (SHP)
		06:00 am to 08:00 pm
	 Supervisor K
		06:00 am to 08:00 pm
	 MHN for MHN Business, Member and Provider Appeals
		06:00 am to 08:00 pm
	 Supervisor L
		06:00 am to 08:00 pm
	 Executive Response Unit
		06:00 am to 08:00 pm

 Table 3 
  

	7.4	Operations 

 Supplier approach to managing operations is as follows: 

  

					
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	 	•	 	Operational Focus: Team huddles, floor walks, daily performance reviews, daily associate communication plan and customer calibration sessions. 

 

	 	•	 	Performance Management: Measure and manage associate performance through data and service dashboards 

  

	 	•	 	Span of Control: Supplier will provide for the following span of control: 

  

	 	•	 	Operations Lead 1:500 

  

	 	•	 	Manager 1:50 

  

	 	•	 	Supervisor 1:15 

  

	 	•	 	Quality Auditor 1:15 

  

	 	•	 	Trainer 1:20 (during training) 

  

	 	•	 	Team Lead 1:15 

  

	 	•	 	Six Sigma & Process Excellence 1:150 

  

	 	•	 	Health Net Training Academy: Supplier will establish a dedicated Health Net Training academy for the management of training content and delivery of training programs. The Appeals and Grievances management
function of the training academy will maintain a “Knowledge Management Portal” for management and easy access to training content, desktop procedure and P&Ps. The Health Net Training Academy will work closely with the Training
operations and facilitate necessary training. Training material will be continuously updated based on system updates and process updates. 

  

	 	•	 	Team Huddle: Supplier’s team leads will conduct daily team meetings for individual processes to share any critical updates, provide feedback and communicate lessons learned, and plan for the day.

  

	 	•	 	Quality: Supplier will implement Health Net mandated specific quality and compliance programs in its delivery model for managing and achieving Service Levels. Supplier will analyze audit findings to determine
root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings, prevalent trends in errors, root causes and preventive actions will be discussed and implemented. 

 

	 	•	 	Continuous Improvement: Supplier will have a dedicated Process Excellence (PEX) team consisting of Six Sigma resources for Health Net Appeals and Grievances functions to optimize performance and handoffs in
Health Net Appeals and Grievances processes while continuously improving standardization. 

  

	 	•	 	Rewards and Recognition: Supplier will recognize the efforts of its best performers using stack ranking and will reward them through a structured reward and recognition program that aligns with quality and
productivity objectives. The Rewards and Recognition will be applicable for both Onshore and Offshore teams. The specific criteria for the awards will be decided by the Operations Leads depending on the specific behavior and/or results to be
achieved. 

  

					
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	7.5	Resource Profile 

 Supplier has a very well defined methodology for the recruitment and
selection of candidates. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper qualifications and experience in
order to ensure a “best-fit” for Health Net. 
 The table below is an illustration of indicative requirements for Offshore staffing
and the minimum qualifications that must be met to be selected for the Appeals and Grievances Services. 
  

			
	 Appeals Coordinator

Qualification & Experience
	  	 Selection Process

	 •    Graduates with one to two (1-2) years with Healthcare experience

•    Excellent written and verbal communication skills

•    Knowledge of healthcare basics

•    Familiar with one or more contact center applications

•    Contact Center and/or A&G experience preferred

•    Letter writing experience required

•    Familiar with multiple Healthcare LOBs
	  	 •    Aptitude Test

•    HR Interview

•    Written test of customer service basics

•    Domain / Operations Interview

•    Technical interview on customer grievance resolution concepts

•    Education and Professional background check

 Table 4 
  

			
	 Appeals Senior Coordinator

Qualification & Experience
	  	 Selection Process

	 •    Graduates with three to four (3-4) years with Healthcare grievance
contact center experience
 •    Excellent written and verbal communication skills.

•    Knowledge of healthcare basics

•    Familiar with one or more contact center and A&G applications

•    Contact Center / Claims experience preferred

•    Letter writing experience required

•    Familiar with multiple Healthcare LOBs
	  	 •    Aptitude Test

•    HR Interview

•    Written test of customer service basics

•    Domain / Operations Interview

•    Technical interview on customer grievance resolution concepts

•    Education and Professional background check

 Table 5 

  

					
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	 Grievance Coordinator

Qualification & Experience
	  	 Selection Process

	 •    Graduates with two to three (2-3) years with Healthcare
experience
 •    Excellent written and verbal communication skills

•    Good analytical skills

•    Knowledge of healthcare basics

•    Familiar with one or more contact center applications

•    Contact Center and/or A&G experience preferred

•    Letter writing experience required

•    Familiar with multiple Healthcare LOBs
	  	 •    Aptitude Test

•    HR Interview

•    Written test of customer service basics

•    Domain / Operations Interview

•    Technical interview on customer grievance resolution concepts

•    Education and Professional Background Check

	  
	  
	  
	  
	  
	  
	  
	  
	  
	  

 Table 6 
  

			
	 Grievance Senior Coordinator

Qualification & Experience
	  	 Selection Process

	 •    Graduates with three to four (3-4) years with Healthcare grievance
contact center experience
 •    Excellent written and verbal communication skills.

•    Knowledge of healthcare basics

•    Familiar with one or more contact center and A&G applications

•    Contact Center / Claims experience preferred

•    Letter writing experience required

•    Familiar with multiple Healthcare LOBs
	  	 •    Aptitude Test

•    HR Interview

•    Written test of customer service basics

•    Domain / Operations Interview

•    Technical interview on customer grievance resolution concepts

•    Education and Professional background check

 Table 7 
  

			
	 Supervisor

Qualification & Experience
	  	 Selection Process

	 •    Graduate with four to five (4 to 5) years’ experience in
Healthcare Industry specifically in respective in-scope process
 •    Excellent written
and verbal communication skills.
 •    Knowledge of healthcare basics

•    Familiar with one or more contact center and A&G applications

•    A&G and Contact Center experience preferred

•    Letter writing experience required

•    Two (2) years of Supervisory experience leading teams of at least 30-40 associates

•    Leadership and Communication skills
	  	 •    HR Interview for Cultural fitment

•    Communication Skills Screening

•    Domain/ Operations Interview

•    Education and Professional Background Check.

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1	  	A-1-14	  	Health Net / Cognizant Confidential

 Final 
  

 Table 8 
  

			
	 Auditors

Qualification & Experience
	  	 Selection Process

	 •    Graduates with three to five (3-5) years’ experience in
Healthcare process auditors
 •    Six Sigma/Lean exposure of at least two (2) years

•    Excellent written and verbal communication skills.

•    Letter writing experience required

•    Knowledge of healthcare basics

•    Familiar with one or more contact center and A&G applications

•    A&G experience required

•    Contact Center experience preferred
	  	 •    HR Interview for Cultural fitment

•    Communication Skills Screening

•    Domain/ Operations Interview

•    Education and Professional Background Check.

 Table 9 
  

			
	 Team Manager

Qualification & Experience
	  	 Selection Process

	 •    Graduate/Post Graduate with 5+ years’ experience in Healthcare
Claims / Enrollment / Appeals and Grievances / Credentialing/ Benefits configuration/ Provider Calls/ Provider Data Management Process

•    Excellent Communication and Leadership skills

•    Three to four (3-4) years’ experience leading large teams

•    Excellent written and verbal communication skills.

•    Knowledge of healthcare basics

•    Familiar with one or more contact center and A&G applications
	  	 •    HR Interview-screening for roles and responsibility

•    Technical Interview

•    Operations Interview

•    HR/ Operations Leadership screening for leadership ability and cultural fit

•    Education and Professional Background Check.

 Table 10 
  

			
	 Delivery Manager

Qualification & Experience
	  	 Selection Process

	 •    MBA with Eight to Ten (8-10) years of experience

•    Excellent Communication and Leadership skills

•    Seven to Nine (7-9) years of overall BPO
	  	 •    Initial screening of profiles by recruitment team

•    Interview with Business Leader/ HR Manager

•    Technical/ Communication ability Interview

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1	  	A-1-15	  	Health Net / Cognizant Confidential

 Final 
  

			
	 experience with at least Six (6) years leading a process in a BPO.

•     Excellent written and verbal communication skills.

•     Knowledge of healthcare basics

•     Familiar with one or more contact center and A&G applications
	  	 •     Screening for leadership ability and cultural
fit
 •     Salary Negotiation

•     Education and Professional Background Verification

	  
	  
	  
	  
	  
	  

 Table 11 
  

	7.6	Voice Solution 

 Health Net expects Supplier to deliver voice assisted Member and
provider interactions from both Onshore in the US and the Philippines. All Supplier Personnel will be skilled to handle Member and provider interactions. Voice based services will be delivered from Woodland Hills and Phoenix in US and Manila and
Cebu in Philippines. 
  

	
	 Indicative Processes

	 Grievances, Expedited Grievances – Member and Provider

	 Appeals, Expedited Appeals - Member and Provider

	 Coordination with internal functions like Medical Management, Claims, Membership, Compliance, Legal, Finance, Contact
Center

	 Coordination with carve out service providers

 Table 12 
  

	7.7	IT Systems 

 The following systems will be used by Supplier for delivery of Appeals and
Grievances Services. 
  

	
	 Appeals and Grievance Applications / Platforms

	MAGIC
	MACESS
	CSI
	OMNI
	PRIME
	ABS
	QCare
	UNITY
	PAOS
	API
	RightFax
	A&G Database

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1	  	A-1-16	  	Health Net / Cognizant Confidential

 Final 
  

 Table 13 
  

	7.8	Third Party Tools 

 Supplier will use the following Tools and Services. The contractual
relationship for all Supplier Managed Third Parties will continue to remain with Health Net. Supplier will be responsible to manage day to day operational liaison. 
  

					
	 Third Party Tools/Service
	  	 Tool/Service Provider
	  	Contract Ownership
	Scanning/Imaging Services	  	Xerox/ACS	  	Health Net
	Diagnostic and Point-of-Care services	  	Alere	  	Health Net
	Short term Temporary Staffing	  	Kelly Services	  	Health Net

 Table 14 

Table 15 
  

	7.9	Regulatory On-shore Requirements 

 Section 7 sets forth the Appeals and Grievances
Services roles that Supplier is required to retain Onshore. Supplier will at all times provide the Appeals and Grievances Services in accordance with Schedule Y (Offshore Prohibitions and Requirements): 

 

	7.10	Service Performance Management 

 Supplier will provide and implement the quality
assurance procedures that are necessary to perform the Appeals and Grievances Services in accordance with the Service Levels, reporting formats and frequency. 

Approach 
  

	 	•	 	Supplier will use a statistically valid sample size for auditing 

 Tools 

Supplier will use quality analysis using tools including: 
  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

	7.11	Mailing Correspondence Onshore 

 Supplier will implement a process to mail 100% of all
correspondence from an Onshore address, including correspondence that requires overnight mailing (e.g. case packets to the Independent 

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1	  	A-1-17	  	Health Net / Cognizant Confidential

 Final 
  

 Review Entity (IRE)). Supplier will have controls in place to reconcile correspondence sent
onshore by Offshore team to correspondence mailed out by onshore team. 
  

	7.12	In-Person Filing Requirement 

 In cases where regulator provisions allow for Members or
their representatives to file appeals and grievances in person, Supplier will have a process that allows the ability to file appeals and grievances at an onshore location as applicable. 

 

	7.13	Receiving Member and Member Representative Calls 

 Supplier will have the technology for
each coordinator to receive phone calls directly from members and their representatives related to A&G cases. Supplier will look into establishing an 800 toll free / US local number, with voice mail capability for after-hours support, and
routing callers to specific coordinators using extensions as a potential solution. 
  

	8.	KEY ASSUMPTIONS 

  

	 	1.	Any work request received directly at Health Net in non-digital format will be batched and sent to the scanning / imaging service provider for conversion into digital format. However for regulatory requirements, Onshore
Supplier Personnel will scan the documents in the United States. 

  

	 	2.	The Onshore/Offshore mix will be validated during detailed Transition planning as set forth in the Transition Manual. 

  

	 	3.	All Services will be provided in English language only. 

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1		A-1-18		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1.1 

APPROVED SERVICE DELIVERY CENTERS 
 The
Service Delivery Centers at (or from) which Supplier is authorized to perform the Services under this Statement of Work are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform
certain aspects of the Services, their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.1 (Approved Service Delivery Centers). 

Supplier will provide sufficient coverage for the Appeals and Grievances Services by leveraging its global delivery network. A list of holidays across
delivery locations will be mutually agreed with Health net to ensure that there is no impact on operations. 
 Onshore Service Delivery
Centers 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	 Hours of

Operation
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key
Platform /
Systems
	  	 Back-up /
Fail-over
Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date

Placed

in Service
	  	 Multi-
client
Site
(Y/N)?

	Phoenix, AZ	  	Office Building	  	Refer to Section 7.3	  	Appeals and Grievances Management	  	English	  	Refer to Section 7.7IT Systems	  	Woodland Hills, CA	  	Third Party	  	 Third
 Party
	  	2010	  	Y
											
	 Woodland
 Hills, CA
	  	Office Building	  	Refer to Section 7.3	  	Appeals and Grievances Management	  	English	  	 Refer to Section 7.7

IT Systems
	  	Phoenix, AZ	  		  		  		  	Health Net site

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1.1	  	A-1.1-1	  	Health Net / Cognizant Confidential

 Final 
  

 Near-shore Service Delivery Centers 

Supplier will not use any near-shore Delivery Centers to perform the Appeals and Grievances Services. 

Offshore Service Delivery Centers 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	 Hours of

Operation
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key
Platform /
Systems
	  	 Back-up /
Fail-over
Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date

Placed

in Service
	  	 Multi-
client
Site
(Y/N)?

	Manila - McKinley Hills – Science Hub 3	  	Office Building	  	Refer to Section 7.3	  	Appeals and Grievances	  	English, Spanish	  	 Refer to Section 7.7

IT Systems
	  	Cebu, Philippines	  	Third Party	  	Third Party	  	2013	  	Y
											
	Cebu -Skyrise 4	  	Office Building	  	Refer to Section 7.3	  	Appeals and Grievances	  	English, Spanish	  	 Refer to Section 7.7

IT Systems
	  	Manila, Philippines	  	Third Party	  	Third Party	  	2013	  	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1.1	  	A-1.1-2	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1.2 

SERVICE DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 

Set out below is a description of Supplier’s ‘To-Be’ Solution for the Appeals and Grievances Services as it will be configured at the
completion of Phase 2. The tactical To Be solution will be mutually defined during the Transition, below is an illustrative technology environment for Appeals and Grievance operations. 

 
 

 

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-1.1		A-1.2-1		Health Net / Cognizant Confidential

 Final 
  

 Member Appeals Grievances Organizational Chart 

 
 

 

  

					
	SOW#5 (Quality Assurance) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

APPEALS AND GRIEVANCES ORGANIZATION CHART 

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-3		A-3		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

APPEALS AND GRIEVANCES ORGANIZATION CHART 

This Exhibit A-3 (Appeals and Grievances Organization Chart) contains organization charts showing, at a specific recent point in time prior to the
Effective Date, the positions (including both filled and currently open positions) that represent the Health Net organizational unit(s) whose Functions are being outsourced to Supplier under this Statement of Work. This document is included as part
of this Statement of Work as a supplemental means of depicting the Functions that comprise the Appeals and Grievances Services for which Supplier is assuming responsibility from Health Net under this Statement of Work. It is not included for
the purpose of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s Charges for the Appeals and Grievances Services. Any changes in the organization charts between the Agreement’s Effective Date and the
BPaaS Services Commencement Date shall not be interpreted to represent a change in the scope of the Appeals and Grievances Services in the absence of Health Net specifically adding or removing Functions from Exhibit A (Appeals and Grievances
Services) of this Statement of Work. 

  

					
	SOW#6 (Appeals and Grievances) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT B-1 

SERVICE LEVEL METRICS 

APPEALS AND GRIEVANCES 
  

	1.	APPEALS AND GRIEVANCES OPERATIONAL LEVELS 

 All Service Levels are subject to the Service
Level Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement and the Exhibits thereto. 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
	Appeals and Grievances- Misrouted Correspondence	  	 Misrouted correspondence is measured by dividing (i) the number of misrouted correspondence re-routed to the appropriate department within 4
hours of Receipt by (ii) the total number of misrouted correspondence received
  

“Receipt” means when the document is scanned and available in the appropriate queue as is the practice as of the Effective Date.
	 	Monthly	 	 Lotus Notes

(current), Prime (future)
	 	Baseline consideration of all misrouted corresponden ce rerouted to the appropriate department within 4 hours of receipt	 	Y	 	TBD	 	C	 	N
									
	Appeals and Grievances - Total Commercial Appeals Processed Per Thousand 	  	PTMPY Ratio of total # of appeals per 1000 members per year measured as (Total number of appeals)*12*1000/ Membership	 	Monthly	 	 Macess/Magic,

Prime, ODW
	 	< = 15.24	 	Y	 	TBD	 	B	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
	Member Per Year (PTMPY)	  	  
 Example:

(3 cases/2149 members)
 x1000 x 12 = 16.75
	 		 		 		 		 		 		 	
									
	Appeals and Grievances – Total Commercial Grievances Processed Per Thousand Member Per Year PTMPY	  	 PTMPY Ratio of total # of grievances per 1000 members per year measured as (Total number of grievances)*12*1000/ Membership

 
 Example:

(3 cases/2149 members)
 x1000 x 12 = 16.75
	 	Monthly	 	 Macess/Magic,

Prime, ODW
	 	< = 8.35	 	Y	 	TBD	 	B	 	Y
									
	Appeals and Grievances- Cal Medi-Connect Los Angeles County Total A&G Processed Per Thousand Member Per Month	  	 Ratio of total # of appeals and grievances per 1000 members Numerator: (Sum of Medicare LA County A&G cases *1000) / Denominator:
Membership Count in LA County
  
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	Prime, ODW	 	< = 1.59	 	Y	 	TBD	 	C	 	Y
									
	Appeals and Grievances- Cal Medi-Connect San Diego County Total A&G	  	Ratio of total # of appeals and grievances per 1000 members Numerator: (Sum of Medicare San Diego County A&G cases 	 	Monthly	 	Prime, ODW	 	 To be
 baselined
	 	Y	 	TBD	 	C	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
	Processed Per Thousand Member Per Month	  	 *1000) / Denominator: Membership Count in San Diego County
  

Example:
 (3 cases/2149 members)

x1000 = 1.396
	 		 		 		 		 		 		 	
									
	Appeals and Grievances Cal Medi Connect All Counties - Quality of Service Access Grievance Rate per 1000 - Dual Eligible Population	  	 Total number of Grievances regarding access to services per 1,000 members - Dual Eligible population Numerator: (Number of access related
Quality of Service grievances resolved * 1000) / Denominator: Membership Count of Duals population
  

Example:
 (3 cases/2149 members)

x1000 = 1.396
	 	Monthly	 	Prime, ODW	 	 To be
 baselined
	 	Y	 	TBD	 	C	 	Y
									
	Appeals and Grievances Cal Medi Connect All Counties - Quality of Care Grievance Rate per 1000 - Dual Eligible Population	  	Total number of Grievances regarding Quality of Care per 1,000 members - Dual Eligible population Numerator: (Number of Quality of care grievances resolved * 1000) / Denominator:	 	Monthly	 	Prime, ODW	 	 To be
 baselined
	 	Y	 	TBD	 	C	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-3	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
		  	 Membership Count of Duals population
  

Example:
 (3 cases/2149 members)

x1000 = 1.396
	 		 		 		 		 		 		 	
									
	Appeals and Grievances- Medicare Total A&G Processed Per Thousand Member Per Month (PTMPM)	  	 Ratio of total # of appeals and grievances per 1000 members Total count to A&G cases/ 1000 members

 
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	 Macess/Magic,

Prime, ODW
	 	< = 3.898	 	Y	 	TBD	 	B	 	Y
									
	Appeals and Grievances – California Medicaid Total A&G Processed PTMPM (CalViva)	  	 Ratio of total # of appeals and grievances per 1000 members Total count to A&G cases/ 1000 members

 
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	 SHP database,

Prime, ODW
	 	< = 0.30	 	Y	 	TBD	 	B	 	Y
									
	Appeals and Grievances – California Medicaid Total A&G Processed PTMPM (Medi-cal )	  	 Ratio of total # of appeals and grievances per 1000 members Total count to A&G cases/ 1000 members

 
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	 SHP database,

Prime, ODW
	 	< = 0.47	 	Y	 	TBD	 	B	 	Y
									
	Appeals and Grievances –	  	Ratio of total # of appeals and grievances per 1000	 	Monthly	 	 SHP database,

Prime, ODW
	 	< = 2.09	 	Y	 	TBD	 	B	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
	California Medicaid Total A&G Processed PTMPM (CalViva SPD)	  	 members Total count to A&G cases/ 1000 members
  

Example:
 (3 cases/2149 members)

x1000 = 1.396
  

H
	 		 		 		 		 		 		 	
									
	Appeals and Grievances – California Medicaid Total A&G Processed PTMPM (Medic-cal SPD)	  	 Ratio of total # of appeals and grievances per 1000 members Total count to A&G cases/ 1000 members

 
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	 SHP database,

Prime, ODW
	 	2.527	 	Y	 	TBD	 	B	 	Y
									
	Appeals and Grievances – Arizona Medicaid Total A&G Processed PTMPM	  	 Ratio of total # of appeals and grievances per 1000 members Total count to A&G cases/ 1000 members

 
 Example:

(3 cases/2149 members)
 x1000 = 1.396
	 	Monthly	 	 SHP database,

Prime, ODW
	 	 To be
 baselined
	 	Y	 	TBD	 	C	 	Y
									
	Appeals and Grievances Quality Monitoring Average	  	Quality Monitoring Average measures the quality of coordinator performance Appeals and Grievance including the accuracy of information provided to Health Nets,	 	Monthly	 	 Conducted

and measured by Q&A
	 	 All LOBs
 Quality

Monitoring
 Average

>= 97.0%
	 	Y	 	TBD	 	A	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
		  	 adherence to established procedures and appeals and grievance skills, and accuracy of entering data into the system of record following an
interaction.
  
 Supplier will perform statistically relevant amount of audits per
associate per month for
 all applicable work types. For each monitored interaction Supplier will complete a scorecard as approved by Health Net. Supplier
will rate each associates performance using the scorecard in a fair, accurate and consistent manner. Scoring for each interaction will be calculated by dividing (i) the total number of quality attributes passed by the associate, by (ii) the total
number of quality attributes measured (0% to 100%).
	 		 		 		 		 		 		 	
									
	Appeals and Grievances Quality - Final Letter	  	Quality Monitoring Final Letter review measures the quality of coordinator in letter writing including	 	Monthly	 	 Macess/Magic,

Prime, audit
 database
	 	 All LOBs
 Quality

Monitoring
 Average -to
	 	Y	 	TBD	 	C	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
		  	 the accuracy of information provided in the letter, clear and concise language used, correct template used, accuracy of spelling and grammar,
etc.
  
 Supplier will review a statistically relevant amount of letters per associate per
month for all applicable work types. For each letter reviewed
 Supplier will complete a scorecard as approved by Health Net. Supplier will rate each
associates performance using the scorecard in a fair, accurate and consistent manner. Scoring for each interaction will be calculated by dividing (i) the total number of quality attributes passed by the associate, by (ii) the total number of quality
attributes measured (0% to 100%).
	 		 		 	be baselined.	 		 		 		 	
									
	NCQA Internal Quality Audit	  	NCQA internal quality audit measures the quality of work against NCQA requirements for A&G.	 	Quarterly	 	 Conducted by

QA&T
	 	 Score 95% or
 higher
	 	Y	 	TBD	 	A	 	Y

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-7	  	Health Net / Cognizant Confidential

 Final 
  

																	
	 Category /

Name
	  	 Description
	 	 Measurement

Period
	 	 Measurement

Tool
	 	 Service

Level
	 	Critical
(Y/N)	 	Weighting
Factor	 	Code	 	Continuous
Improvement
	Inquiry Response Timeliness - (Regulatory, Legal, Compliance)	  	 This service level measures the timeliness of responses to inquiries from Regulatory Affairs, Compliance, Legal or any regulatory/compliance
area (such as DOI, ADOI, DMHC,Better Business Bureau, Legal, etc.), which shall be calculated in accordance with the following formula:
  

(Total # Inquiry Resp - # Late Inquiry Resp)
 Total #
Inquiry Responses
  
 X 100%

 
 Where:
  

“# Late Inquiry Responses” means the number of responses to inquiries that are not Completed within the specified timeframes.
	 	Monthly	 	 Macess/Magic,

Prime,
	 	100% of all inquiries received shall be Completed within the timeline specified within the request or 72 hours (15 days for Better Business Bureau) whichever is shorter.	 	Y	 	TBD	 	C	 	

  

					
	SOW#6 (Appeals and Grievances) Exhibit B-1	  	B-1-8	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT D 

KEY SUPPLIER PERSONNEL 
 Subject to
Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions filled by the individuals listed in the table below. 

 

			
	 Key Supplier Position
	  	 Initially Approved Individual

	Grievance Manager	  	TBD
	Executive Response Unit Supervisor	  	TBD
	Appeals & Grievances Program Manager	  	TBD
	Supervisor Reporting and Analytics	  	TBD

  

					
	SOW#6 (Appeals and Grievances) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms and
Conditions, this Exhibit H (Subcontractors) identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth below.

  

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	***	  		  	

  

					
	SOW#6 (Appeals and Grievances) Exhibit H	  	H-1	  	Health Net / Cognizant Confidential

 Final 
  

 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #7 (MEDICAL MANAGEMENT SERVICES) 

  

					
	SOW#7 (Medical Management)		 		Health Net / Cognizant Confidential

 Final 
  

 AMENDED AND RESTATED 

MASTER SERVICES AGREEMENT 

STATEMENT OF WORK #7 (MEDICAL MANAGEMENT SERVICES) 

This Statement of Work #7 (Medical Management Services), dated November 21, 2014, but effective as of November 2, 2014
(“the SOW Effective Date”), is made by and between Health Net, Inc., a Delaware corporation with its principal place of business located at 21650 Oxnard Street, Woodland Hills, California 91367 (“Health
Net”), and Cognizant Healthcare Services, LLC (“Supplier”), a Delaware corporation having an office at 500 Frank W. Burr Blvd., Teaneck, New Jersey 07666 (each, a
“Party” and collectively, the “Parties”). This SOW #7 (Medical Management Services) is entered into and shall be governed by the terms of that certain Amended and Restated
Master Services Agreement entered into between the Parties dated November 21, 2014 (the “Agreement”). This Statement of Work #7 (Medical Management Services) replaces and supersedes in all respects the Statement
of Work #7 dated November 2, 2014. 
  

	1.	INTRODUCTION 

  

	1.1	Background & Purpose 

 This SOW #7 (Medical Management Services)
describes the Medical Management Services Supplier will provide for Health Net, as such Services are defined in Exhibit A (Medical Management Services) to this SOW #7 (Medical Management Services), and sets forth certain terms and
conditions relating to them, including, among other things: 
  

	 	(a)	The scope of the Medical Management Services; 

  

	 	(b)	The Solution Supplier will use to perform and deliver them; 

  

	 	(c)	The Operational Service Levels Supplier will meet in providing them; 

  

	 	(d)	The Key Supplier Positions applicable to them; and 

  

	 	(e)	The Subcontractors (if any) approved by Health Net to provide certain of them. 

  

					
	SOW#7 (Medical Management)		1		Health Net / Cognizant Confidential

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	1.2	Structure 

 This SOW #7 (Medical Management Services) is comprised of this cover
document and the following Exhibits: 
  

					
	Table 1: Exhibits to SOW #7 (Medical Management Services)
	 Item

#
	  	 Exhibit
	  	 Purpose of Exhibit

	1	  	Exhibit A (Services)	  	Describes the scope of the Medical Management Services.
			
	2	  	 Exhibit A-1 (Solution

Description)
	  	 Describes Supplier’s solution for the provision of the Medical Management Services and includes as exhibits:

 
 •    Exhibit A-1-1
(Approved Service Delivery Centers)
  

•    Exhibit A-1-2 (Service Delivery Configuration at the Completion of Phase
2)

			
	3	  	Exhibit A-3 (Organizational Chart)	  	Identifies the Health Net roles being transferred to Supplier or displaced by Supplier roles as a result of the execution of this SOW #7 (Medical Management Services).
			
	4	  	Exhibit B-1 (Operational SLAs)	  	Identifies the Operational Service Levels applicable to the Medical Management Services.
			
	5	  	 Exhibit D (Key
 Supplier
Positions)
	  	Identifies the Key Supplier Positions applicable to the Medical Management Services.
			
	6	  	Exhibit H (Subcontractors)	  	Identifies the Subcontractors approved by Health Net to provide certain of the Medical Management Services.

  

	2.	DEFINITIONS 

 Capitalized terms used but not defined in this SOW #7 (Medical
Management Services) shall have the meanings given them in the Agreement. 
  

	3.	APPLICABILITY OF THE AGREEMENT 

 This SOW #7 (Medical Management Services) is
hereby made a part of, and is subject to and governed by, the Agreement. This SOW #7 (Medical Management Services) is one of the Initial Statements of Work executed under the Agreement. 

  

					
	SOW#7 (Medical Management)	  	2	  	Health Net / Cognizant Confidential

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 IN WITNESS WHEREOF, Health Net and Supplier have each caused this SOW #7 (Medical Management
Services) to be signed and delivered by its duly authorized officer, all as of the SOW Effective Date set forth above. 
  

									
	Health Net, Inc.				Cognizant Healthcare Services, LLC
					
	By:		  
				By:		  

			
	Print Name:                                 
                                         
     				Print Name:                                 
                                         
     
					
	Title:		  
				Title:		  

					
	Date:		  
				Date:		  

  

					
	SOW#7 (Medical Management)		 		Health Net / Cognizant Confidential

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 EXHIBIT A 

MEDICAL MANAGEMENT SERVICES 
  

	1.	INTRODUCTION 

  

	1.1	General. 

  

	 	(a)	In the most general terms, the “Medical Management Services” are the Functions performed by the non-clinical intake and production teams consisting of the Prior Authorization unit, Hospital
Notification unit, Post Service Review unit and Concurrent Review unit. 

  

	 	(i)	Functions performed by the Prior Authorization unit include the intake, evaluation, determination of specific authorizations, as well as routing, and tracking of authorization requests submitted primarily from Providers
(participating and non-participating) for all Regions and Lines of Business requested of Health Net. 

  

	 	(ii)	Functions performed by the Hospital Notification unit include receipt and processing of Hospital Inpatient Admission requests, including routing correctly to the clinical team as needed and appropriate based on Health
Net processing guidelines. Prior to entering the admission, the team will check source systems for information including but not limited to, eligibility, benefits, and financial risk. 

 

	 	(iii)	Functions performed by the Post Service Review unit (also known as the Medical Review unit) include intake, evaluation and resolution of claim inquiries as well as updates to authorizations, as well as batching and
triaging related requests that require medical review prior to claims adjudication. The Post Service Review unit or Medical Review unit will create and update authorizations as well as route cases to the clinical staff for review as needed and
appropriate based on Health Net guidelines. After updating the authorization and resolving the outstanding concern, the unit will report findings back to Claims for processing. This unit will frequently interact with the Customer Contact Center and
Claims on authorizations and claim payment questions. 

  

	 	(iv)	Functions performed by the Concurrent Review unit include calls to facilities to verify and update the member’s inpatient or discharge status. This unit accurately updates the Medical Management system and ensures
timely monitoring of admissions for discharge and decision and also provides administrative assistance to the clinical staff with updates to authorizations, phone calls as needed and providing other information and follow up as instructed or
required by the clinical team. 

  

	 	(b)	Clinical Determinations. All clinical determinations, whether part of Prior Authorization, Hospital Notification, Post Service Review, Concurrent Review or other function, remain the responsibility of Health Net and its
retained clinical staff. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-1		Health Net / Cognizant Confidential

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	 	(c)	The Medical Management Services are more fully described in this Exhibit A (Medical Management Services), and include the Cross Functional Services described in Section 3 of Schedule A (Cross Functional
Services) and the Functions included as part of the Embedded Processes described in Section 4 of Schedule A (Cross Functional Services), each as they relate to the Functions included as part of the Medical Management Services. For
clarity, this includes Supplier’s responsibility to manage all activities performed under Managed Third Party Contracts in accordance with Section 3.8 (Managed Third Party Contract Services) of Schedule A (Cross Functional
Services). Supplier shall perform the Medical Management Services, except for those Functions that are expressly identified as retained Health Net responsibilities in Section 2 below. For purposes of clarity, the Party that is assigned
responsibility for a Function as per the designations in Section 2 is also responsible for the Embedded Processes applicable to that Function. 

  

	 	(d)	In addition to those Functions specifically designated in this Statement of Work as Functions for which Supplier is responsible, the Medical Management Services to be performed by Supplier include all Functions
performed by or associated with the roles in the Medical Management Organization Chart set forth in Exhibit A-3 (Medical Management Organization Chart), all of which are either being transferred to Supplier or displaced by Supplier roles as a result
of the execution of this Statement of Work unless expressly designated in this Statement of Work as Functions retained by Health Net. Such Functions will be deemed to be part of the Medical Management Services to be performed by Supplier as if
expressly set forth in this Statement of Work. 

  

	 	(e)	In addition to the retained Health Net responsibilities expressly identified in this Exhibit A (Medical Management Services), and in addition to and without limiting Health Net’s rights under Section 18
(Audits and Records) of the Terms and Conditions, Health Net may perform quality reviews and audits of Supplier’s performance of the Medical Management Services in accordance with the Terms and Conditions. For the avoidance of doubt,
Health Net is not obligated to perform any level of such quality reviews and activities, except to the extent required by applicable Law. 

  

	 	(f)	Supplier shall generate and provide to Health Net (i) each operational report generated prior to the BPaaS Services Commencement Date, unless and until Health Net confirms in writing that such operational report is
no longer required, (ii) such other operational reports as Health Net may reasonably request from time to time, and (iii) such modifications to or replacements for the foregoing reports as may be necessary to reflect changes to and
evolutions of the Medical Management Services during the term of this Statement of Work. 

  

	1.2	Definitions. 

  

	 	(a)	Certain Terms. 

  

	 	(i)	“Care Management System” means any and all systems that procedurally must be updated and maintained based on work managed/processed by Supplier and/or Health Net. Care Management Systems include:

  

	 	(A)	PEGA MARS 

  

	 	(B)	Lotus Notes Database (HNU Faxes) 

  

					
	SOW#7 (Medical Management) Exhibit A		A-2		Health Net / Cognizant Confidential

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	 	(C)	Lotus Notes Database (SHP PCU) 

  

	 	(D)	Unity 

  

	 	(E)	Convergence 

  

	 	(F)	CSI - Eligibility Repository 

  

	 	(G)	HNCS - Red Phone 

  

	 	(H)	ABS 

  

	 	(I)	EPA-Enterprise Administrator 

  

	 	(J)	Qcare 

  

	 	(K)	FileNet 

  

	 	(L)	MACESS 

  

	 	(M)	UPS II 

  

	 	(N)	AVES 

  

	 	(O)	MGCS 

  

	 	(P)	Rightfax 

  

	 	(Q)	OON Database 

  

	 	(R)	CDS – Reporting 

  

	 	(S)	Intranet- Medical information and P&Ps 

  

	 	(T)	Shared Drive: MEDDIV 

  

	 	(U)	Shared Drive: Tigard Drive 

  

	 	(V)	Shared Drive: Tempe Drive 

  

	 	(W)	Shared Drive: HCS 

  

	 	(X)	SHP Document Library 

  

	 	(Y)	CMS Website (Intranet) 

  

	 	(Z)	Intranet- Medical information and P&Ps 

  

	 	(AA)	Unity Training Environment 

  

	 	(BB)	PSAS 

  

					
	SOW#7 (Medical Management) Exhibit A		A-3		Health Net / Cognizant Confidential

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	 	(ii)	“Medicare Expedited” means a circumstance where a physician indicates, either orally or in writing, that applying the standard time frame for making a determination could seriously jeopardize the
life or health of the Member. Health Net must provide an expedited organization determination (also known as a “Medicare Expedited Review”). The expedited turnaround time is seventy-two (72) hours or less from receipt. 

 

	 	(iii)	“Member” has the meaning given in Schedule A (Cross Functional Services). 

  

	 	(iv)	“Provider” has the meaning given in Schedule A (Cross Functional Services). 

  

	 	(b)	The following acronyms have the meaning set forth as follows: 

  

			
	 Acronym
	  	 Meaning

	CCS	  	California Children’s Services
		
	CM	  	Case Management
		
	DENC	  	Detailed Explanation of Non Coverage Discharge
		
	DND	  	Detailed Notice of Discharge
		
	QIO	  	Quality Improvement Organization
		
	QOC	  	Quality of Care
		
	SF	  	Service Form
		
	SIU	  	Special Investigations Unit
		
	TAT	  	Turn Around Time
		
	TOC	  	Transition of Care

  

					
	SOW#7 (Medical Management) Exhibit A	  	A-4	  	Health Net / Cognizant Confidential

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	 	(c)	Request Types and Priorities. 

  

							
	 Request

Type
	 	 Definition of

Request Type
	  	 Request

Priority
	  	 Definition of Request Priority

	Pre-service	 	Any request for authorization before the service has been rendered.	  	Immediate (Washington Only)	  	 Any request for approval of an intervention, care or treatment where passage of time without treatment would, in the judgment of the
provider, result in an imminent emergency room visit or hospital admission and deterioration of the enrollee’s health status.
  

Examples of situations that do not qualify under an immediate review request include, but are not limited to, situations where:

 
 (i) The requested service was prescheduled, was not an emergency when scheduled, and there
has been no change in the patient’s condition;
  
 (ii) The requested service is
experimental or in a clinical trial;
  
 (iii) The request is for the convenience of the
patient’s schedule or physician’s schedule; and
  
 (iv) The results of the
requested service are not likely to lead to an immediate change in the enrollee’s treatment.

				
	Pre-service	 	Any request for authorization before the service has been rendered.	  	Urgent/ Expedited	  	 Any request for medical care or treatment when standard determination timeframes could result in the following circumstances: Jeopardizing
the member’s life, limb or bodily function, based on a prudent layperson’s judgment; or
  

In the opinion of the treating practitioner or other practitioner with knowledge of the member’s medical condition, the member would experience severe
pain that cannot be adequately managed without the requested care or treatment.

				
	Pre-service	 	Any request for authorization before the service has been rendered. 	  	Routine	  	Requests that do not meet the guidelines for an urgent request as determined by the treating/requested physician.

  

					
	SOW#7 (Medical Management) Exhibit A	  	A-5	  	Health Net / Cognizant Confidential

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	 Request

Type
	 	 Definition of

Request Type
	  	 Request

Priority
	  	 Definition of Request Priority

	Concurrent	 	Any request for service or inpatient stay for which the member is currently in treatment or in- house and is requesting ongoing treatment.	  	 Urgent

Concurrent
	  	 Any request for service or inpatient stay for which the member is currently in treatment or in-house and is requesting ongoing treatment.

 
 For a request to be considered Urgent Concurrent, the characteristics below must be
identical to original request:
  

•    Provider
  

•    Diagnosis
  

•    Service
  

•    Setting (inpatient, ambulatory, etc.)

				
	Post-service	 	Any review request for appropriateness of medical care or services that has already been received prior to claim submission. Request for services that have already been rendered where there is no ongoing treatment or services
being provided or requested.	  	Routine	  	Request for approval of care or treatment where the services have been rendered to the enrollee and the request is not an urgent care request.
				
	 Retrospective
 Review
	 	The process of determining the medical necessity of a treatment/ service post delivery of care and following claims payment.	  	Routine	  	Retrospective reviews are reviews conducted once the claim (HFCA 1500/UB 04) has been received. Health Net defines retrospective review as part of the claims processing system.

  

	 	(d)	Capitalized terms not defined in this Exhibit A shall have the meanings given them in Schedule W (Glossary) or elsewhere in this Agreement. 

  

					
	SOW#7 (Medical Management) Exhibit A	  	A-6	  	Health Net / Cognizant Confidential

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	2.	RESPONSIBLE PARTY 

 The following table sets forth the responsible party for the Medical
Management Services. 
  

											
	 	  	 	  	Lines	  	 	  	 
	 Process /

Function ID
	  	 Process/Function Name / Description
	  	 of Bsns
(LOB)
	  	 Region
	  	 Resp. Party

	  	  	  	  	 Supplier
	  	 HN

	MM1	  	Utilization Management	  		  		  		  	
	 MM1.1
	  	 Prior Authorization
	  		  		  		  	
	 MM1.1.1
	  	 PA Intake, Support and Referrals
	  	All	  	All	  	X	  	
	 MM1.1.2
	  	 PA Initial Clinical Review
	  	All	  	All	  		  	X
	 MM1.1.3
	  	 PA Clinical Review (MD)
	  	All	  	All	  		  	X
	 MM1.1.4
	  	 PA Pend Management
	  	All	  	All	  		  	X
	 MM1.1.5
	  	 PA Notifications
	  	All	  	All	  	X	  	
	 MM1.1.6
	  	 PA Inquiry Status Management
	  	All	  	All	  	X	  	
	 MM1.2
	  	 Hospital Notification
	  		  		  		  	
	 MM1.2.1
	  	 HN Intake and Support
	  	All	  	All	  	X	  	
	 MM1.2.2
	  	 HN Status Management
	  	All	  	All	  	X	  	
	 MM1.3
	  	 Concurrent Review
	  		  		  		  	
	 MM1.3.1
	  	 CR Administrative Support
	  	All	  	All	  	X	  	
	 MM1.3.2
	  	 CR Initial Clinical Review
	  	All	  	All	  		  	X
	 MM1.3.3
	  	 CR Clinical Review (MD)
	  	All	  	All	  		  	X
	 MM1.3.4
	  	 CR Notifications
	  	All	  	All	  	X	  	
	 MM1.3.5
	  	 CR Medicare DENC/DND Processing
	  	All	  	All	  		  	X
	 MM1.4
	  	 Post Service Review
	  		  		  		  	
	 MM1.4.1
	  	 PSR Intake and Support
	  	All	  	All	  	X	  	
	 MM1.4.2
	  	 PSR Initial Clinical Review
	  	All	  	All	  		  	X
	 MM1.4.3
	  	 PSR Clinical Review (MD)
	  	All	  	All	  		  	X
	 MM1.4.4
	  	 PSR Notifications
	  	All	  	All	  	X	  	
	MM2	  	Regulatory and Quality Improvement Initiatives	  	All	  	All	  		  	X
	MM3	  	Audit Support Services	  	All	  	All	  	X	  	
	MM4	  	Post Transaction Audit Services	  	All	  	All	  	X	  	
	MM5	  	Medical Management Policy Services	  	All	  	All	  	X	  	

  

					
	SOW#7 (Medical Management) Exhibit A	  	A-7	  	Health Net / Cognizant Confidential

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	3.	MEDICAL MANAGEMENT SERVICES, GENERALLY 

 Except as set forth in Section 2, Supplier
will provide the Medical Management Services described in this Exhibit A. Supplier will document and track all Medical Management processes in the appropriate system of record and adhere to all Health Net, regulatory, compliance and business
standards applicable to all Products, Regions and Line of Business. Except as specifically noted, the Services set forth in this Section 3 apply to all Lines of Business and Regions. 

 

	3.1	MM1 Utilization Management. 

  

	 	(a)	MM1.1 Prior Authorization. 

  

	 	(i)	MM1.1.1 PA Intake, Support and Referrals. 

 “PA Intake, Support and Referrals
Services” are the Functions associated with Prior Authorization intake, support and referrals, including the following activities: 
  

	 	(A)	Receive requests for referrals and prior authorization of services and/or procedures for a Member; confirm eligibility for that Member; confirm that the services and/or procedures are covered by that Member’s
benefit plan and require a prior authorization to be issued. As applicable: 

  

	 	(1)	Provide the requested referrals or approve those authorization requests that can be approved and that do not require review by the Initial Clinical Review or Clinical Review (MD) processes (as determined by Health Net
Policies); 

  

	 	(2)	Otherwise, escalate to the Initial Clinical Review process. 

  

	 	(B)	Update the applicable Care Management System(s) accordingly. 

  

	 	(C)	Health Net may change the services requiring pre-certification on a regular basis. Changes to pre-certification conditions may translate into additions or deletions to the prior authorization requirements. The supplier
will be required to implement these changes promptly and in alignment with communications to providers and/or regulators. 

  

	 	(1)	Should Health Net exempt (i.e., “gold card” ) certain providers from prior authorization requirements, the Supplier will follow these guidelines promptly and in coordination with communication timelines agreed
to with the provider(s). 

  

	 	(ii)’	MM1.1.2 PA Initial Clinical Review. 

 “PA Initial Clinical Review
Services” are the Functions associated with Prior Authorization initial clinical review, including the following activities: 
  

	 	(A)	Review requests for referrals and prior authorizations that were escalated from the Intake, Support and Referrals process. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-8		Health Net / Cognizant Confidential

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	 	(B)	Either: 

  

	 	(1)	Provide the requested referrals and/or approve those authorization requests that can be approved and that do not require review by the Clinical Review (MD) process (as determined by Health Net Policies); or

  

	 	(2)	Escalate to the Clinical Review (MD) process. 

 Examples of why a request would be escalated:
medical necessity decisions; denials if required by Law. If the Member’s condition warrants an urgent/expedited review, the physician would request an escalated assessment. 

 

	 	(C)	As needed, route to the Pend Management process for further review. 

  

	 	(D)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iii)	MM1.1.3 PA Clinical Review (MD). 

 “PA Clinical Review (MD) Services”
are the Functions associated with Prior Authorization clinical review (MD), including the following activities: 
  

	 	(A)	Review requests for referrals and prior authorizations that were escalated from the Initial Clinical Review process. Provide the requested referrals and/or approve or deny such requests. 

 

	 	(B)	As needed, route to the Pend Management process for further review. 

  

	 	(C)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iv)	MM1.1.4 PA Pend Management. 

 “PA Pend Management Services” are the
Functions associated with Prior Authorization pend management, including the following activities: 
  

	 	(A)	For cases escalated from the Initial Clinical Review and the Clinical Review (MD) processes, review, research and resolve (including through calls and letters with the Provider and Member) requests for additional
clinical information, labs, photos or other pieces of data in order for the prior authorization determination to be made. 

  

	 	(B)	Provide updates to the Initial Clinical Review and/or Clinical Review (MD) processes. 

  

	 	(C)	Once all required information is obtained, provide the required information and route the case back to the Initial Clinical Review or Clinical Review (MD) processes, as applicable. 

 

	 	(D)	Follow up with the Provider if no information is received and provide updates to the Initial Clinical Review and/or Clinical Review (MD) process. Follow compliance timelines for notifications and decisions whether in
writing or over the phone. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-9		Health Net / Cognizant Confidential

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	 	(E)	Receive input from the Initial Clinical Review or Clinical Review (MD) processes as to whether and when a case should be closed. 

  

	 	(v)	MM1.1.5 PA Notifications. 

 “PA Notifications Services” are the
Functions associated with Prior Authorization notifications, including the following activities: Advise Members and Providers, as applicable, of approval of prior authorization requests, including written and verbal notifications as determined in
accordance with Health Net Policies. 
 All Medicare Expedited requests require verbal notification to the Member and to the Provider.
Notifications must be in the preferred language (both written and verbal). Notifications for all lines of business must be completed with the compliance standards as outlined for each region, and include 

appropriate/required notification verbally and/or in writing. Notification requirements are outlined in the regulations and may include phone
calls as well as letters. 
 Notwithstanding the designations in Section 2, Health Net retains responsibility for notification of all
denials of prior authorization requests. 
  

	 	(vi)	MM1.1.6 PA Inquiry Status Management. 

 “PA Inquiry Status Management
Services” are the Functions associated with Prior Authorization inquiry status management, including the following activities: 
  

	 	(A)	Receive and respond to inquiries from Providers and Members related to prior authorizations, including whether a prior authorization is needed and/or the status of a requested prior authorization. 

 

	 	(B)	Update the applicable Care Management System(s) accordingly. 

  

	 	(b)	MM1.2 Hospital Notification. 

  

	 	(i)	MM1.2.1 HN Intake and Support. 

 “HN Intake and Support Services” are
the Functions associated with Hospital Notification intake and support, including the following activities: 
  

	 	(A)	Receive notifications from hospitals (through various channels, including phone notifications and written notifications) that a Member has been admitted, including via various channels such as fax, email, telephone;
confirm eligibility for that Member; confirm that the services and/or procedures are covered by that Member’s benefit plan, and check PSAS 

  

					
	SOW#7 (Medical Management) Exhibit A		A-10		Health Net / Cognizant Confidential

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	 	(B)	Update the applicable Care Management System(s) accordingly and route the notification to the Concurrent Review process. 

  

	 	(ii)	MM1.2.2 HN Status Management. 

 “HN Status Management Services” are the
Functions associated with Hospital Notification status management, including the following activities: 
  

	 	(A)	Receive and respond to inquiries related to hospital notifications. 

  

	 	(B)	Follow-up with hospitals and PPGs as necessary to obtain additional information. 

  

	 	(c)	MM1.3 Concurrent Review. 

  

	 	(i)	MM1.3.1 CR Administrative Support. 

 “CR Administrative Support
Services” are the Functions associated with Concurrent Review administrative support, including the following activities: 
  

	 	(A)	Proactively communicate with the hospitals and PPGs to track the Member’s status and timing of discharge as well as requesting of medical records. 

 

	 	(B)	Update the applicable Care Management System(s) accordingly and route information to the Clinical Review process. 

  

	 	(ii)	MM1.3.2 CR Initial Clinical Review. 

 “CR Initial Clinical Review
Services” are the Functions associated with Concurrent Review initial clinical review, including the following activities: 
  

	 	(A)	Confirm whether the admission is appropriate (i.e., the Member is eligible for coverage and the hospital stay is covered as part of the Member’s benefit plan). 

 

	 	(B)	Either: 

  

	 	(1)	Approve those benefits coverage that can be approved and that do not require review by the Clinical Reviewer (MD) - (as determined by Health Net Policies); or 

 

	 	(2)	Otherwise, escalate to the Clinical Review (MD) process. Examples of why a request would be escalated - medical necessity decisions; denials if required by Law. 

 

	 	(C)	For instances when benefits coverage is approved (either as part of this process or the Clinical Review (MD) process), develop a discharge plan to address what happens post-discharge (e.g. transfer to rehab, to home
with some home help needs) and ensure this is ready at the point of discharge. Communicate with the hospital, other care facilities and the Member, as needed. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-11		Health Net / Cognizant Confidential

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	 	(D)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iii)	MM1.3.3 CR Clinical Review (MD). 

 “CR Clinical Review Services” are
the Functions associated with Concurrent Review clinical review, including the following activities: 
  

	 	(A)	Review requests for benefits coverage that were escalated from the Initial Clinical Review process. Either approve or deny such requests. 

 

	 	(B)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iv)	MM1.3.4 CR Notifications. 

 “CR Notifications Services” are the
Functions associated with Concurrent Review notifications, including the following activities: Advise Members and Providers, as applicable, of approval of benefits coverage, including written and verbal notifications as determined in accordance with
Health Net Policies. 
 All Medicare Expedited requests require verbal notification to the Member and to the Provider. Notifications must be
in the preferred language require bilingual capabilities, Spanish and English (both written and verbal). Notification requirements are outlined in the regulations and may include phone calls as well as letters. 

Notwithstanding the designations in Section 2, Health Net retains responsibility for notification of all denials of benefits coverage.

  

	 	(v)	MM1.3.5 CR Medicare DENC/DND Processing. 

 “CR Medicare DENC/DND Processing
Services” are the Functions associated with Concurrent Review Medicare DENC/DND processing, including the following activities: 
  

	 	(A)	Receive, review, research and disposition all requests from Medicare Members for review of a decision that Medicare Services should end. 

 

	 	(B)	Prepare and provide to the Member the required Detailed Explanation of Non Coverage Discharge (DENC) and Detailed Notice of Discharge (DND) and provide any needed medical records to the Quality Improvement Organization
(QIO) so that the QIO can issue a determination to either uphold or overturn the decision to end the service. 

 This process
has very tight timelines and precision on letters is critical in meeting compliance on these requests. Ensure that proper notification is made to the member or provider based on the regulatory requirements for that line of business. All
communications must be made within the compliance timelines orally or in writing as outlined for each line of business and region. 
  

	 	(d)	MM1.4 Post Service Review. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-12		Health Net / Cognizant Confidential

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 Notwithstanding the designations in Section 2, Health Net retains responsibility for all
Post Service Review Functions for California Children’s Services (CCS) cases. 
  

	 	(i)	MM1.4.1 PSR Intake and Support. 

 “PSR Intake and Support Services” are
the Functions associated with Post Service Review intake and support, including the following activities: 
  

	 	(A)	Receive requests from the Claims Tower to review particular Claims for coverage determinations. Examples might be when a medical necessity determination is required. Perform initial review and information gathering,
including by working directly with the Claims Tower as needed. 

  

	 	(B)	Either: 

  

	 	(1)	To the extent permitted by Health Net Policies, provide the necessary input and information requested and resubmit back to the Claims Tower for continued adjudication; or 

 

	 	(2)	Otherwise, escalate to the Initial Clinical Review process. 

  

	 	(C)	Update the applicable Care Management System(s) accordingly. 

  

	 	(ii)	MM1.4.2 PSR Initial Clinical Review. 

 “PSR Initial Clinical Review
Services” are the Functions associated with Post Service Review initial clinical review, including the following activities: 
  

	 	(A)	Review requests for authorizations that were escalated from the Intake and Support process. 

  

	 	(B)	Either: 

  

	 	(1)	Approve those authorization requests that can be approved and that do not require review by the Clinical Review (MD) process (as determined by Health Net Policies); or 

 

	 	(2)	Otherwise, escalate to the Clinical Review (MD) process. 

 Examples of why a request would be
escalated - medical necessity decisions; denials if required by Law. 
  

	 	(C)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iii)	MM1.4.3 PSR Clinical Review (MD). 

 “PSR Clinical Review (MD) Services”
are the Functions associated with Post Service Review clinical review (MD), including the following activities: 
  

	 	(A)	Review requests for prior authorizations that were escalated from the Initial Clinical Review process. Either approve or deny such requests. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-13		Health Net / Cognizant Confidential

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	 	(B)	Update the applicable Care Management System(s) accordingly. 

  

	 	(iv)	MM1.4.4 PSR Notifications. 

 “PSR Notifications Services” are the
Functions associated with Post Service Review notifications, including the following activities: Advise Members and Providers of approval of benefits coverage, including written notifications as determined in accordance with regulatory requirements
and/or Health Net Policies. 
 Notifications must be in the preferred language (both written and verbal). All communications must be made
within the compliance timelines orally or in writing as outlined for each line of business and region. Notification requirements are outlined in the regulations and may include phone calls as well as letters. 

Notwithstanding the designations in Section 2, Health Net retains responsibility for notification of all denials of benefits coverage.

  

	3.2	MM2 Regulatory and Quality Improvement Initiatives. 

 “Regulatory and Quality
Improvement Initiatives Services” means those Functions associated with the process to help drive improvements in Member clinical outcomes and satisfaction. Initiatives are generally required as outlined by regulators or accreditation
agencies. Functions include examining HEDIS and CAHPS data annually and implementing interventions with Providers and Members to address and improve results. The goals of regulatory and quality improvement initiatives are Member satisfaction and
wellness. 
  

	3.3	MM3 Audit Support Services. 

 “Audit Support Services” means
those Functions associated with providing support for Audits of the applicable line of business or a component of it, whether conducted by (or on behalf of) Health Net itself or a Health Net Regulator or customer (e.g., a large Employer Group),
including the following: 
  

	 	(a)	Providing data and reports requested by the Auditors; 

  

	 	(b)	Providing subject matter expertise and otherwise supporting the conduct of the Audit as requested by the Auditors; 

  

	 	(c)	Assisting in the development and implementation of corrective action plans in response to Audit findings identifying weaknesses or deficiencies in the Audited Function; and 

 

	 	(d)	Supporting Health Net communications with Regulators. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-14		Health Net / Cognizant Confidential

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	3.4	MM4: Post Transaction Audit Services 

 “Post Transaction Audit
Services” are the functions associated with performing post transaction audit for all in-scope services to identify any errors/omissions in the transaction: 
  

	 	(a)	Supplier will randomly sample the transaction universe with statistically valid sample size (minimum ten (10) audits per month per FTE). 

 

	 	(b)	Supplier will audit (on a post transaction basis) in accordance with Health Net provided Policies and Procedures. 

  

	 	(c)	Notify Processor Associates and their Supervisor of any errors. 

  

	 	(d)	Finalize and publish final error findings and overall accuracy scores on a daily, weekly and monthly basis. 

  

	3.5	MM5: Medical Management Policy Services 

 “Medical Management Policy
Services” means those Functions associated with the development and implementation of “Health Net Medical Management Policies,” which are the Health Net Policies as defined in Schedule P (Health Net
Policies) governing or pertaining to the Medical Management Services, more specifically, the conduct of Health Net’s Medical Management Services. 

Below are some examples of selected Medical Management Policy Services Functions, which include descriptions of the manner in which such
Functions are currently performed by Health Net. The examples are illustrative only: 
  

	 	(a)	Generally, provide operational subject matter expertise with respect to Health Net Medical Management Policies; 

  

	 	(b)	As requested, participate in meetings with Health Net and Supplier stakeholders having responsibility for the development, implementation, monitoring and enforcement of Health Net Medical Management Policies;

  

	 	(c)	In response to changes in Laws, regulations, guidelines, policies, contracts or requests from Health Net’s Enterprise Process Change Organization (“EPCO”) or from Health Net’s or
Supplier’s Compliance organization: 

  

	 	(i)	Participate in Health Net EPCO Steering Committee meetings to review new legal and regulatory changes and assessment of business impact; 

 

	 	(ii)	Participate in Health Net EPCO regulatory implementation Change Teams; 

  

	 	(iii)	Project manage the operational implementation and/or affected system changes of legal and regulatory changes that affect Medical Management Services and participate in operational implementation and/or affected system
changes of legal and regulatory changes that span multiple functions/departments, including tracking the progress of Deliverables and communicating status to Health Net’s EPCO and/or Compliance organization; and 

 

	 	(iv)	Based on the aforementioned meetings and guidance from the EPCO, prepare initial drafts of revised or new Health Net Medical Management Policies and submit them to the relevant Health Net and Supplier stakeholders for
review, comment, and approval; 

  

					
	SOW#7 (Medical Management) Exhibit A		A-15		Health Net / Cognizant Confidential

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	 	(d)	Prepare updated versions of Health Net Medical Management Policies to address input provided by relevant Health Net and Supplier stakeholder groups; 

 

	 	(e)	Provide communications and training to Supplier personnel regarding revised and new Health Net Medical Management Policies and access to Health Net personnel to such communications and training; and 

 

	 	(f)	Implement Heath Net-approved Health Net Medical Management Policies by Supplier Personnel involved in the performance of the Medical Management Services. 

  

					
	SOW#7 (Medical Management) Exhibit A		A-16		Health Net / Cognizant Confidential

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 EXHIBIT A-1 

MEDICAL MANAGEMENT 

SOLUTION DESCRIPTION 

  

					
	SOW#7 (Medical Management) Exhibit A-1		 		Health Net / Cognizant Confidential

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 EXHIBIT A-1 

MEDICAL MANAGEMENT SOLUTION DESCRIPTION 

TABLE OF CONTENTS 
  

					
	 1. INTRODUCTION
		 	1	  
		
	 2. DEFINITIONS AND INTERPRETATION
		 	1	  
		
	 2.1 Defined Terms
		 	1	  
		
	 3. SOLUTION OVERVIEW
		 	1	  
		
	 3.1 High-level Service Delivery Architecture and Configuration
		 	1	  
		
	 3.2 Service Delivery Model
		 	2	  
		
	 4. CHANGES TO SUPPLIER’S SOLUTION
		 	2	  
		
	 5. SOLUTION DESCRIPTION
		 	3	  
		
	 5.1 Delivery Solution:
		 	3	  
		
	 5.2 Risk Mitigated Transition Solution:
		 	3	  
		
	 6. SCOPE OF SERVICES
		 	4	  
		
	 7. OPERATING MODEL
		 	4	  
		
	 7.1 Resource Mix
		 	4	  
		
	 7.2 Location
		 	6	  
		
	 7.3 Operating Hours
		 	7	  
		
	 7.4 Operations
		 	8	  
		
	 7.5 Resource Profile
		 	9	  
		
	 7.6 Voice Solution
		 	12	  
		
	 7.7 IT Systems
		 	12	  
		
	 7.8 Onshore Requirements
		 	13	  
		
	 7.9 Service Performance Management
		 	13	  
		
	 8. KEY ASSUMPTIONS
		 	13	  
		
	 9. RISKS
		 	14	  

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-i		Health Net / Cognizant Confidential

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	1.	INTRODUCTION 

 This document is the Solution Description for Statement of Work #7 –
Medical Management Services (this “Statement of Work”). Whereas Exhibit A (Medical Management Services) describes the Functions which Supplier is responsible for performing under this Statement of Work. This Exhibit
A-1 (Medical Management Solution Description) describes the means by which and the manner in which Supplier will perform those Functions. This document includes an overview of Supplier’s service delivery architecture -
including a depiction on a global map of the geographic configuration and delivery architecture of Supplier’s Solution (as it will exist at the completion of Phase 2). This geographical depiction also identifies all Service Delivery Centers of
Supplier (and its Affiliates and other Subcontractors) that will be utilized in performing and delivering the Services (including the back-up and failover locations for each) and how they will be interconnected to each other and to Health Net’s
IT Environment. It then provides additional descriptive information about each of the principal components of Supplier’s Solution. 

This Exhibit A-1 (Medical Management Solution Description) includes the following attachments, which are incorporated herein by
reference 
 Exhibit A-1.1 Approved Service Delivery Centers 

Exhibit A-1.2 Service Delivery Configuration at the Completion of Phase 2 

 

	2.	DEFINITIONS AND INTERPRETATION 

  

	2.1	Defined Terms 

 The following terms, when used in this Statement of Work, will have the
meanings set forth below unless otherwise specifically defined in the body of this document. Additionally any capitalized term used but not defined in this Exhibit A-1 (Medical Management Solution Description) will have the meaning indicated
in Schedule W (Glossary). 
  

			
	 Defined Term
	  	 Meaning

	“Solution”	  	A collective term referring to the means by which and manner in which Supplier will perform and deliver the Services under this Statement of Work
		
	“Ramp Up”	  	The period of time from when a Supplier Personnel completes process training to the time when the supplier personnel starts meeting the required quality Service Levels and 100% productivity standards.

  

	3.	SOLUTION OVERVIEW 

  

	3.1	High-level Service Delivery Architecture and Configuration 

 This section provides an
overview of the geographical and physical configuration of Supplier’s Solution for the Services under this Statement of Work. Exhibit A-1.1 (Approved Service Delivery Centers) provides additional information about each of the Service
Delivery Centers Supplier will use to provide the Services under this Statement of Work, including both the primary Service Delivery Centers and the back-up / failover locations that Supplier will activate and use to provide the Services if
operations at any primary Service Delivery Center are disrupted or disabled. 

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-1	  	Health Net / Cognizant Confidential

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 Figure 1 

*Dates represent effective end date of each transition wave. 

 
 

 
 The above diagram illustrates the Supplier’s solution and Onshore/Offshore ratio at the beginning of
Phase 2 to end of Phase 2. Initially, all the Health Net resources will be rebadged and would work out of the current Health Net US locations in Rancho Cordova, Glendale and Woodland Hills. The Transition will happen in two (2) waves as
depicted in the diagram with some of the existing work gradually moving to the Offshore locations of Manila and Cebu in the Philippines. 
  

	3.2	Service Delivery Model 

 This section provides an overview of the commercial delivery
model that the Supplier will utilize to provide the Services under this Statement of Work. As described in Exhibit H (Medical Management Subcontractors), Supplier will not use any Supplier Affiliates or Subcontractors to perform the Services
under this Statement of Work. 
  

	4.	CHANGES TO SUPPLIER’S SOLUTION 

 As a general principle, Supplier has both the right
and the obligation to perform the Services to be provided by it under this Statement of Work in the manner described in this Exhibit A-1 (Medical Management Solution). That said, Supplier is charged with responsibility for the adequacy of its
Solution, which is to say that if the Supplier’s Solution, as described in this Exhibit A-1 (Medical Management Solution), should prove inadequate at any point during the Statement of Work Term 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-2		Health Net / Cognizant Confidential

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 for Supplier to perform and deliver the Services in accordance with the obligations of the
Agreement (including this Statement of Work), then Supplier is responsible for making such changes to its Solution as are necessary to enable Supplier to perform and deliver the Services in accordance with such obligations. All such changes are to
be made in accordance with Schedule H (Change Control Process) of the Agreement, as applicable according to its terms; provided, however, that Supplier is responsible for making such changes at its own cost and expense except in those cases
(if any) in which the Agreement expressly provides that Health Net has Financial Responsibility for them. 
  

	5.	SOLUTION DESCRIPTION 

 Supplier’s solution is built on the following foundational
aspects: 
  

	5.1	Delivery Solution: 

  

	 	•	 	Quality Focus– Supplier’s primary focus will be to maintain seamless continuity of Services. For all processes migrated Offshore, the focus will be to first ensure regulatory compliance and get the
quality right. 

  

	 	•	 	Support ratio – To enable focused monitoring and feedback, Supplier’s delivery model an Personnel to Supervisor and QA ratio Onshore and Offshore as described in Section 7.4 of this exhibit.

  

	 	•	 	Continuous Improvement - Supplier will appoint dedicated Six Sigma resources during the Term to identify sustainable improvement opportunities. The typical ratio will be one (1) Six Sigma resource for every
one hundred fifty (150) FTEs. 

  

	5.2	Risk Mitigated Transition Solution: Knowledge Retention: 

  

	 	•	 	Domain Experts – Supplier will invest in staff (existing and hired) with previous experience in Medical Management Intake Operations, Transition, Training, Quality and Compliance experience.

  

	 	•	 	Health Net Training Academy – During Phase 2 and Phase 3, Supplier’s dedicated Health Net Training Academy will be tasked with the mandate of building / maintaining a Knowledge repository, updating
training and process documentation, providing training to new hire supplier personnel and providing higher level training to experienced resources for Medical Management Intake Operations. Supplier will conduct HIPAA and Health Net mandated
compliance/regulatory training once a year for each FTE to keep supplier personnel up-to date on regulatory, process and system changes. 

Supplier will provide to Health Net a documented report, on a quarterly basis, the FTES that attended trainings including but not limited to
regulatory required trainings. 
 Location Solution: 

Supplier will deliver Intake Services from two locations - US and Philippines. 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-3		Health Net / Cognizant Confidential

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 Exhibit A-1.1 (Approved Service Delivery Centers) describes the on-shore, near-shore
and Offshore Service Delivery Centers that Supplier will use to deliver the Medical Management Intake Services. 
  

	6.	SCOPE OF SERVICES 

 The scope of this Statement of Work is associated with Medical
Management Services described in Exhibit A (Medical Management Services). 
  

	7.	OPERATING MODEL 

 The operating model for Intake operations defines the service delivery
blueprint and key aspects of service delivery. The operating model also describes how the in-scope services will be delivered for each functional process area in a scalable global environment 

 

	7.1	Resource Mix 

 Supplier will leverage its global operating model to meet the objectives
of delivering Intake processes. 
 Supplier has considered the following criteria to define its Onshore/Offshore strategy 

 

	 	•	 	Regulatory requirements 

  

	 	•	 	Non-availability of skills at Offshore 

  

	 	•	 	Health Net mandated Offshore restricted functions 

 Process requiring voice support will be
delivered out of US and Philippines 
 Roles identified to move Offshore will continue to be responsible for current tasks and activities
performed Onshore. 
 The Onshore/Offshore resource mix for Intake operations is listed in the following Table 1: 

Table 1 
  

											
	 Resource Mix

	 Function
	  	Estimated End State
	  	Onshore
%	 	 	Offshore
%	 	 	Location
	 Concurrent Review (CCR)
	  				 				 	
	 Comm/Medicare – WH
	  	 	12.5	% 	 	 	87.5	% 	 	M,Cb,W
	 Comm/Medicare – OR
	  	 	100	% 	 	 	0	% 	 	OR
	 Comm/Medicare – SB
	  	 	0	% 	 	 	100	% 	 	M,Cb
	 CCR SHP – Glendale
	  	 	15	% 	 	 	85	% 	 	M,Cb,GL
	 CCR SHP - Rancho Cordova 
	  	 	25	% 	 	 	75	% 	 	M,Cb,R

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-4	  	Health Net / Cognizant Confidential

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	 Resource Mix

	 Function
	  	Estimated End State
	  	Onshore
%	 	 	Offshore
%	 	 	Location
	 Hospital Notification Unit (HNU)
	  		
	 HNU - All LOBs
	  	 	15	% 	 	 	85	% 	 	M,Cb,W
	 Medical Review Unit (MRU)
	  				 				 	
	 MRU - WH, CA
	  	 	15	% 	 	 	85	% 	 	M,Cb,W
	 MRU - Tigard, OR
	  	 	0	% 	 	 	100	% 	 	M,Cb
	 MRU - Tucson, AZ
	  	 	0	% 	 	 	100	% 	 	M,Cb
	 MRU – Telecommuter
	  	 	0	% 	 	 	100	% 	 	M,Cb
	 Prior Authorization (PCU)
	  				 				 	
	 PCU – AZ
	  	 	15	% 	 	 	85	% 	 	M,Cb,W
	 PCU - SHP Rancho Cordova
	  	 	13	% 	 	 	87	% 	 	M,Cb,W
	 PCU - SHP Glendale
	  	 	12.5	% 	 	 	87.5	% 	 	M,Cb,W
	 PCU - OR,CA
	  	 	10	% 	 	 	90	% 	 	M,Cb,W
	 Total
	  	 	15	% 	 	 	85	% 	 	
	 Total (A+B+C+D)
	  	 	15.00	% 	 	 	85.00	% 	 	

  

			
	 Legends

	 Location
	  	 Code

	Woodland Hills (US)	  	W
	Rancho Cordova (US)	  	R
	Glendale (US)	  	GL
	Arizona (US)	  	AZ
	Oregon (US)	  	OR
	Chennai (India)	  	Ch
	Manila (Philippines)	  	M
	Cebu (Philippines)	  	Cb

 Key Note 
  

	 	•	 	The above percentages are approximate estimates 

  

	 	•	 	The above plan will be finalized as part of the process assessment that will take place during the Transition as described in Transition Manual, with agreement between Health Net and Supplier. 

 

	 	•	 	The estimated end state is expected by December 2015. 

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-5	  	Health Net / Cognizant Confidential

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	 	•	 	As shared in Section 6, above only those roles mandated by Health Net or where skills are not available Offshore will be Onshore. 

 

	 	•	 	As shown in the above table, while a process can span across 4 locations there will be no role within a process which will span across more than 2 locations. 

 

	7.2	Location 

 Supplier will deliver the in-scope Services from US and Philippines based
locations. Onshore Services will be provided from Health Net facilities at Woodland Hills, Glendale and Rancho Cordova. The delivery location strategy has been carefully planned considering multiple criteria. 

Location selection criteria: 
  

	 	•	 	Health Net mandated offshoring staffing 

  

	 	•	 	Availability of talent pool 

  

	 	•	 	Skill requirements 

  

	 	•	 	Regulatory limitations 

  

	 	•	 	Business continuity 

 Table 2 

 

					
	 Sub Function
	  	 Delivery Location
	  	 
	 	  	US	  	Philippines
	 Concurrent Review (CCR)
	  		  	
	 Comm/Medicare - WH
	  	US	  	Manila/Cebu
	 Comm/Medicare - OR
	  	US	  	
	 Comm/Medicare - SB
	  	US	  	Manila/Cebu
	 CCR SHP - Glendale
	  	US	  	Manila/Cebu
	 CCR SHP - Rancho
	  	US	  	Manila/Cebu
	 Hospital Notification Unit (HNU)
	  		  	
	 HNU – All LOBs
	  	US	  	Manila/Cebu
	 Medical Review Unit (MRU)
	  		  	
	 MRU – WH, CA
	  	US	  	Manila/Cebu
	 MRU – Tigard, OR
	  	US	  	
	 MRU – Tucson, AZ
	  	US	  	Manila/Cebu
	 MRU - Telecommuter
	  	US	  	Manila/Cebu
	 Prior Authorization (PCU)
	  		  	
	 PCU – AZ US Manila/ Cebu
	  		  	
	 PCU SHP – Rancho
	  	US	  	Manila/ Cebu
	 PCU SHP – Glendale US Manila/ Cebu
	  		  	
	 PCU – OR,CA
	  	US	  	Manila/ Cebu

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-6	  	Health Net / Cognizant Confidential

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 During Phase 2, Supplier intends to keep Health Net rebadged FTEs at its current location.
Depending on operational constraints and requirements, and subject to any restrictions in this Agreement, Supplier has the right to relocate staff across different locations. 

The teams across locations in US and Philippines, will interact on an ongoing basis to ensure effective planning, monitoring and tracking of
Intake processes, activities and requirements. The following are the key activities that will be performed at each location: 
  

	 	•	 	Forecasting – identifying the number of transactions, volumes and activities that would need to be transacted and processed in coming months 

 

	 	•	 	Capacity Planning- ensure staffing in place to manage the forecasted volumes 

  

	 	•	 	Monitor Productivity- An ongoing daily, weekly, monthly exercise to track, analyze and report on productivity trends 

  

	 	•	 	Reallocation based on productivity – Process wherein the transaction and volumes are shifted within teams and individuals to ensure desired productivity 

 

	 	•	 	Monitor Quality and Service Levels - An ongoing daily, weekly, monthly exercise to track, analyze and report on quality and Service Levels 

The organization structure has been functionally designed in a manner that facilitates effective operations across locations. 

The model ensures that workflow is effective in real time facilitating tactical monitoring. 

 

	7.3	Operating Hours 

 Supplier will at minimum replicate the operating hours currently
adhered to by Health Net’s Medical Management organization as of the Effective Date, as set forth in the table below. Supplier acknowledges and agrees that performance of the Medical Management Services will regularly require Supplier Personnel
to perform additional/overtime work outside regular operating hours, and that such additional/overtime work is within the scope of the Medical Management Services. 

Supplier will extend its hours of operations (for example, through overtime, weekend and holiday work) from time to time as needed to meet
regulatory requirements, Compliance and Service Level metrics and other requirements of the Agreement. Supplier’s work during such extended hours of operations is within the scope of the Medical Management Services. 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-7		Health Net / Cognizant Confidential

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 Within the regular Hours of Operations listed below, Supplier will have staff work according
to defined shift schedules. However, Supplier will make reasonable efforts to permit Supplier staff to work flexible shift times when that can be done without jeopardizing Supplier’s ability to meet regulatory requirements, Compliance and
Service Level metrics and other requirements of the Agreement. 
  

					
	 Sub function
	 	 Weekday - Hours of

Operations (PST)
	  	 Weekend- Hours of

Operations (PST)

	Concurrent Review (CCR)	 		  	
	 Comm/Medicare – WH 
	 	08:00 am to 17:00 pm	  	Need basis support
	 Comm/Medicare – OR
	 	08:00 am to 17:00 pm	  	Need basis support
	 Comm/Medicare – SB 
	 	08:00 am to 17:00 pm	  	Need basis support
	 CCR SHP – Glendale
	 	08:00 am to 17:00 pm	  	Need basis support
	 CCR SHP - Rancho 
	 	08:00 am to 17:00 pm	  	Need basis support
	Hospital Notification Unit (HNU)	 		  	
	 HNU – All LOBs 
	 	08:00 am to 17:00 pm	  	07:00 am to 14:00 pm
	Medical Review Unit (MRU)	 		  	
	 MRU – WH, CA 
	 	08:00 am to 17:00 pm	  	Need basis support
	 MRU – Tigard, OR
	 	08:00 am to 17:00 pm	  	Need basis support
	 MRU – Tucson, AZ 
	 	08:00 am to 17:00 pm	  	Need basis support
	 MRU – Telecommuter
	 	08:00 am to 17:00 pm	  	Need basis support
	Prior Authorization (PCU)	 		  	
	 PCU – AZ
	 	08:00 am to 17:00 pm	  	07:00 am to 14:00 pm
	 PCU SHP – Rancho 
	 	08:00 am to 17:00 pm	  	07:00 am to 14:00 pm
	 PCU SHP – Glendale
	 	08:00 am to 17:00 pm	  	07:00 am to 14:00 pm
	 PCU – OR,CA 
	 	08:00 am to 17:00 pm	  	07:00 am to 14:00 pm

 Table 3 
  

	7.4	Operations 

 Supplier’s approach to manage operations is as follows: 

 

	 	•	 	Operational Focus: Team huddles, floor walks, daily performance reviews, and daily supplier personnel communication plan and customer calibration sessions. 

 

	 	•	 	Performance Management: Measure and manage associate performance through data and service dashboards 

  

	 	•	 	Span of Control: Supplier will provide for the following span of control. 

  

	 	•	 	Manager 1:50 

  

	 	•	 	Supervisor 1:15 

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-8	  	Health Net / Cognizant Confidential

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	 	•	 	QA Auditor 1:15 

  

	 	•	 	Trainer 1:20 (during Phase 2) 

  

	 	•	 	Trainer 1:100 (during steady state/refresher training) 

  

	 	•	 	Six Sigma/ Process Excellence 1:150 

 Health Net Training Academy: 

Supplier will establish a dedicated Health Net Training academy for management of training content and delivery of training programs. Supplier
will establish a Knowledge Management Portal for management and easy access to training content, desktop procedures and P&Ps. The Health Net Training Academy will work closely with the Training operations and facilitate necessary training.
Training material will be continuously updated based on System and process updates. 
 Team Huddle 

Supplier’s team leads will conduct daily team meetings for individual processes to share any critical updates, provide feedback and
communicate lessons learned, and plan for the day. 
 Quality: 

Supplier will implement Health Net mandated specific quality / compliance programs in its delivery model for managing and achieving Service
Levels. Supplier will analyse audit findings to determine root causes and will deploy corrective and preventive solutions to improve quality. In the daily team meetings, prevalent trends in errors, root causes and preventive actions will be
discussed and implemented. 
 Continuous Improvement: 

Supplier will have a dedicated Process Excellence (PEX) team consisting of Six Sigma resources for Health Net Medical Management functions to
optimize performance and handoffs in Health Net Medical Management processes while improving standardization and the “To-Be operating model”. 

Rewards and Recognition 

Supplier will recognize the efforts of its best performers using stack ranking and will reward them through a structured reward and recognition
program that aligns with quality and productivity objectives. The rewards and recognition will be applicable for both Onshore and Offshore teams. The specific criteria for the awards will be decided by the Supplier operations leads depending on the
specific behavior and/or results to be achieved 
  

	7.5	Resource Profile 

 Supplier has a very well defined methodology for recruitment,
retention, and selection of candidates. Supplier will work closely with Health Net to establish job descriptions at various levels and functions. Based on these job descriptions, Supplier will select candidates with the proper qualifications and
experience in order to ensure a “best-fit” for Health Net. 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-9		Health Net / Cognizant Confidential

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 The table below illustrates the requirements and the minimum qualifications required to be
selected for Intake operations. 
 Table 4 
  

			
	 Intake Associate – Data Entry
	  	 
	Qualification & Experience	  	Selection Process
	 •    College graduate

•    Knowledge of US Healthcare and Health Insurance industry

•    Minimum one (1) year of Authorization Intake experience

•    Understanding of different types of medical records, intake documents
	  	 •    Aptitude test

•    Data entry/key board test

•    HR Interview for Cultural fitment

•    Domain / Operations Interview

•    Education and Professional Background Check

	  
	  
	  
	  
	  

 Table 5 
  

			
	 Intake Associate – Provider Outreach
	  	 
	Qualification & Experience	  	Selection Process
	 •    College graduate
	  	 •    Aptitude test

	 •    Knowledge of US Healthcare and Health Insurance industry
	  	 •    Data entry/key board test

	 •    Minimum one (1) year of Authorization Intake and provider/member
outreach or customer service experience
 •    Understanding of different types of medical
records, intake documents
	  	 •    Voice and Accent tests

•    HR Interview for Cultural fitment

•    Domain / Operations Interview

•    Education and Professional Background Check

		  	
	  
	  
	  

 Table 6 
  

			
	 Supervisors
	  	 
	Qualification & Experience	  	Selection Process
	 •    Graduate with four (4) years’ experience in
Healthcare Industry specifically in respective in-scope process
 •    Two (2) years
of Supervisory experience leading teams of at least thirty – forty (30- 40) associates

•    Leadership and communication skills
	  	 •    HR Interview for Cultural fitment

•    Communication skills screening

•    Domain/Operations Interview

•    Education and Professional Background Check

	  
	  
	  
	  
	  
	  

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-10	  	Health Net / Cognizant Confidential

 Final 
  

 Table 7 
  

			
	 Auditors
	  	 
	Qualification & Experience	  	Selection Process
	 •    Graduate with two – three (2-3) years’ experience in Healthcare process
auditors
	  	 •    HR Interview for Cultural fitment

	  	 •    Communication skills screening

	 •    Six Sigma/Lean exposure of at least two (2) years
	  	 •    Domain/ Operations Interview

		  	 •    Education and Professional Background Check

 Table 8 
  

			
	 Trainer
	  	 
	Qualification & Experience	  	Selection Process
	 •    College graduate

•    Knowledge of US Healthcare and Health Insurance industry

•    Minimum one – two (1-2) years of Authorization Intake experience

•    Understanding of different types of medical records, intake documents

•    Must be certified by Supplier Train the Trainer Program

•    Must possess facilitation skills, documentation skills and coaching Skills 
	  	 •    HR Interview for Cultural fitment

•    Training and Communication Skills Screening

•    Domain / Operations Interview

•    Education and Professional Background Check

 Table 9 
  

			
	 Team Manager
	  	 
	Qualification & Experience	  	Selection Process
	 •    Five plus (5+) years’ experience in Healthcare Provider calls/Intake
Process
	  	 •    HR Interview-screening for roles and responsibility

	  	 •    Technical Interview

	 •    Excellent communication and leadership skills
	  	 •    Operations Interview

	 •    Three – four (3-4) years’ experience leading large
teams
	  	 •    HR / Operations Leadership screening for leadership
ability and cultural fit

		  
		  	 •    Education and Professional Background Check

 Table 10 
  

			
	 Delivery Manager
	  	 
	Qualification & Experience	  	Selection Process
	 •    Eight – ten (8-10) years’ experience
	  	 •    Initial screening of profiles by recruitment team

	 •    Excellent communication and leadership skills
	  	 •    Interview with Business Leader/ HR Manager

	 •    Seven – nine (7-9) years of overall BPO experience
with at least six (6) years leading a process in a Healthcare BPO.
	  	 •    Technical/ Communication ability Interview

	  	 •    Screening for leadership ability and cultural fit

	  	 •    Education and Professional Background Check

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-11	  	Health Net / Cognizant Confidential

 Final 
  

	7.6	Voice Solution 

 Health Net expects Supplier to deliver voice assisted member and
provider interactions from either Onshore US or Philippines. 
 Table 11 

 

	
	 Indicative Processes

	Telephonic Intake

  

	7.7	IT Systems 

 The following systems will be used by Supplier for delivery of Medical
Management Intake operations. 
 Table 12 
  

	
	 Intake Applications/Platforms

	ABS
	QCare
	FileNet
	MACESS
	PEGA MARS
	UNITY
	Covergence
	RightFax
	CSI-Eligibility repository
	Lotus Notes
	HNCS – Red Phone
	Intranet – Medical Information and P&Ps
	EPA – Enterprise Administrator
	CDS- Reporting
	Multiple Shared Drive
	AVES
	UPS II
	MGCS
	CMS – Website
	CSI
	PSAS

  

					
	SOW#7 (Medical Management) Exhibit A-1	  	A-1-12	  	Health Net / Cognizant Confidential

 Final 
  

	7.8	Onshore Requirements 

 Section 7 sets forth the Medical Management Services roles
that Supplier is required to retain Onshore. Supplier will at all times provide the Medical Management Services in accordance with Schedule Y (Offshore Prohibitions and Requirements). 

 

	7.9	Service Performance Management 

 Supplier will provide and implement the quality
assurance procedures that are reasonably necessary for the services in scope and as per mutually agreed Service Levels, reporting format and frequency 

Approach 
  

	 	•	 	Initially during the Ramp Up phase, higher percentage of audits will be performed and any feedback on errors will be communicated to the processors on a daily basis 

 

	 	•	 	As the processors gain proficiency, the audit percentage will be gradually reduced 

  

	 	•	 	Post Ramp Up, a statistically valid sample size will be considered for auditing 

 Tools

  

	 	•	 	Supplier will use quality analysis using tools like: 

  

	 	•	 	Pareto Analysis 

  

	 	•	 	Fish Bone Diagram 

  

	 	•	 	Box Plot 

  

	8.	KEY ASSUMPTIONS 

  

	 	(a)	Any work request received directly at Health Net in non-digital format will be batched and sent by Supplier to the scanning/imaging service provider for conversion in to digital format However for regulatory
requirements Onshore supplier personnel will scan the documents locally. 

  

	 	(b)	Health Net to communicate to its supplier personnel that post contracting and prior to re-badging, Supplier will actively engage for detailed Transition planning. 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-13		Health Net / Cognizant Confidential

 Final 
  

	 	(c)	The Onshore/Offshore mix will be validated during detailed Transition Planning as set forth in the Transition Manual. 

  

	 	(d)	Health Net to provide workspace and operating infrastructure for the Onshore train the trainer team documented in Schedule Z (Transition). 

 

	9.	RISKS 

 Additional risks, if any will be identified and shared during Transition as part
of the Processes Assessment exercise. 

  

					
	SOW#7 (Medical Management) Exhibit A-1		A-1-14		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1.1 

APPROVED SERVICE DELIVERY CENTERS 
 The
Service Delivery Centers at (or from) which Supplier is authorized to perform the Services under this Statement of Work are those listed below. Even if Health Net has approved Supplier’s use of an Affiliate or other Subcontractor to perform
certain aspects of the Services, their performance must be from an approved Service Delivery Center listed in this Exhibit A-1.1 (Approved Service Delivery Centers). 

Onshore Service Delivery Centers 

Table 14 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	 Hours of

Operation
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform

/ Systems
	  	 Back-up /
Fail-over
Location
	  	Facility
Operator	  	Facility
Owner	  	Date
Placed
in
Service	  	Multi-
client
Site
(Y/N)?
	 Woodland
 Hills
	  	 Office
 Building
	  	Please refer to section 6.3	  	Medical Management Intake Services	  	English	  	 •    Please refer to section 6.7
	  	Rancho	  		  		  		  	
											
	Rancho	  	 Office
 Building
	  	Please refer to section 6.3	  	Management Intake Services	  	English	  	 •    Please refer to section 6.7
	  	 Woodland
 Hills
	  		  		  		  	
											
	Glendale	  	 Office
 Building
	  	Please refer to section 6.3	  	Management Intake Services	  	English	  	 •    Please refer to section 6.7
	  	 Woodland
 Hills
	  		  		  		  	

 Supplier will provide sufficient coverage for the in-scope services by leveraging the global delivery network. List of
holidays across delivery locations will be mutually agreed with Health Net to ensure no impact on operations. 

  

					
	SOW#7 (Medical Management) Exhibit A-1.1	  	A-1-1-15	  	Health Net / Cognizant Confidential

 Final 
  

 Near-shore Service Delivery Centers 

Table 15 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	 Hours of

Operation
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key Platform /
Systems
	  	 Back-up /
Fail-over
Location
	  	 Facility

Operator
	  	 Facility

Owner
	  	 Date
Placed

in
 Service
	  	 Multi-
client Site
(Y/N)?

	NA	  		  		  		  		  		  		  		  		  		  	

 Offshore Service Delivery Centers 

Table 16 
  

																					
	 Primary

Location
	  	 Type of

Facility
	  	 Hours of

Operation
	  	 Functions /
Services
	  	 Languages

Supported
	  	 Key
Platform /
Systems
	  	 Back-up /
Fail-over
Location
	 	Facility
Operator	 	Facility
Owner	 	Date
Placed
in
Service	 	Multi-
client
Site
(Y/N)?
	 Cognizant Technology Solutions ,
 4th &
5th Floor, Paseo Centre Building,
 8757 Paseo de Roxas corner,

Sedeno
 Street,

Makati
 City 1277
	  	 Office
 Building
	  	 Please refer to section
 6.3
	  	Medical Management Intake Services	  	English	  	 •    Please refer to section 6.7
	  	 Intra-city
 Manila

 
 One World
  

Square Building,
  

Unit A, Mckinley
  

Hill, Fort
  

Bonifacio, Taguig
  

City, Philippines
 -

 
 1634
  

Intercity Cebu
	 	Supplier	 	Third
 Party
	 	2013	 	Y

  

					
	SOW#7 (Medical Management) Exhibit A-1.1	  	A-1-1-16	  	Health Net / Cognizant Confidential

 Final 
  

																					
	 Primary

Location
	 	 Type of

Facility
	 	 Hours of

Operation
	 	 Functions /
Services
	 	 Languages

Supported
	 	 Key Platform /
Systems
	 	 Back-up / Fail-
over Location
	 	Facility
Operator	 	Facility
Owner	 	Date
Placed
in
Service	 	Multi-
client
Site
(Y/
N)?
		 		 		 		 		 		 	 Cognizant
 Technology

Solutions,
 11 & 12 / F Sky Rise 4

Tower,
 Block 2,

Lot 4, Cebu IT Park, Cebu City, Philippines
 6000
	 		 		 		 	
											
	 Cebu
  

Cognizant Technology Solutions,
 11 & 12 / F Sky Rise
4
 Tower,
 Block 2,

Lot 4, Cebu
 IT Park, Cebu City, Philippines

6000 
	 	 Office
 Building
	 	 Please refer to section
 6.3
	 	Medical Management Intake Services	 	English	 	 •    Please refer to section 6.7
	 	 Intercity
 Manila

Cognizant Technology Solutions ,
 4th & 5th

Floor, Paseo
 Centre

Building,
 8757 Paseo de Roxas corner,

Sedeno
 Street,

Makati City 1277
	 		 		 		 	

  

					
	SOW#7 (Medical Management) Exhibit A-1.1	  	A-1-1-17	  	Health Net / Cognizant Confidential

 Final 
  

 Supplier will provide sufficient coverage for the in-scope services by leveraging the global delivery
network. List of holidays across delivery locations will be mutually agreed with Health Net to ensure no impact on operations. 

  

					
	SOW#7 (Medical Management) Exhibit A-1.1		A-1-1-18		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-1.2 

SERVICE DELIVERY CONFIGURATION AT THE COMPLETION OF PHASE 2 

Set out below is a description of Supplier’s ‘To-Be’ Solution for the Services as it will be configured at the completion of Phase 2. 

The tactical ‘To Be’ solution will be mutually defined during the transition phase however below is an illustrative technology environment: 

 
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-1.1		A-1-1-19		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT A-3 

MEDICAL MANAGEMENT ORGANIZATION CHART 

This Exhibit A-3 (Medical Management Organization Chart) contains organization charts showing, at a specific recent point in time prior to the
Effective Date, the positions (including both filled and currently open positions) that represent the Health Net organizational unit(s) whose Functions are being outsourced to Supplier under this Statement of Work. This document is included as part
of this Statement of Work as a supplemental means of depicting the Functions that comprise the Medical Management Services for which Supplier is assuming responsibility from Health Net under this Statement of Work. It is not included for the purpose
of establishing any numerical FTE benchmark or baseline for use in determining Supplier’s Charges for the Medical Management Services. Any changes in the organization charts between the Agreement’s Effective Date and the BPaaS Services
Commencement Date shall not be interpreted to represent a change in the scope of the Medical Management Services in the absence of Health Net specifically adding or removing Functions from Exhibit A (Medical Management Services) of this
Statement of Work. 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-1		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-2		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-3		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-4		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-5		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-6		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-7		Health Net / Cognizant Confidential

 Final 
  

  
 

 

  

					
	SOW#7 (Medical Management) Exhibit A-3		A-3-8		Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT B-1 

MEDICAL MANAGEMENT SERVICE LEVEL METRICS 
  

	1.	MEDICAL MANAGEMENT OPERATIONAL SERVICE LEVELS 

 All Service Levels are subject to the
Service Level Methodology set forth in Schedule B (Service Levels) and the applicable provisions of the Agreement and the Exhibits thereto. 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	1.	  	 Prior Authorization: Intake
  

Routing
	  	 Prior Authorization Intake measures the time it takes to complete or appropriately route each case.

 
 Supplier must process each case received, completing the case approval if appropriate for
Intake team to approve, or routing cases that require Health Net’s retained organization to be involved. Cases that must be referred to Health Net’s retained organization include but are not limited to: CCS, Appeals, referrals for disease
management, Quality of Care (QOC) and CM, Transplants and TOC, Pharmacy as well as SIU.
  

“Urgent Concurrent Review” means an assessment that determines medical necessity or appropriateness of services as they are being rendered, such as
an assessment of the need for continued inpatient care for hospitalized patients or continued outpatient therapy such as physical, or speech therapy. Urgent Concurrent cases need a decision within twenty-four (24) hours of receipt. Intake Team must
complete these and route to the clinical staff with sufficient time in order for the clinical team to render a decision within the overall regulatory required TAT.
	  	Monthly	  	PEGA MARS, Unity/CDS, other.	  	 (a) Baseline% of Urgent Concurrent Review cases Completed or Appropriately Routed in 4 hour or prior to the end of same business day
(whichever is sooner); and
  
 (b) Baseline% of non-Urgent Concurrent Review cases
(e.g. all other prior authorization requests) Completed or Appropriately Routed in 4 hours.
	  	Y	  	TBD	  	C	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-1	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 This Service Level is comprised of two measures (parts (a) and (b) below), and Supplier must meet both measures.

 
 (a)    Urgent Concurrent
Review Case Measure Calculation Numerator: The number of non-duplicate Urgent Concurrent Review cases Completed or Appropriately Routed within 4 hours of Receipt or prior to 6 PM PST (whichever is sooner). Denominator: All non-duplicate Urgent
Concurrent Review cases.
  

(b)    Non-Urgent Concurrent Review Cases (e.g. all other prior authorization requests) Measure
Calculation Numerator: The number of non-duplicate, non-Urgent Concurrent Review cases Completed or Appropriately Routed within 4 hours of Receipt.

Denominator: All non-duplicate, non-Urgent Concurrent Review cases.

 
 “Completed or Appropriately Routed” means all of the intake team’s
responsibilities are complete with regard to such case. The steps required for a case to be Completed or Appropriately Routed vary depending on the case, and may involve closing the case by approving it (if it can be approved without clinical
review), cancelling the request (e.g., if an authorization is not required), or populating the necessary data and routing the request to the clinical team for review.
	  		  		  		  		  		  		  	

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-2	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	“Receipt” means the moment that Supplier receives the request via any method (e.g., phone, web, fax).	  		  		  		  		  		  		  	
										
	2.	  	Prior Authorization Notifications	  	 Prior Authorization Notifications measures the number of Member and Provider prior authorization notifications provided in the appropriate
time and manner.
  
 Supplier must advise Members and Providers of approval of prior
authorization requests, including written and verbal notifications The approval notifications must be communicated verbally to Members and Providers as well as through the generation of appropriate and needed correspondences - to Members and
Providers – as outlined in the regulations and/or Health Net’s policies and procedures.
  

Note: Supplier will be responsible for all approval notifications but not denials.
  

Measure Calculation
 Numerator: The number of cases where
prior authorization notification was provided in the appropriate time and manner (including in Member’s requested language), in accordance with the Procedures Manual. Denominator: All cases requiring prior authorization notification.
	  	Monthly	  	Pega/ MARS, Unity/CDS,	  	Baseline% of all prior authorization notifications provided in appropriate time and manner (including in Member’s requested language).	  	Y	  	TBD	  	C	  	Y
										
	3.	  	 Concurrent
 Review
	  	Long Term Care Urgent and Routine requests received into the Concurrent Review UMC team will be reviewed and given a decision within the timelines of the regulatory guidelines.	  		  	TBD	  	(a) Baseline% of Long Term Care cases Completed	  		  		  	B	  	Y for (a) N for (b)

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-3	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	Notification of decision of these requests must be given as per the compliance guidelines	  		  		  	 within the
 required timelines as outlined in
the compliance regulations; and
  
 (b) 100% of notifications of decision must be
completed within the compliance guidelines
	  		  		  		  	
										
	4.	  	 PCU
  

Phone Service
 Levels
	  	 Prior Authorization Inquiry Status measures the answer time and abandon rate of prior authorization inquiry status calls.

 
 Supplier must receive and respond to inquiries from Members and Providers related to prior
authorizations, including whether a prior authorization is needed and/or the status of a requested prior authorization, and update the applicable Care Management System(s) accordingly.

 
 This Service Level is comprised of three measures (parts (a) and (b) and (c) below), and
Supplier must meet both measures.
  

(a)    Call Answer Time Measure Calculation Numerator: The number of prior authorization
inquiry status calls answered in thirty (30) seconds or less. Denominator: The total number of prior authorization inquiry status calls.
	  	Monthly	  	 Convergence
 Reporting
	  	 (a) Percentage of calls answered in thirty (30) seconds or less

>=Baseline%;
 and

 
 (b) <= 5% abandonment rate.

 
 (c) Average

Talk Time
 <=660 seconds
	  		  		  	B	  	 N for (c) Y for (a)
  

and (b)

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-4	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 (b)    Call Abandon Rate Measure Calculation Numerator: Number of prior
authorization inquiry status calls terminated by the caller prior to Supplier answering the call. Denominator: The total number of prior authorization inquiry status calls.
  

(c)    Average length of calls answered should not exceed 660 seconds
	  		  		  		  		  		  		  	
										
	5.	  	 PCU Batching
 Service Levels
	  	 Batch and route all fax requests received into the Prior Authorization Fax lines for all lines of business within two (2) business hours of
receipt to Health Net.
  
 Items should be checked for request priority and identify
categories as outlined in the Batching Desktop procedures and route to the correct region and unit for processing.
	  	Daily	  	Pega Mars	  	Baseline% of requests received by fax are Batched and routed to the correct business unit within two (2) hours of receipt.	  	Y	  		  	B	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-5	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	6.	  	 HNU Phone
  

Service Levels
	  	 Hospital Notification Status measures the answer time and abandon rate of hospital notification status calls.

 
 Supplier must receive and respond to inquiries related to hospital notifications;
follow-up with hospitals and PPGs based on procedures and as necessary to obtain additional, required information.
  

This Service Level is comprised of three measures (parts (a) and (b) and (c) below), and Supplier must meet both measures.

 
 (a)    Call Answer Time
Measure Calculation Numerator: The number of hospital notification status calls answered in thirty (30) seconds or less. Denominator: The total number of hospital notification status calls.

 
 (b)    Call Abandon Rate
Measure Calculation Numerator: Number of hospital notification status calls terminated by the caller prior to Supplier answering the call. Denominator: The total number of hospital notification status calls

 
 (c)    Average length of
calls answered should not exceed 660 seconds
	  	Monthly	  	 Convergence
 Reporting
	  	 (a) Percentage of calls answered in thirty (30) seconds or less

>= Baseline %;
  

(b) <= 5% abandonment rate; and
  

(c) Average
 Talk Time

<=660 seconds
	  		  		  	B	  	 N for (c)
 Y for (a) and
(b)

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-6	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	7.	  	Hospital Notification Intake and Routing to Clinical Team	  	 Hospital Notification Intake measures the time it takes to make necessary updates to the system related to hospital admissions, including
routing cases as necessary within 4 business hours.
  
 Supplier will receive
notifications of a hospital admission of a Health Net Member from hospitals through various channels, including phone, fax, web & written notifications. Supplier must confirm eligibility, benefits and follow the documented Health Net procedures
for case set up and routing as necessary to the clinical team.
  
 Measure
Calculation
 Numerator: The number of updates related to hospital admissions entered into the Medical Management system (and routed if

necessary) within 4 business hours
 (measured Monday through
Saturday, 5 am –
 6 pm PST) of receipt.
 Denominator: The
total number of updates related to hospital admissions requiring entry in the Medical Management system.
	  	Monthly (with daily reporting of Service Level volumes and compliance)	  	Lotus Fax/Right Fax, manual reporting, CDS	  	Baseline% of all updates related to hospital admissions entered into the Medical Management system (and routed if necessary) within 4 hours of receipt.	  	TBD	  	TBD	  	C	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-7	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	8.	  	 Hospital
 Notification

 
 Batching

Service Levels
	  	 Batch and route all fax requests received into the Hospital Notification Fax lines for all lines of business within two (2) business hours of
receipt to Health Net.
  
 Items should be checked for request priority and identify
categories as outlined in the Batching Desktop procedures and route to the correct region and unit for processing.
  

Identify Long Term Care requests and route to the correct Hospital Notification processors for entry and routing
	  	Daily	  	Lotus Fax/Right Fax, manual reporting,	  	Baseline% of requests received by fax are Batched and routed to the correct business unit within two (2) hours of receipt.	  	Y	  		  	B	  	Y
										
	9.	  	 Hospital
 Notification

Long Term
  

Care Processing
	  	Cases identified as Long Term Care services will be entered and routed based on the Long Term Care routing guidelines within four (4) business hours of receipt to Health Net.	  	Daily	  	 Lotus Fax/Right Fax, manual reporting,

CDS,
	  	Baseline% of Long Term Care requests received are processed and routed within four (4) business hours of receipt to Health Net.	  		  		  	B	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-8	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	10.	  	 Hospital
 Notification

 
 Routing

Guidelines
	  	 All routing guidelines will be followed for cases that are being sent to the CCR UMC’s or the CCR Clinical staff. Routing guidelines are
updated by the clinical staff and can be changed at any time.
  
 Implementation of any
changes will need to be rolled out to the HNU Intake teams within one (1) business day of the changes made.
	  	Daily	  	TBD	  	 Baseline% of changes made to the Routing Rules will be

implemented to the intake staff within one (1) business day.
	  		  		  	B	  	Y
										
	11.	  	 Hospital
 Notification

 
 Arizona Access Newborn Notification Entry
	  	All Newborn Notifications received into Health Net from any facility will be entered into the Arizona Access State Website as well as the Medical Management Authorization System within twenty-four (24) hours of receipt into Health
Net.	  	Daily	  	Lotus Fax/Right Fax, manual reporting, CDS	  	Baseline% of Newborn Notification requests received are entered within twenty-four (24) hours of receipt	  		  	`	  	B	  	Y
										
	12.	  	MRU Claims – Inquiry Response Time	  	 Inquiry Response Time measures the time it takes for a PSR (or MRU Representative) to respond to a claims submission request.

 
 Inquiry Response Time is calculated by dividing (i) the number of inquiries with a
Response Time of one (1) Business Days or less by (ii) the number of inquiries.
  

“Response Time” means the time between (i) when a message is Received by the Medical Review Unit to (ii) when a PSR responds to the
Request and sent back to the in the medium of the Customers choice.
	  	Daily	  	 Macess, File
 Net
	  	Baseline% of inquiries responded to within one (1) Business Day	  	Y	  		  	B	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-9	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 “Received” means, for purposes of this

Service Level, that point in time when an inquiry has entered into the Contact Center work queue.

 
	  		  		  		  		  		  		  	
	13.	  	Post Service Intake Routing and Responding to Inquiries/Requests	  	 Post Service Intake measures the number of post service requests responded to in a timely fashion, including routing to the Clinical team as
necessary.
  
 Supplier must receive requests from the Claims Tower to review for coverage
determinations. (Examples: authorization date does not match claim received date or if a medically necessary determination is required.) Intake Team must perform the initial review and gather required information to update the request or service
form and complete the request including the return of the case to Claims for adjudication. Intake may also gather information as needed by the RN team to review the case for clinical review such as medical necessity determinations.

 
 Note: Cases that must be referred to Health Net’s retained organization include but
are not limited to: CCS, Appeals, referrals for disease management, Quality of Care (QOC) and CM, Transplants and TOC as well as SIU.
  

This Service Level is comprised of three measures (parts (a), (b), and (c) below), and Supplier must meet each measure.

 
 (a)    Clinical Review
Routing Measure Calculation
	  	Monthly	  	 MACESS and
 FileNet, Unity
	  	 (a) Baseline% of post service requests requiring Clinical review will be triaged and routed to Health Net within 4 Business Hours;

 
 (b) Baseline% of post service requests escalated from Claims which do not require
Clinical review completed within twenty- four (24) hours and
  
 (c) Baseline% of
post service requests which do not require Clinical review and are not escalated from Claims completed
	  	TBD	  	TBD	  	C	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-10	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 Numerator: The number of post service requests routed for Clinical review within 4 Business Hours of receipt.
Denominator: The total number of post service requests which need to be routed for Clinical review.
  

(b)    Escalation from Claims Measure Calculation

 
 Numerator: The number of post service requests escalated from Claims
that are completed within twenty-four (24) hours of receipt.
 Denominator: The total number of post service requests escalated from
Claims.
  
 (c)    Routine
Measure Calculation Numerator: The number of routine post service requests completed within nine (9) calendar days of receipt. Denominator: The total number of routine post service requests.
	  		  		  	 within nine (9)
 calendar days.
	  		  		  		  	
										
	14.	  	 MRU
  

Phone Service
 Levels
	  	Outbound Calls—Average length of calls answered should not exceed 660 seconds	  	Daily	  	 Convergence
 Reports
	  	 Average Talk Time of calls should be
 <=660
seconds
	  		  		  	B	  	N
										
	15.	  	 Concurrent
 Review Support
	  	Outbound Calls—Average length of calls answered should not exceed 660 seconds	  	Daily	  	 Convergence
 Reports
	  	 Average Talk Time of calls should be
 <=660
seconds
	  		  		  	B	  	N
										
	16.	  	 Concurrent
 Review Support
	  	 Concurrent Review Support measures admission status, discharge disposition, timely RN escalations, and timely system updates of
authorizations.
  
 Supplier must proactively communicate with
	  	Monthly (with daily reporting of Service Level volumes and	  	CDS	  	(a) Baseline% of hospital admissions on daily work list confirmed within four (4)	  	TBD	  	TBD	  	C	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-11	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 the hospitals to track the Member’s status and timing of discharge. Supplier must update the applicable Care Management System(s)
accordingly and route information to the Clinical Review teams.
  
 Supplier must call and
confirm on all hospital admissions within 4 business hours of receiving daily work list for routine cases. Supplier must notify RNs within two (2) business hours of escalated items. Supplier must prepare or update needed authorizations within four
(4) hours of receiving the input.
  
 Note: Cases that must be referred to Health
Net’s retained organization include but are not limited to: CCS, Appeals, referrals for disease management, Quality of Care (QOC) and CM, Transplants and TOC as well as SIU.

 
 This Service Level is comprised of three measures (parts (a), (b), and (c) below), and
Supplier must meet each measure.
  

(a)    Daily Work List Measure Calculation Numerator: The number of non- duplicate hospital
admissions on daily work list confirmed within 4 Business Hours.
 Denominator: The total number of non- duplicate hospital admissions on
daily work list.
  

(b)    RN Escalation Measure Calculation Numerator: The number of cases requiring RN
escalation that are routed within 4 Business Hours.
 Denominator: The total number of cases requiring RN escalation.
	  	compliance)	  		  	 Business
 Hours;

 
 (b) Baseline% of cases requiring RN escalation routed within

two (2)Business
 Hours; and

 
 (c) Baseline% of requested authorizations updated in the system within four (4)
Business Hours of request.
	  		  		  		  	

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-12	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	  

(c)    Authorization Measure Calculation Numerator: The number of requested authorizations
updated in the system within 4 Business Hours of request. Denominator: The total number of requested authorizations requiring system updates.
	  		  		  		  		  		  		  	
										
	17.	  	Concurrent Review UMC Team	  	 Long Term Care request Processes must be completed as outlined below:

 
 (a)    Perform calls to
providers and facilities after 14 days if no TAR or MDS has been received.
  

(b)    Monthly calls are made to the facilities for members who have been identified as potential
LTC members to determine if member is indeed a Long Term Care member. Supplier to communicate outcome from these calls to Health Net contacts prior to the 15th of the month. Desktop outlines the communication protocol.

 
 (c)    Members who are in
Long Term Care, Facility reach out will be performed (thirty) 30 days prior to all Long Term Care Authorizations are set to expire. Calls are made as a reminder for the facility/provider to send in requests for further authorization of
services.
	  	Daily	  	TBD	  	 (a) Baseline% of calls to be made to facilities requesting TAR or MDS.

 
 (b) Baseline% of calls to be made to facilities to identify potential LTC members
prior to the tenth (10th) of each month
  
 (c) Baseline% of calls to be made to
facilities for members in LTC as a reminder to send in authorization request within thirty (30) days
 of authorization expiration date
	  		  		  	B	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-13	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

	18.	  	 Quality – Quality Monitoring Average
  

MRU, PCU, CCR Intake, HNU
	  	 Quality Monitoring Average measures the quality of intake support, including the accuracy of information documented in the Medical Management
Systems, adherence to established procedures and customer relations with outside providers/members or with Health Net Clinical staff.
  

Supplier will perform a minimum of ten (10) audits per associate per month for all applicable established channels of interaction (e.g., email, fax receipts,
Service Form, phone calls, etc.). For each monitored interaction Supplier will complete a scorecard as approved by Health Net. Supplier will rate each UMC, PSR performance using the scorecard in a fair, accurate and consistent manner. Scoring for
each interaction will be calculated by dividing (i) the total number of quality attributes passed by the UMC/PSR, by (ii) the total number of quality attributes measured (0% to 100%).

 
 At Health Net’s request, from time to time, the parties will conduct calibration
sessions in which a sampling of interactions will be jointly monitored and rated by both parties to ensure consistency in the rating of performance. At the end of the measurement period, Supplier will calculate the average score received by each
UMC/PSR during the measurement period (“UMC/PSR Average Score”).
	  	Monthly	  	TBD	  	 All LOBs
  

Quality Monitoring Average
  

>= 97.5%
	  	Y	  		  	B	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-14	  	Health Net / Cognizant Confidential

 Final 
  

																			
	 #
	  	 Category
/ Name
	  	 Description
	  	 Measurement

Period
	  	 Measurement

Tool
	  	 Service Level
	  	 Critical

(Y/N)
	  	 Weighting

Factor
	  	 Code
	  	 Continuous

Improve

		  		  	 Quality Monitoring Average will be calculated by dividing (i) the sum of the UMC/PSR Average Scores, by (ii) the total number of UMC/PSR
whose requests were monitored and scored.
  
	  		  		  		  		  		  		  	
	19.	  	Quality – Customer Satisfaction MRU, PCU, CCR Intake, HNU	  	 Customer Satisfaction measures the level of Customer satisfaction in their interactions with the Medical Management Intake teams. Supplier
shall administer surveys to a random sample of Providers/Facilities who have had a recent contact with the Medical Management Intake Teams.
  

Customer Satisfaction is calculated by dividing (i) the total number of Survey responses with overall ratings of [Baseline] (i.e. “very
satisfied” or “extremely
 satisfied”), by (ii) the total number of Survey responses. Minimum number of respondents for the metric to be
valid, to be mutually
 agreed between Health Net and Supplier
	  	Quarterly	  	TBD	  	 All LOBs
  

>= 90%
	  	Y	  		  	C	  	Y

  

					
	SOW#7 (Medical Management) Exhibit B-1	  	B-1-15	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT D 

KEY SUPPLIER PERSONNEL 
 Subject to
Section 7.4 (Key Supplier Positions) of the Terms and Conditions, the following positions shall be Key Supplier Positions filled by the individuals listed in the table below. 

 

			
	 Key Supplier Position
	  	 Initially Approved Individual

	Supervisor, CCR Support Medi-Cal	  	TBD
	MRU – Arizona	  	TBD
	MRU - Oregon	  	TBD
	Supervisor PCU – Medi-Cal and CMC/Duals	  	TBD

  

					
	SOW#7 (Medical Management) Exhibit D	  	D-1	  	Health Net / Cognizant Confidential

 Final 
  

 EXHIBIT H 

SUBCONTRACTORS 
  

	1.	INTRODUCTION 

 With reference to Section 7.7 (Subcontracting) of the Terms
and Conditions, this Schedule H (Subcontractors) identifies the Subcontractors who are Approved Subcontractors for the purposes of this Statement of Work as of the Effective Date with respect to the Functions of each Subcontractor set forth
below. 
  

	2.	APPROVED SUBCONTRACTORS 

  

					
	 Approved Subcontractor
	  	 Address
	  	 Functions

	***	  		  	

  

					
	SOW#7 (Medical Management) Exhibit H	  	H-1	  	Health Net / Cognizant ConfidentialExhibit 4.6

 

EAGLE BANCORP, INC.

 

Issuer

 

and

 

[                                 ]

 

Trustee

 

SENIOR INDENTURE

 

Dated as of [               ], 20[    ]

 

Senior Debt Securities

 

 

TABLE OF CONTENTS

 

	
 
    	
 
    	
Page
    
	
 
    	
 
    	
 
    
	
ARTICLE ONE
    	
DEFINITIONS AND OTHER PROVISIONS   OF GENERAL APPLICATION
    	
 
    
	
 
    	
 
    	
 
    
	
Section 1.01
    	
Definitions
    	
1
    
	
Section 1.02
    	
Compliance   Certificates and Opinions
    	
6
    
	
Section 1.03
    	
Form of   Documents Delivered to Trustee
    	
6
    
	
Section 1.04
    	
Acts   of Holders
    	
6
    
	
Section 1.05
    	
Notices, Etc.,   to Trustee and Company
    	
7
    
	
Section 1.06
    	
Notice   to Holders; Waiver
    	
8
    
	
Section 1.07
    	
Language   of Notices
    	
8
    
	
Section 1.08
    	
Conflict   With Trust Indenture Act
    	
8
    
	
Section 1.09
    	
Effect   of Headings and Table of Contents
    	
8
    
	
Section 1.10
    	
Successors   and Assigns
    	
8
    
	
Section 1.11
    	
Separability   Clause
    	
8
    
	
Section 1.12
    	
Benefits   of Indenture
    	
8
    
	
Section 1.13
    	
Governing   Law
    	
8
    
	
Section 1.14
    	
Legal   Holidays
    	
8
    
	
Section 1.15
    	
When   Securities Disregarded
    	
9
    
	
Section 1.16
    	
USA   Patriot Act
    	
9
    
	
 
    	
 
    	
 
    
	
ARTICLE TWO
    	
SECURITIES   FORMS
    	
 
    
	
 
    	
 
    	
 
    
	
Section 2.01
    	
Forms   Generally
    	
9
    
	
Section 2.02
    	
Form of   Trustee’s Certificate of Authentication
    	
9
    
	
Section 2.03
    	
Securities   in Global Form
    	
9
    
	
 
    	
 
    	
 
    
	
ARTICLE THREE
    	
THE   SECURITIES
    	
 
    
	
 
    	
 
    	
 
    
	
Section 3.01
    	
Amount   Unlimited; Issuable in Series
    	
10
    
	
Section 3.02
    	
Denominations
    	
12
    
	
Section 3.03
    	
Securities   in Foreign Countries
    	
12
    
	
Section 3.04
    	
Execution,   Authentication, Delivery and Dating
    	
12
    
	
Section 3.05
    	
Temporary   Securities
    	
13
    
	
Section 3.06
    	
Registration,   Transfer and Exchange
    	
13
    
	
Section 3.07
    	
Mutilated,   Destroyed, Lost and Stolen Securities
    	
15
    
	
Section 3.08
    	
Payment   of Interest; Interest Rights Preserved
    	
15
    
	
Section 3.09
    	
Persons   Deemed Owners
    	
16
    
	
Section 3.10
    	
Cancellations
    	
16
    
	
Section 3.11
    	
Computation   of Interest
    	
16
    
	
Section 3.12
    	
Cusip   Numbers
    	
16
    
	
 
    	
 
    	
 
    
	
ARTICLE FOUR
    	
SATISFACTION   AND DISCHARGE
    	
 
    
	
 
    	
 
    	
 
    
	
Section 4.01
    	
Satisfaction   and Discharge of Indenture
    	
17
    
	
Section 4.02
    	
Application   of Trust Money
    	
17
    
	
Section 4.03
    	
Satisfaction,   Discharge and Defeasance of Securities of Any Series
    	
18
    
	
 
    	
 
    	
 
    
	
ARTICLE FIVE
    	
REMEDIES
    	
 
    
	
 
    	
 
    	
 
    
	
Section 5.01
    	
Events   of Default
    	
19
    
	
Section 5.02
    	
Acceleration   of Maturity; Rescission and Annulment
    	
19
    
	
Section 5.03
    	
Collection   of Indebtedness and Suits For Enforcement by Trustee
    	
20
    
	
Section 5.04
    	
Trustee   May File Proofs of Claim
    	
21
    

 

i

 

	
Section 5.05
    	
Trustee   May Enforce Claims Without Possession of Securities
    	
21
    
	
Section 5.06
    	
Application   of Money Collected
    	
21
    
	
Section 5.07
    	
Limitation   on Suits
    	
22
    
	
Section 5.08
    	
Unconditional   Right of Holders to Receive Principal, Premium, Interest and Additional   Amounts
    	
22
    
	
Section 5.09
    	
Restoration   of Rights and Remedies
    	
22
    
	
Section 5.10
    	
Rights   and Remedies Cumulative
    	
22
    
	
Section 5.11
    	
Delay   or Omission Not Waiver
    	
22
    
	
Section 5.12
    	
Control   By Holders
    	
23
    
	
Section 5.13
    	
Waiver   of Past Defaults
    	
23
    
	
Section 5.14
    	
Waiver   of Stay or Extension Laws
    	
23
    
	
 
    	
 
    	
 
    
	
ARTICLE SIX
    	
THE   TRUSTEE
    	
 
    
	
 
    	
 
    	
 
    
	
Section 6.01
    	
Certain   Duties and Responsibilities
    	
23
    
	
Section 6.02
    	
Notice   of Defaults
    	
23
    
	
Section 6.03
    	
Certain   Rights of Trustee
    	
24
    
	
Section 6.04
    	
Not   Responsible For Recitals or Issuance of Securities
    	
24
    
	
Section 6.05
    	
May Hold   Securities
    	
25
    
	
Section 6.06
    	
Money   Held In Trust
    	
25
    
	
Section 6.07
    	
Compensation   and Reimbursement
    	
25
    
	
Section 6.08
    	
Corporate   Trustee Required; Eligibility; Conflicting Interests
    	
25
    
	
Section 6.09
    	
Resignation   and Removal; Appointment of Successor
    	
25
    
	
Section 6.10
    	
Acceptance   of Appointment By Successor
    	
26
    
	
Section 6.11
    	
Merger,   Conversion, Consolidation or Succession to Business
    	
27
    
	
Section 6.12
    	
Appointment   of Authenticating Agent
    	
27
    
	
 
    	
 
    	
 
    
	
ARTICLE SEVEN
    	
HOLDERS’   LISTS AND REPORTS BY TRUSTEE AND COMPANY
    	
 
    
	
 
    	
 
    	
 
    
	
Section 7.01
    	
Company   to Furnish Trustee Names and Addresses of Holders
    	
29
    
	
Section 7.02
    	
Preservation   of Information; Communications to Holders
    	
29
    
	
Section 7.03
    	
Reports   By Trustee
    	
29
    
	
Section 7.04
    	
Reports   By Company
    	
29
    
	
 
    	
 
    	
 
    
	
ARTICLE EIGHT
    	
CONSOLIDATION,   MERGER AND SALES
    	
 
    
	
 
    	
 
    	
 
    
	
Section 8.01
    	
Company   May Consolidate Etc., Only on Certain Terms
    	
30
    
	
Section 8.02
    	
Successor   Corporation Substituted For Company
    	
30
    
	
 
    	
 
    	
 
    
	
ARTICLE NINE
    	
SUPPLEMENTAL   INDENTURES
    	
 
    
	
 
    	
 
    	
 
    
	
Section 9.01
    	
Supplemental   Indentures Without Consent of Holders
    	
30
    
	
Section 9.02
    	
Supplemental   Indentures With Consent of Holders
    	
31
    
	
Section 9.03
    	
Execution   of Supplemental Indentures
    	
32
    
	
Section 9.04
    	
Effect   of Supplemental Indentures
    	
32
    
	
Section 9.05
    	
Conformity   With Trust Indenture Act
    	
32
    
	
Section 9.06
    	
Reference   in Securities to Supplemental Indentures
    	
32
    
	
 
    	
 
    	
 
    
	
ARTICLE TEN
    	
COVENANTS
    	
 
    
	
 
    	
 
    	
 
    
	
Section 10.01
    	
Payment   of Principal, Premium, If Any, and Interest
    	
32
    
	
Section 10.02
    	
Maintenance   of Office or Agency
    	
32
    
	
Section 10.03
    	
Money   For Securities Payments to Be Held in Trust
    	
33
    
	
Section 10.04
    	
Additional   Amounts
    	
34
    
	
Section 10.05
    	
Statements   As To Compliance; Notice of Certain Defaults
    	
34
    
	
Section 10.06
    	
Payment   of Taxes and Other Claims
    	
34
    

 

ii

 

	
Section 10.07
    	
Corporate   Existence
    	
35
    
	
Section 10.08
    	
Waiver   of Certain Covenants
    	
35
    
	
Section 10.09
    	
Calculation   of Original Issue Discount
    	
35
    
	
 
    	
 
    	
 
    
	
ARTICLE ELEVEN
    	
REDEMPTION   OF SECURITIES
    	
 
    
	
 
    	
 
    	
 
    
	
Section 11.01
    	
Applicability   of Article
    	
35
    
	
Section 11.02
    	
Election   To Redeem; Notice To Trustee
    	
35
    
	
Section 11.03
    	
Selection   By Trustee of Securities To Be Redeemed
    	
35
    
	
Section 11.04
    	
Notice   of Redemption
    	
36
    
	
Section 11.05
    	
Deposit   of Redemption Price
    	
36
    
	
Section 11.06
    	
Securities   Payable on Redemption Date
    	
37
    
	
Section 11.07
    	
Securities   Redeemed in Part
    	
37
    
	
Section 11.08
    	
Conversion   Arrangements on Call for Redemption
    	
37
    
	
 
    	
 
    	
 
    
	
ARTICLE TWELVE
    	
SINKING   FUNDS
    	
 
    
	
 
    	
 
    	
 
    
	
Section 12.01
    	
Applicability   of Article
    	
38
    
	
Section 12.02
    	
Satisfaction   of Sinking Fund Payments With Securities
    	
38
    
	
Section 12.03
    	
Redemption   of Securities For Sinking Fund
    	
38
    

 

iii

 

EAGLE BANCORP, INC.

 

Certain Sections of this Indenture relating to Sections 310 through 318, inclusive, of the Trust Indenture Act of 1939:

 

	
TRUST INDENTURE ACT SECTION
    	
 
    	
INDENTURE SECTION
    
	
§310(a)(1), (2) and (5)
    	
 
    	
6.07
    
	
(a)(3)
    	
 
    	
Not   Applicable
    
	
(a)(4)
    	
 
    	
Not   Applicable
    
	
(b)
    	
 
    	
6.07
    
	
§311(a)
    	
 
    	
6.12
    
	
(b)
    	
 
    	
6.12
    
	
§312(a)
    	
 
    	
7.01,   7.02(a)
    
	
(b)
    	
 
    	
7.02(b)
    
	
(c)
    	
 
    	
7.03
    
	
§313(a)
    	
 
    	
1.08
    
	
(b)
    	
 
    	
7.03
    
	
(c)
    	
 
    	
7.03
    
	
(d)
    	
 
    	
7.04
    
	
§314(a)(1), (2) and (3)
    	
 
    	
7.04,   7.03
    
	
(a)(4)
    	
 
    	
7.04
    
	
(b)
    	
 
    	
Not   Applicable
    
	
(c)(1)
    	
 
    	
1.02
    
	
(c)(2)
    	
 
    	
1.02
    
	
(c)(3)
    	
 
    	
Not   Applicable
    
	
(d)
    	
 
    	
Not   Applicable
    
	
(e)
    	
 
    	
1.02
    
	
§315(a)
    	
 
    	
6.01
    
	
(b)
    	
 
    	
6.02
    
	
(c)
    	
 
    	
6.01
    
	
(d)
    	
 
    	
6.01
    
	
(e)
    	
 
    	
6.06
    
	
§316(a)
    	
 
    	
5.12,   5.13
    
	
(b)
    	
 
    	
5.08
    
	
(c)
    	
 
    	
1.04
    
	
§317(a)
    	
 
    	
5.03,   5.04
    
	
(b)
    	
 
    	
10.03
    
	
§318(a)
    	
 
    	
1.08
    

 

iv

 

SENIOR INDENTURE, dated as of [               ], 20[   ] (the “Indenture”), is made by and between EAGLE BANCORP, INC., a corporation duly organized and existing under the laws of the State of Maryland (the “Company”), having its principal office at 7815 Woodmont Avenue, Bethesda, Maryland 20814, and [                    ], having its principal office at [                ], not in its individual capacity but solely as Trustee (the “Trustee”).

 

RECITALS

 

The Company has duly authorized the execution and delivery of this Indenture to provide for the issuance from time to time of its unsecured and unsubordinated debentures, notes or other evidences of indebtedness (the “Securities”), unlimited as to principal amount, to bear such rates of interest, to mature at such time or times, to be issued in one or more series and to have such other provisions as shall be fixed as hereinafter provided.

 

The Company has duly authorized the execution and delivery of this Indenture and all things necessary to make this Indenture a valid agreement of the Company, in accordance with its terms, have been done.

 

This Indenture is subject to the provisions of the Trust Indenture Act of 1939, as amended, that are required to be part of this Indenture and shall, to the extent applicable, be governed by such provisions.

 

NOW, THEREFORE, THIS INDENTURE WITNESSETH:

 

For and in consideration of the premises and the purchase of the Securities by the Holders thereof, it is mutually covenanted and agreed, for the equal and proportionate benefit of all Holders of the Securities or of series thereof, as follows:

 

ARTICLE ONE

 

DEFINITIONS AND OTHER PROVISIONS OF GENERAL APPLICATION

 

Section 1.01. Definitions.

 

For all purposes of this Indenture, except as otherwise expressly provided or unless the context otherwise requires:

 

(1) the terms defined in this Article have the meanings assigned to them in this Article, and include the plural as well as the singular;

 

(2) all other terms used herein which are defined in the Trust Indenture Act, either directly or by reference therein, have the meanings assigned to them therein;

 

(3) all accounting terms not otherwise defined herein have the meanings assigned to them in accordance with generally accepted accounting principles and, except as otherwise herein expressly provided, the term “generally accepted accounting principles” with respect to any computation required or permitted hereunder shall mean such accounting principles as are generally accepted at the date of such computation;

 

(4) the words “herein”, “hereof”, “hereto” and “hereunder” and other words of similar import refer to this Indenture as a whole and not to any particular Article, Section or other subdivision;

 

(5) the word “or” is not exclusive;

 

(6) all words in the singular include the plural and all words in the plural include the singular; and

 

(7) the word “including” means “including without limitations.”

 

Certain terms used principally in certain Articles hereof are defined in those Articles.

 

“Act”, when used with respect to any Holders, has the meaning specified in Section 1.04.

 

“Additional Amounts” means any additional amounts which are required hereby or by any Security, under circumstances specified herein or therein, to be paid by the Company in respect of certain taxes imposed on Holders specified therein and which are owing to such Holders.

 

“Affiliate” of any specified Person means any other Person directly or indirectly controlling or controlled by or under direct or indirect common control with such specified Person. For the purposes of this definition, “control”, when used with respect to any specified Person means the power to direct the management and policies of such Person, directly or indirectly, whether through the ownership of voting Securities, by contract or otherwise; and the terms “controlling” and “controlled” have the meanings correlative to the foregoing.

 

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“Authenticating Agent” means any Person authorized by the Trustee pursuant to Section 6.12 to act on behalf of the Trustee to authenticate Securities of one or more series.

 

“Bank” means (i) any institution organized under the laws of the United States, any State of the United States, the District of Columbia, any territory of the United States, Puerto Rico, Guam, American Samoa or the Virgin Islands which (a) accepts deposits that the depositor has a legal right to withdraw on demand, and (b) engages in the business of making commercial loans and (ii) any trust company organized under any of the foregoing laws.

 

“Board Of Directors” means the board of directors of the Company or any committee of that board duly authorized to act for the Company hereunder.

 

“Board Resolution” means a copy of a resolution certified by the Secretary or an Assistant Secretary of the Company to have been duly adopted by the Board of Directors, or a duly authorized committee thereof, and to be in full force and effect on the date of such certification, and delivered to the Trustee.

 

“Business Day”, except as may otherwise be provided herein or in any Security, means any day, other than a Saturday or a Sunday, that is neither a Legal Holiday nor a day on which banking institutions are authorized or required by law, regulation or executive order to close.

 

“Called Securities” means any Convertible Security that is called for redemption by the Company.

 

“Capital Stock” means, as to shares of a particular corporation, outstanding shares of stock of any class whether now or hereafter authorized, irrespective of whether such class shall be limited to a fixed sum or percentage in respect of the rights of the holders thereof to participate in dividends and in the distribution of assets upon the voluntary liquidation, dissolution or winding up of such corporation.

 

“Commission” means the Securities and Exchange Commission, as from time to time constituted, created under the Securities Exchange Act of 1934 or, if at any time after the execution of this Indenture such Commission is not existing and performing the duties now assigned to it under the Trust Indenture Act, then the body performing such duties at such time.

 

“Common Stock” means all shares now or hereafter authorized of the class of common stock of the Company presently authorized and stock of any other class into which such shares may hereafter have been changed.

 

“Company” means the Person named as the “Company” in the first paragraph of this instrument until a successor corporation shall have become such pursuant to the applicable provisions of this Indenture, and thereafter “Company” shall mean such successor corporation, and any other obligor upon the Securities.

 

“Company Request” and “Company Order” mean a written request or order, as the case may be, signed in the name of the Company by the Chairman of the Board of Directors, the Chief Executive Officer, the Chief Operating officer, the President or an Executive Vice President, and by the Chief Financial Officer, Treasurer, an Assistant Treasurer, the Secretary or an Assistant Secretary of the Company, and delivered to the Trustee.

 

“Convertible Security” or “Convertible Securities” means any Security or Securities, as the case may be, which are by their terms convertible into Common Stock, Preferred Stock (which may be represented by depositary shares), other indebtedness of the Company or another obligor, or warrants for Common Stock, Preferred Stock or indebtedness or other securities of any kind of the Company or any other obligor, and the terms and conditions upon which such conversion or exchange shall be effected, including the initial conversion or exchange price or rate, the conversion or exchange period, the manner in which such conversion or exchange shall be effected, applicable adjustments, if any, and any other provision in addition to or in lieu of those described herein.

 

“Corporate Trust Office” means, the principal office of the Trustee, at which at any particular time its corporate trust business shall be administered, which office at the date of original execution of this Indenture is located at [ ].

 

“Corporation” includes corporations, associations, companies and business trusts.

 

“Defaulted Interest” has the meaning specified in Section 3.08.

 

“Dollars” or “$” means a dollar or other equivalent unit in the currency of the United States, except as may otherwise be provided herein or in any Security.

 

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“Event of Default” has the meaning specified in Section 5.01.

 

“Holder”, in the case of any Security, means the Person in whose name such Security is registered in the Security Register.

 

“Indenture” means this instrument as originally executed or as it may from time to time be supplemented or amended by one or more indentures supplemental hereto entered into pursuant to the applicable provisions hereof, and with respect to any Security shall include the terms of such Securities established as contemplated by Section 3.01; provided, however, that, if at any time more than one Person is acting as Trustee under this instrument, “Indenture” shall mean, with respect to any one or more series of Securities for which such Person is Trustee, this instrument as originally executed or as it may from time to time be supplemented or amended by one or more indentures supplemental hereto entered into pursuant to the applicable provisions hereof and shall include the terms of the or those particular series of Securities for which such Person is Trustee established as contemplated by Section 3.01, exclusive, however, of any provisions or terms which relate solely to other series of Securities for which such Person is Trustee, regardless of when such terms or provisions were adopted, and exclusive of any provisions or terms adopted by means of one or more indentures supplemental hereto executed and delivered after such Person had become such Trustee but to which such Person, as such Trustee, was not a party.

 

“Independent Public Accountants” means accountants or a firm of accountants that are independent public accountants with respect to the Company within the meaning of the Securities Act of 1933, as amended, and the rules and regulations promulgated by the Commission thereunder who may be the independent public accountants regularly retained by the Company or who may be other independent public accountants. Such accountants or firm shall be entitled to rely upon any Opinion of Counsel as to the interpretation of any legal matters relating to the Indenture or certificates required to be provided hereunder.

 

“Interest”, with respect to any Original Issue Discount Security which by its terms bears interest only after Maturity, means interest payable after Maturity and, with respect to any Security which provides for the payment of Additional Amounts pursuant to Section 10.04, includes such Additional Amounts.

 

“Interest Payment Date”, with respect to any Security, means the Stated Maturity of an installment of interest on such Security.

 

“Legal Holiday”, except as otherwise may be provided herein or in any Securities, with respect to any Place of Payment or other location, means a Saturday, a Sunday or a day on which banking institutions or trust companies in such Place of Payment or other location are not authorized or obligated to be open.

 

“Maturity”, with respect to any Security, means the date on which the principal of such Security or an installment of principal becomes due and payable as therein or herein provided, whether at the Stated Maturity or by declaration of acceleration, notice of redemption, notice of option to elect repayment or otherwise.

 

“Officer’s Certificate” means a certificate signed by the Chairman of the Board, the Chief Executive Officer, the Chief Operating Officer, the President, a, Executive Vice President, the Chief Financial Officer, the Treasurer, an Assistant Treasurer, the Secretary or an Assistant Secretary of the Company, and delivered to the Trustee.

 

“Opinion of Counsel”, except as otherwise provided herein or in any Security, means a written Opinion of Counsel, who may be an employee of or counsel for the Company or other counsel.

 

“Original Issue Discount Security” means a Security issued pursuant to this Indenture which provides for declaration of an amount less than the principal thereof to be due and payable upon acceleration pursuant to Section 5.02.

 

“Outstanding”, with respect to Securities, means, as of the date of determination, all Securities theretofore authenticated and delivered under this Indenture, except:

 

(a) Securities theretofore cancelled by the Trustee or the Security Registrar or delivered to the Trustee or the Security Registrar for cancellation;

 

(b) Securities, or portions thereof for whose payment or redemption or repayment at the option of the Holder money in the necessary amount has been theretofore deposited with the Trustee or any Paying Agent (other than the Company) in trust or set aside and segregated in trust by the Company (if the Company shall act as its own Paying Agent) for the Holders of such Securities, provided that, if such Securities are to be redeemed, notice of such

 

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redemption has been duly given pursuant to this Indenture or provision therefor satisfactory to the Trustee has been made;

 

(c) Securities, except to the extent provided in Section 4.03, with respect to which the Company has effected defeasance and/or covenant defeasance pursuant to Section 4.03 hereof; and

 

(d) Securities which have been paid pursuant to Section 3.07 or in exchange for or in lieu of which other Securities have been authenticated and delivered pursuant to this Indenture, other than any such Securities in respect of which there shall have been presented to the Trustee proof satisfactory to it that such Securities are held by a bona fide purchaser in whose hands such Securities are valid obligations of the Company;

 

provided, however, that in determining whether the Holders of the requisite principal amount of Outstanding Securities have given any request, demand, authorization, direction, notice, consent or waiver hereunder or are present at a meeting of Holders of Securities for quorum purposes and for purposes of making the calculations required by Section 313 of the Trust Indenture Act, (i) the principal amount of an Original Issue Discount Security that may be counted in making such determination or calculation and that shall be deemed to be outstanding for such purposes shall be equal to the amount of the principal thereof that pursuant to the terms of such Original Issue Discount Security would be declared (or shall have been declared to be) due and payable upon a declaration of acceleration pursuant to Section 5.02 at the time of such determination or calculation, and (ii) the principal amount of any Security denominated other than in Dollars that may be counted in making such determination or calculation and that shall be deemed outstanding for such purpose shall be equal to the Dollar equivalent, determined by the Company as of the date such Security is originally issued by the Company, of the principal amount (or, in the case of an Original Issue Discount Security, the Dollar equivalent as of such date of original issuance of the amount determined as provided in clause (i) above) of such Security, and (iii) Securities owned by the Company or any other obligor upon the Securities or any Affiliate of the Company or such other obligor, shall be disregarded and deemed not to be Outstanding, except that, in determining whether the Trustee shall be protected in making any such calculation or relying upon any such request, demand, authorization, direction, notice, consent or waiver, only Securities which a Responsible Officer of the Trustee actually knows to be so owned shall be so disregarded. Securities so owned which have been pledged in good faith may be regarded as Outstanding if the pledgee establishes to the satisfaction of the Trustee the pledgee’s right so to act with respect to such Securities and that the pledgee is not the Company or any other obligor upon the Securities or any Affiliate of the Company or such other obligor.

 

“Paying Agent” means any Person authorized by the Company to pay the principal of (and premium, if any) or interest on any Security on behalf of the Company.

 

“Person” means any individual, corporation, partnership, joint venture, association, joint-stock company, trust, unincorporated organization or government or any agency or political subdivision thereof.

 

“Place of Payment”, with respect to any Security, means the place or places where the principal of (and premium, if any) and interest on the Securities of that series are payable as specified in or pursuant to Section 3.01(9) or Section 10.02.

 

“Predecessor Security” of any particular Security means every previous Security evidencing all or a portion of the same debt as that evidenced by such particular Security; and, for the purposes of this definition, any Security authenticated and delivered under Section 3.07 in exchange for or in lieu of a lost, destroyed, mutilated or stolen Security shall be deemed to evidence the same debt as the lost, destroyed, mutilated or stolen Security.

 

“Preferred Stock” means shares of a class or series now or hereafter authorized of the class of preferred stock of the Company presently authorized and stock of any other class into which such shares may hereafter have been changed.

 

“Redemption Date”, with respect to any Security or portion thereof to be redeemed, means the date fixed for such redemption by or pursuant to this Indenture.

 

“Redemption Price”, with respect to any Security or portion thereof to be redeemed, means the price at which it is to be redeemed as determined by or pursuant to the provisions of this Indenture.

 

“Regular Record Date” for the interest payable on any Security on any Interest Payment Date therefor means the date, if any, specified in such Security as the “Regular Record Date”.

 

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“Responsible Officer” when used with respect to the Trustee means any officer within the corporate trust department of the Trustee, including the vice president, any assistant vice president, assistant treasurer, or any other officer of the Trustee who customarily performs functions similar to those performed by the Persons who at the time shall be such officers, respectively, or to whom any corporate trust matter is referred because of such person’s knowledge of and familiarity with the particular subject and who shall have direct responsibility for the administration of this Indenture.

 

“Security” or “Securities” means any Security or Securities, as the case may be, authenticated and delivered under this Indenture; provided, however, that if at any time there is more than one Person acting as Trustee under this Indenture, “Securities” with respect to the Indenture as to which such Person is Trustee shall have the meaning stated in the first recital of this Indenture and shall more particularly mean Securities authenticated and delivered under this Indenture, exclusive, however, of Securities of any series as to which such Person is not Trustee.

 

“Security Register” and “Security Registrar” have the respective meanings specified in Section 3.06.

 

“Special Record Date” for the payment of any Defaulted Interest on any Security means a date fixed by the Trustee pursuant to Section 3.08.

 

“Stated Maturity”, with respect to any Security or any installment of principal thereof, means the date specified in such Security as the fixed date on which the principal of such Security or such installment of principal is due and payable.

 

“Subsidiary” means any corporation of which at the time of determination the Company and/or one or more Subsidiaries owns or controls directly or indirectly more than 50% of the shares of Voting Stock.

 

“Trust Indenture Act” means the Trust Indenture Act of 1939 as in force at the date as of which this instrument was executed, except as provided in Section 9.05.

 

“Trustee” means the Person named as the “Trustee” in the first paragraph of this instrument until a successor Trustee shall have become such with respect to one or more series of Securities pursuant to the applicable provisions of this Indenture, and thereafter “Trustee” shall mean each Person who is then a Trustee hereunder; provided, however, that if at any time there is more than one such Person, “Trustee” shall mean each such Person and as used with respect to the Securities of any series shall mean the Trustee with respect to the Securities of that series.

 

“United States”, except as otherwise provided herein or in any Security, means the United States of America (including the States and the District of Columbia), its territories and possessions and other areas subject to its jurisdiction.

 

“United States Alien”, except as otherwise provided herein or in any Security, means any Person who, for United States Federal income tax purposes, is a foreign corporation, a non-resident alien individual, a non-resident alien fiduciary of a foreign estate or trust, or a foreign partnership one or more of the members of which is, for United States Federal income tax purposes, a foreign corporation, a non-resident alien individual or a non-resident alien fiduciary of a foreign estate or trust.

 

“U.S. Depository” or “Depository” means, with respect to any Security issuable or issued in the form of one or more global Securities, the Person designated as U.S. Depository by the Company pursuant to Section 3.01, which must be a clearing agency registered under the Securities Exchange Act of 1934, as amended, and, if so provided pursuant to Section 3.01 with respect to any Security, any successor to such Person. If at any time there is more than one such Person, “U.S. Depository” or “Depository” shall mean, with respect to any Securities, the qualifying entity which has been appointed with respect to such Securities.

 

“Vice President”, with respect to the Company or the Trustee, means any vice president, whether or not designated by a number or a word or words added before or after the title “Vice President”.

 

“Voting Stock” means stock of a corporation of the class or classes having general voting power under ordinary circumstances to elect at least a majority of the board of directors, managers or trustees of such corporation provided that, for the purposes hereof, stock which carries only the right to vote conditionally on the happening of an event shall not be considered voting stock whether or not such event shall have happened.

 

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Section 1.02. Compliance Certificates and Opinions.

 

Upon any application or request by the Company to the Trustee to take any action under any provision of this Indenture, the Company shall furnish to the Trustee an Officer’s Certificate stating that all conditions precedent, if any, provided for in this Indenture relating to the proposed action have been complied with and an Opinion of Counsel stating that, in the Opinion of such counsel, all such conditions precedent, if any, have been complied with, except that in the case of any such application or request as to which the furnishing of such documents or any of them is specifically required by any provision of this Indenture relating to such particular application or request, no additional certificate or opinion need be furnished.

 

Every certificate or opinion with respect to compliance with a condition or covenant provided for in this Indenture and in any applicable Security (except Section 10.05) shall include:

 

(1) a statement that each individual signing such certificate or opinion has read such condition or covenant and the definitions herein and in any applicable Security relating thereto;

 

(2) a brief statement as to the nature and scope of the examination or investigation upon which the statements or opinions contained in such certificate or opinion are based;

 

(3) a statement that, in the opinion of each such individual, he has made such examination or investigation as is necessary to enable him to express an informed opinion as to whether or not such condition or covenant has been complied with; and

 

(4) a statement as to whether, in the opinion of each such individual, such condition or covenant has been complied with.

 

Section 1.03. Form of Documents Delivered to Trustee.

 

In any case where several matters are required to be certified by, or covered by an opinion of, any specified Person, it is not necessary that all such matters be certified by, or covered by the opinion of, only one such Person, or that they be so certified or covered by only one document, but one such Person may certify or give an opinion with respect to some matters and one or more other such Persons as to other matters, and any such Person may certify or give an opinion as to such matters in one or several documents.

 

Any certificate or opinion of an officer of the Company may be based, insofar as it relates to legal matters, upon a certificate or opinion of, or representations by, counsel, unless such officer knows, or in the exercise of reasonable care should know, that the certificate or opinion or representations with respect to the matters upon which his certificate or opinion is based are erroneous. Any such certificate or Opinion of Counsel may be based, insofar as it relates to factual matters, upon a certificate or opinion of, or representations by, an officer or officers of the Company stating that the information with respect to such factual matters is in the possession of the Company unless such counsel knows, or in the exercise of reasonable care should know, that the certificate or opinion or representations with respect to such matters are erroneous.

 

Where any Person is required to make, give or execute two or more applications, requests, consents, certificates, statements, opinions or other instruments under this Indenture or any Security, they may, but need not, be consolidated and form one instrument.

 

Section 1.04. Acts of Holders.

 

(a) Any request, demand, authorization, direction, notice, consent, waiver or other action provided by this Indenture to be given or taken by Holders may be embodied in and evidenced by one or more instruments of substantially similar tenor signed by such Holders in person or by agent duly appointed in writing. Except as herein otherwise expressly provided, such action shall become effective when such instrument or instruments are delivered to the Trustee and, where it is hereby expressly required, to the Company. Such instrument or instruments (and the action embodied therein and evidenced thereby) are herein sometimes referred to as the “Act” of the Holders signing such instrument or instruments. Proof of execution of any such instrument or of a writing appointing any such agent, or of the holding by any Person of a Security, shall be sufficient for any purpose of this Indenture and (subject to Section 315 of the Trust Indenture Act) conclusive in favor of the Trustee and the Company and any agent of the Trustee or the Company, if made in the manner provided in this Section.

 

Without limiting the generality of this Section 1.04, unless otherwise established in or pursuant to a Board Resolution or set forth or determined in an Officer’s Certificate, or established in one or more indentures 

 

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supplemental hereto, pursuant to Section 3.01, a Holder, including a U.S. Depository that is a Holder of a global Security, may make, give or take, by a proxy, or proxies, duly appointed in writing, any request, demand, authorization, direction, notice, consent, waiver or other action provided in this Indenture to be made, given or taken by Holders, and a U.S. Depository that is a Holder of a global Security may provide its proxy or proxies to the beneficial owners of interests in any such global Security through such U.S. Depository’s standing instructions and customary practices.

 

The Trustee shall fix a record date, which shall be not more than 30 days prior to the first solicitation of such Holders, for the purpose of determining the Persons who are beneficial owners of interest in any permanent global Security held by a U.S. Depository entitled under the procedures of such U.S. Depository to make, give or take, by a proxy or proxies duly appointed in writing, any request, demand, authorization, direction, notice, consent, waiver or other action provided in this Indenture to be made, given or taken by Holders. If such a record date is fixed, the Holders on such record date or their duly appointed proxy or proxies, and only such Persons, shall be entitled to make, give or take such request, demand, authorization, direction, notice, consent, waiver or other action, whether or not such Holders remain Holders after such record date. No such request, demand, authorization, direction, notice, consent, waiver or other action shall be valid or effective if made, given or taken more than 90 days after such record date.

 

(b) The fact and date of the execution by any Person of any such instrument or writing may be proved in any reasonable manner which the Trustee deems sufficient and in accordance with such reasonable rules as the Trustee may determine; and the Trustee may in any instance require further proof with respect to any of the matters referred to in this Section.

 

(c) The ownership, principal amount and serial numbers of Securities held by any Person, and the date of the commencement and the date of termination of holding the same, shall be proved by the Security Register.

 

(d) If the Company shall solicit from the Holders of any Securities any request, demand, authorization, direction, notice, consent, waiver or other Act, the Company may at its option, by Board Resolutions, fix in advance a record date, which shall be not more than 30 days prior to the first solicitation of such Holders, for the determination of Holders of Securities entitled to give such request, demand, authorization, direction, notice, consent, waiver or other Act, but the Company shall have no obligation to do so. If such a record date is fixed, such request, demand, authorization, direction, notice, consent, waiver or other Act may be given before or after such record date, but only the Holders of Securities of record at the close of business on such record date shall be deemed to be Holders for the purposes of determining whether Holders of the requisite proportion of Outstanding Securities have authorized or agreed or consented to such request, demand, authorization, direction, notice, consent, waiver or other Act, and for that purpose the Outstanding Securities shall be computed as of such record date; provided no such authorization, agreement or consent of the Holders of Securities shall be deemed effective unless it shall become effective pursuant to the provisions of this Indenture not later than six months after the record date.

 

(e) Any request, demand, authorization, direction, notice, consent, waiver or other action by the Holder of any Security shall bind every future Holder of the same Security and the Holder of every Security issued upon the registration of transfer thereof or in exchange therefor or in lieu thereof in respect of anything done or suffered to be done by the Trustee, any Security Registrar, any Paying Agent or the Company in reliance thereon, whether or not notation of such action is made upon such Security.

 

Section 1.05. Notices, Etc., to Trustee and Company.

 

Any request, demand, authorization, direction, notice, consent, waiver or Act of Holders or other document provided or permitted by this Indenture to be made upon, given or furnished to, or filed with,

 

(1) the Trustee by any Holder or by the Company shall be sufficient for every purpose hereunder if made, given, furnished or filed in writing to or with the Trustee at its Corporate Trust Office, or

 

(2) the Company by the Trustee or by any Holder shall be sufficient for every purpose hereunder (unless otherwise herein expressly provided) if in writing and mailed, first-class postage prepaid, to the Company addressed to the attention of its Treasurer at the address of its principal office specified in the first paragraph of this Indenture or at any other address previously furnished in writing to a Responsible Officer of the Trustee by the Company.

 

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Section 1.06. Notice to Holders; Waiver.

 

Except as otherwise expressly provided herein or in any Security, where this Indenture provides for notice to Holders of any event, such notice shall be sufficiently given to Holders if in writing and mailed, first-class postage prepaid, to each Holder affected by such event, at his address as it appears in the Security Register, not later than the latest date, and not earlier than the earliest date, prescribed for the giving of such Notice. In any case where notice to Holders is given by mail, neither the failure to mail such notice, nor any defect in any notice so mailed, to any particular Holder shall affect the sufficiency of such notice with respect to other Holders. Any notice which is mailed in the manner herein provided shall be conclusively presumed to have been duly given or provided. In the case by reason of the suspension of regular mail service or by reason of any other cause it shall be impracticable to give such notice by mail, then such notification as shall be made with the approval of the Trustee shall constitute a sufficient notification for every purpose hereunder.

 

Where this Indenture provides for notice in any manner, such notice may be waived in writing by the Person entitled to receive such notice, either before or after the event, and such waiver shall be the equivalent of such notice. Waivers of notice by Holders shall be filed with the Trustee, but such filing shall not be a condition precedent to the validity of any action taken in reliance upon such waiver.

 

Section 1.07. Language of Notices.

 

Any request, demand, authorization, direction, notice, consent, election or waiver required or permitted under this Indenture shall be in the English language, except that, if the Company so elects, any published notice may be in an official language of the country of publication.

 

Section 1.08. Conflict With Trust Indenture Act.

 

If any provision hereof limits, qualifies or conflicts with the duties imposed pursuant to Section 318(c) of the Trust Indenture Act, such imposed duties shall control.

 

Section 1.09. Effect of Headings and Table of Contents.

 

The Article and Section headings herein and the Table of Contents are for convenience only and shall not affect the construction hereof.

 

Section 1.10. Successors and Assigns.

 

All covenants and agreements in this Indenture by the Company shall bind its successors and assigns, whether so expressed or not.

 

Section 1.11. Separability Clause.

 

In case any provision in this Indenture or any Security shall be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

 

Section 1.12. Benefits of Indenture.

 

Nothing in this Indenture or any Security, express or implied, shall give to any Person, other than the parties hereto, any Security Registrar, any Paying Agent and their successors hereunder and the Holders, any benefit or any legal or equitable right, remedy or claim under this Indenture.

 

Section 1.13. Governing Law.

 

This Indenture and the Securities shall be governed by and construed in accordance with the laws of the State of  [                     ] applicable to agreements made or instruments entered into and, in each case, performed in said state.

 

Section 1.14. Legal Holidays.

 

In any case where any Interest Payment Date, Redemption Date or Stated Maturity of any Security, or the last day on which a Holder has the right to convert these Securities, is not a Business Day at any Place of Payment, then (notwithstanding any other provision of this Indenture or any Security other than a provision in any Security that specifically states that such provision shall apply in lieu of this Section) payment of interest or any Additional Amounts or principal (and premium, if any) or conversion of the Securities need not be made at such Place of Payment on such date, but may be made on the next succeeding Business Day at such Place of Payment with the 

 

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same force and effect as if made on the Interest Payment Date or Redemption Date, or at the Stated Maturity, or the last such day of conversion, and no interest shall accrue on the amount so payable for the period from and after such Interest Payment Date, Redemption Date or Stated Maturity, as the case may be.

 

Section 1.15. When Securities Disregarded.

 

In determining whether the Holders of the required aggregate principal amount of Securities have concurred in any direction, waiver or consent, Securities owned by the Company or any Affiliate of the Company shall be disregarded and deemed not to be outstanding, except that, for the purpose of determining whether the Trustee shall be protected in relying on any such direction, waiver or consent, only Securities which the Trustee actually knows are so owned shall be so disregarded. Also, subject to the foregoing, only Securities outstanding at the time shall be considered in any such determination.

 

Section 1.16. USA Patriot Act.

 

The parties hereto acknowledge that in accordance with Section 326 of the USA Patriot Act, the Trustee, like all financial institutions and in order to help fight the funding of terrorism and money laundering, is required to obtain, verify, and record information that identifies each person or legal entity that establishes a relationship or opens an account. The parties to this Indenture agree that they shall provide the Trustee with such information as they may request in order to satisfy the requirements of the USA Patriot Act.

 

ARTICLE TWO

 

SECURITIES FORMS

 

Section 2.01. Forms Generally.

 

Each Security and temporary global Security issued pursuant to this Indenture shall be in the form established by or pursuant to a Board Resolution or in one or more indentures supplemental hereto, shall have appropriate insertions, omissions, substitutions and other variations as are required or permitted by this Indenture or any indenture supplemental hereto and may have such letters, numbers or other marks of identification and such legends or endorsements placed thereon as may, consistently herewith, be determined by the officers executing such Security, as evidenced by their execution of such Security.

 

Definitive Securities shall be printed, lithographed or engraved or produced by any combination of these methods on a steel engraved border or steel engraved borders or may be produced in any other manner, all as determined by the officers of the Company executing such Securities, as evidenced by their execution of such Securities.

 

Section 2.02. Form of Trustee’s Certificate of Authentication.

 

Subject to Section 6.12, the Trustee’s certificate of authentication shall be in substantially the following form:

 

This certificate represents Securities of the series designated therein referred to in the within-mentioned Indenture.

 

	
Dated:   [                       ],   20[ ]
    	
[                                                     ],   
    
	
 
    	
not   in its individual capacity but solely as Trustee 
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:   
    	
 
    
	
 
    	
 
    	
Authorized Signatory
    

 

Section 2.03. Securities in Global Form.

 

If Securities of a series are issuable in global form, any such Security may provide that it shall represent the aggregate amount of Outstanding Securities of such series from time to time endorsed thereon and may also provide that the aggregate amount of Outstanding Securities represented thereby may from time to time be increased or reduced to reflect exchanges. Any endorsement of any Security in global form to reflect the amount, or any increase or decrease in the amount, or changes in the rights of Holders, of Outstanding Securities represented thereby shall be made in such manner and by such Person or Persons as shall be specified therein or in the Company Order to be delivered pursuant to Section 3.04 or 3.05 with respect thereto. Subject to the provisions of Section 3.04 and, if 

 

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applicable, Section 3.05, the Trustee shall deliver and redeliver any Security in permanent global form in the manner and upon instructions given by the Person or Persons specified therein or in the applicable Company Order. If a Company Order pursuant to Section 3.04 or 3.05 has been, or simultaneously is, delivered, any instructions by the Company with respect to a Security in global form shall be in writing but need not comply with Section 1.02 and need not be accompanied by an Opinion of Counsel.

 

The provisions of the immediately preceding sentence shall apply to any Security represented by a Security in global form if such Security was never issued and sold by the Company and the Company delivers to the Trustee the Security in global form together with written instructions (which need not comply with Section 1.02 and need not be accompanied by an Opinion of Counsel) with regard to the reduction in the principal amount of Securities represented thereby.

 

Notwithstanding the provisions of Section 3.08, unless otherwise specified as contemplated by Section 3.01, payment of principal of and any premium and interest on any Security in permanent global form shall be made to the Person or Persons specified therein.

 

Notwithstanding the provisions of Section 3.09, and except as provided in the preceding paragraph, the Company, the Trustee and any agent of the Company and the Trustee shall treat as the Holder of such principal amount of Outstanding Securities represented by a permanent global Security (i) in the case of a permanent global Security in registered form, the Holder of such permanent global Security in registered form, or (ii) in the case of a permanent global Security in bearer form, the Person or Persons specified pursuant to Section 3.01.

 

ARTICLE THREE

 

THE SECURITIES

 

Section 3.01. Amount Unlimited; Issuable in Series.

 

The aggregate principal amount of Securities which may be authenticated and delivered under this Indenture is unlimited.

 

The Securities may be issued in one or more series. There shall be established in or pursuant to one or more Board Resolutions, and set forth in an Officer’s Certificate, or established in one or more indentures supplemental hereto,

 

(1) the title of the Securities and the series in which such Securities shall be included;

 

(2) any limit upon the aggregate principal amount of the Securities of such title or the Securities of such series which may be authenticated and delivered under this Indenture (except for Securities authenticated and delivered upon registration of transfer of, or in exchange for, or in lieu of, other Securities of the series pursuant to Section 3.05, 3.06, 3.07, 9.06 or 11.07 or the terms of such Securities);

 

(3) whether any Securities of the series are to be issuable initially or otherwise in global form and, if so, (i) whether beneficial owners of interests in any such global Security may exchange such interest for Securities of such series and of like tenor of any authorized form and denomination and the circumstances under which any such exchanges may occur, if other than in the manner specified in Section 3.06, (ii) the name of the depository or the U.S. Depository, as the case may be, with respect to any global Security and (iii) the manner in which interest payable on a global Security will be paid;

 

(4) the date as of which any global Security representing Outstanding Securities of the series shall be dated if other than the date of original issuance of the first Security of the series to be issued;

 

(5) the terms, if any, upon which the Securities of any series may be convertible into or exchanged for Common Stock, Preferred Stock (which may be represented by depositary shares), other indebtedness of the Company or another obligor, or warrants for Common Stock, Preferred Stock or indebtedness or other securities of any kind of the Company or any other obligor, and the terms and conditions upon which such conversion or exchange shall be effected, including the initial conversion or exchange price or rate, the conversion or exchange period, the manner in which such conversion or exchange shall be effected, applicable adjustments, if any, and any other provision in addition to or in lieu of those described herein;

 

(6) the date or dates, or the method, if any, by which such date or dates shall be determined, on which the principal of such Securities is payable;

 

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(7) the rate or rates at which such Securities shall bear interest, if any, or the method, if any, by which such rate or rates are to be determined, the date or dates, if any, from which such interest shall accrue or the method, if any, by which such date or dates are to be determined, the Interest Payment Dates, if any, on which such interest shall be payable and the Regular Record Date, if any, for the interest payable on Securities on any Interest Payment Date, whether and under what circumstances Additional Amounts on such Securities or any of them shall be payable, and the basis upon which interest shall be calculated if other than that of a 360-day year of twelve 30-day months;

 

(8) the place or places, if any, where the principal of (and premium, if any) and interest (including Additional Amounts), if any, on such Securities shall be payable, any Securities of the series may be surrendered for registration of transfer, Securities of the series may be surrendered for exchange or conversion and notices or demands to or upon the Company in respect of the Securities of the series and this Indenture may be served;

 

(9) whether and the terms and conditions upon which the Securities of the series or any of them are to be redeemable at the option of the Company and, if so, the period or periods within which, the price or prices at which and the other terms and conditions upon which such Securities may be redeemed, in whole or in part, at the option of the Company;

 

(10) whether and terms and conditions upon which the Company is obligated to redeem, or purchase Securities of the series or any of them pursuant to any sinking fund or at the option of any Holder thereof and, if so, the period or periods within which, the price or prices at which and the other terms and conditions upon which such Securities shall be redeemed or purchased, in whole or in part, pursuant to such obligation, and any provisions for the remarketing of the Securities of the series so redeemed or purchased;

 

(11) the denominations in which Securities of the series, if any, shall be issuable if other than denominations of $1,000 and any integral multiple thereof;

 

(12) if other than the principal amount thereof, the portion of the principal amount of the Securities of the series of any of them which shall be payable upon declaration of acceleration of the Maturity thereof pursuant to Section 5.02 or the method by which such portion is to be determined;

 

(13) if other than such coin or currency of the United States of America as at the time of payment is legal tender for payment of public or private debts, the coin or currency, composite currencies or currency unit or units in which payment of the principal of (and premium, if any) or interest, if any, on or any Additional Amounts in respect of the Securities of the series or any of them shall be payable;

 

(14) if the principal of (and premium, if any) or interest, if any, on or any Additional Amounts in respect of the Securities of the series or any of them are to be payable, at the election of the Company or a Holder thereof, in a coin or currency, composite currencies or currency unit or units other than that in which the Securities of the series or any of them are stated to be payable, the period or periods within which, and the terms and conditions upon which, such election may be made;

 

(15) whether the amount of payments of principal of (and premium, if any) or interest (including Additional Amounts), if any, on the Securities of the series may be determined with reference to an index, formula or other method (which index, formula or method may be based, without limitation, on one or more currencies, currency units, composite currencies, commodities, equity indices or other indices), and, if so, the terms and conditions upon which and the manner in which such amounts shall be determined and paid or payable;

 

(16) whether the principal of (and premium, if any) or interest (including Additional Amounts), if any, on the Securities of the series are to be payable, at the election of the Company or any Holder thereof or otherwise, in a currency or currencies, currency unit or units or composite currency or currencies other than that in which such Securities or any of them are denominated or stated to be payable, the period or periods within which, and the other terms and conditions upon which, such election, if any, may be made, and the time and manner of determining the exchange rate between the currency or currencies, currency unit or units or composite currency or currencies in which such Securities or any of them are denominated or stated to be payable and the currency or currencies, currency unit or units or composite currency or currencies in which such Securities or any of them are to be so payable;

 

(17) any deletions from, modifications of or additions to the Events of Default or covenants of the Company with respect to the Securities of the series or any of them, whether or not such Events of Default or covenants are consistent with the Events of Default or covenants set forth herein;

 

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(18) the applicability, if any, of Section 4.03 to the Securities of the series and any provisions in modification of, in addition to or in lieu of any of the provisions of Section 4.03;

 

(19) if the Securities of the series or any of them are to be issued upon the exercise of warrants, the time, manner and place for such Securities to be authenticated and delivered;

 

(20) if the Securities of the series are to be issuable in definitive form (whether upon original issue or upon exchange of a temporary Security of such series) only upon receipt of certain certificates or other documents or satisfaction of other conditions, then the form and terms of such certificates, documents or conditions;

 

(21) if there is more than one Trustee, the identity of the Trustee and, if not the Trustee, the identity of each Security Registrar, Paying Agent and/or Authenticating Agent with respect to the Securities of the series;

 

(22) whether any of the Securities of a series shall be issued as Original Issue Discount Securities; and

 

(23) any other terms of the Securities of the series or any of them.

 

All Securities of any one series shall be substantially identical except as to denomination and the rate or rates of interest, if any, and Stated Maturity, the date from which interest, if any, shall accrue and except as may otherwise be provided by the Company in or pursuant to one or more Board Resolutions and set forth in such Officer’s Certificate or in any indenture or indentures supplemental hereto pertaining to such series of Securities. All Securities of any one series need not be issued at the same time and, unless otherwise so provided by the Company, a series may be reopened for issuances of additional Securities of such series.

 

If any of the terms of the Securities of any series were established by action taken by or pursuant to a Board Resolution, the Board Resolution shall be delivered to the Trustee at or prior to the delivery of the Officer’s Certificate setting forth the terms of such series.

 

Section 3.02. Denominations.

 

Unless otherwise established with respect to any Securities pursuant to Section 3.01, the Securities of each series denominated in Dollars shall be issuable in registered form without coupons in denominations of $1,000 and any integral multiple thereof. Securities not denominated in Dollars shall be issuable in such denominations as are established with respect to such Securities pursuant to Section 3.01.

 

Section 3.03. Securities in Foreign Countries

 

Whenever this Indenture provides for (i) any action by, or the determination of any of the rights of, Holders of Securities of any series in which not all of such Securities are denominated in the same currency, or (ii) any distribution to Holders of Securities, in the absence of any provision to the contrary in the form of Security of any particular series, any amount in respect of any Security denominated in a currency other than United States dollars shall be treated for any such action or distribution as that amount of United States dollars that could be obtained for such amount on such reasonable basis of exchange and as of the record date with respect to Securities of such series (if any) for such action, determination of rights or distribution (or, if there shall be no applicable record date, such other date reasonably proximate to the date of such action, determination of rights or distribution) as the Company may specify in a written notice to the Trustee or, in the absence of such written notice, as the Trustee may determine.

 

Section 3.04. Execution, Authentication, Delivery and Dating.

 

The Securities shall be executed on behalf of the Company by its Chairman of the Board, its President, its Chief Operating Officer or one of its Executive Vice Presidents under its corporate seal reproduced thereon and attested by its Secretary or one of its Assistant Secretaries. The signature of any of these officers on the Securities may be manual or facsimile.

 

Securities bearing the manual or facsimile signatures of individuals who were at any time the proper officers of the Company shall bind the Company, notwithstanding that such individuals or any of them have ceased to hold such offices prior to the authentication and delivery of such Securities or did not hold such offices at the date of such Securities.

 

At any time and from time to time after the execution and delivery of this Indenture, the Company may deliver Securities of any series, executed by the Company, to the Trustee for authentication, and, provided that the Board Resolution or Resolutions and Officer’s Certificate or supplemental indenture or indentures with respect to

 

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such Securities referred to in Section 3.01 and a Company Order for the authentication and delivery of such Securities, has been delivered to the Trustee, the Trustee in accordance with the Company Order and subject to the provisions hereof of such Securities shall authenticate and deliver such Securities.

 

The Trustee shall not be required to authenticate or to cause an Authenticating Agent to authenticate any Securities if the issue of such Securities pursuant to this Indenture will affect the Trustee’s own rights, duties or immunities under the Securities and this Indenture or otherwise in a manner which is not reasonably acceptable to the Trustee or if the Trustee, being advised by counsel, determines that such action may not lawfully be taken or if the Trustee in good faith shall determine that such action would expose the Trustee to personal liability to existing Holders.

 

Each Security shall be dated the date of its authentication.

 

No Security shall be entitled to any benefit under this Indenture or be valid or obligatory for any purpose, unless there appears on such Security a certificate of authentication substantially in the form provided for in Section 2.02 or 6.12 executed by or on behalf of the Trustee by the manual signature of one of its authorized officers, and such certificate upon any Security shall be conclusive evidence, and the only evidence, that such Security has been duly authenticated and delivered hereunder.

 

Section 3.05. Temporary Securities.

 

Pending the preparation of definitive Securities of any series, the Company may execute and deliver to the Trustee and, upon Company Order the Trustee shall authenticate and deliver, in the manner provided in Section 3.04, temporary Securities of such series which are printed, lithographed, typewritten, mimeographed or otherwise produced, in any authorized denomination, substantially of the tenor of the definitive Securities in lieu of which they are issued, in registered form without coupons and with such appropriate insertions, omissions, substitutions and other variations as the officers of the Company executing such Securities may determine, as conclusively evidenced by their execution of such Securities. In the case of Securities of any series, such temporary Securities may be in global form.

 

Except in the case of temporary Securities in global form, which shall be exchanged in accordance with the provisions thereof, if temporary Securities of any series are issued, the Company shall cause definitive Securities of such series to be prepared without unreasonable delay. After the preparation of definitive Securities of any series, the temporary Securities of such series, if any, shall be exchangeable upon request for definitive Securities of such series containing identical terms and provisions upon surrender of the temporary Securities of such series at an office or agency of the Company maintained for such purpose pursuant to Section 10.02, without charge to any Holder. Upon surrender for cancellation of any one or more temporary Securities of any series, the Company shall execute and the Trustee shall authenticate and deliver in exchange therefor a like principal amount of definitive Securities of authorized denominations of the same series containing identical terms and provisions. Unless otherwise specified as contemplated by Section 3.01 with respect to a temporary global Security, until so exchanged the temporary Securities of any series shall in all respects be entitled to the same benefits under this Indenture as definitive Securities of such series.

 

Section 3.06. Registration, Transfer and Exchange.

 

With respect to the Securities of each series, if any, the Company shall cause to be kept, at an office or agency of the Company maintained pursuant to Section 10.02, a register (each such register being herein sometimes referred to as the “Security Register”) in which, subject to such reasonable regulations as it may prescribe, the Company shall provide for the registration of the Securities of each series and of transfers of the Securities of such series. In the event that the Trustee shall not be the Security Registrar, it shall have the right to examine the Security Register at all reasonable times. [                    ] is hereby initially appointed as Security Registrar for each series of Securities. In the event that [                    ] shall cease to be Security Registrar with respect to a series of Securities, the Trustee shall have the right to examine the Security Register for such series at all reasonable times.

 

Upon surrender for registration of transfer of any Security of any series at any office or agency of the Company maintained for such series pursuant to Section 10.02, the Company shall execute, and the Trustee shall authenticate and deliver, in the name of the designated transferee or transferees, one or more new Securities of the same series of any authorized denominations, of a like aggregate principal amount bearing a number not contemporaneously outstanding and containing identical terms and provisions.

 

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At the option of the Holder, Securities of any series may be exchanged for other Securities of the same series containing identical terms and provisions, in any authorized denominations, and of a like aggregate principal amount, upon surrender of the Securities to be exchanged at any such office or agency. Whenever any Securities are so surrendered for exchange, the Company shall execute, and the Trustee shall authenticate and deliver, the Securities which the Holder making the exchange is entitled to receive.

 

Notwithstanding the foregoing, except as otherwise specified as contemplated by Section 3.01, any global Security of any series shall be exchangeable for Securities of such series only if (i) the Securities Depository is at any time unwilling or unable or ineligible to continue as Securities Depository and a successor depository is not appointed by the Company within 90 days of the date the Company is so notified in writing, (ii) the Company executes and delivers to the Trustee a Company Order to the effect that such global Security shall be so exchangeable, or (iii) an Event of Default has occurred and is continuing with respect to the Securities. If the beneficial owners of interests in a global Security are entitled to exchange such interests for Securities of such series and of like tenor and principal amount of any authorized form and denomination, as specified as contemplated by Section 3.01, then without unnecessary delay but in any event not later than the earliest date on which such interests may be so exchanged, the Company shall deliver to the Trustee definitive Securities of that series in aggregate principal amount equal to the principal amount of such global Security, executed by the Company. On or after the earliest date on which such interests may be so exchanged, such global Security shall be surrendered from time to time by the U.S. Depository or such other depository as shall be specified in the Company Order with respect thereto, and in accordance with instructions given to the Trustee and the U.S. Depository or such other depository, as the case may be (which instructions shall be in writing but need not comply with Section 1.02 or be accompanied by an Opinion of Counsel), as shall be specified in the Company Order with respect thereto to the Trustee, as the Company’s agent for such purpose, to be exchanged, in whole or in part, for definitive Securities of the same series without charge. The Trustee shall authenticate and make available for delivery, in exchange for each portion of such surrendered global Security, a like aggregate principal amount of definitive Securities of the same series of authorized denominations and of like tenor as the portion of such global Security to be exchanged; provided, however, that no such exchanges may occur during a period beginning at the opening of business 15 days before any selection of Securities of such series to be redeemed and ending on the relevant Redemption Date. Promptly following any such exchange in part, such global Security shall be returned by the Trustee to such Depository or the U.S. Depository, as the case may be, or such other Depository or U.S. Depository referred to above in accordance with the instructions of the Company referred to above. If a Security is issued in exchange for any portion of a global Security after the close of business at the office or agency where such exchange occurs on (i) any Regular Record Date and before the opening of business at such office or agency on the relevant Interest Payment Date, or (ii) any Special Record Date and before the opening of business at such office or agency on the related proposed date for payment of interest or Defaulted Interest, as the case may be, interest will not be payable on such Interest Payment Date or proposed date for payment, as the case may be, in respect of such Security, but will be payable on such Interest Payment Date or proposed date for payment, as the case may be, only to the Person to whom interest in respect of such portion of such global Security is payable in accordance with the provisions of this Indenture.

 

All Securities endorsed thereon issued upon any registration of transfer or exchange of Securities shall be the valid obligations of the Company evidencing the same debt, and entitling the Holders thereof to the same benefits under this Indenture as the Securities surrendered upon such registration of transfer or exchange.

 

Every Security presented or surrendered for registration of transfer or for exchange, redemption or conversion shall (if so required by the Company or the Security Registrar for such series of Security presented) be duly endorsed, or be accompanied by a written instrument of transfer in form satisfactory to the Company and such Security Registrar duly executed by the Holder thereof or his attorney duly authorized in writing.

 

No service charge shall be made for any registration of transfer or exchange, redemption or conversion of Securities, but the Company may require payment of a sum sufficient to cover any tax or other governmental charge that may be imposed in connection with any registration of transfer or exchange of Securities, other than exchanges pursuant to Section 3.05, 9.06 or 11.07 not involving any transfer.

 

Except as otherwise specified as contemplated by Section 3.01, the Company shall not be required (i) to issue, register the transfer of or exchange any Securities of any series during a period beginning at the opening of business 15 days before the day of the selection for redemption of Securities of such series under Section 11.03 and ending at the close of business on the day of such selection, or (ii) to register the transfer of or exchange any Security so selected for redemption in whole or in part, except in the case of any Security to be redeemed in part, the

 

14

 

portion thereof not to be redeemed, or (iii) to issue, register the transfer of or exchange any Security which, in accordance with its terms specified as contemplated by Section 3.01, has been surrendered for repayment at the option of the Holder, except the portion, if any, of such Security not to be repaid.

 

Section 3.07. Mutilated, Destroyed, Lost and Stolen Securities.

 

If any mutilated Security is surrendered to the Trustee, subject to the provisions of this Section 3.07, the Company shall execute and the Trustee shall authenticate and deliver in exchange therefor a new Security of the same series containing identical terms and of like principal amount and bearing a number not contemporaneously outstanding.

 

If there be delivered to the Company and to the Trustee (i) evidence to their satisfaction of the destruction, loss or theft of any Security, and (ii) such Security or indemnity as may be required by them to save each of them and any agent of either of them harmless, then, in the absence of notice to the Company or the Trustee that such Security has been acquired by a bona fide purchaser, the Company shall execute and upon its request the Trustee shall authenticate and deliver, in exchange for or in lieu of any such mutilated, destroyed, lost or stolen Security, a new Security of the same series containing identical terms and of like principal amount and bearing a number not contemporaneously outstanding.

 

Notwithstanding the foregoing provisions of this Section 3.07, in case any such mutilated, destroyed, lost or stolen Security has become or is about to become due and payable, the Company in its discretion may, instead of issuing a new Security, pay such Security.

 

Upon the issuance of any new Security under this Section, the Company may require the payment of a sum sufficient to cover any tax or other governmental charge that may be imposed in relation thereto and any other expenses (including the fees and expenses of the Trustee) connected therewith.

 

Every new Security of any series issued pursuant to this Section in lieu of any destroyed, lost or stolen Security shall constitute a separate obligation of the Company, whether or not the destroyed, lost or stolen Security shall be at any time enforceable by anyone, and shall be entitled to all the benefits of this Indenture equally and proportionately with any and all other Securities of that series.

 

The provisions of this Section are exclusive and shall preclude (to the extent lawful) all other rights and remedies with respect to the replacement or payment of mutilated, destroyed, lost or stolen Securities.

 

Section 3.08. Payment of Interest; Interest Rights Preserved.

 

Unless otherwise specified as contemplated by Section 3.01, interest on any Security which is payable, and is punctually paid or duly provided for, on any Interest Payment Date shall be paid to the Person in whose name that Security (or one or more Predecessor Securities) is registered as of the close of business on the Regular Record Date for such interest.

 

Any interest on any Security of any series which shall be payable, but shall not be punctually paid or duly provided for, on any Interest Payment Date for such Security (herein called “Defaulted Interest”) shall forthwith cease to be payable to the Holder on the relevant Regular Record Date by virtue of having been such Holder; and such Defaulted Interest may be paid by the Company, at its election in each case, as provided in Clause (1) or (2) below:

 

(1) The Company may elect to make payment of any Defaulted Interest to the Persons in whose names the Securities affected (or their respective Predecessor Securities) are registered at the close of business on a Special Record Date for the payment of such Defaulted Interest, which shall be fixed in the following manner. The Company shall notify the Trustee in writing of the amount of Defaulted Interest proposed to be paid on each such Security and the date of the proposed payment, and at the same time the Company shall deposit with the Trustee an amount of money equal to the aggregate amount proposed to be paid in respect of such Defaulted Interest or shall make arrangements satisfactory to the Trustee for such deposit on or prior to the date of the proposed payment. Money will be held in trust for the benefit of the Persons entitled to such Defaulted Interest as in this Clause provided. Thereupon, the Trustee shall fix a Special Record Date for the payment of such Defaulted Interest which shall be not more than 15 days and not less than 10 days prior to the date of the proposed payment and not less than 10 days after the receipt by the Trustee of the notice of the proposed payment. The Trustee shall promptly notify the Company of such Special Record Date and, in the name and at the expense of the Company shall cause notice of the proposed payment of such Defaulted Interest and the Special Record Date therefor to be mailed, first-class postage

 

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prepaid, to each Holder of such Securities at his address as it appears in the Security Register not less than 10 days prior to such Special Record Date. Notice of the proposed payment of such Defaulted Interest and the Special Record Date therefor having been mailed as aforesaid, such Defaulted Interest shall be paid to the Persons in whose names such Securities (or their respective Predecessor Securities) are registered at the close of business on such Special Record Date and shall no longer be payable pursuant to the following Clause (2).

 

(2) The Company may make payment of any Defaulted Interest in any other lawful manner not inconsistent with the requirements of any securities exchange on which such Securities may be listed, and upon such notice as may be required by such exchange, if, after notice given by the Company to the Trustee of the proposed payment pursuant to this Clause, such payment shall be deemed practicable by the Trustee.

 

At the option of the Company, interest on Securities of any series that bear interest may be paid by mailing a check to the address of the person entitled thereto as such address shall appear in the Security Register.

 

Subject to the foregoing provisions of this Section and Section 3.06, each Security delivered under this Indenture upon registration of transfer of or in exchange for or in lieu of any other Security shall carry the rights to interest accrued and unpaid, and to accrue, which were carried by such other Security.

 

Section 3.09. Persons Deemed Owners.

 

Prior to due presentment of a Security for registration of transfer, the Company, the Trustee and any agent of the Company or the Trustee may treat the Person in whose name such Security is registered as the owner of such Security for the purpose of receiving payment of principal of (and premium, if any), and (subject to Sections 3.06 and 3.08) interest on or any Additional Amounts with respect to, such Security and for all other purposes whatsoever, whether or not any payment with respect to such Security be overdue, and neither the Company, the Trustee nor any agent of the Company or the Trustee shall be affected by notice to the contrary.

 

Section 3.10. Cancellation.

 

All Securities surrendered for payment, redemption, registration of transfer or exchange or for credit against any sinking fund payment shall, if surrendered to any Person other than the Trustee or the Security Registrar, be delivered to the Trustee or the Security Registrar, and any such Securities and Securities surrendered directly to the Trustee or the Security Registrar for any such purpose shall be promptly cancelled by the Trustee or the Security Registrar, as the case may be. The Company may at any time deliver to the Trustee or the Security Registrar for cancellation any Securities previously authenticated and delivered hereunder which the Company may have acquired in any manner whatsoever, and all Securities so delivered shall be promptly cancelled by the Trustee or the Security Registrar, as the case may be. No Securities shall be authenticated in lieu of or in exchange for any Securities cancelled as provided in this Section, except as expressly permitted by this Indenture or as otherwise specified as contemplated by Section 3.01. All cancelled Securities held by the Trustee or the Security Registrar shall be returned to the Company by the Trustee or the Security Registrar, as the case may be, upon a Company Order. The Trustee shall promptly notify the Company of all cancelled Securities.

 

Section 3.11. Computation of Interest.

 

Except as otherwise specified as contemplated by Section 3.01 for Securities of any series, interest on the Securities of each series shall be computed on the basis of 360-day year of twelve 30-day months.

 

Section 3.12. Cusip Numbers.

 

The Company in issuing the Securities may use “CUSIP” numbers (if then generally in use), and if so, the Trustee shall use “CUSIP” numbers in notices of redemption as a convenience to Holders; provided that any such notice may state that no representation is made as to the correctness of such numbers either as printed on the Securities or as contained in any notice of a redemption and that reliance may be placed only on the other identification numbers printed on the Securities, and any such redemption shall not be affected by any defect in or omission of such numbers. The Company will promptly notify the Trustee of any change in the “CUSIP” numbers.

 

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ARTICLE FOUR

 

SATISFACTION AND DISCHARGE

 

Section 4.01. Satisfaction and Discharge of Indenture.

 

Upon the direction of the Company by a Company Order, this Indenture shall cease to be of further effect with respect to any series of Securities specified in such Company Order (except as to any surviving rights of registration of transfer or exchange of Securities of such series herein expressly provided for and any right to receive Additional Amounts, as provided in Section 10.04), and the Trustee, on receipt of a Company Order, at the expense of the Company, shall execute proper instruments acknowledging satisfaction and discharge of this Indenture as to such series, when

 

(1) either

 

(A) all Securities of such series theretofore authenticated and delivered (other than (i) Securities of such series which have been destroyed, lost or stolen and which have been replaced or paid as provided in Section 3.07, and (ii) Securities of such series for whose payment money has theretofore been deposited in trust or segregated and held in trust by the Company and thereafter repaid to the Company or discharged from such trust, as provided in Section 10.03) have been delivered to the Trustee for cancellation; or

 

(B) all Securities of such series thereto not theretofore delivered to the Trustee for cancellation

 

(i) have become due and payable, or

 

(ii) will become due and payable at their Stated Maturity within one year and such Securities are not convertible into other Securities, or

 

(iii) if redeemable at the option of the Company, such Securities are not convertible into other Securities and are to be called for redemption within one year under arrangements satisfactory to the Trustee for the giving of notice of redemption by the Trustee in the name, and at the expense, of the Company,

 

and the Company, in the case of (i), (ii) or (iii) above, has deposited or caused to be deposited with the Trustee as trust funds in trust for the purpose, a sum of money in an amount sufficient to pay and discharge the entire indebtedness on such Securities not theretofore delivered to the Trustee for cancellation, for principal (and premium, if any) and interest, or any Additional Amounts with respect thereto, to the date of such deposit (in the case of Securities which have become due and payable) or to the Stated Maturity or Redemption Date, as the case may be;

 

(2) the Company has paid or caused to be paid all other sums payable hereunder by the Company; and

 

(3) the Company has delivered to the Trustee an Officer’s Certificate and an Opinion of Counsel, each stating that all conditions precedent herein provided for relating to the satisfaction and discharge of this Indenture as to such series have been complied with.

 

In the event there are two or more Trustees hereunder, then the effectiveness of any such instrument shall be conditioned upon receipt of such instruments from all Trustees hereunder.

 

Notwithstanding the satisfaction and discharge of this Indenture, the obligations of the Company to the Trustee under Section 6.06 and, if money shall have been deposited with the Trustee pursuant to subclause (B) of Clause (1) of this Section, the obligations of the Trustee under Section 4.02 and the last paragraph of Section 10.03 shall survive such satisfaction and discharge.

 

Section 4.02. Application of Trust Money.

 

Subject to the provisions of the last paragraph of Section 10.03, all money deposited with the Trustee pursuant to Section 4.01 or this section 4.02 shall be held in trust and applied by it, in accordance with the provisions of the Securities and this Indenture, to the payment, either directly or through any Paying Agent (including the Company acting as its own Paying Agent) as the Trustee may determine, to the Persons entitled thereto, of the principal (and premium, if any) and any interest or any Additional Amounts for whose payment such money has been deposited with the Trustee; but such money need not be segregated from other funds except to the extent required by law.

 

All monies deposited with the Trustee pursuant to Section 4.01 (and held by it or any Paying Agent) for the payment of Securities subsequently converted shall be returned to the Company upon Company Request.

 

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Section 4.03. Satisfaction, Discharge and Defeasance of Securities of Any Series.

 

If pursuant to Section 3.01 provision is made for defeasance of Securities of any series pursuant to Section 4.03, the Company shall be deemed to have paid and discharged the entire indebtedness on all the Outstanding Securities of such series and the Trustee, at the expense of the Company, shall execute proper instruments acknowledging satisfaction and discharge of such indebtedness, when

 

(1) either

 

(A) with respect to all Outstanding Securities of such series,

 

(i) the Company has deposited or caused to be deposited with the Trustee, as trust funds in trust for such purpose, an amount sufficient to pay and discharge the entire indebtedness on all Outstanding Securities of such series for principal (and premium, if any), any Additional Amounts, and interest to the Stated Maturity or any Redemption Date as contemplated by the penultimate paragraph of this Section 4.03, as the case may be; or

 

(ii) with respect to any Series of Securities which are denominated in United States dollars, the Company has deposited or caused to be deposited with the Trustee, as obligations in trust for such purpose, such amount of direct obligations of, or obligations the timely payment of the principal of and interest on which are fully guaranteed by, the United States of America and which are not callable at the option of the issuer thereof as will, together with the income to accrue thereon without consideration of any reinvestment thereof, be sufficient to pay and discharge the entire indebtedness on all Outstanding Securities of such series for principal (and premium, if any), any Additional Amounts, and interest to the stated Maturity or any Redemption Date as contemplated by the penultimate paragraph of this Section 4.03; or

 

(B) the Company has properly fulfilled such other means of satisfaction and discharge as is specified, as contemplated by Section 3.01, to be applicable to the Securities of such series; and

 

(2) the Company has paid or caused to be paid all other sums payable hereunder with respect to the Outstanding Securities of such series; and

 

(3) the Company has delivered to the Trustee a certificate signed by a nationally recognized firm of Independent Public Accountants certifying as to the sufficiency of the amounts deposited pursuant to subsections (A) (i) or (ii) of this Section for payment of the principal (and premium, if any) and interest on the dates such payments are due, an Officer’s Certificate and an Opinion of Counsel, each such Certificate and opinion stating that no Event of Default or event which with notice or lapse of time or both would become an Event of Default with respect to such Securities shall have occurred and all conditions precedent herein provided for relating to the satisfaction and discharge of the entire indebtedness on all Outstanding Securities of any such series have been complied with; and

 

(4) the Company has delivered to the Trustee

 

(A) a ruling from the Internal Revenue Service or an opinion of independent counsel that the holders of the Securities of such series will not recognize income, gain or loss for Federal income tax purposes as a result of such deposit, defeasance and discharge and will be subject to Federal income tax on the same amount and in the same manner and at the same times, as would have been the case if such deposit, defeasance and discharge had not occurred; and

 

(B) if the Securities of such series are then listed on a national securities exchange, an Opinion of Counsel that the Securities of such series will not be delisted as a result of the exercise of this option.

 

Any deposits with the Trustee referred to in subsection (1) (A) of this Section shall be irrevocable and shall be made under the terms of an escrow trust agreement in form and substance satisfactory to the Trustee. If any Outstanding Securities of such series are to be redeemed prior to their Stated Maturity, whether pursuant to any optional redemption or repayment provisions or in accordance with any mandatory sinking fund requirement, the Company shall make such arrangements as are satisfactory to the Trustee for the giving of notice of redemption by the Trustee in the name, and at the expense, of the Company.

 

Upon the satisfaction of the conditions set forth in this Section 4.03 with respect to all the Outstanding Securities of any series, the terms and conditions of such series, including the terms and conditions with respect thereto set forth in this Indenture, other than the provisions of Sections 3.06, 3.07, and 10.02, other than the right of 

 

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Holders of such series to receive, from the trust fund described in this Section, payment of the principal (and premium, if any) of, the interest on or any Additional Amounts with respect to such Securities when such payments are due, other than any right of conversion of such Securities and the rights, powers, duties and immunities of the Trustee hereunder, shall no longer be binding upon, or applicable to, the Company except those responsibilities and obligations which by the terms of the Indenture survive the termination of the Indenture; provided that the Company shall not be discharged from any payment obligations in respect of Securities of such series which are deemed not to be Outstanding under clause (iii) of the definition thereof if such obligations continue to be valid obligations of the Company under applicable law.

 

ARTICLE FIVE

 

REMEDIES

 

Section 5.01. Events of Default.

 

“Event of Default”, wherever used herein with respect to Securities of any series, means any one of the following events (whatever the reason for such Event of Default and whether it shall be voluntary or be effected by operation of law pursuant to any judgment, decree or order of any court or any order, rule or regulation of any administrative or governmental body):

 

(1) default in the payment of any installment of interest upon any Security of that series, as and when the same shall become due and payable, and continuance of such default for a period of 30 days;

 

(2) default in the payment of the principal of or premium, if any, on any Security of that series as and when the same shall become due and payable, whether at maturity, upon redemption, by declaration, upon required repurchase or otherwise;

 

(3) default in the payment of any sinking fund payment with respect to any Security of that series as and when the same shall become due and payable;

 

(4) failure by the Company to deliver the required securities or other rights upon an appropriate conversion or exchange election by any Holder of Convertible Securities;

 

(5) failure on the part of the Company duly to observe or perform any other of the covenants or agreements on the part of the Company in the Securities of that series, in any resolution of the Board of Directors authorizing the issuance of that series of Securities, in this Indenture with respect to such series or in any supplemental Indenture with respect to such series (other than a covenant a default in the performance of which is elsewhere in this Section specifically dealt with), continuing for a period of 90 days after the date on which written notice specifying such failure and requiring the Company to remedy the same shall have been given, by registered or certified mail, to the Company by the Trustee or to the Company and the Trustee by the Holders of at least 25% in aggregate principal amount of the Securities of that series at the time Outstanding;

 

(6) a court having jurisdiction in the premises shall enter a decree or order for relief in respect of the Company in an involuntary case under any applicable bankruptcy, insolvency or other similar law now or hereafter in effect, and adjudging it a bankrupt or insolvent or appointing a receiver, liquidator, assignee, custodian, trustee, sequestrator (or similar official) of the Company or for any substantial part of its property, or ordering the winding-up or liquidation of its affairs, and such decree or order shall remain unstayed and in effect for a period of 60 consecutive days;

 

(7) the Company shall commence a voluntary case under any applicable bankruptcy, insolvency or other similar law now or hereafter in effect, or shall consent to the entry of an order for relief in any involuntary case under any such law, or shall consent to the appointment of or taking possession by a receiver, liquidator, assignee, trustee, custodian, sequestrator (or similar official) of the Company or for any substantial part of its property, or shall make any general assignment for the benefit of creditors, or shall fail generally to pay its debts as they become due or shall take any corporate action in furtherance of any of the foregoing; or

 

(8) any other Event of Default provided with respect to Debt Securities of that series.

 

Section 5.02. Acceleration of Maturity; Rescission and Annulment.

 

Unless the Board Resolution or supplemental indenture establishing such series provides otherwise, if an Event of Default (other than an Event of Default specified in Section 5.01(6) or 5.01(7)) with respect to Securities of any series at the time outstanding occurs and is continuing, then the Trustee or the Holders of not less than 25% in 

 

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principal amount of the Outstanding Securities of that series may declare the principal of all the Securities of that series, or such lesser amount as may be provided for in the Securities of that series, to be due and payable immediately, by a notice in writing to the Company (and to the Trustee if given by the Holders), and upon any such declaration such principal or such lesser amount, together with accrued and unpaid interest, if any, thereon, shall become immediately due and payable. Unless the Board Resolution or supplemental indenture establishing such series provides otherwise, if an Event of Default specified in Section 5.01(6) or 5.01(7) with respect to Securities of any series at the time Outstanding occurs, the principal amount of all the Securities of that series (or, if any Securities of that series are Original Issue Discount Securities, such portion of the principal amount of such Securities as may be specified by the terms thereof), together with accrued and unpaid interest, if any, thereon, shall automatically, and without any declaration or other action on the part of the Trustee or any Holder, become immediately due and payable.

 

At any time after such a declaration of acceleration with respect to Securities of any series has been made and before a judgment or decree for payment of the money due has been obtained by the Trustee as hereinafter in this Article provided, the Holders of not less than a majority in principal amount of the Outstanding Securities of that series, by written notice to the Company and the Trustee, may rescind and annul such declaration and its consequences if

 

(1) the Company has paid or deposited with the Trustee a sum sufficient to pay

 

(A) all overdue installments of interest on and any Additional Amounts payable in respect of all Securities of such series,

 

(B) the principal of (and premium, if any, on) any Securities of such series which have become due otherwise than by such declaration of acceleration and interest thereon at the rate or rates borne by or provided for in such Securities,

 

(C) to the extent that payment of such interest is lawful, interest upon overdue installments of interest or any Additional Amounts at the rate or rates borne by or provided for in such Securities, and

 

(D) all sums paid or advanced by the Trustee hereunder and the reasonable compensation, expenses, disbursements and advances of the Trustee, its agents and counsel as provided in Section 6.06 hereof; and

 

(2) all Events of Default with respect to Securities of such series, other than the non-payment of the principal of Securities of that series which have become due solely by such declaration of acceleration, have been cured or waived as provided in Section 5.13.

 

No such rescission shall affect any subsequent default or impair any right consequent thereon.

 

Section 5.03. Collection of Indebtedness and Suits For Enforcement By Trustee.

 

The Company covenants that if:

 

(1) default is made in the payment of any installment of interest on or any Additional Amounts payable in respect of any Security when such interest or Additional Amounts shall have become due and payable and such default continues for a period of 30 days, or

 

(2) default is made in the payment of the principal of (or premium, if any, on) any Security at its Maturity,

 

then the Company will, upon demand of the Trustee, pay to it, for the benefit of the Holders of such Securities, the whole amount then due and payable on such Securities for principal (and premium, if any) and interest or Additional Amounts, if any, with interest upon the overdue principal (and premium, if any) and, to the extent that payment of such interest shall be legally enforceable, upon overdue installments of interest or any Additional Amounts, at the rate or rates borne by or provided for in such Securities, and, in addition thereto, such further amount as shall be sufficient to cover the costs and expenses of collection, including the reasonable compensation, expenses, disbursements and advances of the Trustee, its agents and counsel.

 

If the Company fails to pay such amounts forthwith upon such demand, the Trustee, in its own name and as trustee of an express trust, may institute a judicial proceeding for the collection of the sums so due and unpaid, and may prosecute such proceeding to judgment or final decree, and may enforce the same against the Company or any other obligor upon such Securities and collect the moneys adjudged or decreed to be payable in the manner provided by law out of the property of the Company or any other obligor upon such Securities, wherever situated.

 

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If an Event of Default with respect to Securities of any series occurs and is continuing, the Trustee may in its discretion proceed to protect and enforce its rights and the rights of the Holders of Securities of such series by such appropriate judicial proceedings as the Trustee shall deem most effectual to protect and enforce any such rights, whether for the specific enforcement of any covenant or agreement in this Indenture or such Securities or in aid of the exercise of any power granted herein, or to enforce any other proper remedy.

 

Section 5.04. Trustee May File Proofs of Claim.

 

In case of the pendency of any receivership, insolvency, liquidation, bankruptcy, reorganization, arrangement, adjustment, composition or other judicial proceeding relative to the Company or any other obligor upon the Securities or the property of the Company or of such other obligor or their creditors, the Trustee (irrespective of whether the principal of the Securities shall then be due and payable as therein expressed or by declaration or otherwise and irrespective of whether the Trustee shall have made any demand on the Company for the payment of any overdue principal or interest) shall be entitled and empowered, by intervention in such proceeding or otherwise,

 

(1) to file and prove a claim for the whole amount or such lesser amount as may be provided for in the Securities of such series, of principal (and premium, if any) and interest and any Additional Amounts owing and unpaid in respect of the Securities and to file such other papers or documents as may be necessary or advisable in order to have the claims of the Trustee (including any claim for the reasonable compensation, expenses, disbursements and advances of the Trustee, its agents or counsel) and of the Holders allowed in such judicial proceeding, and

 

(2) to collect and receive any moneys or other property payable or deliverable on any such claims and to distribute the same;

 

and any custodian, receiver, assignee, trustee, liquidator, sequestrator or other similar official in any such judicial proceeding is hereby authorized by each Holder to make such payments to the Trustee and, in the event that the Trustee shall consent to the making of such payments directly to the Holders, to pay to the Trustee any amount due to it for the reasonable compensation, expenses, disbursements and advances of the Trustee, its agents and counsel and any other amounts due the Trustee under Section 6.06.

 

Nothing herein contained shall be deemed to authorize the Trustee to authorize or consent to or accept or adopt on behalf of any Holder any plan of reorganization, arrangement, adjustment or composition affecting the Securities or the rights of any Holder thereof, or to authorize the Trustee to vote in respect of the claim of any Holder in any such proceeding.

 

Section 5.05. Trustee May Enforce Claims Without Possession of Securities.

 

All rights of action and claims under this Indenture or any of the Securities may be prosecuted and enforced by the Trustee without the possession of any of the Securities or the production thereof in any proceeding relating thereto, and any such proceeding instituted by the Trustee shall be brought in its own name as trustee of an express trust, and any recovery or judgment, after provision for the payment of the reasonable compensation, expenses, disbursements and advances of the Trustee, its agents and counsel, shall be for the ratable benefit of the Holders of the Security in respect of which such judgment has been recovered.

 

Section 5.06. Application of Money Collected.

 

Any money collected by the Trustee pursuant to this Article shall be applied in the following order, at the date or dates fixed by the Trustee and, in case of the distribution of such money on account of principal (and premium, if any), interest or any Additional Amounts, upon presentation of the Securities, and the notation thereon of the payment if only partially paid and upon surrender thereof if fully paid:

 

FIRST: To the payment of all amounts due the Trustee and any predecessor Trustee under Section 6.06;

 

SECOND: To the payment of the amounts then due and unpaid upon the Securities for principal (and premium, if any) and interest or any Additional Amounts payable in respect of which or for the benefit of which such money has been collected, ratably, without preference or priority of any kind, according to the aggregate amounts due and payable on such Securities for principal (and premium, if any), interest or any Additional Amounts, respectively; and

 

THIRD: The balance, if any, to the Company.

 

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Section 5.07. Limitation on Suits.

 

No Holder of any Security of any series shall have any right to institute any proceeding, judicial or otherwise, with respect to this Indenture, or for the appointment of a receiver or trustee, or for any other remedy hereunder, unless

 

(1) such Holder has previously given written notice to the Trustee of a continuing Event of Default with respect to the Securities of such series;

 

(2) the Holders of not less than 25% in principal amount of the Outstanding Securities of that series shall have made written request to the Trustee to institute proceedings in respect of such Event of Default in its own name as Trustee hereunder;

 

(3) such Holder or Holders have offered indemnity reasonably satisfactory to the Trustee against the costs, expenses and liabilities to be incurred in compliance with such request;

 

(4) the Trustee for 60 days after its receipt of such notice, request and offer of indemnity has failed to institute any such proceeding; and

 

(5) no direction inconsistent with such written request has been given to the Trustee during such 60-day period by the Holders of a majority in principal amount of the Outstanding Securities of such series;

 

it being understood and intended that no one or more of such Holders shall have any right in any manner whatever by virtue of, or by availing of, any provision of this Indenture or any Security to affect, disturb or prejudice the rights of any other such Holders or Holders of Securities of any other series, or to obtain or to seek to obtain priority or preference over any other Holders or to enforce any right under this Indenture, except in the manner herein provided and for the equal and ratable benefit of all such Holders.

 

Section 5.08. Unconditional Right of Holders to Receive Principal, Premium, Interest and Additional Amounts.

 

Notwithstanding any other provision in this Indenture, the Holder of any Security shall have the right, which is absolute and unconditional, to receive payment of the principal of (and premium, if any) and (subject to Sections 3.06 and 3.08) interest on or any Additional Amounts in respect of such Security on the respective Stated Maturity or Maturities specified in such Security (or, in the case of redemption, on the Redemption Date) and to institute suit for the enforcement of any such payment, and such right shall not be impaired without the consent of such Holder.

 

Section 5.09. Restoration of Rights and Remedies.

 

If the Trustee or any Holder has instituted any proceeding to enforce any right or remedy under this Indenture and such proceeding has been discontinued or abandoned for any reason, or has been determined adversely to the Trustee or to such Holder, then and in every such case the Company, the Trustee and each such Holder shall, subject to any determination in such proceeding, be restored severally and respectively to their former positions hereunder, and thereafter all rights and remedies of the Trustee and each such Holder shall continue as though no such proceeding had been instituted.

 

Section 5.10. Rights and Remedies Cumulative.

 

Except as otherwise provided with respect to the replacement or payment of mutilated, destroyed, lost or stolen Securities in the last paragraph of Section 3.07, no right or remedy herein conferred upon or reserved to the Trustee or to the Holders is intended to be exclusive of any other right or remedy, and every right and remedy, to the extent permitted by law, shall be cumulative and in addition to every other right and remedy given hereunder or now or hereafter existing at law or in equity or otherwise. The assertion or employment of any right or remedy hereunder, or otherwise, shall not prevent the concurrent assertion or employment of any other appropriate right or remedy.

 

Section 5.11. Delay or Omission Not Waiver.

 

No delay or omission of the Trustee or of any Holder of any Security to exercise any right or remedy accruing upon any Event of Default shall impair any such right or remedy or constitute a waiver of any such Event of Default or an acquiescence therein. Every right and remedy given by this Article or by law to the Trustee or to the Holders may be exercised from time to time, and as often as may be deemed expedient, by the Trustee or by the Holders, as the case may be.

 

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Section 5.12. Control By Holders.

 

The Holders of a majority in principal amount of the Outstanding Securities of any series shall have the right to direct the time, method and place of conducting any proceeding for any remedy available to the Trustee or exercising any trust or power conferred on the Trustee with respect to the Securities of such series, provided that:

 

(1) such direction shall not be in conflict with any rule of law or with this Indenture,

 

(2) the Trustee may take any other action deemed proper by the Trustee which is not inconsistent with such direction, and

 

(3) such direction is not unduly prejudicial to the rights of other Holders of Securities of such series.

 

Section 5.13. Waiver of Past Defaults.

 

The Holders of not less than a majority in principal amount of the outstanding Securities of any series may on behalf of the Holders of all the Securities of such series waive any past default hereunder with respect to such series and its consequences, except a default:

 

(1) in the payment of the principal of (and premium, if any) or interest on or Additional Amounts payable in respect of any Security of such series, or

 

(2) in respect of a covenant or provision hereof which under Article Nine cannot be modified or amended without the consent of the Holder of each Outstanding Security of such series affected.

 

Upon any such waiver, such default shall cease to exist, and any Event of Default arising therefrom shall be deemed to have been cured, for every purpose of this Indenture; but no such waiver shall extend to any subsequent or other default or impair any right consequent thereon.

 

Section 5.14. Waiver of Stay or Extension Laws.

 

The Company covenants (to the extent that it may lawfully do so) that it will not at any time insist upon, or plead, or in any manner whatsoever claim or take the benefit or advantage of, any stay or extension law wherever enacted, now or at any time hereafter in force, which may affect the covenants or the performance of this Indenture; and the Company (to the extent that it may lawfully do so) hereby expressly waives all benefit or advantage of any such law and covenants that it will not hinder, delay or impede the execution of any power herein granted to the Trustee, but will suffer and permit the execution of every such power as though no such law had been enacted.

 

ARTICLE SIX

 

THE TRUSTEE

 

Section 6.01. Certain Duties and Responsibilities.

 

The duties and responsibilities of the Trustee shall be as provided by the Trust Indenture Act. Notwithstanding the foregoing, no provision of this Indenture shall require the Trustee to expend or risk its own funds or otherwise incur any financial liability in the performance of any of its duties hereunder, or in the exercise of any of its rights or powers, if it shall have reasonable grounds for believing that repayment of such funds or adequate indemnity against such risk or liability is not reasonably assured to it. Whether or not therein expressly so provided, every provision of this Indenture relating to the conduct or affecting the liability of or affording protection to the Trustee shall be subject to the provisions of this Section.

 

Section 6.02. Notice of Defaults.

 

Within 90 days after the occurrence of any default hereunder with respect to the Securities of any series, the Trustee shall transmit to the Holders in the manner and to the extent provided in Section 313(c) of the Trust Indenture Act, notice of such default hereunder known to a Responsible Officer of the Trustee, unless such default shall have been cured or waived; provided, however, that, except in the case of a default in the payment of the principal of (or premium, if any) or interest on, or any Additional Amounts with respect to, any Security of such series or in the payment of any sinking fund installment with respect to Securities of such series, the Trustee shall be protected in withholding such notice if and so long as the board of directors, the executive committee or a trust committee of directors and/or Responsible Officers of the Trustee in good faith determine that the withholding of such notice is in the interests of the Holders of such series.

 

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Section 6.03. Certain Rights of Trustee.

 

Subject to the provisions of Section 6.01:

 

(1) the Trustee may conclusively rely and shall be protected in acting or refraining from acting upon any resolution, certificate, statement, instrument, opinion, report, notice, request, direction, consent, order, bond, debenture, note, or other paper or document reasonably believed by it to be genuine and to have been signed or presented by the proper party or parties;

 

(2) any request or direction of the Company mentioned herein shall be sufficiently evidenced by a Company Request or a Company Order (other than delivery of any Security to the Trustee for authentication and delivery pursuant to Section 3.04 which shall be sufficiently evidenced as provided therein) and any resolution of the Board of Directors may be sufficiently evidenced by a Board Resolution or Board Resolutions;

 

(3) whenever in the administration of this Indenture the Trustee shall deem it desirable that a matter be proved or established prior to taking, suffering or omitting any action hereunder, the Trustee (unless other evidence be herein specifically prescribed) may, in the absence of bad faith on its part, conclusively rely upon an Officer’s Certificate;

 

(4) the Trustee may consult with counsel of its selection and the advice of such counsel or any Opinion of Counsel shall be full and complete authorization and protection in respect of any action taken, suffered or omitted by it hereunder in good faith and in reliance thereon;

 

(5) the Trustee shall be under no obligation to exercise any of the rights or powers vested in it by this Indenture at the request or direction of any of the Holders of Securities of any series pursuant to this Indenture, unless such Holders shall have offered to the Trustee reasonable security or indemnity satisfactory to it against the costs, expenses and liabilities which might be incurred by it in compliance with such request or direction;

 

(6) the Trustee shall not be bound to make any investigation into the facts or matters stated in any resolution, certificate, statement, instrument, opinion, report, notice, request, direction, consent, order, bond, debenture or other paper or document, but the Trustee, in its discretion, may make such further inquiry or investigation into such facts or matters as it may see fit, and, if the Trustee shall determine to make such further inquiry or investigation, it shall be entitled to examine the books, records and premises of the Company, personally or by agent or attorney at the sole cost to the Company and shall incur no liability or additional liability of any kind by reason of such inquiry or investigation;

 

(7) the Trustee may execute any of the trusts or powers hereunder or perform any duties hereunder either directly or by or through agents or attorneys and the Trustee shall not be responsible for any misconduct or negligence on the part of any agent or attorney appointed with due care by it hereunder;

 

(8) the Trustee shall not be liable for any action taken, suffered, omitted to be taken by it in good faith and reasonably believed by it to be authorized or within the discretion or rights or powers conferred upon it by this Indenture;

 

(9) the Trustee shall not be deemed to have knowledge or notice of any default or Event of Default unless a Responsible Officer of the Trustee has actual knowledge thereof or unless written notice of any event which is in fact such a default or Event of Default is received by the Trustee at the Corporate Trust Office of the Trustee, and such notice references the Securities and this Indenture; and

 

(10) the rights, privileges, protections, immunities and benefits given to the Trustee, including, without limitation, its right to be indemnified, are extended to, and shall be enforceable by, the Trustee in each of its capacities hereunder, and to each agent, custodian and other Person employed to act hereunder.

 

Section 6.04. Not Responsible For Recitals or Issuance of Securities.

 

The recitals contained herein and in the Securities, except the Trustee’s certificate of authentication, shall be taken as the statements of the Company and neither the Trustee nor any Authenticating Agent assumes responsibility for their correctness. The Trustee makes no representations as to the validity or sufficiency of this Indenture or of the Securities, except that the Trustee represents that it is duly authorized to execute and deliver this Indenture, authenticate the Securities and perform its obligations hereunder and that the statements made by it in a Statement of Eligibility and Qualification on Form T-l supplied to the Company are true and accurate, subject to the 

 

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qualifications set forth therein. The Trustee or any Authenticating Agent shall not be accountable for the use or application by the Company of Securities or the proceeds thereof.

 

Section 6.05. May Hold Securities.

 

The Trustee, any Authenticating Agent, any Paying Agent, any Security Registrar or any other Person that may be an agent of the Trustee or the Company, in its individual or any other capacity, may become the owner or pledgee of Securities and, subject to Sections 310(b) and 311 of the Trust Indenture Act, may otherwise deal with the Company with the same rights it would have if it were not Trustee, Authenticating Agent, Paying Agent, Security Registrar or such other Person.

 

Section 6.06. Money Held In Trust.

 

Money held by the Trustee in trust hereunder need not be segregated from other funds except to the extent required by law and shall be held uninvested. The Trustee shall be under no liability for interest on any money received by it hereunder.

 

Section 6.07. Compensation and Reimbursement.

 

The Company agrees:

 

(1) to pay to the Trustee from time to time such compensation for all services rendered by it hereunder as shall be mutually agreed upon by the Company and the Trustee in writing (which compensation shall not be limited by any provision of law in regard to the compensation of a trustee of an express trust);

 

(2) except as otherwise expressly provided herein, to reimburse the Trustee upon its request for all reasonable expenses, disbursements and advances incurred or made by the Trustee in accordance with any provision of this Indenture (including the reasonable compensation and the reasonable expenses and disbursements of its agents and counsel), except any such expense, disbursement or advance as may be attributable to its negligence or bad faith; and

 

(3) to indemnify each of the Trustee and any predecessor Trustee and its agents for, and to hold them harmless against, any loss, liability, claim, damage or expense including taxes (other than taxes based upon, measured by or determined by the income of the Trustee) incurred without negligence or bad faith on their part, arising out of or in connection with the acceptance or administration of the trust or trusts hereunder, including the costs and expenses of defending themselves against any claim or liability in connection with the exercise or performance of any of their powers or duties hereunder.

 

The provisions of this Section 6.07 shall survive the termination of this Indenture and the resignation or removal of the Trustee.

 

Section 6.08. Corporate Trustee Required; Eligibility; Conflicting Interests.

 

There shall at all times be a Trustee hereunder that is a corporation permitted by Section 310(a)(1) and (5) of the Trust Indenture Act to act as trustee under the Trust Indenture Act and that has a combined capital and surplus (computed in accordance with Section 310(a) (2) of the Trust Indenture Act) of at least $50,000,000. If at any time the Trustee shall cease to be eligible in accordance with the provisions of this Section, it shall resign immediately in the manner and with the effect hereinafter specified in this Article. If the Trustee has or shall acquire any conflicting interest, as defined in Section 310(b) of the Trust Indenture Act, with respect to the Securities of any series, the Trustee shall take such action as is required pursuant to said Section 310 (b).

 

Section 6.09. Resignation and Removal; Appointment of Successor.

 

(a) No resignation or removal of the Trustee and no appointment of a successor Trustee pursuant to this Article shall become effective until the acceptance of appointment by the successor Trustee pursuant to Section 6.10.

 

(b) The Trustee may resign at any time with respect to the Securities of one or more series by giving written notice thereof to the Company. If the instrument of acceptance by a successor Trustee required by Section 6.10 shall not have been delivered to the Trustee within 30 days after the giving of such notice of resignation, the resigning Trustee may petition, at the expense of the Company, any court of competent jurisdiction for the appointment of a successor Trustee with respect to such series.

 

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(c) The Trustee may be removed at any time with respect to the Securities of any series by Act of the Holders of a majority in principal amount of the Outstanding Securities of such series, delivered to the Trustee and the Company. If an instrument of acceptance by a successor Trustee shall not have been delivered to the Trustee within 30 days after the giving of such notice of removal, the Trustee being removed may petition, at the expense of the Company, any court of competent jurisdiction for the appointment of a successor Trustee with respect to the Securities of such series.

 

(d) If at any time:

 

(1) the Trustee shall fail to comply with the obligations imposed upon it under Section 310(b) of the Trust Indenture Act after written request therefor by the Company or by any Holder of a Security who has been a bona fide Holder of a Security for at least six months, or

 

(2) the Trustee shall cease to be eligible under Section 6.08 and shall fail to resign after written request therefor by the Company or by any such Holder of a Security, or

 

(3) the Trustee shall become incapable of acting or shall be adjudged a bankrupt or insolvent or a receiver of the Trustee or of its property shall be appointed or any public officer shall take charge or control of the Trustee or of its property or affairs for the purpose of rehabilitation, conservation or liquidation,

 

then, in any such case, (a) the Company, by or pursuant to Board Resolution, may remove the Trustee with respect to all Securities, or (b) subject to Section 315(c) of the Trust Indenture Act any Holder of a Security who has been a bona fide Holder of a Security of any series for at least six months may, on behalf of himself and all others similarly situated, petition any court of competent jurisdiction for the removal of the Trustee with respect to all Securities of such series and the appointment of a successor Trustee or Trustees.

 

(e) If the Trustee shall resign, be removed or become incapable of acting, or if a vacancy shall occur in the office of Trustee for any cause, with respect to the Securities of one or more series, the Company, by or pursuant to Board Resolutions, shall promptly appoint a successor Trustee or Trustees with respect to the Securities of that or those series (it being understood that any such successor Trustee may be appointed with respect to the Securities of one or more or all of such series and that at any time there shall be only one Trustee with respect to the Securities of any particular series) and shall comply with the applicable requirements of Section 6.10. If, within one year after such resignation, removal or incapability, or the occurrence of such vacancy, a successor Trustee with respect to the Securities of any series shall be appointed by Act of the Holders of a majority in principal amount of the Outstanding Securities of such series delivered to the Company and the retiring Trustee, the successor Trustee so appointed shall, forthwith upon its acceptance of such appointment in accordance with the applicable requirements of Section 6.10, become the successor Trustee with respect to the Securities of such series and to that extent supersede the successor Trustee appointed by the Company. If no successor Trustee with respect to the Securities of any series shall have been so appointed by the Company or the Holders of Securities and accepted appointment in the manner required by Section 6.10, any Holder of a Security who has been a bona fide Holder of a Security of such series for at least six months may, on behalf of himself and all others similarly situated, petition any court of competent jurisdiction for the appointment of a successor Trustee with respect to the Securities of such series.

 

(f) The Company shall give notice of each resignation and each removal of the Trustee with respect to the Securities of any series and each appointment of a successor Trustee with respect to the Securities of any series by mailing written notice of such event by first-class mail, postage prepaid, to the Holders of Securities, if any, of such series as their names and addresses appear in the Security Register. Each notice shall include the name of the successor Trustee with respect to the Securities of such series and the address of its Corporate Trust Office.

 

Section 6.10. Acceptance of Appointment By Successor.

 

(a) In case of the appointment hereunder of a successor Trustee with respect to all Securities, every such successor Trustee so appointed shall execute, acknowledge and deliver to the Company and the retiring Trustee an instrument accepting such appointment, and thereupon the resignation or removal of the retiring Trustee shall become effective and such successor Trustee, without any further act, deed or conveyance, shall become vested with all the rights, powers, trusts and duties of the retiring Trustee; but, on the request of the Company and/or the successor Trustee, such retiring Trustee shall, upon payment of its charges, execute and deliver an instrument transferring to such successor Trustee all the rights, powers and trusts of the retiring Trustee and shall duly assign, transfer and deliver to such successor Trustee all property and money held by such retiring Trustee hereunder.

 

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(b) In case of the appointment hereunder of a successor Trustee with respect to the Securities of one or more (but not all) series, the Company, the retiring Trustee and each successor Trustee with respect to the Securities of one or more series shall execute and deliver an indenture supplemental hereto wherein each successor Trustee shall accept such appointment and which (1) shall contain such provisions as shall be necessary or desirable to transfer and confirm to, and to vest in, each successor Trustee all the rights, powers, trusts and duties of the retiring Trustee with respect to the Securities of that or those series to which the appointment of such successor Trustee relates, (2) if the retiring Trustee is not retiring with respect to all Securities, shall contain such provisions as shall be deemed necessary or desirable to confirm that all the rights, powers, trusts and duties of the retiring Trustee with respect to the Securities of that or those series as to which the retiring Trustee is not retiring shall continue to be vested in the retiring Trustee, and (3) shall add to or change any of the provisions of this Indenture as shall be necessary to provide for or facilitate the administration of the trusts hereunder by more than one Trustee, it being understood that nothing herein or in such supplemental indenture shall constitute such Trustees co-trustees of the same trust, that each such Trustee shall be trustee of a trust or trusts hereunder separate and apart from any trust or trusts hereunder administered by any other such Trustee and that no Trustee shall be responsible for any notice given to, or received by, or any act or failure to act on the part of any other Trustee hereunder, and upon the execution and delivery of such supplemental indenture the resignation or removal of the retiring Trustee shall become effective to the extent provided therein, such retiring Trustee shall with respect to the Securities of that or those series to which the appointment of such successor Trustee relates have no further responsibility for the exercise of rights and powers or for the performance of the duties and obligations vested in the Trustee under this Indenture other than as hereinafter expressly set forth, and each such successor Trustee without any further act, deed or conveyance, shall become vested with all the rights, powers, trusts and duties of the retiring Trustee with respect to the Securities of that or those series to which the appointment of such successor Trustee relates; but, on request of the Company or any successor Trustee, such retiring Trustee shall duly assign, transfer and deliver to such successor Trustee, to the extent contemplated by such supplemental indenture, the property and money held by such retiring Trustee hereunder with respect to the Securities of that or those series to which the appointment of such successor Trustee relates.

 

(c) Upon request of any such successor Trustee, the Company shall execute any and all instruments for more fully and certainly vesting in and confirming to such successor Trustee all such rights, powers and trusts referred to in paragraph (a) or (b) of this Section, as the case may be.

 

(d) No successor Trustee shall accept its appointment unless at the time of such acceptance such successor Trustee shall be qualified and eligible under this Article.

 

Section 6.11. Merger, Conversion, Consolidation or Succession to Business.

 

Any corporation into which the Trustee may be merged or converted or with which it may be consolidated, or any corporation resulting from any merger, conversion or consolidation to which the Trustee shall be a party, or any corporation succeeding to all or substantially all of the corporate trust business of the Trustee, shall be the successor of the Trustee hereunder, provided such corporation shall be otherwise qualified and eligible under this Article, without the execution or filing of any paper or any further act on the part of any of the parties hereto. In case any Securities shall have been authenticated, but not delivered, by the Trustee then in office, any successor by merger, conversion or consolidation to such authenticating Trustee may adopt such authentication and deliver the Securities so authenticated with the same effect as if such successor Trustee had itself authenticated such Securities.

 

Section 6.12. Appointment of Authenticating Agent.

 

The Trustee may appoint an Authenticating Agent or Authenticating Agents, which may be an Affiliate of the Company, with respect to one or more series of Securities which shall be authorized to act on behalf of the Trustee to authenticate Securities of that or those series issued upon original issue or exchange, registration of transfer or partial redemption thereof or pursuant to Section 3.07, and Securities so authenticated shall be entitled to the benefits of this Indenture and shall be valid and obligatory for all purposes as if authenticated by the Trustee hereunder. Wherever reference is made in this Indenture to the authentication and delivery of Securities by the Trustee or the Trustee’s certificate of authentication, such reference shall be deemed to include authentication and delivery on behalf of the Trustee by an Authenticating Agent and a certificate of authentication executed on behalf of the Trustee by an Authenticating Agent.

 

Each Authenticating Agent shall be acceptable to the Company and, except as specified as contemplated by Section 3.01, shall at all times be a corporation that would be permitted by Section 310(a) (1) and (5) of the Trust 

 

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Indenture Act to be able to act as a trustee under an indenture qualified under the Trust Indenture Act, is authorized under applicable law and by its charter to act as such and that has a combined capital and surplus (computed in accordance with Section 310(a) (2) of the Trust Indenture Act) of not less than $50,000,000. If at any time an Authenticating Agent shall cease to be eligible in accordance with the provisions of this Section, such Authenticating Agent shall resign immediately in the manner and with the effect specified in this Section. If the Authenticating Agent has or shall acquire any conflicting interest, as defined in Section 310(b) of the Trust Indenture Act, with respect to the Securities of any series, the Authenticating Agent shall take action as is required pursuant to said Section 310 (b).

 

Any corporation into which an Authenticating Agent may be merged or converted or with which it may be consolidated, or any corporation resulting from any merger, conversion or consolidation to which such Authenticating Agent shall be a party, or any corporation succeeding to the corporate agency or corporate trust business of an Authenticating Agent, shall continue to be an Authenticating Agent, provided such corporation shall be otherwise eligible under this Section, without the execution or filing of any paper or any further act on the part of the Trustee or the Authenticating Agent.

 

An Authenticating Agent may resign at any time by giving written notice thereof to the Trustee and the Company. The Trustee may at any time terminate the agency of an Authenticating Agent by giving written notice thereof to such Authenticating Agent and the Company. Upon receiving such a notice of resignation or upon such a termination, or in case at any time such Authenticating Agent shall cease to be eligible in accordance with the provisions of this Section, the Trustee may appoint a successor Authenticating Agent which shall be acceptable to the Company and shall mail written notice of such appointment by first-class mail, postage prepaid, to all Holders of Securities, if any, of the series with respect to which such Authenticating Agent will serve, as their names and addresses appear in the Security Register. Any successor Authenticating Agent upon acceptance of its appointment hereunder shall become vested with all the rights, powers and duties of its predecessor hereunder, with like effect as if originally named as an Authenticating Agent. No successor Authenticating Agent shall be appointed unless eligible under the provisions of this Section.

 

The Company agrees to pay each Authenticating Agent from time to time reasonable compensation for its services under this Section.

 

The provisions of Sections 3.09, 6.04 and 6.05 shall be applicable to each Authenticating Agent.

 

If an appointment with respect to one or more series is made pursuant to this Section, the Securities of such series may have endorsed thereon, in addition to or in lieu of the Trustee’s certificate of authentication, an alternate certificate of authentication in the following form:

 

This certificate represents Securities of the series designated herein referred to in the within-mentioned Indenture.

 

	
Dated:   [                        ]
    	
[                                         ],
    
	
 
    	
not   in its individual capacity but solely as Trustee
    
	
 
    	
 
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
By:
    	
 
    
	
 
    	
Authorized   Signatory
    
	
 
    	
 
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
By:
    	
 
    
	
 
    	
Authorized   Signatory
    

 

If all of the Securities of any series may not be originally issued at one time, and if the Trustee does not have an office capable of authenticating Securities upon original issuance located in a Place of Payment where the Company wishes to have Securities of such series authenticated upon original issuance, the Trustee, if so requested in writing (which writing need not comply with Section 1.02) by the Company, shall appoint in accordance with this Section an Authenticating Agent having an office in a Place of Payment designated by the Company with respect to such series of Securities.

 

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ARTICLE SEVEN

 

HOLDERS’ LISTS AND REPORTS BY TRUSTEE AND COMPANY

 

Section 7.01. Company to Furnish Trustee Names and Addresses of Holders.

 

In accordance with Section 312(a) of the Trust Indenture Act, the Company will furnish or cause to be furnished to the Trustee

 

(1) semi-annually, not later than 15 days after the Regular Record Date for interest for each series of Securities, a list, in such form as the Trustee may reasonably require, of the names and addresses of the Holders of Securities of such series as of such Regular Record Date, or if there is no Regular Record Date for interest for such series of Securities, semi-annually, upon such dates as are set forth in the Board Resolution or indenture supplemental hereto authorizing such series, and

 

(2) at such other times as the Trustee may request in writing, within 30 days after the receipt by the Company of any such request, a list of similar form and content as of a date not more than 15 days prior to the time such list is furnished,

 

provided, however, that so long as the Trustee is the Security Registrar no such list shall be required to be furnished.

 

Section 7.02. Preservation of Information; Communications to Holders.

 

(a) The Trustee shall comply with the obligations imposed upon it pursuant to Section 312 of the Trust Indenture Act.

 

(b) Every Holder of Securities, by receiving and holding the same, agrees with the Company and the Trustee that neither the Company nor the Trustee nor any Paying Agent nor any Security Registrar shall be held accountable by reason of the disclosure of any such information as to the names and addresses of the Holders of Securities in accordance with Section 312 of the Trust Indenture Act, regardless of the source from which such information was derived, and that the Trustee shall not be held accountable by reason of mailing any material pursuant to a request made under Section 312(b) of the Trust Indenture Act.

 

Section 7.03. Reports By Trustee.

 

(a) Within 60 days after May 15 of each year commencing with the year following the first issuance of Securities pursuant to Section 3.01, if required by Section 313(a) of the Trust Indenture Act, the Trustee shall transmit pursuant to Section 313(c) of the Trust Indenture Act a brief report dated as of such May 15 with respect to any of the events specified in said Section 313(a) which may have occurred since the later of the immediately preceding May 15 and the date of this Indenture.

 

(b) The Trustee shall transmit the reports required by Section 313(b) of the Trust Indenture Act at the times specified therein.

 

(c) Reports pursuant to this Section shall be transmitted in the manner and to the Persons required by Sections 313(c) and (d) of the Trust Indenture Act.

 

Section 7.04. Reports By Company.

 

The Company shall file with the Trustee and the Commission, and transmit to Holders, such information, documents and other reports, and such summaries thereof, as may be required pursuant to the Trust Indenture Act at the times and in the manner provided pursuant to such Act; provided that any such information, documents or reports required to be filed with the Commission pursuant to Section 13 or 15(d) of the Exchange Act shall be filed with the Trustee within 15 days after the same is so required to be filed with the Commission.

 

Delivery of such reports, information and documents to the Trustee is for informational purposes only and the Trustee’s receipt of such shall not constitute constructive or other notice of any information contained therein or determinable from information contained therein, including the Company’s compliance with any of its covenants hereunder (as to which the Trustee is entitled to rely exclusively on Officer’s Certificates). Notwithstanding the foregoing, to the extent any of the information required by this Section 7.04 is filed by the Company with the Commission and publicly available on the Commission’s EDGAR system (or any successor system thereto), then such information shall be deemed to be filed with the Trustee.

 

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ARTICLE EIGHT

 

CONSOLIDATION, MERGER AND SALES

 

Section 8.01. Company May Consolidate Etc., Only on Certain Terms.

 

Nothing contained in this Indenture or in any of the Securities shall prevent any consolidation or merger of the Company with or into any other Person or Persons (whether or not affiliated with the Company), or successive consolidations or mergers in which the Company or its successor or successors shall be a party or parties, or shall prevent any conveyance, transfer or lease of the property of the Company as an entirety or substantially as an entirety, to any other Person (whether or not affiliated with the Company); provided, however, that:

 

(1) in case the Company shall consolidate with or merge into another Person or convey, transfer or lease its properties and assets substantially as an entirety to any Person, the entity formed by such consolidation or into which the Company is merged or the Person which acquires by conveyance or transfer, or which leases, the properties and assets of the Company substantially as an entirety shall be a corporation organized and existing under the laws of the United States of America, any State thereof or the District of Columbia and shall expressly assume, by one or more indentures supplemental hereto, executed and delivered by the successor Person to the Trustee, in form satisfactory to the Trustee, the due and punctual payment of the principal of (and premium, if any) and interest on or any Additional Amounts in respect of all the Securities and the performance of every other covenant of this Indenture on the part of the Company to be performed or observed;

 

(2) immediately after giving effect to such transaction no Event of Default, and no event which, after notice or lapse of time or both, would become an Event of Default, shall have happened and be continuing; and

 

(3) each of the Company and the successor Person has delivered to the Trustee an Officer’s Certificate and an Opinion of Counsel, each stating that such consolidation, merger, conveyance, transfer or lease and such supplemental indenture comply with this Article and that all conditions precedent herein provided for relating to such transaction have been complied with.

 

Section 8.02. Successor Corporation Substituted For Company.

 

Upon any consolidation or merger or any conveyance, transfer or lease of the properties and assets of the Company substantially as an entirety to any Person in accordance with Section 8.01, the successor Person formed by such consolidation or into which the Company is merged or to which such conveyance, transfer or lease is made shall succeed to, and be substituted for, and may exercise every right and power of, the Company under this Indenture with the same effect as if such successor Person had been named as the Company herein, and thereafter, the Company shall be relieved of all obligations and covenants under this Indenture and the Securities.

 

ARTICLE NINE

 

SUPPLEMENTAL INDENTURES

 

Section 9.01. Supplemental Indentures Without Consent of Holders.

 

Without the consent of any Holders, the Company, when authorized by Board Resolutions, and the Trustee, at any time and from time to time, may enter into one or more indentures supplemental hereto, in form satisfactory to the Trustee, for any of the following purposes:

 

(1) to evidence the succession of another Person to the Company, and the assumption by any such successor of the covenants of the Company herein and in the Securities;

 

(2) to add to the covenants of the Company for the benefit of the Holders of all or any series of Securities (and if such covenants are to be for the benefit of less than all series of Securities, stating that such covenants are expressly being included solely for the benefit of such series) or to surrender any right or power herein conferred upon the Company;

 

(3) to add to or change any of the provisions of this Indenture to such extent as shall be necessary to permit or facilitate the issuance of Securities in bearer form, registrable or not registrable as to principal, and with or without interest coupons, or to permit or facilitate the issuance of Securities in uncertificated form;

 

(4) to establish the form or terms of Securities of any series as permitted by Sections 2.01 and 3.01;

 

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(5) to evidence and provide for the acceptance of appointment hereunder by a successor Trustee with respect to the Securities of one or more series and to add to or change any of the provisions of this Indenture as shall be necessary to provide for or facilitate the administration of the trusts hereunder by more than one Trustee, pursuant to the requirements of Section 6.10(b);

 

(6) to cure any ambiguity, to correct or supplement any provision herein which may be defective or inconsistent with any other provision herein, or to make any other provisions with respect to matters or questions arising under this Indenture which shall not be inconsistent with the provisions of this Indenture and which shall not adversely affect the interest of the Holders of Securities of any series in any material respect;

 

(7) to add to, delete from or revise the conditions, limitations and restrictions on the authorized amount, terms or purposes of issue, authentication and delivery of Securities, as herein set forth;

 

(8) to add any additional Events of Default for the benefit of the Holders of all or any series of Securities (and if such additional Events of Default are to be for the benefit of less than all series of Securities, stating that such additional Events of Default are expressly being included solely for the benefit of such series);

 

(9) to modify, eliminate or add to the provisions of this Indenture to such extent as shall be necessary to conform the obligations of the Company and the Trustee under this Indenture to the obligations imposed on such Persons hereunder pursuant to the Trust Indenture Act or under any similar federal statute hereafter enacted and rules or regulations of the Commission thereunder;

 

(10) to make provisions with respect to the conversion rights of Holders of Convertible Securities; or

 

(11) to add to, change or eliminate any of the provisions of this Indenture in respect to one or more series of Securities; provided, however, that any such addition, change or elimination (i) shall neither (A) apply to any Security of any series issued prior to the execution of such supplemental indenture and entitled to the benefit of such provision nor (B) modify the rights of the Holder of any such pre-existing series of any Security with respect to the application of such provision to such pre-existing series of a Security or (ii) shall become effective only when there is no such pre-existing series of a Security outstanding.

 

Section 9.02. Supplemental Indentures With Consent of Holders.

 

With the consent of the Holders of not less than a majority in principal amount of the Outstanding Securities of each series affected by such supplemental indenture, by Act of said Holders delivered to the Company and the Trustee, the Company, when authorized by Board Resolutions, and the Trustee may enter into an indenture or indentures supplemental hereto for the purpose of adding any provisions to or changing in any manner or eliminating any of the provisions of this Indenture or of modifying in any manner the rights of the Holders of Securities of such series under this Indenture; provided, however, that no such supplemental Indenture shall, without the consent of the Holder of each Outstanding Security affected thereby, shall:

 

(1) change the Stated Maturity of the principal of, or any installment of interest on, any Security, or reduce the principal amount thereof or the rate of interest thereon or any Additional Amounts payable in respect thereof, or any premium payable upon the redemption thereof, or change the obligation of the Company to pay Additional Amounts pursuant to Section 10.05 (except as contemplated by Section 8.01(1) and permitted by Section 9.01(1)), or reduce the amount of the principal of an Original Issue Discount Security that would be due and payable upon a declaration of acceleration of the Maturity thereof pursuant to Section 5.02, or change the Place of Payment, coin or currency in which any Security or any premium or the interest thereon is payable, or impair the right to institute suit for the enforcement of any such payment on or after the Stated Maturity thereof (or, in the case of redemption, on or after the Redemption Date), or

 

(2) reduce the percentage in principal amount of the Outstanding Securities of any series, the consent of whose Holders is required for any such supplemental indenture, or the consent of whose Holders is required for any waiver (of compliance with certain provisions of this Indenture or certain defaults hereunder and their consequences) provided for in this Indenture, or

 

(3) modify any of the provisions of this section, or Sections 5.12, 5.13 or Section 10.11, except to increase any such percentage or to provide that certain other provisions of this Indenture cannot be modified or waived without the consent of the Holder of each Outstanding Security affected thereby.

 

The Company may, but shall not be obligated to, fix a record date for the purposes of determining the Persons entitled to consent to any indenture supplemental hereto. If a record date is fixed, the Holders on such

 

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record date, or their duly designated proxies, and only such Persons, shall be entitled to consent to such supplemental indenture, whether or not such Holders remain Holders after such record date; provided, that unless such consent shall have become effective by virtue of the requisite percentage having been obtained prior to the date which is 90 days after such record date, any such consent previously given shall automatically and without further action by any Holder be cancelled and of no further effect.

 

A supplemental indenture which changes or eliminates any covenant or other provision of this Indenture which has expressly been included solely for the benefit of one or more particular series of Securities, or which modifies the rights of the Holders of Securities of such series with respect to such covenant or other provision, shall be deemed not to affect the rights under this Indenture of the Holders of Securities of any other series.

 

It shall not be necessary for any Act of Holders of Securities under this Section to approve the particular form of any proposed supplemental indenture, but it shall be sufficient if such Act shall approve the substance thereof.

 

Section 9.03. Execution of Supplemental Indentures.

 

As a condition to executing, or accepting the additional trusts created by, any supplemental indenture permitted by this Article or the modifications thereby of the trust created by this Indenture, the Trustee shall be provided with, and (subject to Section 315 of the Trust Indenture Act) shall be fully protected in relying upon, an Opinion of Counsel stating that the execution of such supplemental indenture is authorized or permitted by this Indenture and that it complies with the terms of this Indenture. The Trustee may, but shall not be obligated to, enter into any such supplemental indenture which affects the Trustee’s own rights, duties or immunities under this Indenture or otherwise.

 

Section 9.04. Effect of Supplemental Indentures.

 

Upon the execution of any supplemental indenture under this Article, this Indenture shall be modified in accordance therewith, and such supplemental indenture shall form a part of this Indenture for all purposes; and every Holder of a Security theretofore or thereafter authenticated and delivered hereunder shall be bound thereby.

 

Section 9.05. Conformity With Trust Indenture Act.

 

Every supplemental indenture executed pursuant to this Article shall conform to the requirements of the Trust Indenture Act as then in effect.

 

Section 9.06. Reference in Securities to Supplemental Indentures.

 

Securities of any series authenticated and delivered after the execution of any supplemental indenture pursuant to this Article may, and shall if required by the Trustee, bear a notation in form approved by the Trustee as to any matter provided for in such supplemental indenture. If the Company shall so determine, new Securities of any series so modified as to conform, in the opinion of the Trustee and the Company, to any such supplemental indenture may be prepared and executed by the Company and authenticated and delivered by the Trustee in exchange for Outstanding Securities of such series.

 

ARTICLE TEN

 

COVENANTS

 

Section 10.01. Payment of Principal, Premium, If Any, and Interest.

 

The Company covenants and agrees for the benefit of the Holders of each series of Securities that it will duly and punctually pay the principal of (and premium, if any), interest on or any Additional Amounts payable in respect of the Securities of that series in accordance with the terms of such series of Securities and this Indenture.

 

Section 10.02. Maintenance of Office or Agency.

 

The Company will maintain in each Place of Payment for any series of Securities an office or agency where Securities of such series may be presented or surrendered for payment, where Securities of that series may be surrendered for registration of transfer or exchange and where notices and demands to or upon the Company in respect of the Securities of that series and this Indenture may be served. The Company will give prompt written notice to the Trustee of the location, and any change in the location, of such office or agency. If at any time the Company shall fail to maintain any such required office or agency or shall fail to furnish the Trustee with the address thereof, such presentations, surrenders, notices and demands may be made or served at the Corporate Trust

 

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Office of the Trustee, at the place specified for the purpose pursuant to Section 3.01, and the Company hereby appoints the Trustee as its agent to receive all such presentations, surrenders, notices and demands.

 

The Company may also from time to time designate one or more other offices or agencies where the Securities of one or more series may be presented or surrendered for any or all such purposes and may from time to time rescind such designations; provided, however, that no such designation or rescission shall in any manner relieve the Company of their obligation to maintain an office or agency in each Place of Payment for Securities of any series for such purposes. The Company will give prompt written notice to the Trustee of any such designation or rescission and of any change in the location of any such other office or agency. Unless otherwise specified as contemplated by Section 3.01, the Company hereby designates as the Place of Payment for each series the Corporate Trust Office of the Trustee.

 

Section 10.03. Money For Securities Payments to Be Held in Trust.

 

If the Company shall at any time act as its own Paying Agent with respect to any series of Securities, it will, on or before each due date of the principal of (and premium, if any), or interest on, any of the Securities of that series, segregate and hold in trust for the benefit of the Person entitled thereto a sum sufficient to pay the principal (and premium, if any) or interest so becoming due until such sums shall be paid to such Persons or otherwise disposed of as herein provided, and will promptly notify the Trustee of its action or failure so to act.

 

Whenever the Company shall have one or more Paying Agents for any series of Securities, it will, on or prior to each due date of the principal of (and premium, if any), or interest on, any Securities of that series, deposit with any Paying Agent a sum sufficient to pay the principal (and premium, if any) or interest so becoming due, such sum to be held in trust for the benefit of the Persons entitled to such principal, premium or interest, and (unless such Paying Agent is the Trustee) the Company will promptly notify the Trustee of its action or failure so to act.

 

The Company will cause each Paying Agent for any series of Securities other than the Trustee to execute and deliver to the Trustee an instrument in which such Paying Agent shall agree with the Trustee, subject to the provisions of this Section, that such Paying Agent will:

 

(1) comply with the provisions of the Trust Indenture Act applicable to it as Paying Agent;

 

(2) hold all sums held by it for the payment of the principal of (and premium, if any) or interest on Securities of that series in trust for the benefit of the Persons entitled thereto until such sums shall be paid to such Persons or otherwise disposed of as herein provided;

 

(3) give the Trustee notice of any default by the Company (or any other obligor upon the Securities of that series) in the making of any payment of principal (and premium, if any) or interest on the Securities of that series; and

 

(4) at any time during the continuance of any such default, upon the written request of the Trustee, forthwith pay to the Trustee all sums so held in trust by such Paying Agent.

 

The Company may at any time, for the purpose of obtaining the satisfaction and discharge of this Indenture or for any other purpose, pay, or by Company Order direct any Paying Agent to pay, to the Trustee all sums held in trust by the Company or such Paying Agent, such sums to be held by the Trustee upon the same terms as those upon which such sums were held by the Company or such Paying Agent; and, upon such payment by any Paying Agent to the Trustee, such Paying Agent shall be released from all further liability with respect to such money.

 

Except as otherwise provided hereby or pursuant hereto, any money deposited with the Trustee or any Paying Agent, or then held by the Company, in trust for the payment of the principal of (and premium, if any) or interest and Additional Amounts on any Security of any series and remaining unclaimed for two years after such principal (and premium, if any) or interest has become due and payable shall be paid to the Company on Company Request, or (if then held by the Company) shall be discharged from such trust; and the Holder of such Security shall thereafter, as an unsecured general creditor, look only to the Company for payment thereof, and all liability of the Trustee or such Paying Agent with respect to such trust money, and all liability of the Company as trustee thereof, shall thereupon cease; provided, however, that the Trustee or such Paying Agent, before being required to make any such repayment, may at the expense of the Company cause to be published once, in an English language newspaper of general circulation, published on each Business Day, in each Place of Payment for such series or to be mailed to Holders of Securities for such series, or both, notice that such money remains unclaimed and that, after a date specified therein, which shall not be less than 30 days from the date of such publication or mailing nor shall it be

 

33

 

later than two years after such principal (and premium, if any) or interest has become due and payable, any unclaimed balance of such money then remaining will be repaid to the Company.

 

Section 10.04. Additional Amounts.

 

If any Securities of a series provide for the payment of Additional Amounts, the Company agrees to pay to the Holder of any such Security of any such series Additional Amounts as provided therein. Whenever in this Indenture there is mentioned, in any context, the payment of the principal of (or premium, if any) or interest on, or in respect of, any Security of any series or the net proceeds received on the sale or exchange of any Security of any series, such mention shall be deemed to include mention of the payment of Additional Amounts provided by the terms of such series established hereby or pursuant hereto to the extent that, in such context, Additional Amounts are, were or would be payable in respect thereof pursuant to such terms and express mention of the payment of Additional Amounts (if applicable) in any provisions hereof shall not be construed as excluding Additional Amounts in those provisions hereof where such express mention is not made.

 

Except as otherwise provided herein or pursuant hereto, if the Securities of a series provide for the Payment of Additional Amounts, at least 10 days prior to the first Interest Payment Date with respect to such series of Securities (or if the Securities of that series shall not bear interest prior to Maturity, the first day on which a payment of principal (and premium, if any, is made), and at least 10 days prior to each date of payment of principal (and premium, if any) or interest if there has been any change with respect to the matters set forth in the below-mentioned Officer’s Certificate, the Company will furnish the Trustee and the principal Paying Agent or Paying Agents, if other than the Trustee, an Officer’s Certificate instructing the Trustee and such Paying Agent or Paying Agents whether such payment of principal (and premium, if any) of or interest on the Securities of that series shall be made to Holders of Securities of that series who are United States Aliens without withholding for or on account of any tax, assessment or other governmental charge described in the Securities of that series. If any such withholding shall be required, then such Officer’s Certificate shall specify by country the amount, if any, required to be withheld on such payments to such Holders and the Company agrees to pay to the Trustee or such Paying Agent the Additional Amounts required by this Section. The Company covenants to indemnify the Trustee and any Paying Agent for, and to hold them harmless against, any loss, liability or expense reasonably incurred without negligence or bad faith on their part arising out of or in connection with actions taken or omitted by any of them in reliance on any Officer’s Certificate furnished pursuant to this Section.

 

Section 10.05. Statement As To Compliance; Notice of Certain Defaults.

 

(a) The Company will, in addition to the reports required by Section 7.04, deliver to the Trustee, within 120 days after the end of each fiscal year (which on the date hereof ends on December 31), commencing December 31, 20[ ], a written statement, which need not comply with Section 1.02, signed by the Chairman of the Board, the Chief Executive Officer, the President, the Chief Operating Officer or an Executive Vice President and by the Chief Financial Officer, the Treasurer or an Assistant Treasurer of the Company, stating, as to each signer thereof, that

 

(1) a review of the activities of the Company during such year and of performance under this Indenture has been made under his supervision, and

 

(2) to the best of his knowledge, based on such review, (a) the Company has fulfilled all of its obligations under this Indenture throughout such year, or, if there has been a default in the fulfillment of any such obligation, specifying each such default known to him and the nature and status thereof, and (b) no event has occurred and is continuing which is, or after notice or lapse of time or both would become, an Event of Default, or, if such an event has occurred and is continuing, specifying each such event known to him and the nature and status thereof.

 

(b) The Company will deliver to the Trustee as soon as possible, and in any event, within five days after the occurrence thereof, written notice of any event which after notice or lapse of time or both would become an Event of Default.

 

Section 10.06. Payment of Taxes and Other Claims.

 

The Company will pay or discharge or cause to be paid or discharged, before the same shall become delinquent, (1) all taxes, assessments and governmental charges levied or imposed upon the Company or any Subsidiary or upon the income, profits or property of the Company or any Subsidiary, and (2) all lawful claims for labor, materials and supplies which, if unpaid, might by law become a lien upon the property of the Company or any subsidiary; provided, however, that the Company shall not be required to pay or discharge or cause to be paid or

 

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discharged any such tax, assessment, charge or claim whose amount, applicability or validity is being contested in good faith by appropriate proceedings.

 

Section 10.07. Corporate Existence.

 

Subject to Article Eight, the Company will do or cause to be done all things necessary to preserve and keep in full force and effect its corporate existence, rights (charter and statutory); provided, however, that the Company shall not be required to preserve any such right or franchise if the Company shall determine that the preservation thereof is no longer desirable in the conduct of the business of the Company and that the loss thereof is not disadvantageous in any material respect to the Holders.

 

Section 10.08. Waiver of Certain Covenants.

 

Except as otherwise specified as contemplated by Section 3.01 for Securities of such series, the Company may omit in any particular instance to comply with any term, provision or condition set forth pursuant to Section 3.01(17), or in Section 10.06 or 10.07 with respect to the Securities of any series if before the time for such compliance the Holders of at least a majority in principal amount of the Outstanding Securities of such series shall, by Act of such Holders, either waive such compliance in such instance or generally waive compliance with such term, provision or condition, but no such waiver shall extend to or affect such term, provision or condition except to the extent so expressly waived, and, until such waiver shall become effective, the obligations of the Company and the duties of the Trustee in respect of any such term, provision or condition shall remain in full force and effect.

 

Section 10.09. Calculation of Original Issue Discount.

 

The Company shall file with the Trustee promptly at the end of each calendar year (i) a written notice specifying the amount of original issue discount (including daily rates and accrual periods) accrued on Outstanding Securities as of the end of such year and (ii) such other specific information relating to such original issue discount as may then be relevant under the Internal Revenue Code of 1986, as amended from time to time.

 

ARTICLE ELEVEN

 

REDEMPTION OF SECURITIES

 

Section 11.01. Applicability of Article.

 

Redemption of Securities of any series at the option of the Company as permitted or required by the terms of such Securities shall be made in accordance with the terms of such Securities and (except as otherwise provided herein or pursuant hereto or as specified as by Section 3.01) this Article.

 

Section 11.02. Election To Redeem; Notice To Trustee.

 

The election of the Company to redeem any Securities shall be evidenced by Board Resolution or in such other manner specified as contemplated by Section 3.01. In case of any redemption at the election of the Company of the Securities of any series, with the same issue date, interest rate and Stated Maturity, the Company shall, at least 60 days prior to the Redemption Date fixed by the Company (unless a shorter notice shall be satisfactory to the Trustee), notify the Trustee of such Redemption Date and of the principal amount of Securities of such series to be redeemed.

 

Section 11.03. Selection By Trustee of Securities To Be Redeemed.

 

If less than all the Securities of any series with the same issue date, interest rate, Stated Maturity and other terms are to be redeemed, the particular Securities to be redeemed shall be selected not more than 60 days prior to the Redemption Date by the Trustee from the Outstanding Securities of such series not previously called for redemption, by such method as the Trustee shall deem fair and appropriate and which may provide for the selection for redemption of portions of the principal amount of Securities of such series; provided, however, that no such partial redemption shall reduce the portion of the principal amount of a Security of such series not redeemed to less than the minimum denomination for a Security of such series established herein pursuant hereto.

 

If any Convertible Security selected for partial redemption is converted in part before termination of the conversion right with respect to the portion of the Security so selected, the converted portion of such Security shall be deemed (so far as may be) to be the portion selected for redemption. Securities which have been converted during a selection of Securities to be redeemed shall be treated by the Trustee as Outstanding for the purpose of such selection.

 

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The Trustee shall promptly notify the Company and the Security Registrar (if other than itself) in writing of the Securities selected for redemption and, in the case of any Securities selected for partial redemption, the principal amount thereof to be redeemed.

 

For all purposes of this Indenture, unless the context otherwise requires, all provisions relating to the redemption of Securities shall relate, in the case of any Securities redeemed or to be redeemed only in part, to the portion of the principal of such Securities which has been or is to be redeemed.

 

Section 11.04. Notice of Redemption.

 

Notice of redemption shall be given in the manner provided in Section 1.06, not less than 30 nor more than 60 days prior to the Redemption Date, unless a shorter period is specified in the Securities to be redeemed, to the Holders of Securities to be redeemed. Failure to give notice by mailing in the manner herein provided to the Holder of any Securities designated for redemption as a whole or in part, or any defect in the notice to any such Holder, shall not affect the validity of the proceedings for the redemption of any other Securities or portion thereof.

 

Any notice that is mailed to the Holder of any Securities in the manner herein provided shall be conclusively presumed to have been duly given, whether or not such Holder receives the notice.

 

All notices of redemption shall state:

 

(1) the Redemption Date,

 

(2) the Redemption Price,

 

(3) if less than all Outstanding Securities of any series are to be redeemed, the identification (and, in the case of partial redemption, the principal amount) of the particular Securities to be redeemed,

 

(4) in case any Security is to be redeemed in part only, the notice which relates to such Security shall state that on and after the Redemption Date, upon surrender of such Security, the Holder of such Security will receive, without charge, a new Security or Securities of authorized denominations for the principal amount thereof remaining unredeemed,

 

(5) in the case of Convertible Securities, the Conversion Price then in effect, the date on which the right to convert the principal amount of the Securities or the portions thereof to be redeemed will terminate and the place or places where such Securities may be surrendered for conversion,

 

(6) that on the Redemption Date the Redemption Price will become due and payable upon each such Security to be redeemed and that interest thereon and Additional Amounts, if any, shall cease to accrue on and after said date,

 

(7) the place or places where such Securities are to be surrendered for payment of the Redemption Price,

 

(8) that the redemption is for a sinking fund, if such is the case, and

 

(9) the CUSIP number, if any.

 

Notice of redemption of Securities to be redeemed at the election of the Company shall be given by the Company or, at the Company’s request, by the Trustee in the name and at the expense of the Company.

 

Section 11.05. Deposit of Redemption Price.

 

On or prior to any Redemption Date, the Company shall deposit with the Trustee or with a Paying Agent (or, if the Company is acting as its own Paying Agent, segregate and hold in trust as provided in Section 10.03) an amount of money sufficient to pay the Redemption Price of, and (except if the Redemption Date shall be an Interest Payment Date) accrued interest on and any Additional Amounts with respect thereto, all the Securities or portions thereof which are to be redeemed on that date.

 

If any Convertible Security or portion thereof called for redemption is converted in accordance with the terms of such Convertible Security, any money deposited with the Trustee or so segregated and held in trust for the redemption of such Security or portion thereof shall (subject to any right of the Holder of the Security on a Regular Record Date preceding such conversion to receive interest) be paid to the Company upon Company Request or, if then held by the Company, shall be discharged from such trust.

 

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Section 11.06. Securities Payable on Redemption Date.

 

Notice of redemption having been given as aforesaid, the Securities so to be redeemed shall, on the Redemption Date, become due and payable at the Redemption Price therein specified, and from and after such date (unless the Company shall default in the payment of the Redemption Price and accrued interest) such Securities shall cease to bear interest. Upon surrender of any such Security for redemption in accordance with said notice, such Security shall be paid by the Company at the Redemption Price, together with accrued interest (or any Additional Amounts) to the Redemption Date; provided, that installments of interest on Securities whose Stated Maturity is on or prior to the Redemption Date shall be payable to the Holders of such Securities, or one or more Predecessor Securities, registered as such at the close of business on the Regular Record Dates according to their terms and the provisions of Section 3.08.

 

If any Security called for redemption shall not be so paid upon surrender thereof for redemption, the principal (and premium, if any) shall, until paid, bear interest from the Redemption Date at the rate prescribed therefor in the Security.

 

Section 11.07. Securities Redeemed in Part.

 

Any Security which is to be redeemed only in part shall be surrendered at any office or agency of the Company maintained for that purpose pursuant to Section 10.02 (with, if the Company or the Trustee so requires, due endorsement by, or a written instrument of transfer in form satisfactory to the Company and the Trustee duly executed by, the Holder thereof or his attorney duly authorized in writing) and the Company shall execute and the Trustee shall authenticate and deliver to the Holder of such Security without service charge, a new Security or Securities of the same series, containing identical terms and provisions, of any authorized denomination as requested by such Holder in aggregate principal amount equal to and in exchange for the unredeemed portion of the principal of the Security so surrendered. If a Security in global form is so surrendered, the Company shall execute, and the Trustee shall authenticate and deliver to the U.S. Depository or other depository for such Security in global form as shall be specified in the Company Order with respect thereto to the Trustee, without service charge, a new Security in global form in a denomination equal to and in exchange for the unredeemed portion of the principal of the Security in global form so surrendered.

 

Section 11.08. Conversion Arrangements on Call for Redemption.

 

Notwithstanding anything to the contrary contained in this Indenture, in connection with any redemption of Convertible Securities of any series, the Company, by an agreement with one or more investment bankers or other purchasers, may arrange for such purchasers to purchase all such Convertible Securities called for redemption (the “Called Securities”) which are either (i) surrendered for redemption or (ii) not duly surrendered for redemption or conversion prior to the close of business on the Redemption Date, and to convert the same into shares of Common Stock, by the purchasers’ depositing with the Trustee (acting as Paying Agent with respect to the deposit of such amount and as conversion agent with respect to the conversion of such Called Securities), in trust for the Holders of the Called Securities, on or prior to the Redemption Date in the manner agreed to by the Company and such purchasers, an amount sufficient to pay the Redemption Price, payable by the Company on redemption of such Called Securities. In connection with any such arrangement for purchase and conversion, the Trustee as Paying Agent shall pay on or after the Redemption Date such amounts so deposited by the purchasers in exchange for Called Securities surrendered for redemption prior to the close of business on the Redemption Date and for all Called Securities surrendered after such Redemption Date. Notwithstanding anything to the contrary contained in this Article Eleven, the obligation of the Company to pay the Redemption Price of such Called Securities shall be satisfied and discharged to the extent such amount is so paid by such purchasers. However, nothing in this Section 11.08 shall in any way relieve the Company of the obligation to pay such Redemption Price on all Called Securities to the extent such amount is not so paid by said purchasers. For all purposes of this Indenture, any Called Securities surrendered by the Holders for redemption, and any Called Securities not duly surrendered for redemption or conversion prior to the close of business on the Redemption Date, shall be deemed acquired by such purchasers from such Holders and surrendered by such purchasers for conversion and shall in all respects be deemed to have been converted, all as of immediately prior to the close of business on the Redemption Date, subject to the deposit by the Purchasers of the above amount as aforesaid. Nothing in this Section 11.08 shall in any way limit the right of any Holder of a Security to convert his Security pursuant to the terms of this Indenture and of such Security at any time prior to the close of business on the Redemption Date applicable thereto.

 

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ARTICLE TWELVE

 

SINKING FUNDS

 

Section 12.01. Applicability of Article.

 

The provisions of this Article shall be applicable to any sinking fund for the retirement of Securities of a series, except as otherwise permitted or required by any form of Security of such series issued pursuant to this Indenture.

 

The minimum amount of any sinking fund payment provided for by the terms of Securities of any series is herein referred to as a “mandatory sinking fund payment”, and any payment in excess of such minimum amount provided for by the terms of Securities of such series is herein referred to as an “optional sinking fund payment”. If provided for by the terms of Securities of any series, the cash amount of any sinking fund payment may be subject to reduction as provided in Section 12.02. Each sinking fund payment shall be applied to the redemption of Securities of any series as provided for by the terms of Securities of such series.

 

Section 12.02. Satisfaction of Sinking Fund Payments With Securities.

 

The Company may, in satisfaction of all or any part of any sinking fund payment with respect to the Securities of such series to be made pursuant to the terms of such Securities as provided for by the terms of such series (1) deliver Outstanding Securities of such series (other than any of such Securities previously called for redemption or any of such Securities in respect of which cash shall have been released to the Company), and (2) apply as a credit Securities of such series which have been redeemed either at the election of the Company pursuant to the terms of such series of Securities or through the application of permitted optional sinking fund payments pursuant to the terms of such Securities, provided that such series of Securities have not been previously so credited. Such Securities shall be received and credited for such purpose by the Trustee at the Redemption Price specified in such Securities for redemption through operation of the sinking fund and the amount of such sinking fund payment shall be reduced accordingly.

 

Section 12.03. Redemption of Securities For Sinking Fund.

 

Not less than 90 days prior to each sinking fund payment date for any series of Securities, the Company will deliver to the Trustee an Officer’s Certificate specifying the amount of the next ensuing mandatory sinking fund payment for that series pursuant to the terms of that series, the portion thereof, if any, which is to be satisfied by payment of cash and the portion thereof, if any, which is to be satisfied by delivering and crediting of Securities of that series pursuant to Section 12.02, and the optional amount, if any, to be added in cash to the next ensuing mandatory sinking fund payment, and will also deliver to the Trustee any Securities to be so credited and not theretofore delivered. If such Officer’s Certificate shall specify an optional amount to be added in cash to the next ensuing mandatory sinking fund payment, the Company shall thereupon be obligated to pay the amount therein specified. Not less than 60 days before each such sinking fund payment date the Trustee shall select the Securities to be redeemed upon such sinking fund payment date in the manner specified in Section 11.03 and cause notice of the redemption thereof to be given in the name of and at the expense of the Company in the manner provided in Section 11.04. Such notice having been duly given, the redemption of such Securities shall be made upon the terms and in the manner stated in Sections 11.06 and 11.07.

 

* * * * *

 

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This instrument may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, but all such counterparts shall together constitute but one and the same instrument.

 

IN WITNESS WHEREOF, the parties hereto have caused this Indenture to be duly executed as of the day and year first above written.

 

	
 
    	
EAGLE   BANCORP, INC.
    
	
 
    	
 
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
By:
    	
 
    
	
 
    	
Name:
    	
 
    
	
 
    	
Title:
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
[                                     ], not in its individual capacity but solely as Trustee
    
	
 
    	
 
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
By:
    	
 
    
	
 
    	
Name:
    	
 
    
	
 
    	
Title:
    	
 
    
					

 

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