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determine whether a Risk Surcharge, not to exceed 15% of the charged premium <br />shall be imposed. <br />It is the County's intention that the operation of the Regionalized benefits <br />program be cost neutral to the County. Political Subdivisions that wish to <br />participate will pay the County's healthcare consultant a consulting fee as <br />outlined in the Sub-Agreement. This fee has already been incorporated into the <br />quoted rates, however the fee will be paid directly to the consultant. <br />Ongoing Service fees are payable for management of the benefits program <br />for the County's medical and prescription programs. Fees are payable regardless <br />of the number of programs chosen and are subject to change at the discretion of <br />Cuyahoga County. These services are outlined in the Sub-Agreement. <br />In the Initial Underwriting, the County has sole discretion as to the <br />underwriting guidelines used to determine the eligibility of a political subdivision. <br />The County has the right to deny entry in to the Benefits Regionalization Program <br />for any reason. If a political subdivision is approved for entry in to the Benefits <br />Regionalization Program, the County will waive the Initial Underwriting Fee. <br />Annual Adjusts:ent of Fully Insured Equivalent Rate <br />On an annual basis, the County shall set afully-insured equivalent rate for <br />the following calendar year. Annual fully-insured equivalent rate adjustments <br />will be made for each of the annual contract years as required by the program <br />term (3 years). The County has sole discretion as to the underwriting guidelines <br />and actuarial assumptions used to determine the fully-insured equivalent rate for <br />the following calendar year. The County will provide written notice by <br />November 1 of each year to a political subdivision of the fully-insured equivalent <br />rate for the following calendar year. <br />Annual Adjustment of Administrative Fee and Risk Surcharge <br />On an annual basis, the County shall set the Administrative Fee to be <br />charged to both self-funded political subdivisions and fully-insured political <br />subdivisions. On the initial underwriting, the County shall set the Risk Surcharge, <br />if applicable, for a political subdivision for the term of the agreement (3 years). <br />Annual adjustments for the Administrative Fee may be made each year of the <br />agreement. The County has the sole discretion to set the Administrative Fee, at a <br />minimum of 3% and a maximum of 6% of the fully-insured equivalent rate and in <br />the case of aself-funded political subdivision, will be a rate set by the County <br />based upon the services selected. The County also has the sole discretion to set <br />the Risk Surcharge, not to exceed 15% of the fully-insured equivalent rate for <br />each sub-division. The County will provide written notice to political <br />subdivisions of the Administrative Fee and Risk Surcharge, if applicable, at the <br />time of entry into the Benefits Regionalization Program. <br />4 <br />