Sample Company IBP Insurance Services Employee Benefit Program Services Performance Guarantee



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Page 1 of 5 Employee Benefit Program Performance s Financial Guarantee Sample Report Card

Page 2 of 5 Exceeding Your Expectations is committed to partnering with and exceeding the expectations in the delivery of your employee benefit program. We realize benefits are an important part of your organization and a key element in your overall compensation package. Employee Benefit Programs are Important The experience employees have under the employee benefit program is a direct reflection on, the human resources department and the employee benefit program. We understand and appreciate that as the consultant charged with managing your employee benefit program, this experience also reflects on us. In an effort to demonstrate our commitment to offering a quality employee benefit program, and more importantly high quality employee benefit brokerage and consulting services, we are offering a. IBP Insurance What is the IBP Insurance? The Services Performance Guarantee is our way of quantifying our commitment to. If we do not exceed your expectations, we will refund up to $10,000 of our income. It is that simple. The grid below outlines our commitment to. Financial Risk Grid ( - Money at Risk) Score Percentage Returned Dollars Returned to Client 100% - 95 % 0% Varies 94% - 90% 25% Varies 89% - 85% 50% Varies 80% - 84% 75% Varies 79% - below 100% Varies In an effort to quantify our commitment to world class customer service IBP is willing to provide a money back guarantee on our service. We are willing to place a portion of our brokerage fees at risk to ensure we maintain the customer service standards we promised. Scoring At the end of each policy year we ask representatives from the human resources department to complete the report card based on both quantitative and qualitative analysis. Quantitative factors are easier to measure. (i.e. we received 200 email correspondence to the benefits@sample Company.com email during the year and 192 of them were responded to in four hours or less our score would be 96% 192/200.) We will provide annual statistics at the end of the year to assist you in this area (a summary of the monthly reports). Qualitative analysis is a little more difficult but it gauges how well we are doing our job. Qualitative factors include areas such as how we conduct ourselves during the renewal negotiations or if we keep you informed on trends and developments in the employee benefit arena. Included below are our services standards and a sample report card to record our performance. The report card is provided at the beginning of the client engagement and it will assist you in quantifying our services performance standards. The report card is filled out at the end of the year and any refunds payable will be processed within 30 days of receipt of the report card.

Page 3 of 5 Employee Benefit Program Brokerage Service s Customer Service s (all hours are business hours) Return telephone calls Respond to email correspondence and benefits@samplecompany.com Respond to Problem Documentation and Resolution Forms requests Employee Communication Materials (all days are business days) Establish employee benefit email alias benefits@samplecompany.com Produce and deliver customized employee ID cards Design and create proof of employee communication package Create employee benefit intranet (after employee communication package finalized) Renewal s (all days are business days) ProForma renewal analysis presented (prior to the renewal) Actual carrier renewal presented (prior to renewal) Create RFP and review annual case marketing (prior to renewal) Reporting s (all days are business days) Quarterly claims experience reports (after receipt of data from carrier) Monthly claim issue and benefit call activity report (after end of month) Compliance (all days are business days) Prepare and review signature ready Form 5500 (after year end) Prepare and review Summary Annual Report for distribution (after year end) Review Section 125 discrimination testing (after completed) Employer HIPAA Compliance Package (April 14, 2003) Consulting Practices Provide plan design direction and guidance Review financial competitiveness of carrier offering Provides relevant benchmarking standards for our industry Provide relevant benchmarking standards for overall industry Demonstrates knowledge of employee benefit business and trends Demonstrates knowledge of our unique business issues Legislative Update s Keep us updated on both Federal and state legislative developments Weekly Benefits IBP Insights Ezine Monthly Publications (Printed) 3 days 20 days 90 days 90 days 5 days 15 days Immediate Annual Weekly Monthly

Page 4 of 5 Sample Client Employee Benefit Program Brokerage Report Card For the Year Ending December 31, 2002 Customer Service s (all hours are business hours) Grade Return telephone calls 96% Respond to email correspondence and benefits@samplecompany.com 97% Respond to Problem Documentation and Resolution Forms requests 95% Employee Communication Materials (all days are business days) Grade Setup employee benefit email alias benefits@samplecompany.com 3 days 100% Produce and deliver customized employee ID cards 100% Design and create proof of employee communication package 20 days 100% Create employee benefit intranet (after employee communication package finalized) 100% Renewal s (all days are business days) Grade ProForma renewal analysis presented (prior to the renewal) 100% Actual carrier renewal presented (prior to renewal) 90 days 100% Create RFP and review annual case marketing (prior to renewal) 90 days 100% Reporting s (all days are business days) Grade Quarterly claims experience reports (after receipt of data from carrier) 95% Monthly claim issue and benefit call activity report (after end of month) 5 days 95% Compliance (all days are business days) Grade Prepare and review 5500 and supporting schedules (signature ready) 100% Prepare and review Summary Annual Report for distribution 100% Review Section 125 discrimination testing (after completed) 15 days 100% Employer HIPAA Compliance Package (April 14, 2003) Immediate 100% Consulting Practices Grade Provide plan design direction and guidance 100% Review financial competitiveness of carrier offering Annual 90% Provides relevant benchmarking standards for our industry 100% Provide relevant benchmarking standards for overall industry 100% Demonstrates knowledge of employee benefit business and trends 100% Demonstrates knowledge of our unique business issues 95% Legislative Update s Grade Keep us updated on both Federal and state legislative developments 100% Weekly Benefits IBP Insights Ezine Weekly 100% Monthly Publications (Printed) Monthly 100% Total Score 2463% Report Card (Total Score/25) 98.5% Performance Guarantee Refund Due Client $0

Page 5 of 5 This agreement is entered into between and effective June 1, 2003 and will be renewable on annual basis effective June 1, 2004 and renewable annually thereafter. payments will be 30 days after receipt of the applicable period report card. Peter V. Kuhn Principal Date Name Title Date