Consulting Services Agreement | City of San Leandro & Intercare Holdings Insurance Services, Inc.
Effective July 1, 2026 Page 1 of 2
EXHIBIT B
COMPENSATION SCHEDULE & REIMBURSABLE EXPENSES
Annual Claims Administration Fee Fees
Year 1 - 7/1/26-6/30/27 $ 131,337.35
Year 2 - 7/1/27-6/30/28 $ 135,277.47
Year 3 - 7/1/28-6/30/29 $ 140,012.18
Extension Option Year 1 - 7/1/29-6/30/30 $ 144,912.61
Extension Option Year 2- 7/1/30-6/30/31 $ 149,984.55
Total $ 701,524.16
Miscellaneous Services
Bill Review Services Base Contract Extension Option
• Bill Review Processing – all bill types Year 1 Year 2 Year 3 Year 4 Year 5 • Secondary Review (Out of Network &
Bills not subject to OMFS)
15% of
savings
15% of
savings
15% of
savings
15% of
savings
15% of
savings
• EDI, WCIS State Reporting No Charge No Charge No Charge No Charge No Charge • Duplicate Bills No Charge No Charge No Charge No Charge No Charge Utilization Review
• Level 1 – Nonclinical – Adjuster/RFA $18.63 $19.28 $19.95 $20.65 $21.37 • Level 2 – Nurse per hour $119.02 $123.18 $127.49 $131.95 $136.57 • Peer Review – Medical Advisor/hour $253.58 $262.45 $271.63 $281.14 $290.98 • Specialty Peer Review /hour $375.00 $375.00 $375.00 $375.00 $375.00 Case Management
• Telephonic Case Management/hour $108.85 $110.00 $112.00 $112.00 $112.00 • Field Case Management/hour $124.00 $125.00 $125.00 $125.00 $125.00 • Nurse Triag/hour $103.85 $107.48 $111.24 $115.13 $119.16 • Lien Negotiations 15% of
savings
15% of
savings
15% of
savings
15% of
savings
15% of
savings
• Telemedicine OMFS OMFS OMFS OMFS OMFS
SIU Services
• FD1-Fraud Submission (per filing) $150.00 $150.00 $150.00 $150.00 $150.00 • SIU Case Filingi (per filing) $375.00 $375.00 $375.00 $375.00 $375.00 • Background Checks- per assignment $345.00 $345.00 $345.00 $345.00 $345.00 • Social Media Search – per case $500.00 $500.00 $500.00 $500.00 $500.00 MMSEA Section 111 Reporting (per year) $775.00 $775.00 $775.00 $775.00 $775.00 Intake – online No charge No charge No charge No charge No charge Intake – Phone/Fax/Mail/Email $20.00 $20.00 $20.00 $20.00 $20.00 Consulting Services Agreement | City of San Leandro & Intercare Holdings Insurance Services, Inc.
Effective July 1, 2026 Page 2 of 2
i Filing fee for a complete package of SIU claim. Includes research, packaging and discussing with Department of Insurance. Plus Travel cost billed at the current IRS rate for mileage.