towers watson v../ - texas
TRANSCRIPT
PVC Docket No. 46449 Schedule G2.2
J!kttaChrhent 1 Page 6 of 10
American Electric Power
Non-UMINA Postretlrement Health Care Plan
Actuarial Valuation Report Postretirement Welfare Cost for Fiscal Year Ending December 31, 2015 under U.S. GAAP
Employer Contributions for Plan Year Beginning January 1, 2015
April 2015
TOWERS WATSON V../
This report is confidential and intended solely for Ihe informetion arid benefit of the irnmetitate recent Nivea ti may nOt be distributed tO a third party unless worm?' allowed under de Purpose and Actuarial cerrifIcatiorr section herein..
2399.
PUC Docket No.46449 Schedule G2.2
Attachment 1 Page 7 of 10
Noa-UtAWA Poaresernert Health Care Pla;
43
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Prom Co. 512.01.04 3E7004 050090 3Z011 147190 0/00.0740 (m1.5310 1161030 01;04 ps7) 101 4460104.4•1 -9•00901 AMMOMIsin Pim Cs. -FE= 090.570.014 411.112,132 12711.201.40 0143.440 00.00.1135 Is1a.5*111) ott441.4145 gvu.soi 11103.34411
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012.1414 002 di atcas.ses so 131,117 il10,01; 0.3031 lams 1334000 0223.11122.7W 917,213.70 1371.1313230 11. mon suwile 00,104310 (0040010) 00300 01000,440
211 A EP 100 C4011 470031 - 000.07, 03.224.712 140111 1101.371.02 1334 292 13,1000 ,10,44310.0 03911043 0 MOWS i05.13Z41 147 AEP Tom 13478*t Comm - Gm*USs so so a PO 10 so (33.3373 W (00.3311 WS +EP Taos CS.M1C441546i - Timm.. 47 052.134 559229 0333E0 30.374 139:14341 0033041 15191.301 192.317 001011
*EP 7exa• Cent. Co. 10227.514 14.303.333 811970.11/1 3416.110 0,04.1141 41.131.714, 134.233.3043 11.117.1711 04.300,337
103.013 .. 0 0o.:11 414 571.121.772 $00540 02 2000 0.07.7371 03 110 .4-10 3719 445 t43 152.1*/ •70 Pm. C4 10mo Miss. • Eisslaisn 12 Mins 01 101 442 32.347.74 014 00.9341 m 390 , 0120.02 07.301 4971 (I , 1130.130 1393 37) 12.70 239 • Iii19044 ?me, Co - Coma.
.., 0 wk.") 0.040,4•• .0.4.., 0.4 - 141.04r WA1S. 83 103 00 937,30.20 00 335 $1.1124.441 44.191575) (13 581,7* 141211WS3 44 213.*11 122 Mims M.46va, Primes - T1*s50. mon 81190761 876013 90.70401 09.023 301.3111 31237.0131 046.ES) 1,43 501 200140 30 00 17.0 401 tn...., .56• Sit 370191 1727,WO 111,731.010 1,40,1*1 501.00 (8103.401 00 1770 1130.471 01911.417)
Indio,. o 00000 Power Co. • MSC 8112.331.382 511.430.817 8301.314.148 11431.116 11.111.230 013.2000 (8140.319 12,0)4.113 012.00,7235 ZW Poto PAerCom SO 03 30 30 17 30 SO SO so
0000 031020 F mot Co.. 340 013,33902 111,430917 1101.511.510 11,523.740 0.30139 013,04.310 (11.411.303 13.024133 012519732)
i 1C 0000 Poole Co. • 01.1.04.1 123.7113.104 SI 4370)9 134912731 004.427 1704,2311 31.50300i cs1.2)0 5711, 1330.323 01.0113.0120 117 100000 Porm Co,- 040040 102.170.3411 4175337 . 313.46.7 V; $40..91 ime.ws 35014.04 2111.031 Ms 430 (5144,4147) 130 0499430 Peoor Co - 10400454o
CO OP.SOO, 81.373901 0002 0.3713.401 1230 30912 01413941 (81111.190 03710 r3330.510
1920.123 30.011 81.1)4.40 122.04 ssr.szy 411.413, 043.339 111,444 1048.1210 MO Komeoly POOR - Am. 703 fumucky Pam703 - 10300 Mhos
- 34.107.1131 525.03 13.344.00 015203 000 Mt (1300.30) (5160.707) 114135 4131.413/
910 710.391 0103063 511.30.07 $0 91944.ry oz,,,u(1":759,45:
1132.031 11525,100) 7C/Zein4m 70440000 114900 1000 100000 Pam, Co. 9111.114,141 83,07.11111 10.1193.00 041.971 0/.09.081.°271 5431.10 04,344.290
790 000 Pam 02 - 010031.40 inessoat 311203 WI $412.305.331 06570 19 729.51‘ (511 881.320) C15 Ble OM 31 833 as ;711.441 41771 00 010 Pars Co • Tonseresmo 81990114 11,401234 02443.200 10,00 030,073 0 0.7.510 :V 01.1401 0239 503 2199309
090 Poror Co 110.5*440 011,0300 7214.110447 4161M* 31341W488 012.937•4431 0901.000 12. stsse 1511.987m5;
at P. Some Co 0 000040 - Dontmon 7,093 ammo Os 01.10000 - Cororman 410 of
141.991,30 81.00.432 01.121 00 137707 11 10.013 04.00,1211 (0.477 00)) 904.730 (31.403.855) 13Z719034 3141402 13E114.0311 1247,475 9311.727 01 110 6040 41 401340 1.02 40 01931.201
Co 0110040 10•00040 15.020.50 SOO WO 113.00 327 364.107 00012 0433 920 0311 301 1 70 1020.194(
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155 0090400411 6acs.. P. Co -04309.404 333,3**2 33.285.792 841.1*7 /5 5151.417 *300 MD 42.1.1541 01.794.1150 1413.0111 (90•416.5519 MS 34.0041300 4000 Poop Co. 00400 • 131.167.04 12.511.805 1.34.01/21 101 MS 11.10.06 (52.90.319 41 117.00) 107907 (13.010.0320
Paw Co 115.01.317 91.042.01 031.2311.194 0040 1007 10 01 2000 00.0714 1191201 (5*219 1357 110 0444044400 8.0340 • Nam -130109,04 10 10,4040440 Elam Pow CO • Taxos - 1004.4440
41•3740 9044, Ca • 90944004. 93 91 SO $O 93 10 $S so 33
010301 1301.740 30.312.5.13 SalTEMI M1•99. (107011) 83284.2-48 3041 (020.0:1) 01 5031Posn40 elOOlfiC POMO, 08. 334.113.412 33.1011790 1804.515364 1142.550 11.1417112 (14.140.1031 (1515311051 11,011417 (13.601.344 1110401NOONOIO
1.• •EP T..04 IMO 03.9.9 • 000401 122.442,120 0.503 5* 127.034 041 8137067 12415.130 41 332.24.18 .813113461 00.544 41.70,900 ise MP Iva* Hof Orrp•ro, - Co0100, 0.0.3.044 .00.332 011.3103011 SO 1219.7711 risean 307.177) 534 0915 14S71.13503 102 AEP 244.01207C90.431 - Timmire *001270 5197.010 43.011.773 032.022 031.00 1429000 (12.040 13030 2211141I
AEP 14448110111 Co. 01.017,20 12,3111.11112 103.1 0.10 1,001 11.3040 (13.01.0411 1097700 001001 113.101.1121
230 10000 Porm Oa 7.41.9142. $4.427.434 8345.1122 SS 442.01 05 1 3171 135 11300140 fr,7...111 VA *3 (1377 22/0 200 0000 Poop Os • TIO1P-oD1O4 W5.4* 140513 1703143 /5 121 TV 445 907) (540.4111) ST 047 3570101
PoO0Or CO. 84.1101,101 901.437 891404.0 132.403 01020 004,2911 S1.117.8333 01.123 024.00
Pam Co. 11.101.10s 15.1...514 00130 003 WO 13a= 1352.5111 C54112.0201 (12354011 573.143 4454.2423 710 01400 - on 1331,345 240.130 9191.991 1/2 3,2,437 337719 (175071 14.120 012001) X0 %MOM P000r Ca Towns*
0.0100 031.00 07.7040 133.02 130.140 030090 (5311.114) 3111.141 0411354E1 0140102P0A3•Co.
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01230.1 3111.00.410 1372379.733 03.10.10 1111 564 027 424 WPM 317.214.721( 11.751 1 3001.90) 00.071.1112 011,012.410 071.10,711 81.505,924 014002 014,036.4433 417.242330 11.731.1 0122.4014031
443 ACP Po 10404 M. 00.01 07013 109.710 30 10 in awes; aima ancis (14.001 SW 000CW Co01014, ' so so a so a so so a so 01 OW 000. los
11.44441.4044. 022224 1221112 00.2)5 SO 512 4S1 420.072) 475.3.041 13.091 035.040 41114510 017/3/1 017.324 0 053.541 411.1731 4154* KIN 1111.1131
210 c4ok 001111400 31.292036 571101 01.03Z014 31,158 04461 (30.93Z 047,747) 04 WS 013,100 $1.2020013 179911 81.4411414 0.70 50,4101 00.00 (981.70) 6030 094.3041 ASP 04900111000/0001
104 Co0100,4010 Comoro 181 OM P90,430. -Comenlon
S3Z990031 01,00.420 177.373.732 $0407 3143.100 (11.790437) /111,1143311 4273,04 41 104..0.011/ 1105 5411.117 SS 1142014 3(33 131.733 9393.7011 14222011 /111.01310:911 w sass% stsaast 27.240317)
MP 100,44444•1101C 11/1.71111.371 915491.001 003031 1977.90 000401 010.4011.399 01,474,2010 01.433.131 (00.031.175) (000010 S1.4713,3 312111110 11 743.541 30 la We (1114.714 081.01 317.430 <51.4 303) Cod Prw.14Wo• Cornwref 230 C.w.o.
MP Ono 014411944444041 WIC 3131.5*114 0113.01( la 9154.0i4.0.4 9377.03 0 10.931 )$10.03.90) 01.917.101 11.490/0 111,112.4422 173 AEP €s.o5 P.M 03010 12.01* 3.01.234 343 1 Snag MEMO 4131.4180 101543 (33-2141
AEP 0.4/09- 0.0.9 )I3Z191.3111 00,384.320 110.01.011 021,239 31115.701 091.121.031 0.40,144 csaaussi 011.111,4311
WO 005.00 076100 WOW 12.1734117 MSC 07.203 002709 070.091 131,114 2351 049 3.'32 AEP /Mr Opmlam. LLC 15.043.220 taus samomo 1014.544 1411544 0901 3348 (s /WW1) ssa 1 29143 001
004 Nor Opanions 0 1.71191110 14111.01 810143.047 14011.144 SW ,741 (stoma w.smaro ssasa 01. man
1101 81.30,117.01 133..14.3174 009471.421 00,914.00 032014.00 01111.90.011 00.00.41011) 110.719.131 2514 329719
Tamers Watson Confp3e918al
TOWERS WATSON tdfLi
2400_
PVC Docket lo. 46449 Schedule G2.2
Attachment 1 Page 8 of 10
American Electric Rower
Non-UMWA Postretirement Health Care Plan
Actuarial Valuation Report Postretirement Welfare Cost for Fiscal Year Ending December 31, 2016 under U.S. GAAP
Ernployer Contributions for Plan Year Beginning January 1, 2016
April 2016
WillisTowersWatson Wield
This report is confidential and intended solely foe the intonation and bend* of the immediate recipient thereof It rna not be cfistsfouted to a third patty unless expressly allowed under the 'Purpose and Achlartal Certification' section heresn.
2401
820 04
35,878,980
133,276,640
(58,790) (514,882)
RIC Docket No. 46449 Schedule G2.2
Attachment 1 Page 9 of 10
10
Non-UMINA Pos r ent Health Care Rao
2.2 Summary and comparison of postretirement benefit cost and cash flovis
AS
ary amounts shown in US Dollars
A Total Postretirement Bonen Cost
1 Empioyer service cost
2 Interest cost
3 Expected return on assets
4 SubtotW
5 Net prior service costi(credit) aniortization
6 Net lossf(gain) amortization
7 Transition obligation/(asset) amortization
8 Amortization subtotal
9 Net periodic postretirement benefit costkincome)
a Assumptions'
1 Discount rate
2 Long-term rate Of return on assets
3 Rate of comPensatioNsalary increase
4 Current heafth care cost trend rate
5 Ultimata heatth care cost trend rate
6 Year ultimate vend rate is expected
C Census Date
- cumber 31; 2015L'e
9,318,249 10,816,370
57,400.055 52,684,680
(105,278,181) (109,557,619)
(38,559,877) (46,056 569)
(68,626.236) (69,056,806)
30,634,961 16.785,124
0 0
(37,991,275) (52,271,882)
(76,551,152} (98,328,251y
4.30% 4 OP%
7.00% 6.75% Rates vary by age Rates vary by age
' from 3.5% to 12.0% from 3.5% to 12.096
7 GO% 6 25%
5.00% 5,00%
2024 2020
January 1, 2016 January 1. 2015
D Assets at Beginning of Year
1 Fair market value
E Cash Flow 1 Employer contrrixdions
2 Plan participants contributions
3 BeneMs paid from plan awe%
4 Expected Metficare retiree drug subsidy on current year benefit payments
These assumptions were used to calculate the Net Posiretirament Benet Cost/ (Income) as of tbe begirring the yea/. Rates are expressed on an amuai basis where applicabie. Fe; aSsOropii0O3 used for eitedm measurement periods, d any, re,* to Acpendix
WillisTowerswatson I.1I lJ
Wetis Towers Watson Coriklenlial
PUG Docket No. 46449 Schedule 02 2
Attachment 1 Page 10 of 10
Non-UMWA Postretirernent 1-,ealth
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2403 , •• •_.
PUC Docket No. 46449 Schedule 0-2.3
SOUTHWESTERN ELECTRIC POWER COMPANY ADMINISTRATION FEES
FOR THE TEST YEAR ENDING JUNE 30, 2016
Please refer to Attachment 1 for the schedules of administration fees paid principally from the AEP Voluntary Employees Beneficiary Association - (VEBA) trusts on behalf of SWEPCO's employee benefits plans. For most of the Company's employee benefits plans, the employee/retiree claims and the fees to adminiSter the plans are paid directly from the trust accounts and are not recorded on the Company's books.
The functional amounts shown on Attachment 1 do not represent the actual cost of administration fees recorded on SWEPCO's books since these costs are included in SWEPCO's contributions to the trust funds. Refer to Schedule 0-2 for support of the SWEPCO's requested level of active employee benefits costs and Schedule G-2.2 for support of the SWEPCO's requested level of postretirernent benefits costs (OPEB), both of which include the costs of administration fees.
The administration costs of the pension plan are paid directly from the plan assets and are not paid by SWEPCO. The administrative costs of the savings plan are paid directly by the plan participants and are not paid by SWEPCO.
2. Please refer to the attached copies of contract that detail the administration services provided, the period covered, and the calculation of the administration fee for the medical (including mental health, employee assistance, prescription drug and disease management), flexible spending account, health savings account, dental, long-term disability benefit plans. The VEBA trust makes premium payments to insurance carriers for the life insurance and the HMO plan and therefore, there are no administrative service contracts for these benefit plans.
The information responsive to this schedule is Voluminous. The voluminous inforrnation is available for review at the Austin offices of American Electric Power Cornpany (AEP), 400 W. 15th Street, Suite 610, Austin, Texas, 78701, (512) 481-4562, during normal business hours.
3. SWEPCO will provide updates to 1 and 2 as necessary.
Sponsored by: Curt Cooper
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PUG Docket No. 46449 Schedule 0-2.3
Attachment 2 Page 1 of 59
Quality health pians & benefits Healthier living Financial well-being intelligent solutions
American Electric Power Administrative Services Contract (ASC)
Financial Renewal Overview: January I., 2015 through December 31, 201.5
Policyholder Number - 2068
2406 . ,
PuC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 2 of 59
ae na- Gregory Seledyn Regional Director
National Accounts Phone: (860) 273-6386
E-mail: [email protected]
Teri M. Derksen Underwriting Consultant
National Accounts Phone: (860) 273-6388
E-mail: [email protected]
Updated August 13, 2014 May 2, 2014
Mr. Curt Cooper Director of Benefits American Electric Power One Riverside Plaza, 15th Floor Columbus, OH 43215-2373
Dear Mr. Cooper:
Your continued collaboration with us is important. We want to make the healthcare system more convenient connected and personalized for you.
Enclosed is your Aetrial self-funded medical renewal for the January 1, 2015 through December 31, 2015 contract year. We view the renewal process as an opportunity to review your current benefit and prograrn offerings and explore new options. We can help you find the right cornbination of benefits and programs that best fit the needs of you and your employees. Your renewal package is broken into sections. Below you will find a brief explanation of what you can find in each section.
Fee Schedule Your Fee Schedule contains the administrative service fees (foced costs) for our standard services and any added programs that will be in place during the 2015 year.
Aetna Pharmacy Management We will be providing renewal information regarding your Aetna Pharmacy Management program under separate cover.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company. Health benefit and health insurance plans contain limitations and exclusions. Policy form nurnbers include GR-29, GR-700-W, GR-88435
PL1C Docket No. 46449 ' Schedule G-13
Attachment 2 Page 3 of 59
Renewal Assumptions Your renewal is contingent unon the parameters outlined. It is important to note that deviations from these assumptions may result in additional charges and/or adjustments to our guaranteed fees. Please review this section thoroughly.
Plan Benefit information This renewal is intended to be compliant with all applicable federal laws, including health care reform. Please refer to this section for further details.
Outside Service Invoice payments — We'll continue this service and charge a coordination fee of 10 percent, capped at $5,000 per invoice, for all third party vendor related invoices sent in for payment. We'll calculate the fee and bill you via Clairn Wire.
Medical Program Services arid Services/Direct Charges In these sections, you wili find information ibout the products and services you currently have. You will also find information on other services you can add for a fee. If selected, these non-standard services can be added to the monthly fee, recovered via claim wire or billed separately as a direct bill. If charged via claim wire, we will use a single claim account and the charges will be outlined separately on your monthly Claim Detail Reports.
Future Program Costs The projected claim costs for your health plan are outlined here.
In the absence of any changes impacting the conditions of this renewal as outlined in your Renewal Assumptions, the fees will rernain in effect through December 31, 2015. You can contact your Account Executive, Angie Morris, if you have eny questions or need additional information at 614-933-7323 or [email protected]. You'll also need to notify her with your icceptance of our renewal fees by October 3, 2014.
At an unprecedented time of change, Aetna is strategically positioned to help you and your employees "get to healthy" — and to simplify the way you get there. Let's work together toward a healthier future.
Sincerely,
in -1 o2,K5-0A-
Gregory E. Sefedyn
Teri M. Derksen 'Regional Director
Undetwriting tonsultant
PUC Docket No. 46449 Schedule 6-2.3
Attactiment 2 Page 4 ot 59
2409
POO DOCIòt No, 46449 Schedule 0-2.3
Attachment 2 Page 5 of 59
Fee Schedule
American Electric Power
Aetna Life insurance Company January 01, 2015 through December 31, 2015 Customer Number - 2068
This exhibit outlines the fees for the contract between American Electric Power and Aetna Life Insurance Company (hereinafter "Aetna"). The fees are for services performed by Aetna under the Administrative Services Agreement (hereinafter 'Agreement") for the Guarantee Period January 1, 2015 through December 31, 2015. These fees replace the Fees described in the Agreement for the Guarantee Period January 1, 2014 through December 31, 2014.
Choice POS II
HDHP
Choice POS II
with HSA
Open Access Choice
POS II
Medicare Direct
indemnity
Indemnity
2014 Guaranteed Billing Fee PEPM. 534.21 $34.21 $34.21 $20.73 $21.02
2015 Guaranteed Billing Fee PEPM $35.07 S35.07 S35.07 52L25 521.55
Percentage Change 2.5% 2.5% 2.5% 2.5% ' 2.5%
2015 Total Guaranteed Billing Fee
PEPM4 2 535.07 535.07 S35.07 521.25 $21.55
Effective 1/1/2015 Aetna Custom
Care Management Sofutions- Aetna in Touch Care Premier
55.00 $5.00 $5.00 n/a n/a
Effective 1/1/2015 - IOQ Program - waived annual $20,000 program cost
Avolies Applies Applies
2015 Final Guaranteed Billing Fee PEPM
540.07 $40.07 $40.07 521.25 521.55
, Fees at Other Enrollment levels
10,001. to 13,000 Employees $42.62 $42.62 . $42.62 $23.80 $24.10 13,001 to 16,000 Employees 541.97 $41.97 $41.97 $23.17 523.46
16,001 to 19,000 Employees 541.34 $4t34 $41.34 $22.52 $22.83 19,001 to 22,000 Employees 540.80 540.80 $40.80 $21.99 $22.29
22,001. to 25,000 Employees 540.38 540.38 540.38 $21.57 $21.87
25,001 to 28,000 Employees 540.07 540.07 $40.07 $2L25 $2L55
28,001 to 31.000 Employees $39.90 $39.90 $39.90 .521.08 521.39
.2 Employee includes only those active employees, retirees, COBRA continuees and disabled employees that
are covered under your Aetna medical plan
2This renewal assurnes AEP win be retained as the sole provider of the ASC PPO Dental and Fully Insured DMO
product3 for the 2015 plan year. There is a $0.18 PEPM Dental credit built into the 2015 ASC Medical Guaranteed Service Fees. lf AEP terminates the ASC PPO Dental or Fully Insured DMO products then Aetna reserves the riKht to reinove the $0.18 PEPM Dental credit from the 2013 ASC Medical Service fees above.
May 2014 aetna Page 5
2410
RIC Docket No, 46449 Schedule G-23
Attachment 2 Page 6 of 59
Fee Schedule
American Electric Power Aetna Life Insurance Company
January 01, 201$ through December 31, 2015
Customer Number — 2068
Choice POS II
HDHP Choice PO5 II
with HSA
Open Access Choice POS II
Medicare Direct
Indemniti Indemnity
31,001 to 35,000 Employees $39.75 $39.75 $39.75 $20.93 $21.24
Teladoc — Anthem population PEPM
$0.76
Enhanced Clinical Review — Per Member Per Month (PMPM)
$0.50 $0.50 $0.50 n/a n/a
Heatth Savings Account — HSA PAPM. (Per Account Holder Per Month)
n/a $3.45 n/a n/a n/a
Guaranteed Fees
Self-Funded Fee Guarantee — The fees (hereinafter "Guaranteed Fees") for the self-funded coverages for the period January 3., 2015 through December 31, 2015 are guaranteed according to the PEPM fees provided above.
Billing of Fees We will bill and collect your monthly Medical fees as outlined above. We will reconcile the collected fees at the end of the Agreement year. Any surplus due American Electric Power, or any shortfall due Aetna, will be payable within the timeframe specified in the Agreernent.
Your fees do not include charges for additional services you may request. Fees for any additional services requested by American Electric Power will be billed as described in the Services/Direct Charges section.
Guaranteed aaim Wire Billing Fees win be excluded from the monthly billing invoice. They will be collected via the claim wire and included with the standard wire request. These fee transactions are separated in the Claim Detail data by individual Claim Reporting System (CRS) draft accounts.
We bill the Health Savings Account per-account, per-month ("PAPM") fee under a separate billing system from the medical benefits.
National Advantage Program with Facility Charge Review and Remixed Bill Review • Included 35.0% of savings.
May 201.4 aetna Page 6
_2411
PVC Docket No. 48449 Schedule G-2.3
Attachment 2 Page 7 of 59
Fee schedule
American Electric Power Aetna Life Insurance Company January 01, 2013 through December 31, 2015 Customer Number — 2068
National Advantage Program The National Advantage Program (NAP) offers access to contracted rates for many medical claims that could otherwise be paid at billed charges under indemnity pians, the out-of-network portion of managed care plans, or for emergency and medically necessary services not provided within the standard network. The NAP network consists of rnany Aetna-contracted hospitals, ancillary providers, and physicians as well as hospitals, ancillary providers and physicians accessed through vendor arrangements where we do not have contractual arrangements.
Fees for the program are charged as a percentage of savings achieved by NAP. Savings are generally defined as the difference between the reference price and the NAP priced amount, where the reference price is typically defined as (a) for facility services, the amount billed by the provider; (b) for professional services, the 80th percentile of the applicable FAIR Health database; or (c) for claims reviewed under Itemized Bill Review, the in-network rate prior to removal of any non-payable charges identified through the claim review. Additional details and any exceptions to the general savings definition above are available upon request.
Facility Charge Review (FCR) - Facility Charge Review Modified Balance Bill (FCR-MBB) FCR is a feature of NAP. This program provides reasonable charge allowance review for most inpatient and outpatient facility claims where a NAP contracted rate is not available. Though many facilities accept the reasonable charge arnount as payment in full, there may be circumstances where facilities may not accept the determination of the reasonable charge and may balance bill the mernber.
In the event that a member is balance billed, Aetna has a review process and will initiate negotiations with the facility in an attempt to come to a mutually agreeable payment amount. Aetna will negotiate with the facility so that the Member is not responsible for any charges in excess of any applicable deductible and coinsurance/copayments. ,
Even with FCR, if a provider refuses to agree to a negotiated rate, ctaims may be paid at billed charges in certain circumstances. The program is only available in conjunction with NAP.
Itemized Bill Review (IBR) IBR is a feature of NAP. Inpatient facility bills with submitted expenses of $20,000 or more in an Aetna-contracted facility (excluding per diem arrangements) are provided with an additional level of review which supplementi Aetna's standard bill review procedures prior to claim adjudication. Plan Sponsors must participate in NAP in order to elect IBR.
May 2014 aetna Page 7
Ric Docket No. 46449 Schedule 0-2.3
Attachment 2 Page 8 of 59
Fee Schedule
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015 Customer Number — 2068
Claim and Meinber Services Medical Service Center — Your claim administration and member services is managed centrally by the New Albany, OH Service Center. Members will be able to reach the Member Service representatives Monday through Friday, from 8 a.m. to 6 p.m. EST.
Alternate Office Processing (AOP) — We regularly use both internal and external claim adjudication services to meet service requirements of our business. These services may be located inside or outside of the United States. Aetna quality standards and controls apply to all claims regardless of where they are processed. Standard pricing assumptions are In effect based on type of product, auto-adjudication, plan design and customer specific requirements. We may adjust service fees based on the above factors and/or where plan sponsors wish to limit use of Alternative Office Processing (AOP).
Sutter Health Contracting Requirement - Sutter Health and Affiliates, the dominant health system in rnuch of northern Califomia, uses its bargaining power to insist on unique requirements to participate in our network. Our contract with Sutter requires us to pay claims we otherwise would deny such as those not medically necessary or experimental or investigational (but does not require us to pay for services your plan expressly excludes from coverage, such as for cosmetic surgery). Aetna will charge your plan for these claims in order to be able to continue providing your plan's participants with access to Suttees services on an in-network basis. Consult your SPD text to ensure that the description of Aetna's services accommodates such arrangements.
Network Re-Contracting - In addition to standard fee-for-services rates, contracted rates with network providers may also be based on case and/or per diem rates and in some circumstances, include risk-adjustment calculations, quality incentives, pay-for-performance and other incentive and adjustment mechanisms. These mechanisms may include payments to organizations that may refer to themselves as accountable care organizations C'ACOsi and patient-centered medical homes ("PCMHs), in the form of accountable care payments (ACP) and incentive arrangements based on clinical performance and cost-effectiveness. The ACP amount is based upon an assessment for each member who is already accessing providers in an ACO, and is assessed retrospectively on a quarterly basis and collected through established claim wire. Each ACO will have a different ACP based on the clinical efficiencies targeted and Aetna's negotiations. The ACP assists the ACO in funding transformation of the health care system to improve quality, reduce costs and enhance the patient experience by:
• Identifying and engaging patients at risk for health crises sooner through more data-sharing
May 2014 aetna Page 8
PUC [Nickel No. 46449 ScheCule 0-2.3
Attachment 2 Page 9 of 59
Fee Schedule
American Electric POwer . Aetna Life Insurance Company . January 01, 2015 through December 31, 2015 Customer Number -- 2068
• Increasing patient engagement in best-in-class care management programs through doctor-driven outreach
• Delivering better health outcomes through increased collaboration between Aetna and ACO providers
Enhanced Clinical Review Program Aetna's Enhanced Clinical Review Program can limit the financial impact of high cost radiology, facility based sleep studies, diagnostic cardiology and cardiac rhythm implant devices by coordinating information provided by the ordering doctor. The information is reviewed by board-certified physicians and registered nurses, to maximize savings on these high cost services. In one year, markets with Aetna's Enhanced Clinical Revievii Program had costs that were 24 to 32 percent lower than those markets without the program. You will be charged a $0.50 PMPM fee through the claim wire on behalf of youremployees and covered dependents for participation in this program under your PPO-based plan.
Teladoce Teladoc provides 24/7/365 access to a national network of U.S. board-certified physicians who can resolve many medical issues via phone or online videò consultations. It's quality healthcare, when and where you need it, at a price you can afford. There is also a $40 per Teladoc consult in addition to the per-employee, per-month fee.
Run-off Processing Charges The Agreement for American Electric Power was written on an immature basis. Therefore, the fees do not include the cost of processing run-off claims for the number'of employees covered during the initial year, for whom immature fees were paid.
Upon termination, you may request, and we may agree, to process run-off claims that were incurred prior to, but not processed, as of the termination date. Aetna will process runoff claims received during the 12 months following termination, subject to payment of an additional Service Fee charge.
The determination of the run-off charges, which will be billed upon Agreement termination, is as follows:
Average PEPM fee over the last 3 months prior to termination * the average number of employees over the last 3 months* 3 * 80%. "
May 2014 aetna Page 9
2414
PUG Docket No, 46449 Schedule G-2.3
Attachment 2 Page 10 of 69
Fee Schedule
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015 Customer NuMber — 2068
Based on the latest three month average enrollment of the 2014 pOlicy year, we are estimating a run-off processing charge of $1,767,866.54, based on the formulas above, subject to change. A final run-off charge will be calculated once the actual enrollment for October, November and December is determined and will be included in all future renewal letters.
ketna reserves the right td revise'the above referenced run-off charge in the event of termination prior to the end of the initial policy- year.
Should American Electric Power elect to convert to a mature Agreement prior to terrnination, please contact your Account ExeCutive.
Compensation
We honor "Agent of Record" or "Broker of Recorci" letters when an agent, broker, or consultant sells new business or takes over an Aetna case from another agent, broker, or consultant. Please have an appropriate representative from your organization sign the letter using your organization's letterhead. The change will become effective on the first day of the month after our payment unit receives the "Agent of Records' or "Broker of Record" letter, unless another future date is designated in the letter.
We have various programs for compensating agents, brokers and consultants.. If you would like information about compensation programs for which your agent, broker, or consultant is eligible, payment'S(if any) which Aetna has made to your agent, broker, or conSuitant, or other material relationships'yOur agent, broker, or consultant may have with Aetna, you may contact Your agent, broker. or consultant, or Angie Morris in our Cleveland field office. Informationsabout our programs for compensating agents, brokers and conšultants is also ava ila ble at www.aetna.com.
Late liaiment Charges if American Electric Power fails to provide funds on a timely basis to cover benefit payrnents as provided in the Agreement, and/or fails to pay service fees on a timely basis provided in Rich Agreement, Aetna will assess a late payment charge.
The charges for 2014 are outlined belovi: 1. late funds to cover benefit payments (e.g., late wire transfers): 12.0 percent annual
rate 2. late payments of Service Fees: 12.0 perCent annual rate
May 201A aetna Page 10
PUC Docket No. 46449 Schedule G-2.3
Aftactonent 2 Page 11 of 59
Fee Schedule
American Electric Power Aetna Life insurance Company January 02, 2015 through December 31, 2015 Customer Number — 2068
wire on a monthly basis provided there are no other special payment arrangements in-force to fund any incurred late payment charges. American Electric Power will be notified by Aetna in writing to obtain approval prior to billing any late payment charges through the claim wire.
In addition, Aetna will charge to recover its costs of collection including reasonable attorneys fees.
May 2014 aetna Page 1.1
2416
RIO Docket No. 46449 Schedule G-2.3
Attachment 2 Page 12 of 59
Renewal Assumptions
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015
Customer Number -2068
Services
Choice POS II
HDHP Choice POS II
wIth HSA
Open Access Choice PPS Il
Medicare Direct
Indemnity Indemnity
Enrolled Lives 11,884 2,102 19 12,369 0
Projected PCTs per Employee 35.02 24.36 35.02 NIA N/A Member to Employee Ratio 2.52 2.26 2.52 1.55 N/A Retiree Percentage 1.13% 0.43% 1.13% 100.0% 0.0% AVA Level Level 2 Level 2 Level 2 Level 2 Level 2 Navigator Enrollment Percent 55.0% 55.0% 55.0% 55.0% 55.0% Electronic EOB Percent 52.0% 52.0% 52.0% 52.0% 52.0% Manual PCTs Per Employee 4.72 3.29 4.72 N/A N/A
Definitions: AVA Level - Aetna Voice Advantage Level
Level 1.0 - Automated AVA module; no opt out to Member Services needed (does not apply to medical)
Level 2.0 - Automated AVA module; member may opt out to Member Services after automated services are offered.
Level 3.0 - initial selection AVA module; member may opt out immediately to Member Services
No AVA - Plan Sponsor elects immediate live voice access by member
Navigator Enrollment Aetna Navigator", secure member portal, allows members online access to member
services.
Manua! Processed Cktim Transaction (PCn per Employee Adjustments are applied reflecting the variation in the number of manually processed PCTs and those which are auto adjudicated. Claim processing charges increase as manual processing increases.
May 2014 aetna Page 12
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 13 of 59
Renewal Assumptions
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31., 2015 Customer Number — 2068
Our guaranteed fees have taken into account the overall business relationship we enjoy with you. We factor into our pricing the economies of offering multiple products and services you have with us. Our pricing assumes that the quoted plans and programs are in effect for the full twelve months of the plan year If any programs are terminated before the plan year ends, there may be financial implications. This is due to the fact that each of our programs have startup costs, shut down costs and staffing implications. We reserve the right to recalculate the Guaranteed Fees, using its then current book of business formula, under the circumstances described below. In such case, you will be required to pay any difference between the fees collected and the new fees calculated retroactive to the start of the Guarantee Period. Aetna rnay recalculate:
i. If, for any product identified above, there is a;
• change to the actual number of employees enrolled during the Guarantee Period, which falls outside of the enrollment scenarios provided in our bracketed fee quotation. If such a change occurs, Aetna will make a charge for processing runoff for the terminated employees.
15 percent increase in the processed claim transactions per employee (PCTs/de) ratio from the ratio above, or from any subsequently reset assumptions (reset if a new fee is established).
• 15 percent increase in the retiree percentage above, or from any subsequently reset assumptions (reset if a new fee is established).
• 15 percent increase in the member to employee ratio above, or from any subsequently reset assumptions (reset if a new fee is established).
z. If a material change in the plan of benefits is initiated by American Electric Power or by legislative or regulatory action.
3. if a material change is initiated by American Electric Power or by legislative or regulatory action in the claim payment requirements or procedures, claim fiduciary option, account structure, or any other change materially affecting the manner or cost of paying benefits.
4. If the agreement is terminated by American Electric Power requiring Aetna to incur charges for maintaining plan structure to report and/or process runoff claims.
lvlay 2014 aetna Page 13
PVC Docket No. 46449 Schectule
Attachment 2 Pa9e14 of 59
Renewal Assumptions
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015 Customer Number —2068
s. lf the National Advantage"' Program (NAP), Facility Charge Review (FCR) or Itemized Bill Review (IBR) programs are terminated by Arnerican Electric Power.
6. If Aetna Programs and Services, including but not limited to Beginning Right° Maternity Program, Flexible Management Model option 3, Enhanced Clinical Review, Teladoc, and Informed Health° Line (IHL) are terminated by American Electric Power.
7. If American Electric Power terrninates any other Aetna products and services not addressed within this renewal package, including but not limited to Pharmacy, Fully Insured Dental and Seif Insured Dental.
if one of the circumstances identified above should occur, then any additional financial guarantees between Aetna and American Electric Power may also be modified or terrninated based upon the financial conditions contained within those documents.
May 2014 aetna Page 14
2419
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 15 of 59
Medicai Programs/Services
American Electric Power Aetna Life Insurance Company - January 01, 2015 through December 31, 2015
Customer Number —2068
Programs and Services We have provided a list, by product, of those programs and services that are included or available to American Electric Power.
Choice PO5 II HDHP Choke POS 11 with HSA
Open Access Choice PDS II
Medicare ' Direct
Indemnity
Indemnity
General Administration
, Account Management included Inciuded Included Included Included
Customer Team Services - Included Included Included Included Included
Communication Materials • Included Included - Included Included Included
Eligibility Included Included included Included Included
Customized Forms Not Included Not Included Not Included Not Included Not included Printing of Booklets or Certificates
Not Included Not Included Not Included Not Included Not Included
Claim Fiduciary - Option 1 Included included included included included
Extern-al Review Included Included Included Included Included HIPAA Certification Not Included Not Included Not Included Not Included Not included
Claims Subrogation Not Included Not Included Not Included Not included Not included
flanking
Banking Method Fed Wire Aetna
Initiated
Fed Wire Aetna
Initiated
Fed Wire
Aetna Initiated
Fed Wire
Aetna Initiated
Fed Wire Aetna Initiated
Funding Basis Cleared Cleared Cleared Cleared Cleared
Alternate Stockpiling Does Not Apply
Does Not Apply Does Not Apply
Does Not Apply
Does Not Apply
Seed Money Does Not Apply
Does Not Apply Does Not
APplY
Does Not Apply
Does Not Apply
Claim and Member
Services ,
Claim Administration Included Included Included Included included Member 5er/ices Included Included Included Included Included
Aetna Voice Advantage* (IVR) .
Included —Included Included Included .
Included
First Impression
Treatment (F1T) Not Included Not lnduded Not included Not included Not tncluded
Network Administration
Network Management included Included Included Not included Not included
Provider Relations Included Included Included Included Included
Teladoc Included Included included Not included Not included Neocare Not Included Not included Not Included Not Included Not Included
Hospital Only PPO Not Included Not Included Not Included Not Included Not Included
Passive PPO Not Included Not included Not Included Not Included Not Included
Rural PPO Network Program
Included Included Included Not included Not Included '
May 2014 aeina Page 15
PUC Docket No, 46449 Schedule G-2_3
Attachment 2 Page 16 of 59
Medical Programs/Services
American Electric Powei
Aetna Life insurance Company January 01, 2015 through December 31, 2015
Custorner Number — 2068 .
Choice POS 11 HMO Choice P0511 with HSA
,
Open Access Choice POS 11
Medicare
Dlrect
Indemnity
Indemniti
Aetna Performance Not included
Network Not Included - Not Included Not Included Not Included
Institutes of Quality
Program
Included Included Included Not Included Not Included
Paper Directories Not Included Not Included Not Included Not Included Not Included
National Advantagerm Program
Included , Included Included Included Included
Standard Facility Charge Review
Not included Not Included Not Included Not Included Not Included
Facility Charge Review Modified Balance Bill
Included Included Included Included Included
Facility Charge Review Fixed Determlnation
Not Included Not Included Not Included Not Included Not Included
Itemized Bill Review Included Included 'included Not Included Not Included
Patient Management ,
Precerttfication ' Included Included Included Included included
Case Management Included included Jncluded Included Included
Concurrent Review Included ' Included Included Included Included
Discha e Planning ' Included Included Included Included Included
Enhanced Clinical Review Program
Included _ Included Included Not included Not Included
Designated • P recertification
Not Included Not included
..
Not lncluded Not Included Not Included .
, Aetna Compassionate Caresm Program
Included Included Included Included Included
.
National Medical Excellence
Included Included included Included Included
Flexible Medical Management Model
Option 1
Not Included t
Not Incitided Nat included Not Included •Not Included
Flexible Medical Management Model Option 2 ,
Not Included Not Included Not Included Not Included
'
Not Included
Flexible Medical Management Model
Option 3
Not Included
fl
Not Included -Not Included • Not Included Not Included
Aetna Custom Care Managerdent Solutions — Aetna In Touch Care Premier ,
Included Included Included Not Included Not Included
Care Advocate Team Not Included Not Included Not Included Not Included Not Included
Custom Care
Managernent Unit
Not Inchided Not Included -
Not Included Not Included Not Included
May 2014 aetna Page 16'
PUG Docket No. 46449 Schedule G-2.3
AttaChment 2 Page 17 of 59
Medical Programs/Services
American Electric Power
Aetna Life hisurance Company January 01, 2015 through December 31, 2015
Customer Number — 2068
Choice POS II HDHP Choice POS II with HSA
Open Access Choice POS 11
Medicare Direct
Indemnity
Indemnity
Paper Preventative Care Considerations
Not Included Not Included Not Included Not Included Not Included
Member Health / Wellness Programs
Biometric Screenings Not included Not Included Not Included Not Included Not Included Aetna Health Connections — Disease Management
Not Included Not Inchided Not Included Not Included Not Included
MedQuere with Basic Member Messaging
Included Included Included Not Included Not Included
- Enhanced Member Messaging
Not Included Not Included Not Included Not Included Not Included
CareEngine• Personal
Health Record Included Included Included Not Included Not Included
Healthy Lifestyle Coaching Not Included Not Included Not Included Not Included Not Included
Healthy Lifestyle Coaching Custom
Not included Not Included Not Included Not Included Not Included
Healthy Lifestyle Coaching
Lite Not Included Not Included Not Included Not Included Not Included
Healthy Ufestyle Coaching Healthy Weight
Not Included fl
Not Included Not Included Not Included Not included
Healthy Lifestyle Coaching Tobacco Free
Not Included Not Included Not Included Not Included Not Included
Simple Steps To A Healthier Life. or Health Assessment
Included Included Included Not included Not Included
Aetna Healthy Actions Not Included Not Included Not Included Not Included Not Included Begln ning Rights" Maternity Program
Not Included Not Included Not Included Not Included Not Included
Informed Health. Une - Nurseline (200 #) only
Included Included Included Not Included Not Included
Informed Health Line - Welcome Letters
Not Included Not Included Not Included Not Included Not Induded
Informed Health Line -
Seml-Annual Reports Not Included Not Included Not Included Not Included Not Included
Informed Health line -
Annual Survey/Results Not Included Not Included Not fncluded Not Included Not Included
Aetna Concierge Program Not Included Not Included. Not tncluded Not Included Not Included Aetna In Touch Care Program
Not Included Not Included Not Included Not Included Not Included
Custorner Specific
Network (Acute Care Included)
Not Included Not Included Not Included Not Included Not Included
Nlay 201.4 aetna Page 17
PDC Docket No: 46449 SChedule G-2.3
Attactvnent 2 Page18 of 59
Medical Programs/Services
American Electric Power
Aetna Life Insurance Company January 01, 2015 through December 31, 2015
Customer Number — 2068
Choice POSH HDHP Choice POS II with HSA
Open Access Choice POS II
Medicare DireCt
Indemnity
Indemnity
Designated Disease tvlanagement
Not Included Not Included Not included Not Included Not Included
Get Active - Shape up Not Included Not included Not Included llot included Not Included
Get Active - Shape up & Stay in Shape
Not Included Not Included Not Included Not Included Not Included
Get Active - Welcome Kit (720-ITC Pedometer
Not Included Not Included Not Included Not Included Not Included
Get Active - Welcome Kit (HJ-1.50 Pedometer)
Not included Not Included Not Included Not Included Not included
Get Active - Welcome Kit (Std. Pedometer)
Not Included Not Included
.
Not Included Not Included Not Included
Mindfulness at Work ' Program
Not Included Not Included Not Included Not Included Not Included
Preference Sensitive Conditions and Surgery Decision Support
Not Included Not Included Not Included Not Included Not Included
Metabolic Health in Small Bytes Program
' Not Included Not Included Not Included Not Included Not Included
Member Health Engagement Plan
Not Included Not Included Nat Included Not Included Not Included
Fitness Reimbursement Program
Not Included Not Included ' Not Included Not Included Not Included
Aetna Discount Programs* at home products Included Included Included lnduðed Included
books Included Included Included Included Included
fitness Included Included , Included Included Included
hearing Included Included Included Included Included
natural products and services
Included Included included Included Included
oral health care included Included Included included Included
vision Included Included Included Included Included
weight management Included Included Included included Included
Standard Behavioral Health Focused Psychiatric Review
Not Mcluded Not Included Not included Not Included Not Included
Managed Behavioral Health
Not Included Included Not Included Not Included Not Included
Behavioral Health Disease Management Programs
tvlay 2014 aetna Page 18
PLIC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 19 of 59
Medicat Programs/Services
American E1ectric Power
Aetna Life Insurance Company January 01, 2015 through December 31, 2015
Customer Number 2068
Choice POS II HEMP Choice POS It with HSA
Open Access Choice P05 II
Medicare Direct
Indemnity
Indemnity
Alcohol Disease Management
Not Included Not Included Not Included Not Included Not Included
Anxiety Disease
Management
Not Included Not Included Not Included Not Included Not Included
Depression Disease
Management Not Included Not Included Not Included Not Included Not Included
Med/Psych Program Not Included Not Included Not Included Not Included Not Included
Case Management Behavioral Health
Programs
Intensive Case Management
Included Included Included Not included Not Included
Member Internet
Services _ Public Sites
DocFinci. Included Included _Included tnctuded Included
Custom DocFind• Not included Not Included Not lncluded Not tncluded Not Included
Aetna InteliHealth° Included Included Included Included Included
Learning Resources Included Included included Included Included
iTriage Not Included Nat Included Not Included — Not Included Not Included
Mindbloom Included included Included Included Included
Secure Sites
Aetna Navigator Included Included included Included Included
ALEX Nat Included Not Included Not Included Not Included Nat Included
Staying Healthy Included Included Included included Included
Estimate the Cost of Care Tool
Included Included Included Included Included
Claim Research/Forms/Contact
us
Included Included included included Included
Spanish version Included Included included Included Included
WellMatch Not included Not Included Not Included Not included Not Included
Nan Sponsor Internet Servkes e.Plan Sponsor Monitor'm Reporting
Aetna integfated Informatics
- Level A Reporting Included Included Included Included Included
- Level B Reporting Included Included Included Included Included
- Level C Reporting Not Included Not Included ..-
Not Included Not Included Not Included
- Level D R.eporhng Not Included Not Included Not Included Not Included Not Included
May 2014 • aetna Page 19
2424
PIK Docket No. 46449 Schedule G-2.3
Attachntent 2 Page 20 of 59
Medical Programs/Services
American Electric Power
Aetna Life Insurance Company January 01, 2015 through December 31, 2015
Customer Number —2068
' Choice POS II HMV Choice
POS II with HSA
Open Access
Choice POS II
Medicare Direct
Indemnity
Indemnity
Aetna Health Information
Advantage"' Included Included Included Included Included
Aetna Health Information
Advantage"' Gold Not included Not Included Not Included Not included Not Included
Online Disease Management
Included Included Included Not Included Not Included
Aetna Navigator*
Reporting included Included Included Included Included
May 2014 aetna Page 20
PUC Docke No. 46449 Schedule G-2.3
Attachnient 2 Page 21 0159
Services/Direct Charges
Arnerican Electric Power Aetna Life insurance Company January 01, 2015 through December 31, 2015 Customer Number — 2068
Your Guaranteed Service Fees include a number of services that we routinely perform to administer the Aetna book of business. The guaranteed fees include, but are not limited to, the iterns identified on the chart on the following pages in the column'labeled "Standard Services Examples."
• Excess Banking Wire Lines • Medicare Subsidy Reporting • Universal Files to Medco and Thomson Reuters • Pharmacy Integration for HSA HDHP Accumulators • Late Claim Wire • Behavioral Health Integration • Pharmacy Integration for Aetna Custom Care Management Solutions —Aetna In
Touch Care Premier
Your Total Guaranteed Billing Fees exclude non-standard services (direct chimes) that you may request (other than specified above). Before we proceed with any non-standard request, we will provide you with the additional cost and obtain your approval. Whenever possible, we will bill the charge(s) for these additional services through the claim wire during the contract period.
An estimated $0717 PEPM PEPM has been included in the monthly PEPM billed fees. These estimated fees will be reconciled in the year-end accounting to actual non-standard direct charges you incur American Electric Power.
May 2014 aetna Page 21
2426
PUG Docket No.46449 Setteduie G-2.3
Attachment 2 , Page 22 of 69
Services/Direct Charges
American Electric Power Aetna Life Insurance Compiny
January 01, 2015 through December 31, 2015 Customer Number 2058
Any aaditional non-standard services (direct charges) not collected through the claim
wire will be direct billed or reconciled in the year-end accounting. This may result in an
adjustment to the final administration charge.
The chart listš examples of standard services by function as well as some &the more
common non-standard services. Your Underwriting Consultant, Teri M. Derksen, can
answer any questions you have regarding what may or may not be included in yciur guaranteed fees. The pricing shown below is subject to change without notification. Please contact your Account Executive for a customized quote.
A.
, ...
J .: " ,
i0:s - • '-' ti '-'i ., , ..3 ,..
Banking - Claims are "stockpiled" until they reach $20,000, on a drafts cleared basis, exeept that on the first banking day of each month, all remaining claims from the prior month are requested regardless of the amount. ' - 3 Wire lines (aaim Wires)
- Atternate stockpiling arrangements - Excess of 3 wire lines (claim wires) to be shared across all self-funded products, excluding FSA. For _January 1, 2015-the annual charge is $30.62 per wire line. - Late funds to cover benefit payments (i.e., late wire. transfers) .
Billing/Fees/Premium Collection
,
- Standard per billing period within the standard - 31-day grace period
- Multiple service fee statements - COBRA and/orRetiree direct billing administration.- - Charges for Late Payment of Service Fees & Stop Loss Prernium. This charge will be reconciled, based on aetual payment activity, at the time of the annual accounting
Claim Administration Serv - Online real time system - Claim checks, u.sed to identify up-coded, unbundled and/or '
'fragrnented claim submissions - Maintenance of Pan and Member information for claim calculation - Fraud Prevention Programs - Provider Red Flags - Initial overpayment recovery effort including referral to
- Customized claim forms - Aetna Claim fiduciary - Claim audits of more than 250 claims - Audits other than 5 consecutive business days per 12 month period - Escheat services • - Third party data integration services - Customized benefit provisions
May 2014 aetna Page 22
PUC Docket No. 48449 Schedule G-2.3
Attachment 2 Page 23 of 59
Services/Direct Charges
American Electric Power
Aetna Life insurance Company
January 01, 2015 through December 31, 2015
Customer Number — 2068
+4.'M-4:111. :r.--1,A,'.4:''',..
1:.... , ' , , • t14., 1 ,' • ,,,'-' - ir. - .., , ' 21,f,i.,
1 tr,... ' P. , c''',6:` :CS' 1 ,,,-'..-':t-..;,,-1:- . -.-- .:: . _
' _ arg ' ' 6., .-, . .r., ' '
,
outside collection agency
- Cost containment programs - Application of R & C limits for physician claims for Indemnity
and out-of-network PPO and
POS pian designs - Application of negotiated fees
with providers for in-network portion of plan designs - Claim adjudication based on
plan design - Coordination of benefits - Aetna appeal administration
onty - Standard claim Processing performance targets
- Customer claim payment audits c250 claims completed in 5 consecutive business days
which require a reduction in auto- adjudication. - Runoff Claim Processing
Drafting - Preparing Master Services Agreements and other related agreements/ amendments - Review Plan Sponsor
documents (14 calendar days for
1-2 Summary Plan Descriptions
(SPDs), 28 calendar days for 3-4 SPOs arid 45 calendar days for 5
or more SPDs) or produce Plan documents in an electronic version for printing (printing not included) or Internet use.
- Accelerated Tum Around Time
(TAT) - Printing and mailing of SPDs - Extraordinary Drafting
(extensive customization) - Drafting and reviewing a customer-produced document
Eligilziltty
-,
- Up to 4 ELRs/segments (physical media or electronic) per submission received weekly,
twice a week or everY two weeks - Aetna Consolidated Electronic
File (CEF) or Electronic Data
Interchange (EDI) layout
,
- Deviations from Aetna standard layouts or EDI eligibility specs
- Submissions requiring rnanual Intervention to load into the Aetna system - Cumulative programrnIng that
exceeds 8 days per year
-COBRA or other eligibility submitted via a non-standard
listing - Member Enrollment Application extracts when there are more than 4 extracts requested per year '
May 2014 aetna Page 23
2428
PUODocket No. 46449 Schedule G-2.3
Attachment 2 Page 24 of 59
Services/Direct Charges
American Electric Power
Aetna Life insurance Company
January 01, 2015 through December 31, 2015
Customer Number — 2068
,
^ ', ; . ''—.,„,,„ `4 ,-_,,,,,D, -,„7- '":1. 6, • 1 I
s. , •I ' , , , ,
- Primary Care Physician (PCP) interface charge when the PCP data is not provided with normal eligibility submissions where a PCP is required - Custom Enrollment Forms and Enrollment Form Keying - Customized zip code files when we must manipulate a standard zip code file to support such things as account structure or plan changes - Extracting eligibility from a customer or vendor site - HIPAA certifications
Enrollment - Aetna standard enrollment forms or standard Aetna listing - Completed required enrollment fields - Standard enrollment material
- Customized enrollment forms or listings - Customized annual enrollment materials
Held Sales/Service Support - Account Management - Open enrollment support
.
Financial Underwriting - Prepare and communicate annual accounting package reconciling fees pakl vs. actual charges - Prepare and communicate renewal fees • Provide quotations for alterriate benefits and/or levels of administrative services - Support Field/Account Executives with ad hoc issueš management
- Custom level financial information (accountings, ratings) - Custom reports
Health Care Reform - Transitional Reinsurance Contribution reporting and submission - Production of Summary of Benefits and Coverage (SI3C-0-
Home Office - Claim accounting, draft reconciliation, ancl provider 1099 reporting - Claim Systems production and development
- Customized EOBs - Production of EOBs for POS, EPO and PPO where there is no member liability
May 2014 aetna Page 24
PUC Docket No. 48449 Schedule 6-2.1
Attachment 2 Pege 25 of 59
Services/Direct Charges
American Electrk Power
Aetna Life Insurance Company
January 01, 2015 through December 31, 2015
Customer Number — 2068
. . — . , „
ir.„,. -s, *---&., - .. .- ' .4" , -- ' .,"()----:,. ";• ,:rt. 7'
•.. 1, - - , . "- - ;,„, -I _ .1,w- -,'.4,- ;-aT41-4 -'
4:: "p0_,' "T" 7- ' '''W. '. --*Jrn-,-.,
- ,•,-1-- ' r--" ' '',2 :.-:' . :•.,-er,..rir— ' ' i 4,
. .1: - - Distribution of drafts, standard EOBs and explanation of provider payments (EPPs)
ID Cards - Standard wording, formatting and mailing - Family 10 cards
- Customized ID cards or ID cards issued for non-business reasons - integration of Third Party RX Vendor Information - Individual II) cards (vs. family ID cards) - Generic stuffers for non- business reasons - Custom ID card stuffers - Zero Day/Overnight/ Two Day Mailing of ID Cards
Member Services - Documentation of member inquiries - Toll free telephone service provided to members and providers with standard hours of operation from 8 a.m. to 6 p,m. - Access to standard DocFind via Internet - Access to Aetna Navigator- via Internet - Member Support - Handle employee appeals, complaints and grievances as appropriate based on fiduciary option.
- Extended hours of operation - Dedicated Resources/Services - Provider Directories - Custom DocFind
Other Services - Printing Expenses & Postage - Customer negotiated network-an-angement, installation and ongoing maintenance charges. - Interfacing and integrating with a third party vendor. Charges vary based on data requirements
Plan Set-up/Maintenance - In accordance with Aetna standard structure units - Evaluate changes in account, benefit and billing structures
- Account structure units in excess of standard - Customer requested changes to benefrts and/or account structure based on level of complexity-
Reporting - Monthly Electronic Claim - Customized reports which
May 2014 aetna Page 25
2430 _
PUC Docket No. 46440 Schedule G-2.3
Attachment 2 Page 26 of 59
Services/Direct Charges
American Electric Power
Aetna Life Insurance Cornpany January 01, 2015 through December 31, 2015
Customer Number — 2068
' ' " ,5•11,34' : r' " 7'', ' --, ' ' , ' ' gr. „ „„
Detail Reports require development or - Monthly Fund Summary modification programming. Reports - Special services not included in - Aetna Informatics Level A the Aetna informatics program - Reporting Reports in excess of the prepaid - Aetna informatics Level 13 50 hours based on the number of Reporting employees, which are included in
the service fees are produced on a fee for service basis. e.Plan Sponsor Monitorl" and AHIA reports and services are not included in this cost and are billed at the level of service. - Excess or custom Claim Detail Report, Claim Totals Report or Funds Summary Report - Requests to receive Funds Summary data by the e business day following the close of the rnonth. - Receipt of Cumulative Claim Detail Reports, Alternately Sequenced Claim Detail Reports, Large Claim Reports or Outstanding issued Draft Reports - Standard Third Party Stop Loss Reports are billed from $4,600 to $6,900 based on the frequency of reports. - Retiree Drug Subsidy claim, rebate and eligibility reporting.
May 2014 aetna Page 26
PUG Docket No. 46449 Schedule G-2.3
Attachment 2 Page 27 of 59
Services/Direct Cbargis
American Electric Rimer
Aetna Life insurance Company January 01, 2015 thrOugh December 31, 2015
Customer Number — 2068
Underwriting Repo s Pricing Schedule ,t- _ • , .
-.h. ̀ • _. •
- =
_ • .
.1Basls :-••
1 '. I
•I Basis .
-. •• •
..
• .r.1-• ii-= " ;-: • _•,f, rr'2 1,„ ' ,• -
E rotirnent by Service A ea 1.0 51 00 5600 300 Nocharge EnrollmentbyAgeBand 1.0 51,800 $600 $co No Charge
—. Enrollment by Controt 1.0 $1,800 $600 $300 No Charge Enrotlment by Cont ol - by Tier) 2.0 $3,600 $ ,200 $600 • $300 Enrotiment by Control - Suffix 1 0 51,800 5600 5300 ' o Charge E rof men Control - Suffix by (Tie 2.0 53 600 $ ;200 $600 5300 Enrollment by Cantrol- Sufiix/Account 1.5 $2, 00 5900 $450 5225 Enrollment by Control - Suffix/Account by (Fíer) 3.0 55,400 $1,800 $ $450 Enrollment by Control - Suffix/Account/Pian 1 5 $2,700 5900 Š450 $225 Enrollment by Control - S A ount/Plan by e 4.0 $7,200 52,400 $1,200 S600
t.argeclaims 1.0 "‘• 51,800 $600 $300 NoCharge
pi at o if Applicable) 1 0 51,800 5600 5300 o Ctiarge Run Off Ctairns i 1 $1, 00 $600 5300 •" No Charge Date Ctaim lrscurred 1.0 5.1,800 $6 $ 00 No Ch rg Ciaims by Control 1.0 51,800 5500 00 No Ch rge Claims by Control - by Product 1.0 $1,800. $600 $300 No Charge tier Con o — Suffix 1.0 $1,800 5600 $ 00 No Charge
aims by Control - Sutfìx/Account 1.5 52,700 0 $450 5225 Clatrns by Cntrot - Sufflx/AccountjPtan 1.5 $2,700 $900 $450 225 Claim la by Control 1.0 51,800 5500 $300 '''• oCharge CI im Lag by Control - by Prociuct 10 51,800 5600 5300 'No Clsarge Claim 1.ag by Controi —Suffix 1 0 $1,800 $600 5300 No Charge a im b Con l - Suffix/Account 1.0 51,800 $600 300 No Charge
- --:, '' 1 :'• ;`=r4 . ;;',EIT.3.- ,.-f , ' :,v.,;,--,A '4- L Clainis on oring Report for in force plan sponsors 1 0 No Charge
, No Charge No Charge No Charge
Claims Monitoring Re rt R fo er inated plan sponsors 1.0 51,800 $600 5300 $150
Sunnarysite Match 1.0 $1,800 5600 $300 No Charge
" Estimated hours assume maximum account structure totals of: 1 Control, 5 Suffixes, 15 Accounts, and 5 products
Addidonal charges may apply if: accotmt structure exceeds that referenced above, any non-standard formatting is requested, or there are other factors that increase the estimated hours referenced above. A rate of $1,50/hour will be assessed for any additional reporting hours. •••
These reports will be provided in conjunction with the annual financial renewal package upon request.
May 2014 aetna Page 27
2432. _
PVC Docket No. 48449 Schedule G-2.3
Attachment 2 ' Page 28 of 59
.Services/Direct Charges
American Electric Power
Aetna Life insurance Company January 01, 2015 through December 31, 2015
Customer Number — 2068
'' 1•• •,,,,, l'',
' ''' S •,r.
, " I
.1.•
':
c, '
r ,
' l'i.•
r,•
,,,,
1
', , ..z
'
'1',...
• . A
Age and Gender LO $1,800 $600 $300 No Charge $300 - Geo Access i' 2.0 $3,600 $1,200 5600
Aetna Heatth Fund 2.0 $3,600 51,200 5600 5300 Disruption 2.0 53,600 $1,200 • $600 $300 Adhoc or Non Standard Report Requests — Report costs will be determined prior to any work being completed.
May 2014 - aetna Page 28 "
2433 _
PUD Docket No. 46449 Schedule G-2.3
Attachment 2 Page 29 of 59
Plan Benefit information
American Electric Power
Aetna Life Insurance Company January 01, 2015 through December 31, 2015
Customer Number — 2068
We believe this renewal to be compliant with ail applicable state and federal laws, including health care reforrn.
Federal
HIPAA Certificates Currently, non-excepted health plans are rewired to provide Certificates of Credible Coverage under the Health Insurance Portability and Accountability Act (HIPAA.) These HIPAA Certificates reduce pre-existing condition clauses for new enrollees in plans. Under the Affordable Care Act, all Americans have access to health care coverage regardless of a pre-existing condition. A pre-existing condition is a physical or mental health condition, disability or illness that is diagnosed prior to enrollment in a health plan. Pre-existing condition exclusions were prohibited for children under 19 for plan years beginning on or after September 23, 2010. As of 2014, this prohibition extends to adults as well. In fact, the Affordable Care Act eliminates the use of pre-existing conditions clauses for most types of coverage offered in the Individual and group health plan markets. On February 24, 2014,, the Treasury, the Department of Labor ("DO11, and the Department of Health and Human Service ("HHS") (together, the "Departments") jointly issued final regulations that adopted a proposal eliminating the requirement for plan sponsors to issues HIPAA certificates of . credible coverage after December 31, 2014. As a result, Aetna will no longer produce HIPAA certificates of credible coverage effective January 1, 2015.
Support for SBC Draft Documents At American Electric Power's request and expense, Aetna will provide assistance in connection with the preparation of draft Summaries of Benefits and Coverage (SBCs) subject to the direction, review and final approval of American Electric Power. The development of draft SBCs by Aetna will be based on the benefits information American Electric Power has provided and existing plan information from our benefit source system. Aetna will include plan design information in the draft SBC relating to products or services administered under the Services Agreement by Aetna as well as any additional pharmacy or behavioral health carve out information provided by American Electric Power or its delegate. SBCs are not required for "retiree-only plane as defined by the ACA and Aetna will not be supporting generation of S9Cs for "retiree-only plans."
May 2014 aetna Page 29
PLIC Dooket NO. 46449 Schedule G-2.3
Attachment 2 Page 30 of 59
Plan Benefit Information
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015 Customer Number — 2068
American Electric Power has the responsibility to review and approve any SBCs and revisions thereto and to consult with Arnerican Electric Power's legal counsel, at its discretion, in connection wtth said review and approval, as well as to disseminate the final SBC to Plan participants. Aetna has no responsibility or liability for the content or distribution of any of the American Electric Powers SBCs, fegardless of the role Aetna may have played in the preparation of the documents. The production of SBCs will not be subject to Service or Performance Guarantees.
Provision of draft SBCs is subject to the following service pricing: $1,500 per draft SBC, with an annual charge not to exceed $15,000.
Aetna's preference is to collect this fee over the claim funding wire. This SBC charge will be processed into a unique CRS Draft Account so it can be easily segregated from other activity. We will send American Electric Power a Claim Wire Billing (CWB) Notification email on the day after it records in CRS. This process is fully transparent and will show the fee as due and paid in all documentation such as the accounting package and Schedule C filing. As an alternative, Aetna can send American Electric Power a Direct Bill for this service.
For applicable plans and policies with effective dates of January 1, 2014, and later, the SBC must include statements about whether the plan or coverage provides minimum essential coverage (MEC) and if the coverage meets minimum value (MV) requirements. Under ACA, minimum value and minimum essential coverage determinations are associated with the' employees shared responsibility provisions. Aetna will include the MV and MEC statements in SBCs that are produced for plans with effective dates of January 1, 2014, and later. However, we will not make the MV or MEC determinations. The variable fields will be left blank for plan sponsor to complete since it is the responsibility of the plan sponsor to make this determination. Aetna will provide the SBC in editable format so plan sponsors for self-funded plans can update MV and MEC statements within the document to appropriately reflect their determination for each respective plan. Aetna does not provide legal or tax advice, and recommends that plan sponsors consult with their own legal and tax counselors when making MEC and MV determinations. Aetna has no responsibility or liability regarding the minimum value or minimum essential coverage evaluation, regardless of the role we may have played in reviewing/producing the SBC documents.
fvlay 2014 aetna Page 30
PM Docket No. 46449 Schedule G-2.3
Attachment 2 Page 31 of 59
Plan Benefit Information
American Electric Power Aetna Life insurance Company January 01, 2015 through December 31, 2015 Customer Number —2068
Federal Niental Health Parity The Federal Mental Health Parity and Addiction Equity Act of 2008 (the Act) applied to fully insured traditional and HMO, Middle Market (MM) & National Accounts (NA) commercial plans as well as self-hindecl Traditional and HMO MM & NA comrnercial plans for plan years beginning on or after October 3, 2009. This means many calendar year plans were required to comply with the Act by January 1, 2010. The 2010 Interim Final Rule applied to plan years beginning on or after July 1, 2010, so calendar year plans were required to comply with the regulations by January 1, 2011. Final rules were recently released and generally apply to group health plans and health insurance issuers offering group health insurance coverage for plan years beginning on or after July 1, 2014, including non-grandfathered small group and all individual plans. Until the applicability date of the Final rules, plans and issuers subject to Federal Mental Health Parity must continue to comply with the Interim Final rules. However, given that this is a self-funded plan, it is ultimately up to American Electric Power to comply with Federal Mental Health Parity. We can continue to make our recommendation regarding application and how we think American Electric Powees plan should be designed in order to comply but we are not in the position to provide self-funded plan sponsors legal advice. Therefore, American Electric Power should speak to its own legal counsel and make the final determination related to compliance with Federal Mental Health Parity.
Health Care Reform This renewal is intended to be compliant with health care reform.
The Federal government released regulations related to grandfathering of health plans in existence on March 23, 2010. Under the health care reforrn legislation, health plans existing prior to the enactment of the legislation may be "grandfathered" and not subject to some of the mandated benefits and reform provisions. Changes in your benefit design as well as your contribution strategy may affect grandfathering. Plan sponsors are required to notify Aetna if their contribution rate changes for a grandfathered plan at any point during the plan year.
This renewal offering assumes your plan is not grandfathered.
As a non-grandfathered plan, the plan will include Preventive care as defined by regulation without cost sharing on In Network services.
This renewal includes the women's preventive care coverage requirements, e.g., coverage for contraceptive methods and counseling, breastfeeding support and equipment, and prenatal care.
May 2014 aetna Page 31
2436
PDC Docket No. 46449 Schell4e G-2.3
Attachment 2 Page 32 of 59
Plan Benefit Informa ion
American Electric Power Aetna Life Insurance Company January 01, 2015 through December 31, 2015 Customer Number — 2068
Certain religious employers and organizations may be exempt frorn contraceptive services coverage requirements, or may be eligible for a religious accommodation. If you qualify and want to be exempt from including ACA contraceptive services benefits in your policy, please work with your Account Manager/Account Executive to provide the required documentation to Aetna so that we can administer accordingly. Aetna will assume and treat your plan as subject to the ACA contraceptive services coverage requirements without an executed certification docurnent.
Except for specific and limited scenarios described as transitional rules in the health care reform legislation, if a plan's grandfathered status has been lost, it cannot be regained. lf, after reviewing the grandfathering rules with your benefit consultant or counsel, American Electric Power determines that your coverage could be or is grandfathered, and you want to retain grandfathered status, you should contact Aetna for further instructions.
Guidance issued by the Internal Revenue Service (IRS), and the U.S. Department of Labor (DOL), and Department of Health and Human Services (NHS) has indicated that "retiree only" plans are exempt from the benefit mandates under the ACA (Retiree only plans are subject to certain ACA fees and assessments). In order to demonstrate the establishment of a retiree only plan, a plan should maintain, separately from the plan for current (i.e., active) emploiees, a separate plan document and Summary Plan Description (SPD) and file a separate Form 5500. If you have a retiree only plan, and want to be considered exempt, please submit a retiree only certification form and required documentation to Aetna.
The benefits and fees within this proposal are subject to change pending any required approvals or future guidance from state or federal regulatory agencies. lf you have questions, please contact your Account Executive.
Aetna reserves the right to modify its products, services, rates and fees, in response to legislation, regulation or requests of government authorities resulting in changes to plan benefits and to recoup any material fees, costs, assessments, or taxes due to changes in the taw even if no benefit or plan changes are mandated.
May 2014 aetna Page 32
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PVC Docket No, 48449 Schedule G-2.3
Attachment 2 page 33 pf 59
Plan Benefit information
American Electric Power Aetna Life lnsuiance Company January 01, 2015 through December 31, 2015 Customer Number — 2068
Transitional Reinsurance Contribution:
ACA Taxes and Feei- Notice of Self-Funded Group Health Plan's Financial Liability Any taxes or fees (assessments) related to the Affordable Care Act that apply to self-funded benefit plans will be solely the obligation of the plan sponsor.
Under Section 1341. of the Affordable Care Act, self-funded group health plans are responsible for paying an assessment to fund state based non-profit reinsurance entities that will administer a high-risk pool for the individual market. The assessment is imposed for a limited number of years, beginning in 2014 and ending in 2016.
Regulations frorn the Secretary of Health and Human Services (HHS) provide the rnethods for determining the amount each self-funded group health plan is required to pay. Beginning in 2014, self-funded group health plans are required to submit membership counts and related payments to HHS. The administrative service fees that Aetna is presenting do not include any such plan sponsor liability or reporting services.
Benefit Mandates --:Essential Health Benefits The ACA prohibits the application of annual dollar limits for any Essential Health Benefits for all plans effective on or aftei Januar/ 1, 2014 (the prohibition of lifetime dollar limits on Essential Health Benefits has been in effect since 2010). To the extent that your current benefit plan includes such limits, this renewal quote includes the removal of those limits.
May 2014 aetna Page 33
PUC Decket No_ 46440 Schedule G-2.3
Attachment 2 Page 34 of 59
Plan Benefit Information
American Electric Power Aetna Life insurance Company January 01, 201.5 through Decernber 31, 201.5 Customer Number —2068
Benefit Mandates - Out of Pocket Requirements For non-grandfathered plans renewing on or afterJanuary 1, 2014, all in-network medical, behavioral health, and pharmacy member coit sharing, which Includes all copays, coinsurance and deductibles, must apply to a member out-of pocket (00P) maximums. The OOP maximum limit cannot exceed the limits set under the tax law for high deductible health plans paired with HSAs. For the first plan year beginning on or after January 1, 2014, there is a one year transition relief (safe harbor) for plans that utiliie more than one service provider to administer benefits, allowing them to maintain separate out-of-pocket limits.
Subsequently the U.S. Department of Labor, Health and Human Services, and Treasury collectively issued a Frequently Asked Question that clarified a new option for OOP maximums. A plan may maintain separate 00P maximums for different benefit categories, as long as the combined totals dO not exceed the statutory limit. For plans renewing on or after January 1, 2015 plans will have two options to maintain compliance:
• integrated medical and pharmacy OOP maximum that does not exceed the statutory limit
• Non-integrated medical and pharmacy OOP maxirnums that collectively do not exceed the statutory lirnit— this option is not available for high deductible health plans paired with HSAs
Employers who offer self-funded plans are responsible for ensuring compliance with the Member Payment Limit regulations.
American Electric Power offers plans that ccintain an integrated OOP maximum. Aetna will continue to maintain an integrated OOP maximum for those plans unless informed otherwise by an authorized member of your organization.
May 2014 aetna Page 34
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Current Rate 1'2015 - 12;2015 Product Offering
11.33 pcpm $1.33 pcpm AIM — Integrated & Steep Management
American Electric Power
Contract Period: 1/1/2015 — 12/31/2015
1. Administrative Service Fees
PPO w/ HRA Administration $46.72 pcpm $48.72 pcpm
IHM -Customized Health and $7.36 pcpm Weiness
TOTALMministration Fees 548.05 peran $55.41 pcpm
PUC Dodiet No. 46449 Schedule G-2.3
Attachment 2 Page 35 of 59
11. Financial Assumptions The services and fees within this proposal assume an effective date of January 1, 2015. Anthem National Accounts (ANA) reserves the right to change the Administrative Services Fees under any of the following circumstances:
o A change in enrollment of 10% or more from 6,498 contracts.
o A change in the member to contad ratio of 5% or more from 2.52.
o Any Wes, fees and assessine it> prescribed by any statutory, regulatory or other legal authority that, according to ANA's discretion, invatdates this quote.
• American Electric Power moves any of the Plan benefits administered by ANA to another third party administrator or public or private exchanges
o A change in nature of Employers business.
• A change to the Plan benefits initiated by American Electric Pcwer that result in substantial changes in the service or networks, as detemtned by ANA
o Legislation or other matters resulting in an imease in the cost or amount of administrative services from those being proposed by Anthem in this proposal. By way of example the Patient Protection and Affordable Care Act has been enacted and is a very broad law impacting the entire health care industry and those that seek ts services. As a result of the size and scope of the legislation and the fad that the law requires federal departments to issue more detailed implementation regulations, it will take tirne to fully analyze all the changes and the subsequent impact on administrative requirements.
Under the Patient Protection and Affordable Care Act plan sponsors are required to pay fees that will partially support the Patent- Centered Outcomes Research Institute. The fees will be required for plan years ending after Septernber 30, 2012, and before October 1, 2019 (starting November 1, 2011 and later). Fees for the Patient —Centered Outcomes Research
Institute are not included in the above administrative
2440
PUG Docket No 46449 Schedule G-2.3
Attachment 2 Page 36 01 59
Seition 1341 of the Affordable Care Act (ACA or health care reform law) provides that a transitional reinsurance prtgram be established in each State to help stabifize premiums for coverage in the individual market during the years 2014 through 2016. This quote or renewal does not include the ACA Reinsurance Fees, since it S assumed that the employer will remit parnent to HHS directly.
Additional Finar.ciat Assuilptions
3 Commissions and consultant fees are excluded from administrative fees;
The Administrative fees listed above cover expenses related to the processing of claims incurred and paid during the service period. if American Electric Power remains a client of ANA for at least three years, the charge for processing twelve months of run-out claims S also included in the proposed fees.
III. Basic ServiCes Included in Administrative Service Fees • Costs of administering the inform HRA plan designs.
o aaims Fiduciary coverage.
a All network access fees.
O Anthem discounts (SpecialOffers) — Through our online Discounts program, members have access to discounts on over 50 health-related products and services. Members can save on ftness center memberships, baby products, drugstore items, vision and hearing care, weight management and 1110113.
a Non-network clain discounts - Discounts negotiated by our vendor, National Care Network, on certain non-network claims. The fee will be equal to 40% of the negotiated savings.
o Blue DisInction programs - Blue Distinction is a national designation program which recognizes facilities that have demonstrated expertise in delivering quality specialty care for patients with highly complex medical needs. Designations are offered in six concentrations: bariatric surgery, cardiac care, complex and rare cancer, knee/hip replacements, spine surgery and transplants. The Blue Distinction prograrn is evolving into a value-based designation awarded to faciffies that meet stringent quality measures as well as cost of care criteria Quaky remains the foundatice of Blue Distinction — Caddies must first meet the quality criteria to be evaluated for cost. ln 2013, the first Blue Distinction Value (BDC +) designations launched for the spine surgery and knee/hip replacement and cardiac care programs. The value criteria will be phased into other Blue Distinction programs (bariatric and transplants) in 2014.
o Reporting - Management reports (standard account reporting package, perfomiance guarardee reporting, lag reports, online reporting tool/access, eta), In addhion to these reports, ANA will provide 20 ham of time needed to generate custom or ad-hoc reports (e.g., care management and utilization review reports) at no charge per year. The charge beyond 20 hours per year is $150 per hour of time needed to generate the custom or ad-hoc report
O Subrogation services -These services do not involve front-end costs and are paid by American Electric Power as a percentage of recovery. The fee is 25% of the gross subrogation recovery, or if outside counsel S retained, 15% of net recovery after a deduction for outside counsel fees for subrogation-related services.
O Standard ID cards with the American Electric Power logo
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PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 37 of 59
O Group structure - Existing group structure. Additonal charges may apply if sub-groups are added. O Banking - The establishment of one bankirig arrangement
• Assumes that eligbility data will be provided In Anthem National Accounts standard format Additional charges may apply fgr non-standard formats.
.3 Data feeds - Twelve annual electronic data feeds to an outside vender in ANA's standard format ($1,000 for each additional standard feed)
• State/federal reporting - Information necessary to comply with state or federal reporting requirements (e.g., 5500 reporting)
o Open enrollment meeting support — locations will be mutually agreed upon by American Electic Power and ANA.
o Electronic version of the benefrt booklets O Online/mobile provider directory
IV.Core Health and Wellness Programs Included in Administrative Service Fees
o imaging Cost and Quaky - This outbound telephonic program delivers a consistent, national imaging management solution for outpatient advanced imaging procedures (CT, MRI, Nuclear Cardiology, PET) through a clinical appropriateness review and proactive outreach to members.
o Sleep Management -AIM's sleep management program is designed to align the diagnosis and treatment of sleep apnea against clinical guidelines, enhance member access to high value providers and ensure treatment compliance for the dispensing of supplies.
O Standard medical management serv"ces, whk:h include pre-certificalion, concurrent review, retrospective review, discharge planning, outpatient review, case management and transplant management Additional fees may appty if Anthern's standard pre-certification list is not used.
The Behavicfal Health UM/CM program, which includes inpatient concurrent review, facility-based treatment concurrent review, out-patient review if required by benefit design, with care management focused on level of care transitions.
o Oncology Management provides decision support and incentives to oncologists to help ensure our members get the most cost-effective and evidence-based care.
▪ anthem.com web resources, includim: - Personal online health management tools powered by our partners WetivID and Vitals
Transparency tools, including Our Estimate Your Cost tool, which is the nation's first online tool capable of generating comprehensive cost comparison infomiation for over 350 common medical procedures
- WebMD consumer engagement toots and resources:
Personal Health Record; internet-based health record which wi 11 gather and store extensive individual medical data Symptom checkers, health trackers, message boards, condition centers and an A-Z health topk:s library Online Heatth Risk Assessment for members enrolled in an ANA plan (only include when Healthy Lifestyles is not quoted or for CDHP Healthy Lifestyles groups with effective dates before 1/1/15 )
2442
n The online Health Assistant tool offers members their own virtual advisor that helps members make positive changes in the areas of weight loss, exercise, nutrition, quitting srnoking or tobacco use, stress management and emotional health.
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 38 of 59
V. Customized Health and Wellness Prograrns
Integrated Health Model (IHM) Anthem offers a comprehensive suite of health and wellness programs that are designed to improve the health of American Electric Powers members. With IHM, we use predictive modeling and custom triggers to target the top 20% of an em*yers at-risk mernbers and engage them in programs that will improve their health.
Anthem's clinical model is enhanced by combining the benefits of multidisciplinary, co-located clinical professionals overseeing all aspects of member health care, many in one place, and anchored by a Personal Heatth Consultant. The IHM includes the following programs/support
o Personal Health Consultant Personal Health Consuttants help members and their famHy members navigate the complexities of the health care delNery system, assist them with the coordination and management of their heatth care needs, collaborate with relevant providers and care managers invotved in their treatment arid offer a wide array of outreach for heatth care support and educational services. Personal Health Consuttants provide:
Medical management services, which include pre-certification, concurrent review, retrospective review, discharge planning, outpatient review, cese management and transplant management (cost included in base medical adrnin fee).
- Case rnanagement services, which includes case manager collaboration with members, their family, and providers to identify and set goals, as well as develop strategies to achieve optimal health outcomes and functional status improvements (cost included in base medical admin fee).
Coaching for a wide variety of heatth conditions that are identified through predictive modeling and custcrn program triggers.
• NICU, which consists of inpatient post-discharge and extended outpatient management by a NICU case manager (CM) with neonatal and/or pediatric nursing experience.
o Transplant a transplant case manager will manage all care for the member (inpatient, outpatient home care, discharge planning, etc) from the day of approval through six months post-transplant
a MyHealth Advantage gaps in care program, which is designed to help improve members' compliance with evidence-based care recommendations and to help reduce their out-of-pocket costs.
o Future Moms program, which provides coaching and resources for all pregnant members — including support for higt-risk rnatemity cases.
.3 High Risk Inpatient Maternity Management program, which provides complex case management for high risk pregnant members and includes managernent throughout the high risk pregnancy, duriig admissions and pcst-birth for NICU admissions if needed.
o ComptexCa re; a program to help members who need a higher level of support due to complex or high-risk chronic condtis.
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PUC Docket No. 46449 Schedtde 0-2.3
Attacturient 2 Page 39 of 59
ConditionCare programs promote member education and self-care and provide a strategy for all participants with gridations for risk level that allows for targeted outreach and individualkzed intervention plans including support for the physician's plan of care. included in the programs is Diabetes Management Congestive Heart Failure, Coronary Artery Disease, Chronic ObStructive Puknonary Disease and Asthma
VI, Additional Services Available • Online physician consultations - Livellealth Online allows members to engacie with a physician
via live web/video/chat on demand, in a structured, secure environment from any computer. American Bectric Power can structure the benefit so that the cost is incurred by the member, the employer or a combination of the two.
o External appeals - The PPACA requires that ASO groups provide a process for external claims appeals to be available in situations where adverse benefit determinations have been made. American Electric Power may contract with Anthem for this service or arrange to work directly with an extern& vendor. The year one price wdl be $550 per external appeal for the service ccotracted with Anthem.
o Quick Care Options educates members about the range of non- Ernergency Room (ER) options available to them. Frorn corwenient care clinics to urgent care centers, we offer access to care that can cost less than the ER while still meeting the needs of members. Quick Care OPfions features a robust provider finder website to support member searches for ER alematives; and uses post-claim tocis (such as targeted EOB messages and Myl-featth Notes) to alert the member when an ER alternative might have been more appropriate for care of a non-urgent diagnosis.
FSA administration 0. COBRA administration to Administration of Health Savings Accounts. Pricing is available upon request
Vil. Additional Health and Wellness Programs Available
o Enhanced Cost and Quality -The cost of the Enhanced Cost and Quality program is S0.35 per contract per month. This program provides inbound telephonic support to help mernbers rnake more infomied decisions on where they go to receive care. This indudes support for all 350+ procedures included in Anthem's Estimate Your Cost tool. The program offen members a national soiution — so no matter where they reside or travel within the United States, person-to-person available.
• Blue Distinction bariatric benefit differentials and care management The cost of the Blue Distinction buy-up option for Bariatric services, which includes benefit differentials and specialized care management is an additional $0.60 per contract per month.
o Fitness tracking devices - Fitbd devices are portable, pedometer-Die frtness tracking devices that American Electric Paver can purchase on behalf of employe= in order to help them monitor their activity levels and achieve their fitness goals. We offer a buk purchase option which allows us to offer Fitbit devices at the following discounted rates:
- Fabit Zip - $52 per device
2444
• PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 40 of 59
Fitbit One - S86 per device
- Fitbit Aria - 5110 per device
• Online personal training - FrtOrbit S an online provider of wellness information and personal fitness instruction. FitOrbit provides an affordable, comprehensive weight loss and fitness experience. FrtOrbit combines the human touch of a certified personal trainer with scientifically based meal and workout plans and daily trainer feedback to deliver consistent healthy weight loss success to members. $0.65 ornpm plus $99 registration fee.
• EAP -The Employee Assistance Program (EAP) provides solutions to help enhance employee productivity and total wellness through its confidential and easily accessible services. Cost rs $1.12 per employee per month. Ernployees and household mernbers are eligible for four EAP cOureseling sessions per issue; access to the EAP website; and referrats for work/life services including legal and financial consultations, child arid elder care services, tobacco cessation coaching, and identity theft protection. EAP also includes a bank hours that rnay be used for wellness trainings or for critical incident services, the amount of hours will be based on group size. Please contact your account representative for details. Custom designed EAP model is available upon request
o Worksite Wellness progr I Pricing for the Worksite Wellness prograrns is available upon request. The Worksite Wellness teams are staffed by certified heath educators, travel to offices and workplaces to teach and share expert knowledge on a wide variety of health and ltestyle topics.
u The basic 24R NurseUne service; The program cost is $0.50 per contract per month - provides members with professional, non-emergency health care information via a toll free number.
• NurseLine Audio Lit:eery; audio library of more than 300 heath care topics in English and Spanish.
• The cost of WIN Fertility is 50.73 per contract per month. The program provides cost and patient care management for infertility treatments and their related medications.
a The Healthy Lifestyles program costs, which include assistance for exercise and fitness, heathy eating, weight management, tobacco cessation, stress management, medication adherence, appointment adherence, depression prevention and self care are as follows:
PCPlit Fee unless Per Coothing Per Fitness Points and Program noted Enrollee Center Visit Rewards Online 20.40 PCPM N/A NIA N/A
One On One $2.03 PCPM $120 $5.25 $0,12 PCPM
Complete $4.03 PCPPA $5.25 $0.12 PCPM— " Smoking Cessation $1.01 PCPM $150 N/A N/A
Nicotine Replacement , $150 per NRT N/A N/A N/A enrollee
Note: One On One FroGran: offers the option of eltner heetth coa=hing cn the fitness cen. ter. but not both
a Our ConottionCare programs promote member education 'and self-care and provide a strategy for all participants with gradatons for risk level that allows for targeted autreacti.and individualized intervention plans including support for the physician's plan of care, The cos's are as follows:
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ConditionCare
PUC Doeket No. 46449 Schectule G-2.3
Attachment 2 Page 41 of 59
Health Suppor t Conditions Lower Back Pain
$0.45 per contract per month
Vascular At-Risk (Hypertension. ObesitY. $1.51 per contract per month Hypenipidernia and Metabolic Syndrome)
Musculoskeletal (Arthritis, Osteoporosis. Hip and Knee $0.50 per contract Per month Replacement)
o The cost of the Behavioral Health Resource buy up prograrn is $0.63 per contract per month. This program includes a 24R call center for behavioral health, where specialists can view member benefits and refer them to the appropriate provider or program; and where licensed clinicians can manage arty clinically complex situation or crisis need. This program also includes clinical care management for members with depression or complex behavioral conditions;
o The cost of the basic Anthem Health Guide program is $1.99 per contract per month. Anthem Health Guide is a full-service support program with high-touch services that goes above and beyond the care provided to members today through traditional outreach and service programs. Customer service and chnicalrwellness coaching are integrated through multi-channel technology (phone, web chat, e-mail, etc.) that incorporates speech analytics (sPecific terms will Prompt questions or transfers to the appropriate wellness program) and automated engagement triggers (gaps in care, predictive modeling, etc.) to deepen members engagement in their own total well-being. The effectiveness of this program is tied to integration with our other services. The offering is avaable with the purchase Anthern CasP Management, Utinzation Management and Behavioral Management programs, as well as ConclitionCare, ComplexCare, My Health Advantage, and 24/7 Nurseline.
O Staying Healthy Reminders targeted communications sent to households regarding topics such as Mmunizations, flu shots, pelvic exams and other subjects. Costs are as follows and assume a standard, non-customized layout and delivery.
Prentiurn - five reminders delivered once annually. Cost is 50.43 per contact per month.
Val. Addifional Specialty Programs Available
Productivity So4rtions with Lite and Disability
Produdvity Solutions integrates Our Health and Wellness Programs to our disability case management. The program rs designed to irnprove mernber outcomes, reduce absenteeism and help employers prornote a productive, heafthy worictorce We offer more than just a disability check for members by including Resource Advisor that focuses on counseling services and ID theft recovery, Newborn Parenting Resources' that provides assistance to new mothers and Travel Assistance2 that offers emergency medical assistance and travel services when members are traveling more than 100 miles away from home.
2446
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 42 of 59
Dental and Vision
Wrth access to one ci the largest Dental PPO networks in the country and growing, our dental network provides excellent in-network choices for members. Our unique dental analytics tool gives us the ability to analyze the cost and quality of our PPO networks to deliver savings for employe's. And with our dental prograrns, members can receive negotiated fee discounts beyond their annual maximum and for non-covered services, such as teeth whitening.
Anthem vision plans offer access to one of the countrys largest vision networks with more than 50,000 providers and provider locations including independent optometrists, ophthalmologists and popular retail locations like LensCrafters® Pearle Vision®, Sears OpticalSM, Target Optical®, and JCPenney® Optical. 1Mth so much choice and convenience, our members stay in network 97% of the time.' Members aiso have access to discounts between 15% to 40% on additional eyeglasses, conventional contacts and other items, such as sunglasses, beyond their annual benefits maximums!
Included with short-term disability product.
2 Included with group term life/AD&D product
3 Internal data, 2009
2447 • V••••••• I.. • •••
Ric Docicet No. 46449 Schedule G-2.3
Attachment 2 Page 43 of 59
XPRESS SCRIPTS°
August 22, 2014
Mr. Curt D. Cooper Director, Employee Benefits American Electric Power Service Corporation 1 Riverside Plaza Columbus, Ohio 43215
Re: Letter of Agreement - Renewal of PBM Agreement
Dear Mr_ Cooper
We are pleased that you have agreed to renew your PBM Agreement with Express Scripts under the Towers Watson Collaborative. 'This Letter of Agreement will serve to confirm our agreement that Express Scripts will continue ro manage the costs and utilization of your prescription drug benefit plan for art edditional two years.
Effective January I, 2015 ESI will implement the pricing and other tenns set forth in the Remit Network and Home Delivery Pricing attached, and will continue to act as your PBM eccording to the terms and conditions outlined in this Letter of Agreement. This Letter of Agreement shall be binding upon the parties front the date of execution hereof until superseded by the execution of a PBM Agreement, which the parties agree to continue to negodate in good faith in accordance with the terms specified in this Letter of Agreement.
While we fully expect to expeditiously complete the negotiation of the PBM Agreement, please be aware that our company policy prohibits payment of such items as rebates, guarantees, COMMiSSi00.5 or other similar payments, as well 23 the processing of subsidy reports until tbe PBM Agreement is fully executed. lf an executed PBM Agreement is not in place by the time we bin the manufacturers rebates, ESI may flOt be able to bill for rebates for your prograrn for that quarter, but will however do so (usually within two weeks of the end of a calendar quarter) after the PBM Agreement is fully executed.
In order to implement the pticing, we must receive a signed version of this Letter of Agreement no later than 90 days before the effective date indicated above in thls Utter of Agreement. If this Letter of Agreement is not executed by this date, the pricing attached will be implemented oo the first day of the first month 90 days after execution.
Express Scripts looks forward to a long and mutually satisfying working relationship with you. If you have any questions, please contact Patricia Gallagher at 614-448-8542. Please sign and return dds Letter of Agreement, indicating your assent to the terms comalned herein, via fax or email to Judy Mercille at 300-287-0359 or 'mercitlefaxertss-scrints,corn, and mail an original to her at the addrera below.
Sincerely,
er- ."
Sean Donnelly President, Commercial
e2eng Bina Soots Haan; coroaer At Mg* Nounoi
2448
Agreed to this2...Cday
Signature:
Printed Name: - o e rs
Me= • &Tivoli eenetila Triter
ipts • Qne ExpressWay . St. Lou* MO 63121 . 314.9960903 • Expres&Scripts.corn nfidential Information
F..rrod tratnowa dee ewes it property imam
-
PUG Docket No.46449 Schedule- G-2.3
Attachment 2 Page 44 of 59
RETAIL PHARMACY NETWORK AND HOME DELIVERY PRICING
gs'ir4';.,-:=—It' :PA', Thrbugp'•
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-cirrire Delive ' • 7.1- .5.. ".• .4, -,
';2: ik unts‘, .
Minimum' Guarantee
e: A 1 . or greater
AWP-24.0% or greater
Brands Dispensing Fee/Rx
Guarantee averagc $0.50fib, or less $0.00/9a
Generics
Minimum Discount Guarantee
•
Guarantee average: AWP-76.5% or greater fac 2013
AWP-77.0% or greater for 2016
Guarantee averagw AWP-83.0% or greater for 2015 AWP-83.5% or greater for 2016
Dispensing Fea/Rx Guarantee average: 0.5001x or less $0-0319x
Administrative Fee (PEPM) $0.50
Re b ates/Brand Rx
Rebate Share 100% 100%
Rebate Guarantee Greaber al MO% or: $39.06 for 2015 $42.45 for 2016
Greater of 100% or $153.83 for 2015 $168.17 for 2016
Manufacturer Administrative Fee Share
100% 100%
Rebates/each Spedaity Drug that is a Brand Name Drug
Custom Spedaity Rebate Guarantee
NIt 1
$350.00
V Confide-nit* WorrnatIon
Erne Unknown datumat property attn.
PUG Docket No. 46449 Schedule G-2.3
Attachment 2 Page 46 of 59
Assumptionst
• Quoted fees are guaranteed for the term of the two-year contract, subject to terms and conditions stated herein axd in the PBM Agreement.
• The ingrdient cost discounts are calculated before deduAing memšcr cost share. This calculation is determined by measuring the billed network discounts, maximum allowable cost pricing, and generic U&C pricing. excluding compound iwescriptions and brand name drugs adjudicated at U&C, against the AWP of all prescriptions, excluding compound prescriptions and brand name drugs adjudicated at U&C, dispensed and submitted under the program by participating pharmacies and home delivery pharmacies in the aggregate, respectively for the retail and home delivery channels, in a format agreed upon by ESI and Towers Watson. No prescriptions, regardless of plan cost, will be included in the ingredient cost calculations with a discount equal or greater to 100% of AWP. In the eveat of a material plan design modification, or an increase or decrease in the total number of participating pharmacies by five (5%) percent or more, or a change in ownership of five (5%) percent or more of participating pharmacies, ESI will work with' SPONSOR and Towers Watson to modify the guaranteed discount at retail, as of effective date of modification or change on an equitable basis.
• Compounds and U&C Brand claims will be excluded flout the diseount guarantees stated in the pricing exhibit above. Also, over-the-counter (OTC). member submitted claims, Subrogation claims, vaccines, biosimilar products, long term care pharmacy claims, and products filled through in-house or 340b pharmacies (if applicable) are excluded from the guarantees.
• Mail Specialty claims will be priced in accordance to the Towers Watson Rx Collaborative specialty guarantees stated in the PBM Agreement.
• Mail order pricing includes handling and postage expense of mail-order prescriptions. If postage rates (i.e., U.S. mail andior applicable commercial courier services) after the first contract year increase during the terra of this agreement, the dispensing fee will be increased to reflect such increase(s).
• SPONSOR agrees to adopt Express Scripts National Preferred Fprmulary, in order to be eligible for rebates guaranteed above.
• If Medi-Span or other applicable source changes the methodology for calculating AWP or pricing for covered drugs, or ceases pablishing or replaces AWP, or if ESI uses a source approved by Towers' Watstm other than Medi-Span, in a way that changes the economics of the Program, including prior to the Effective Date ("AWP Change or Replacement"), the parties agree to work with Towers Watson and each other to modify the program pricing terms to preserve the parties' relative economics before such changedmethodology. Repackaging which has the effect of inflating AWP is explicitly prohibited,
• For each eligible Brand Drug or Generic Drug prescription-drug claim, ingredient cost will be calculated at the lesser of the applicable U&C, MRA (if applitable), or AWP discount price in determining the disCount achieved for purposes of the guarantee, including 100% member copayment (claims where full cost is paid by member).
• If Sprmsor changes its benefit design or formulary during the term of the Agreement, the guarantee will be equitably adjusted if there is a material impact on the discounts achieved.
' The above is a stimmary. Mull copy of an emancial assumptions and qvalifiettions will be provided once a ecneedeasarsairSoriptsfrowers Watson Rx Collaborathe contract is completed.
Error lialtotoot demount property name.
PUG Docket No. 46449 Schedule G-2.3
Attachment 2 Page 46 of 59
HealthEquity* Health Savings Account (HSA) Fees
American Electric Pöwer
Contract Period': O1/01/2016-12131/2018 Per CDHP with HSA plan contract per month: S2.50
HSA services included in the fee: o HSA activation and set-up
o 24/7 customer service
o Visa® HSA debit card (HealthEquity-branded) O Welcome Krt (co-branded Anthem and HealthEquity)
o Annual tax reporting
o Monthly electronic accountholder statements
o Designated implementation rnanager
O Designated account manager and business analyst for ongoing employer service Poist: implementation
o CDHP with HSA health plan eligibility integration: Anthem sends eligibility to HealthEquity (on behalf of the client) and HSAs are opened automatically upon plan effective data for consumers that have passed the Patriot Act screening.
o Anthem claims integration: medical claims sent daity from Anthem to HealthEqUity (HEQ) and displayed on HEas website; Rx claims (6 AnthernRx) sent once/week to HEQ.
• Member portal integration: Anthem.com will display HSA balances and a single sign-on (SSO) link to the HEQ member portal.
Separate employer fee cha6ed for the following HSA-related services: o Electronic file of H SA contributions: No charge for uploading contributions via the HeatthEquity
employer portal or via Pre-Paid Deposit (PPD, directly depositing funds into individual accounts by ACH).
• Electronic claims feed from non-Anthem vendor to HEct Available for employers with 5,000+ employees, $1,000 one-tirne set up per vendor.
2451
Ric Docket No. 46449 Schedule G-2.3
Attachment 2 Page 47 of 59
rd• Employer Contribution Returns: $20 per request (deducted from the reimbursement)
o Emptoyer Corrections: $20 per request (deducted from the reimbursement)
0 Employer Returned Deposit ttem: $20 per request (deducted from the reimbursement)
Separate accountholder (consumer) fees: Descqtion of Fee Charge (subject to chanqp) Notes Monthly Account Maintenance $0
Assumes the employer is paying the
for an Employer sponsored
monthly account maintenance fee giga
(listed at the top of page 1) Monthly Aconunt Maintenance $3.95 if an employee /eaves the (*Many soonsore0 Plan but retains the Hee/the:wily HSA
Monthly Investment Account $0 Fee
42 Test-in-Clase mutual fund options available once (=sumer reaches $1,000 balance. (Separate "investor Choice" low cost index funds are accessible for a 0.40% annual fee per $1,000 invested.)
Account Closure Fee $25.00 One-time, charged to accountholder.
Cash Advance Fee Not applicable Cash advances are not allowed with the debt card.
Check Reorder Fee Not *Webb Chedc Wrilktg Fee Not appNcable Debit Card — ATM withdrawal Not applicable Debit Card Replacement Feel $5.00 Additional Card Fee
E-checking only E-checking only Card not able to be used at ATM's First 3 debit cards are included for free. Fee applicable with each replacement or additional card, deducted from members account.
Debit Card Transadions
No charge Excess Contribution Refund
$20.00
Deducted tiem account. Monthly Statement — Paper
$1.00
Deducted from account. Fee is waived if member chooses paperless statements.
Oveniraft Fee
520.00 Deducted from account, per transaction.
Payment Directed to Provider No charge Reimbursement Check $2.00
Retum Deposdeð Item
$20.00
For paper check, deducted from reimbursement amount. No fee for electronic funds transfer.
Per transaction.
Stop Payrnent Fee
$20.00 Per request Deducted from account.
Teller Withdrawal
Not applicable
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 • Page 48 of 59
HSA FDIC Insured interest rates HSA cash balances are interest bearing and FDIC insured. Interest is calculated and compounded monthly. Interest is paid on the average daily collected balance according to the funds held within each tier and that tiees 4ssnciated interest rate (FDIC Tiering Method E3). interest is credited to the FISA monthly as of the last business day of the statement cycle. HSAs closed prior to the end of their statement cycle will not be paid any accrued interest Interest rates and balance tiers are subject to change at any tinte.
Balance Her Average Daily Account Balance Interest Rate APY'' Tier 1 $0.01 - $2,000.00 0.05% 0.05% Tier 2 $Z000.01 - $7,500.00 0.10% 0.05% to 0.09% Ter 3 $7,500.01 - $10,000.00 0.20% 0.09% to 0.12% Tier 4 Over $10,000,.00 0.40% 0.12% to 0.37%
if you select to have your HSA balance in a non-FDIC insured option. ttie above rates do not apply that portion of your HSA balance. You can view your current HSA balance allocations on your monthly statements or by logging on to the Member Portal.
'Rates in effect as of January 1. 2015
—APY means Annual Percentage Yield. Fees reduce earnings.
2453
Pt1C Docket No. 46449 Schedule G-2.3
Attachment 2 Page 49 of 59
December 9, 2014
Mr. Curt Cooper Director. Employee Benefits American Electric Pow= Service Comorstico One Riverside Phut Columbus, OH 43215
Dear Mt Cooper
This letter is to serve as a renewal and an arnmvinv-..t of the eutrent Services Agtemient ("Agreement") by and between MAGELLAN BEHAVIORAL HEALTH, INC, MAGELLAN HEALTH SERVICES OF CALIFORNIA, INC—EMPLOYER SERVICES (collectively, "Idagellin"), and AMERICAN ELECTRIC POWER SERVICE CORPORAIION rSpocaorl. which is effective for the period of Jsmury 1, 2007 through December 31, 2009 (and extended by prior ameadments through December 31, 2014
Effective jimmy 1, 2015:
1. Magdlan Heahhcate, Inc is substituted for Magellan Behsvineal Health. TIM piny to this Agteement and successor in interest to the eights and obligations of Magellan Behavioral Health, Inc. under the
2. Secticm 3.4.1 is deleted in ha entirety and replaced with the followinp
3.4.1 caremanpliatirin
(a) The PEPM Ram foe EAP services amnia a Base Population of 19,090 Employees, with a standard populaticin variation of up to ten percent (10%). Employees are located as follows:
4 Caftfoenia
19.086 United States, Noo-Califonis
(b) The PSPM Rate far managed Belurviand Health Savices want* a Base Population of 18,766 Subscobers, with standard population variation of up to ten percent (10%).
I Section 41 itmn..10SIZeneled is amended mich that the term of this Agreement shall be attended through December 31, 2017 unless otherwise terminated in accordance with this Agreement
Section 42i is added to the Agnetactit as famine
423 Issaitilati2ILNIAGIAL.Citliz Sponsoc may taminate this Agreement at any convenience upon no less than ninety (90) days prior mittenriotice to Magellan.
S. Section 29 of Addendum A-1 CdticaUncidenaltreasitisnagement is amended euch that each hour of CISM Services requested by Sponsoe in excess of 60 hours pa Cocirsct Year and otherwise subject to a Supplemental Pee may, at Sponsoes op6oe, be furnished at no additional charge in exchange for three (3)
2454,
POC Docket No_ 46449 Schedule G-2.3
Attacrienent 2 Page 50 0159
AstreiCan Electric Power December 9, 2014 Page 2 of 6
unused hours of onsite health and benefit fair support services (u described in Section 2.10 of this Addendum A). Any such exchange of health fair setvice hours foe CISM Services must occur dazing the same Contact Yam
ti. Addendum B Ere. Srh,"1"1. is deleted in its cntircty and replaced with Addendum B, ss attached hereto.
7. Addendum C rafcsmancratandassk is deleted in its etnitety and replaced with Addendum C, as attached hereto.
0. Saliba #1, r.nrnhirwrt Wvirlenre of rawnew wad TlitrICKISTP Form is deleted in its entirety znd replaced with PAilit #1, provided u a separate attachment.
AU rernairting teams of the Akstr....u.at shall remain unchanged and in effect.
If this letter reflects 3rour undemanding of the new teem of our agreement, please have this letter signed by the appropriate peeson and resumed to me.
We appreciate your continued confidence in Magellan and are proud to be able to Eurt American Electric Power Service Corporation es one of Magellan's clients.
Sincerely,
Cece Weeks Senior Account Exerathre
MA(ELLAN HEALTHCARE, INC.
Dam la5,1) j5 By -Rty, 431". 0
MILIAN HEALTH SERVICES OF INC—EMPLOYER SERVKES
BI alte_ _ AMERICAN ELECTRIC POWER SERVICE
Dttr
Dam
2455
PLIC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 51 of 59
Amain= Eleatic Powa December 9. 2014 Page 3 of 6
ADDENDUM FEE SCHEDULE
1 - 6 In-peace Session EAP
Managed Behevioral Health Servkes
Supplemental Feel
CISM Service; in excess of 60 holm per Contract Year
C1SM ireo.-4lotion Feel
$1.70 PEPM
$2.15 PSFM
1220.00 per C1SM provider per hour plus non-local travel expense; if any
$220.00 per C1SM p4v. per hour
Attendance st Heahh Fairs, in EXCCS3 of 56 hours per Contract Year 1230.00 per hour
aaiats Run-Out Services 1540 per claim processed
Fdeml Review by ludependenr Review Organization 1400.00 per case
I The cancelletion fee will gut apply if Maga= receives at least 72 boars of melee of cancellatiothescheduling of OSM Services
2456_ ,
PUC Docket No, 46449 Schedule G-2.3
Attachment 2 Page 52 of 59
Anusiont Poems Decembet 9, 2014 Page 4 ea
ADDENDUM C PERFORMANCE STANDAEDS
A. Perfoun Guarantee*
If Magellan fah to ensure that the average speed of answer of Panicipint and Member calls to Sponsoes dedicated telephone line is 25 scoonds ot leu of the fint zing. Sponsoe may kapott a penalty on Magellan of $1,200 far each second greater than 25 second*, up to an annual maximum of 1% of the Base Fee for EAP and managed Behavioral Health Services.
2. Call Abandonrnpnt kat, If Magellati fails to ensure that fewer than 3% of P.:tikiesiit Sid Member callers to Sponsat's dedicated telephone line abandon their calls after waiting 10 seconds az mare to speak with In intake *entice zepresentative, Sponsor May impose a penalty on Magellan of $1,200 for each patcestage point Wearer dem 3%, up to an annual inarinium of 10/. of the annual Esse Fee for RAP and managed Behavioral Heakh
3. linsistuallULTIRat If Magellan fella to satisfy useu of die EAP and nuosged Behavioral Heath Services, such that at least 90% of Participant:1 and Members who respond to the EAP and managed Behavioral Health Services satisfaction memo express satisfaction rsatisfied" et "very satisfied" widi the timeliness of their first appointment, Sponsor may impose s penalty on Magellan of $1,000 for each percentage point below 90%, up to an annual mean= of 13% of the siinual Base Fee foe EAP and =rased Behavioral Health Se,..icu, purvided, however, such penalty may be imposed oaly if the ountiset of respondents to the surveys is 50 or more in the subject Contract Yeat.
4. Enpagar-taliarnecausafaunza If Magellan fuls to respond to at kat 95% clan dOcumented conceals widtio 10 business days of being bovIghr to the attention of the Magenta Account Executive by Sponsor matagemmt, Sponsor may impose a penalty on Magellan of $1,600 for each percentage point below 95%, up to an annual maximum of 1.5% of the annual Base Fee foe EAP and managed Behavioral Health Services. NOM: A elo6triented concern" is a concern presented to Magellan in writing with all necessary pope:Work, which
may au authorization of cfnclosute, i( rir-ns
S. aretaLSILialikaelina If Magellan fails to achieve an avenge score of 3 ("satisfied") or greater on the single overall Aomunt Executive satisfaction question5 using a sok of I to 4 (with 1 "very dissatisfied" being the lowest, and 4 "very satisfied" bang die highest sane), from Sponsor faison(s) who respond to Magellan's customer satiabetion Spam( may impale * penalties& Magellm of $1,600 for eadi 0.5% below 3, up to ttl annual inximurn of 1.25% of the annual BUt Fee far EAP and managed Behavioral Health Services.
feizaigaraumastSatisfactiaa If Magellan full to satisfy nun of its managed Behavisral Heabh Services, such that at lout 65% of Members c;ilo respond to Magellan's managed Behavioral Health Services diem satisfaction fumy express overall satisfaction raukfier or "Very astiafied, with services received, Spans= may impose penalty on Magellan of $1,000 for each prierxg. point below 65%, up to an atonal maximum of 1-5%
1. dungslysaidlizenc
2457
PUG Docket No. 46449 Schechee G-Z3
Attachment 2 Page 53 of 59
AIII.C4C10 Meet& Power December 9, 2014 Page 5 of 6
of the snood Base Fee for managed Behavioral Heahh Serticea, provided, however, mach penalty may be imposed only if the number of =spot:dents to the survey is 75 or more io the subject Contract Yam
7. FAP User %tie:anion If Magellan Ms to satisfy users of the EAP, such that at lent 90% of Participants and Members who respond to Magellan's HAP client satisfaction survey express overall satisfaction ("satisfied" or "very satisfied") with services received, Sponsor may impose a penalty on Magellan of $1,000 for each percentage point below 90%, up to an annual maximum of 1.5% of the annual BIZ! Fee for EU services, provided, however, such penalty may be imposed only if the number of respondents to the survey is 50 or more during the subject Contract Year.
8- Clakos.,4221E14 If Maitaan fails to pay accurately at least 99% of &inn dollars paid, Sponsor may impose penalty on Magellan of $1,250 for each percentage point below 9S0/., up to an annual maximum of 125% of the annual Base Fee for managed Behavioral Health Services.
UsimaSashagAccusaw If Magellan fais to code accurately with respect to non-financial information et least 97% of claims, Sponsor nay impose a penalty on Magellan of $1,250 for cads percentage point below 97%, up to an anruml maximum of 1.25% of the annual Base Fee foe managed Behavioral Health Services.
10. rausly...ClikaPzumising If Magdlan faila to process (a determined= is made to pay or deny) et least 95% of dun &inn within 30 calendar days, Sponsor may impose a penalty ou Magellan of $1,600 for each percentage point bdow 99%, up to an annual maximum of 1.5% of the annual Base Fee foe Dunned Behavioral Health Services.
11. Emagsagatppsiotnicala If Motel= falls to (a) compkte risk aseessanents in 100% of applicable cases, (b) schedule an appointment for a caller to be som by * provider within 4 hours of denonination that s life-tbreatening emergency may exist in 100% of cases of apparent life-threatening emergencies, and (c) schedule an appointment for IL caller to be seen by s provider within 48 honor of a deennication that a non-Efe threatening ernagency may mixt in 100% of eases of apparent non-fife threatening emergencies, Sporn= may impon a Funky on Magellan of $1,000 for each pereentsge point below 100% fire each benchmark, up to an annual maximum of 1% of the snousl Base Fes for EAP and managed Behavioral Health Servicea
12. If Magellan falls to urazige for ambulatory follow-up within 30 days of a Membees dissbuge from an inpatient fealty in 100% of nianaged Behnicsal Health Services cues, Sponsoc troy impose z penalty on Magellan of $1,000 for each percentage paint below 100%, up to an =anal maxim= of Bs% of The annual Base Fee for managed Behrviced Health Services.
13. Ealisszak If Magellan falls to provide wren to 2 BAP Cosset:dots in at least 90% of Employee residence lo,vtions within the parameters end defmitioas stated below, Sponsor nuy impose a penalty cc Magellan foe each benchmark missed, up to an annual maximum L25% of the annual Base Fee foe EAP services.
Urban 10 =des (Penalty $1,250 per percentage point below 90%) Suburban 25 nub (Penalty $1,250 per pacentage point below 90%) Rural 45 miles (Penalty $1,250 per percentage point below 90%)
PUG Docket No. 46449 Schedule G-2.3
AtIachme0 2 Page 54 ot 59
1 American Mende Power Decembet 9, 2014 Page 6 of 6
14. Mensgret.RAsvintaulealth Services N - • dr If Mardian hula to provide *cress to outpatient treatment provides and in-pstient treatment facilities within the pssameteta stnted below, Sporrent may impose a penalty on Magellan for each benchtnark mined, up to m annual maxim= of 1% of the annual Base Fee fee managed Behiniceal Health Services for each respective benchmark.
. • itt 1,1 . ••• • •••• ••• •• • • {AA'. •
Uzbszt 0 miles osahy $1,000 pet peromtage point below 90%) Subusban 25 miler, (Penalty $1,000 per percentage point below 90%) Rural 45 miles (Penalty $1,000 pet pereetuage point below 90%)
90°4 of Subscriber residence locetions will hire sccess to 1 in-patient facility withier Urban 25 miles (Penalty $1,000 per percentage point below 90%) Suburban 40 mules (Penalty $1,000 per percentage point below 90%) Runt 60 miles (Penalty $1,000 per percestage point below 90%)
Letwitse..ta.CatoPliinn If Magellan fails to respond to at least 98% of Perticipant and Member compleints received by Magellan within 2 business days of receipt, Sponsor may impose a penehy on Magellan of $1,000 foe each
"""'Plaint not =oozing the up to an =anal 112211i31111.131 of 1% of the snmul Base Fee for EAP and managed Batavia:id Health Service; NOTE: A "response menu tekphonic sod/ot 'written acknowledgement of receipt of the complsint and communication of an initial plea of action.
16. arsalathatiaCcotplaut If Magdlan fails to provide a resolution to st lent 98% of Participant sod Member campleints received by Msgellars within 30 calendar days following receipt of the cosapkim, Spornor nay impose a penalty on Magellan of $1,000 for each complaint not meeting the benchmark up to rut annual main= of 1% of the annual Base Fee for EAP and managed Behavioral Health Service; provided, that such pfrsity mey be imposed only with respect to complaints for which Magellan receives all necessary documentation within 10 business days following its reqoest for documentation. NOTE: A wresokrtion" means action taken to *dames a complaint or developsnent of e time-apecifsc action plan in the cue when an issue, by its nsture ne eormirgity, recydnis s longer time to investigate and ecespletdy resolve (e.g., solicitation of records) or the logistics] inn= preclude compledon of resolution within 10 days (e.g., complaint relates to a providet erho is on vacstion).
B. Calculation and Payment The pesfolsoance guanatoos set forth above shall be effective commencing on „Tsinuary 1, 2015, peovided, the performance graertantees shall vat be effective for any yen in which less than six (6) months of Magellan performance can be messuzed against the pedoemance guarantees. Ilse penalties, if any, la be calculated within ninety (90) days thee the end of each Contract Year. AR suds ralruhtione wel be made on an amitzel basis, however., if the perfoturince guarantees are in effect for * period of eleven (11) months or less in sny year, the penalties will be calculated on a pm rate Insie commensurate with the number of months the guarantees were itz effect. All menturzemrs of r.rfrwvw.rtr.. wall be roonded to the nearest integer, using standard rostacEng convention so that calculations for performance guarantees represented by integers me rounded down ter up to the nett lower or higher whole nuarber. Por aim* if the tninirnain standard anticipated a 90% result with the penalty being imposed foe nth percentage point by which the standatd is not met, and if the actual statistics sefiect a 89.49% result, the penalty may be imposed fce fang the performance stendsad by one (3) percentage point (89.49% would be rounded down to 89%). The total 'mount of the penalties assessed shall not exceed, collectively, twenty pacent (20%) of the Base Fees st dak pm Contract Year.
PVC Docket No. 46449 Schedule G-2.3
Attachment 2 Page 55 of 59
Agreemento 46653 Elective Date: Jarrary 1, 2009
EXHIBIT D Schedule of Charges
A Basic Pen: "ftwi bed fee of $353 per Participant per month is br eS sonnets, other than these desaibed lc 8, C. D, E, F, G and H beim" end is based on the foaowing canponents:
1. $0 62 per Parhcipant per month with 20,723 Parpants at the erne of proposal
2 552 00 per claim payment per month with 698 takeover claims and 170 new claims per month.
3 A one trne charge of S595 per new dairn For tie 685 takeover darns, the one time $595 charge sPread over the nye (5) year frx) guaiantee
4. A on* tire charge for cipt of overpaymerft by Pnor Administrator of S595 00 per claim
B Experience Adjustment Charges:
1 At the end of eeM calendar year for five (5) years, Prudential shall analyze the experience of tie Phan based on the foilowbgc
1. Actual number of Parldpants on a mont)y basis X $0 62. 2 Actual number of new claims submitted X 5595 00. 3 Aual number of takeover darns X 5595, divided try five (5) years 4_ Actual ntanber et dairn payments X 152.
2 At the termnation of the agreement wrthin five (5) years or less. Prudental shaa analyze Me expels:toe of the Plan based on the toriossingt
(a) Actual nureber cf Participants on a mate* basis X SO 82. (b) Actual turtle of new daims subsreted X 5596 01). (c) Actual MTh:le of takoova darns X $595, divided by eve (5) years or if less, the length of
the Aireernent (d)Aotual number of dam payments X $62.
Such analysis may resuit in either i An Experience Attjustment C2-iarge amount to be peyabte to Prudential by the Purchaser if the result ot B .1 andior B 2 above is greater than the Basic Fee paid during the given Urns period: or
A Fee Return annum to be credrted to the Purchaser by Prudergal If the result cf B 1 andlor 5 2 above is less than the Basic Fee paid during the given time period
PL/C DOcket No. 46449 Schedule G-2.3
Attachment 2 Page 56 of 59
C Additional lrnpiementadon Charges:
For on-Ste implementation meetings hi excess of four (4): $80 OC per person per hour o'us travel eAcekises
For interface development with the Rachaser $ data aggregation service vendor: S2 500 00 inkjet set-uo charge
C. Charges for Vendor Services:
For vendor sdNiCte n cortnec5o.n eith the Long Tenn Olsabtay cc. .iiwc under the Ras Actual cost as inventoried plus a 325 00 per occurrence service fee But, with respect to e.ess malt, it Is actual cost as inveitoried Otis a $10 00 per °mt./rents service fee
E Charges for Non-Standard Services:
Custom claim reports that recalre %atomized programming 5250 00 per report
Customized experience analysts: $150 03 per hoir vAth a 51.000 00 minimum.
Consultation with a Prudential Medical Direi•Air in seams of they (30) rntriutes $200 CO per hour
Ctstorn dinica rnanaganenk inckiding =Waltzed case management, use of veadors other than those selected hy Prudential or on-site management: $500 00 per claim.
Custom vocataral rehabaltabon services: Actual cost as inventoried
Custom claimant letters 5300 OD sot up charge for a package of otaknant letatirs
Custom claim packet Actual oast as inventoried.
Handing of second level of Long Term thsabffity appeals: 5595 03 per appeal
Spec:el treesegetWe Unil charges Actual cost as inventoried Oils a 525 00 per occurrence service fee.
Actuarial services — reserve data and sivailysis $300 CO per analyst per hour with a 51,000 OD mkiimum
Legal fees (internal cr externs) Actuai cost as invertoried plus a 525 00 per occurrence scrvice fee
F Charges for Purchaser's Audit
580 00 per hour per person
G Late Fee Charge:
FCf each fee payment remitted ba Prudential more then sixty (50) days after me ta../ling date: 1 0% of the Med amount for each month or porton thereof that it is overckie Such Fate fee charge eigi commence on die strty-Frst day atter the aim date
2461
PUC Docket No. 46449 SChedule G-2.3
Attachment 2 Page 57 of 59
H. Late Divest& Charge:
An amount computed at the rate of 1.5% of the knount Due for each month or polio° thereof that is overdue. The Amount Due a the amount required to pay in full alf requests for wire transfer of funds.
Performance Level*:
Prudential and the Pwchaser shdt from tirne to time, establiSh the performance service levets for each of the services to be measured. vilech may include, whhout krriation. standards for Man administration. customer servioe. phew* service and abandonment nees, and timeliness of enrollment. underwrkino and claim trafeedi01111. Prudential and the Purchaser shat mutually agree uPon a prooesa fcr determining whether such perfcrmance levels have been rriM and the amount of any su:h payment that shall be made es a result of fatted to meet such performance levels Mese Prudential and the Purchasw mutually agree to another process Or &nein., a revieW of Prudential's performance wit be done al ese end of each calendar year and any eppOcabie payment wi be made on a date determined by Prudentlet.
Arty amounts payable anal be paid deecty by dleck to the Purchaser cr to a tnntee or other PertY at the Purchaseee dire:ton. To the meant any porton of the amounts paid to the Rycflaser is required by taw (including the Employee Rettrensant income Security Act of 1974, as amended', to be used or apptied solely for the benefit of Employees covered wear leis Agreement the Purchaser agrees to LZE4 or apply such porton solely fry the tenet of such Employees end to odieraise comply with any of Pa obligafions under EFtroA or odies applicable law Upon transfer, Prudental shall have no reeponstday for lb! Use arld/Cf aflocation clam such funds, nor shai Pruderidal here any condnuing obligations under this provision relating to performance leels This provision does not c-eate any tied party beneficiary:101s in arty plan partclpent or other person.
2462
PUC Docket No. 46449 Schedule G-2.3
Attachment 2 Page $8 of 59
-t
!DUD Docket No. 46449 Schedule G-2.3
Attachment 2 Page 59 of 59.
Plan Review and Recommendations Effective Jantlary 1, 2016
ASO LTD — The AEP ASO LTD plan with Prudential was effective January 2009. As you may recall in the Basic Fees outlined in the ASO agreement, we charge a fixed rate per employee per month and then provide a true up at year end. The current Basic Fees are:
I. $0.95 per employee per month 2. S52.00 per claim payment per inontb 3. One time charge of $595.00 per new clairn.
We have consulted with our chdrns management leadership and underwtiting on AEP specific expenses. As you know, we are always reviewing our pricing structure to see if there are any necessary changes in order to price this type of service for our custonaers. Since we renewed these fees effective 1/1/2014, our pricing structure has not changed significantly enough to consider a change. Based on this, we art recommending that no increases in price are necesKary.
The exhibits provided in Smtion 11 show both the historical premiums paid to Prudential for administration of the plan and a surnrnary of annual costs projected for 2016 based off of the recent experience year.
It is important to note that the original run-in claims cast ended in 2014 and is no longer part of the annual equation. However. please note that there will be a charge if AEP has any future acquisitions that would result in Prudential adding future takeover claims.
Rate Guarantee These rates and fees are offered with a 1-year rate guarantee. i.e. as long as the current lives that are inforce at AEP today do not increase or decrease by more than 10%. we will guarantee the rates and fees quoted here until January 1, 2017.
2464. „„
PUC Docket No. 46449 Schedule G-3
Page 1 of 3
SOUTHWESTERN ELECTRIC POWER COMPANY Bad Debt Expense For the Test Year Ended June 30, 2016
Charge Off Policy
The bad debt policy for all AEP operating companies is as follows:
(1) In regard to retail electric sales, a debt is deemed to be uncollectible, in the absence of defmitive information regarding the likelihood of collection, due to an unpaid final billing, bankruptcy or other condition of insolvency, and will be charged-off in the fourth month after the month of the initial determination of default (fmal billing). This charge-off schedule applies to all uhpaid end-user electric accounts billed by AEP's Customer Information System (MACSS).
(2) An unpaid electric account debt may be charged off prior to the end of the fourth following month if available information indicates that there is no likelihood of subsequent payment. Charge-off may also be delayed indefinitely after the fourth following month if available information indicates a likelihood of subsequent payment. Circumstances supporting either accelerated or delayed charge-off will be documented by AEP Credit Policy & Payment Administration and available for audit.
(3) The transfer of the debt from active accounts receivable status to uncollectible status ("open" to "close& status in PeopleSoft) for accounts not billed by MACSS will be performed manually by Miscellaneous Receivables as authorized by the applicable AEP business unit.
(4) For accounts billed by MACSS, unpaid balances will automatically charge-off as specified in item (1) above unless manually accelerated or delayed as specified in item (2) above. The amount charged off will be reduced by any applicable account security or credit.
(5) Any subsequent payment against a previously charged-off debt will be matched by an equal reinstatement or re-invoicing of that debt for either retail electric or other debt. This will effect a partial or complete reversal of the original transfer to uncollectible (closed) status.
Sponsored by: Renee Hawkins / Randall Hamlett
2465_
MC Docket No. 46449 Schedule 0-3
Page 2 of 3
SOUTHWESTERN ELECTRIC POWER COMPANY Bad Debt Expense For the Test Year Ended June 30, 2016
Monthly Bad Debt Expense
The bad debt expense recorded by SWEPCO is a component of the factoring expense charged to SWEPCO by AEP Credit. Under the factoring agreement with AEP Credit, SWEPCO sells their customer accounts receivable balances and unbilled revenues to AEP Credit. Bad debts actually written off are recorded on the books of AEP Credit. SWEPCO has executed an "Agency Agreement'' by which SWEPCO agrees to service, administer and collect the receivables on behalf of AEP Credit. Please see RFP Schedule G-10 and the Direct Testimony of Renee Hawkins for a description of the factoring ageement between SWEPCO and AEP Credit.
Monthly Revenues, Bad Debt Expense and Bad Debts Actually Written Off
See Schedule G-3, page 3 for SWEPCO's total company retail revenues and factoring expense recorded in the test year and the three years prior to the test year. As noted above, bad debts acumlly written off are recorded on the books of AEP Credit. Therefore, this information is not provided on page 3.
Monthly Fluctuations
While there are monthly fluctuations in actual charge-offs by AEP Credit due to factors such as economic conditions and seasonal usage, the bad debt component of the factoring expense charged to SWEPCO is a rolling twelve month average of the receivables charged-off by AEP Credit and the receivables purchased by AEP Credit.
Sponsored by: Renee Hawkins / Randall Hamlett
_ _2466_
PUC Docket No. 46449 Schedule G-3
Page 3 of 3 SOUTHWESTERN ELECTRIC POWER COMPANY Amounts Factored and Bad Debt Expense For the Test Year Ended June 30, 2016
(1) Une No.
(2) Amount Factored Total Company
(3) Bad Debt Expense
1 Test Year 2 July 2015 176,616,946 449,303 3 August 2015 160,454,369 399,326 4 September 2015 142,520,930 340,570 5 October 2015 149,168,765 345,657 6 November 2015 109,975,086 246,011 7 Decernber 2015 125,744,546 280,064 8 January 2016 115,998,761 252,279 9 February 2016 120,366,695 255,259
10 March 2016 108,072,834 241.083 11 April 2016 119,591,472 277,840 12 May 2016 122,706,393 290,783 13 June 2018 154,797,122 373,499 14 1,606,011,918 3,751,675
15 16 January 2014 152,052,156 328,052 17 February 2014 121,227,653 255,801 18 March 2014 126,833,383 267,800 19 April 2014 136.642,773 282,233 20 May 2014 141,290,058 298,176 21 June 2014 153,168,968 327,346 22 Juty 2014 172,965,439 378,976 23 August 2014 149,376,575 337,141 24 September 2014 155,936,709 369,773 25 October 2014 152,636,341 381662 26 November 2014 105,218,480 267,120 27 December 2014 128,993,160 332,460 28 Total 1,596,341 696 3,826,560 29 30 January 2013 135,388,693 290,475 31 February 2013 107,093,766 233,994 32 March 2013 97,604,420 200,288 33 April 2013 122,941,880 232.310 34 May 2013 139,365,472 258,305 35 June 2013 136,112,270 252,207 36 July 2013 155,284,380 318,542 37 August 2013 155,658,852 306,959 38 September 2013 140,236,406 279,809 39 October 2013 142,296,738 298,128 40 November 2013 105,528,897 224,484 41 2015 Total 123,631,178 261,927 42 Total 1,571,140,751 3,157,429
43 44 January 2012 116,902,335 239,225 45 February 2012 105,255,606 214,035 46 March 2012 107,376,562 224,779 47 April 2012 108,401,747 245,480 48 May 2012 132,767,725 306,046 49 June 2012 147,253,085 344,904 50 July 2012 158,063,583 356,945 51 August 2012 172,747,848 392,282 52 September 2012 124,527,463 272,594 53 October 2012 128,805,341 276,002 54 November 2012 111,817,283 239,630 55 December 2012 104,422,044 226,952 56 Total 1,518,340,623 3,338,872
Sponsored by: Renee Hawkins / Randall Hamlett
2467
PUC Docket No. 46449 Schedule G-4
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Advertising, Contributions & Dues For the Test Year Ended June 30, 2016
(1)
(2)
(3) (4) tine FERC
Schedule Test Year No. ACCT
Categonj
No. Amount
1 Advertising G-4.1 $ 1,094,308 2 Contributions/Donations 6-4.2 311,082 3 Organization Memberships/Dues 3-4.3 214,197
4 Total Expenses Subject to 0.3% Limitation 1,619,587
Test of Substantive Rule Sec'. 25.231(b)(1)(E):
Advertising, Contribution, and Dues Limitation
Applicable Test Year Revenues $ 1,015,487,364 % Limitation x 0.003
Dollar Limitation
Total Test Year Expense (above)
(Over) / Under Limit
3,046,462
1.619,587
1,426,875
Sponsored by: Randall Harnlett
SOUTHWESTERN 'ELECTRIC POWER COMPANY Summary of Advertising Expense For the Test Year Ended June 30, 2016
(1)
(2)
(3) (4) Line FERC
Schedule Test Year No. ACCT
Categort
No. Amount A
PUC Docket No. 46449 Schedule G-4.1
Advertising 1 909/930 informational/Instnictionat G-4.1a $ 939,071 2 930 Promote & Retain Usage G-4.1b 9,369 3 9301 General G-4.1c 145,868
4 Total Advertising Expense Subject to Limitation 1,094,308 G-4
Sponsored by: Carey Sullivan/Randall Hamlett
2469,
PUC Docket No. 46449 Schedule G-4.1 a
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Informational/Instructional Advertising For the Test Year Ended June 30, 2016
(1) (2) (3) Line FERC Test Year
No, ACCT Category Amount
1 9090 INVENTIVA INC 873,474 2 9090 MOORE SYNDICATION INC 45 3 9301 5 STAR SPORTS CALENDAR 1,115 4 9301 ARKANSAS DEMOCRAT GAZETTE 1,200 5 9301 BERRY NETWORK INC 31,902 6 9301 DATA SCRIBE SOLUTIONS LLC 6,636 7 9301 EAST TEXAS JOURNAL 2,340 8 9301 E H KIDS PRESS 700 9 9301 GANNETT NEWSPAPERS OF LOUISIANA 2,500 10 9301 GLADEWATER MIRROR 882 11 9301 • HOPE STAR 955 12 9301 MOORE SYNDICATION INC 5,331 13 9301 NASHVILLE LEADER 800 14 9301 NORTHWEST ARKANSAS NATURALS 9,000 15 9301 PABST CREATIVE COMMUNICATIONS 300 16 9301 TEXAS PRESS ASSOCIATION 250 17 9301 WEATHERLINE INC 1,641
18 Total Informational/Instructional Advertising $ 939,071 Subject to Limitation G-4.1
Sponsored by: Carey Sullivan/Randall Hamlett
_ 2470
PUC Docket No. 46449 Schedule G-4.1b
SOUTHWESTERN ELECTRIC POWER COMPANY Sumrnary of Advertising to Promote & Retain Usage For the Test Year Ended June 30, 2016
(1)
(2)
(3) Une FERC
Test Year
No. ACCT
Category
Amount
1 9301 MSR GROUP
9,369
2 Total Advertising to Prornote & Retain Usage Subject to Limitation G-4.1
9,369
Sponsored by: Carey Sullivan/Randall Hamlett
. 2471
PUC Docket No. 46449 Schedule G-4.1c
SOUTHWESTEFIN ELECTRIC POWER COMPANY Summary of General Advertising Expense For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
(2)
Category
(3) Test Year Arnount
1 9301 ALLEGRO PRODUCTIONS INC 4,500 2 9301 ARKANSAS PRESS ASSOCIATION 550 3 9301 BUNYARD BFIOADCASTING INC 4,800 4 9301 ELITE BROADCASTING COMPANY 150 5 9301 GRAPH X 537 6 9301 IDEGY INC 1,490 7 9301 JP MORGAN CHASE CORPORATE CARD AC 7,175 8 9301 KMHT- ACCOUNTS RECEIVABLE 1,000 9 9301 KNCB AM & FM 775 10 9301 LONGVIEW NEWS JOURNAL 1,000 11 9301 LOUISIANA FILM PRIZE 3,500 12 9301 MIRACLE 89.1 FM 350 13 9301 MULTIMEDIA SALES & MARKETING 105 14 9301 NATIONAL THEATRE FOR CHILDREN 61,750 15 9301 NORTH & EAST TX PRESS ASSOC 2,000 16 9301 OGLETREE, PATRICIA ANN-POA ENTERPRI! 4,315 17 9301 PANHANDLE PRESS ASSOCIATION 500 18 9301 SABINE INDEX 240 19 9301 T2 COMPUTING INC 3,225 20 9301 MCCLOUD, scan- R 97 21 Subtotal 98,059
22 Sch G-4.1c.1 Billed Frorn AEP Service Corporation 51,688
23 Amounts not included in cost e service (3,879)
24 Total General Advertising Expense Subject to Limitation 145,868 G-4.1
Sponsored by: Carey A Sullivan/Randall W. Hamlett
2472 ,
Docket No. 46449 Schedule G-4.1c.1
American Electric Power Service Corporation Billings to Southvvestem Electric Power Company Summary of General Advertising Expense For the Test Year Ended June 30, 2016
Line NO.
FEFIC ACCT Category
Test Year Amount
1 9301 AEPSC LABOR 19,523 2 930.1 AEPSC LABOR 2,472 ** 3 9301 BERSON, BRADLEY S 84 ** 4 9301 J D POWER AND ASSOCIATES 15,698 6 9301 JP MORGAN CHASE CORPORATE CARE) ACTIVIrf 1,829 6 9301 JP MORGAN CHASE CORPORATE CARD ACTIVITY 1,223 ** 7 9301 MCHENRY, MELISSA A 32 8 9301 MOORE SYNDICATION INC 3,909 9 9301 PR NEWSWIRE ASSOCIATION LLG 6,704 10 9301 QUESTIONPRO INC 21.0 11 9301 ROSING, JAMES R 3 ** 12 Subtotal 51,688
13 ** Amount Not Included in Cost of Service (3,782)
14 Total General Advertising Expense Subject to Limitation 47,906 G-4.1c
— These items are not being requested in cost of service.
Sponsored by: Carey SuIlivan/Randall Hamlett
2473
PUC Docket No. 46449 Schedule G-4.1d
SOUTHWESTERN ELECTRIC POWER COMPANY Surnmary of Capitalized Advertising For the Test Year Ended June 30, 2016
(1)
(2)
(3) Line FERO
Test Year No. ACCT
Category
Amount ,
1 1070/1080
2 Total Capitalized Advertising
SWEPCO did not capitalize advertising in the test year.
Sponsored by: Carey Sullivan/Randall Hamlett
2474
PUC Docket N. 46449 Schedule G-4.2
,
Line No.
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Contribution & Donation Expense For the Test Year Ended June 30, 2016
' (1) () (3) FERC
, Schedule
ACCT Cate9 ori No.
k (4)
Test Year • Amount
.
1 Educational G-4.2a $ 55,529' 2 Community Service G-4.2b 70,561 3 Economic Development G-4.2c 184,992
4 Total Contributions and Donations 311,082 G-4
SponSored by: Brian Bond/Randall Hamlett
2M_
PUC Docket No. 46449 Schedule G-4.2a
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Educational Contributions & Donations For the Test Year Ended June 30, 2016
Une No.
(1) (2) FERC ACCT Category
(3) (4) Test Year Brief Purpose of Amount Organization "
1 4261 ADMINISTRATORS OF THE TULANE EDUCATIONAL •
1,000 2 4261 BOONEVILLE HIGH SCHOOL 6,000 3 4261 BOSSIER PARISH COMMUNITY COLLEGE 400 4 4261 COSSATOT COMMUNITY COLLEGE 500 5 4261 FOUKE HIGH SCHOOL 500 a 4261 GRAMBLING UNIVERSITY 500 7 4261 GRANT HIGH SCHOOL. 250 a 4261 HELLSTERN MIDDLE SCHOOL 500 9 4261 HENDERSON INDEPENDENT SCHOOL DISTRICT 250 10 4261 JOHN BROWN UNIVERSITY 2,000 11 4261 LE TOURNEAU UNIVERSITY 1,000 12 4261 LIVE UNITED TEXARKANA BOWL 250 13 4261 LOUISIANA STATE UNIVERSITY 3,250 14 4261 LOUISIANA TECH UNIVERSITY FOUNDATION INC 500 15 4261 MCNEESE STATE UNIVERSITY 250 16 4261 NEW MEXICO STATE UNIVERSITY FOUNDATION 3,000 17 4261 NSU FOUNDATION INC 1,000 18 4261 PLAIN DEALING HIGH SCHOOL 500 19 4261 RUSHEON MIDDLE SCHOOL 352 20 4261 SAM HOUSTON MIDDLE SCHOOL 500 21 4261 SCI-PORT: LOUIS1ANAS SCIENCE CENTER 5,000 22 4261 STOCKWELL. PLACE ELEMENTARY 398 23 4261 SUN CITY ELEMENTARY 500 24 4261 TEXAS AEA 300 25 4261 TEXAS HIGH SCHOOL 6,500 26 4261 UNIVERSITY OF ARKANSAS 1,500 27 4261 UNIVERSITY OF ARKANSAS FOUNDATION 1,950 28 4265 INDEPENDENCE BOWL 200 29 9302 BOSSIER PARISH COMMUNITY COLLEGE 100 30 9302 LONGVIEW UNIVERSITY CENTER 250 31 9302 LOUISIANA STATE UNIVERSITY 3,000 32 Subtotal 42,200
33 Sch G-4.2a.1 Billed From AEP Service Corporation 13,484
Amounts not included in cost of service (155)
35 Total Educational Contributions/Donations Subject to Limitation $ 55,529 G-42
* The purpose is indicated in the title in the Description column. ** These items are not being requested in cost of service.
Sponsored by: Brian Bond/Randall Hamlett
PUC Docket No. 46449 Schedule G-4.2a1
American Electric Power Service Cerperation Bdlings to Southwestern Electric Power Company Summary of Educational Contributions & Donations, For the Test Year Ended June 30, 2016
Une No.
(1) (2) FERC ACCT Categoty
(3) Test Year Amount
(4) Brief Purpose of Organization-
1 4261 BETHANY LUTHERAN COLLEGE 40 " 2 4261 BINGHAMTON UNIVERSITY FOUNDATION 31 3 4261 BROWN UNIVERSITY 234 4 4261 CATHOLIC UNIVERSITY OF AMERICA 115 " 5 4261 COLUMBIA UNIVERSITY 115 6 4261 COOPER UNION so 7 4261 DARTMOUTH COLLEGE 172
4261 DREW UNIVERSITY 30 9 4261 DUKE UNIVERSITY 30 10 4261 EASTERN WASHINGTON UNIVERSITY 29 11 4261 EUZABETHTOWN COLLEGE 120 12 4261 FAIRLEIGH DICKINSON UNIVERSITY 60 13 4261 FLORIDA COLLEGE 115 14 4261 HARVARD UNIVERSITY 5,997 15 4261 HOFSTRA UNIVERSITY 36 16 4261 JOHN HOPKINS UNIVERSITY 115 17 4261 LEHIGH UNIVERSITY 29 18 4261 MANHATTAN COLLEGE 126 19 4261 MASSACHUSETTS INSTITUTE OF TECHNOLOGY 173 20 4261 MONTCLAIR STATE UNIVERSITY 115 21 4261 NATIONAL MERIT SCHOLARSHIP CORPORATION 2,437 22 4261 NEW MEXICO STATE UNIVERSITY FOUNDATION 29 23 4261 NEW YORK UNIVERSITY 32 24 4261 NIAGARA UNIVERSITY 57 25 4261 NYACK COLLEGE 57 26 4261 OHO UNIVERSITY FOUNDATION 115 27 4261 PENNSYLVANIA STATE UNIVERSITY 30 , 28 4261 PITTSBURG STATE UNIVERSITY 115 29 4261 RENSSELAER POLYTECHNIC INSTITUTE 359 30 4261 RIPON COLLEGE 115 31 4261 STEVENS INSTITUTE OF TECHNOLOGY 105 32 4261 TRUSTEES OF PRINCETON UNIVERSITY 115 33 4261 UNITED STATES NAVAL ACADEMY 86 34 4261 UNIVERSITY OF GEORGIA 120 35 4261 UNIVERSITY OF HARTFORD 30 36 4261 , UNIVERSITY OF ILLINOIS FOUNDATION 150 37 4261 UNIVERSITY OF NORTH CAROUNA 86 38 4261 UNIVERSITY OF ST THOMAS 120 39 4261 UNIVERSITY OF WISCONSIN 240 40 4261 WASHINGTON UNIVERSITY 65 41 4261 WORCESTER POLYTECHNIC INSTITUTE 57 42 4265 ROOSEVELT INSTITUTE 1,197 43 Subtotal 13,484
44 IN< Amount Not Included in Cost of Service (155)
45 Total Educational Contributions/Donations Subject to Limitation 13,329 G4.2a
' The purpose is indicated in the title in the Description column. These items are not being requested in cost of service.
Sponsored by. Brian Bond/Brian Frantz
2477_
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Community Service Contributions & Donations For the Test Year Ended June 30, 2016
PUC Docket No. 46449 Schedule G4.26
Page 1 of 2
Line No.
(1) FERO ACCT
(2)
Category
(3) Test Year Amount
(4) Brief PuipoSe of
Organization*
1 1840 TEAMMATES MENTORING PROGRAM 250 2 4261 AFRICAN AMERICAN AWARDS 1,500 3 4261 AMERICAN ROSE SOCIETY 1,000 4 4261 ARKANSAS FOODBANK 1,000 5 4261 ARKANSAS WOMEN IN POWER 2,000 6 4261 ARTS COUNCIL OF SOUTHWEST AFIKANSAS 500 7 4261 BOYS & GIRLS CLUBS 2,000 a 4261 BUCKNER CHILDREN & FAMILY SERVICES 1,000 a 4261 CADDO CAREER & TECHNOLOGY CENTER 1,500
10 4261 CANE RIVER THUNDER 250 11 4261 CHRISTUS HEALTH FOUNDATION 500 12 4261 CLARENDON COMMUNITY FUND 750 13 4261 CRIME STOPPERS 1,000 14 4261 DALLAS MILITARY BALL FOUNDATION 5,000 15 4261 DEKALB OCTOBERFEST 250 16 4261 E G HUCKABAY F. O. P. #3 250 17 4261 EAST TEXAS UTERACY COUNCIL 1,000 la 4261 EASTER SEALS 5,000 19 4261 EUREKA SPRINGS COMMUNITY FOUNDATION 2,500 20 4261 FRtENDS OF SAFETY TOWN 1,000 21 4261 GENTRY MAIN STREET 100 22 4261 GOOD SHEPHERD FOUNDATION 500 23 4261 GREENWOOD. TOWN OF 350 24 4261 HAWKINS 1SD 500 25 4261 HEART OF HOPE MINISTRY Z000 — 26 4261 HOUSING AUTHORITY 750 27 4261 HUMANE SOCIETY 250 28 4261 JUNIOR UVESTOCK 500 29 4261 JUVENILE DIABETES RESEARCH FOUNDATION 2,000 30 4261 LA STATE COMMITTEE 500 31 4261 MARSHALL HOSPITAL FOUNDATION 650 32 4261 MINISTERING OUR MIUTARY 250 "* 33 4261 MULTI-CULTURAL CENTER OF THE SOUTH 500 34 4261 NAPLES RODEO CLUB 250 35 4261 NORTHWEST ARKANSAS FOOD BANK 500 36 4261 PAISANOS OF EAST TEXAS 500 37 4261 PHILADELPHIA CENTER 500 38 4261 RHO OMEGA & FRIENDS INC 1,500 39 4261 RIGHT TO PLAY INC 301 40 4261 RUSK COUNTY HISTORICAL 1,000 41 4261 SAINTS ROOST MUSEUM 500 42 4261 SENIOR CITIZENS 300 43 4261 SHREVEPORT JOURNAUSM FOUNDATION 250 44 4261 SHREVEPORT OPERA 750 45 4261 SHREVEPORT SYMPHONY ORCHESTRA 1200, as 4261 SPINE INSTITUTE OF LOUISIANA FOUNDATION 500 47 4261 STATE FAIR 2,000 aa 4261 SUSAN G KOMEN FOR THE CURE 500 49 4261 TEXARKANA TEXAS FIRE ASSOCIATION 250 50 4261 TEXAS COUNTRY MUSIC HALL OF FAME 500 51 4261 THINKFIRST 500 52 4261 UNITED WAY 300 53 4261 VOLUNTEERS FOR YOUTH JUSTICE 1,000 54 4261 WILD & FREE AGAIN 1,000 55 4261 WINGS OVER NATCHITOCHES INC 500 56 4261 WORKFORCE sournorsts 1 iao . 57 4261 YMCA 500 58 4265 BOYS & GIRLS CLUBS 100
Sponsored br. Brian Bond/Randall Hamlett
2478
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Community ServiOe Contributions & Donations For the Test Year Ended June 30, 2016
Docket No. 46449 Schedule G-4.2b
Page 2 of 2
Line No.
(1) (3) FERO ACCT Category
(3) Test Year Amount
(4) Brief Purpose of
Organizetion*
69 4265 CASS COUNTY CHAMPIONSHIP RODEO ASSOC 250 60 4265 - EL KARUBAH SHRINERS 365 61 4265 GENTRY MAIN STREET 500 62 4265 MCKINNON, MADELINE 500 63 4265 MUDBUG MADNESS FESTIVAL 2000 64 4265 POLICE JURY ASSOCIATION OF LOUISIANA 250 — 65 4265 SHREVEPORT BOSSIER AFRICAN SOO 66 4265 TSTC FOUNDATION 100 87 4261 NELSON, NICOLE 500 88 4264 UNITED PARCEL SERVICE 13 -* 69 4265 ADAMS, MICHELLE 250 70 4265 BLEW, LORI 500 71 4265 HARP, JOHNNY 500 72 4265 HARP, VALARIE 500 73 4265 SCHRIVER, SARAH 490 74 4265 WALDON, SHELLY 487 75 Subtotal 60,105
76 Sch G-4.2b.1 Billed frorn AEP Service Corporation 14,282
77 ** Amounts not included in cost of service (3,827)
78 Total Community Service Contributions/Donations Subject to Limitation $ 70.561 G-4.2
* The purpose is indicated in the title in the Descliption column. • These items are not being requested in cost ot service. ▪ Item is in a clearing account, due to immateriality is included with 426 accounts above.
Sponsored by: Brian Bond/Randall Hamlett
PUG Docket No. 46449 Schedule G-4.2111
Page 1 of 1
American Electric Power Service Corporation Billings to Southwestern Electric Power Company Summary of Community Service Contributions & Donations For the Test Year Ended June 30, 2016
Line No.,
FERC ACCT Category
Test Year Brief Purpose of Amount Organization"
1 4261 AMERICAN JEWISH COMMITEE 300 2 406 4261 BE r t R WORLD FUND 3 4261 C200 FOUNDATION 300 4 4261 CHARITY NEWSIES 115 5 4261 EDWIN D HILL CHARITABLE TRUST 600 6 4261 FIRST TEE OF GREATER WASHINGTON DC 573 7 4261 GREEN BERET FOUNDATION 41,799 8 4261 HOLMES COUNTY SHARE A CHRISTMAS eo 9 4261 HORTONS KIDS INC 573 10 4261 JP MORGAN CHASE CORPORATE CARD ACTIVITY 4 "* 11 4261 KURT B SEYDOW DYSTONIA FOUNDATION 344 12 4261 LICKING COUNTY 12 13 4261 MEALS ON WHEELS 23 14 4261 NATIONAL AIR & SPACE MUSEUM 2,279 15 4261 NATIONAL MULTIPLE SCLEROSIS SOCIETY 2,863 16 4261 OHIO ATHLETICS 58 , 17 4261 RUSH COMMUNITY CHURCH OF THE NAZARENE 11 18 4261 TORONTO BEAUTIFICATION COMMITTEE 2 19 20
4261 VETERANS HONOR GUARD 4265 BUCK, JON P
(11) 24 **
21 4265 GENESIS DANCE TEAM 26 22 4265 JUNIOR ACHIEVEMENT 18 23 4265 KING ARTS COMPLEX 107 — 24 4265 MAKING A DIFFERENCE INC 37 25 4265 MICROEDGE LLC 2,694 26 4265 STONEWALL COLUMBUS INC 772 ** 27 4265 VANCEBURG LIONS CLUB 44 28 4265 WEST VIRGINIA STATE POLICE 251 29 Subtotal 14,282
30 *Amount Not Included in Cost of Service (1,314)
31 Totai Community Service Contributions/Donations Subject to Limitation 12,968 G-4.2b
* The purpose is indicated in the title in the Description column. These items are not being requested in cost of service.
•
Sponsored by. Brian Bond/Brian Frantz
_2480_
PVC Docket No. 46449 Schedule G-4.2c
Page 1 of 1
SOUTHWESTERN ELECTRIC POWER COMPANY Surnmary of Economic Development Contributions & Donations For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
(2)
Category
(3) (4) Test Year Brief Purpose of Amount Organization*
1 4261 AVERY, CITY OF 500 2 - 4261 BONANZA, cry OF 100 3. 4261 CENTER ECONOMIC DEVELOPMENT CORPORATION 1,600 4 4261 FAYETTEVILLE, CITY OF 1,000 5 4261 FULTON, CITY OF , 500 6 4261 GREATER NEW ORLEANS INC 5,000. 7 4261 GREATER SHREVEPORT 11,250 8 4261 HEMPSTEAD COUNTY ECONOMIC DEVELOPMENT 500 9 4261 HIGHLAND AREA PARTNERSHIP 1,000 10 4261 KILGORE ECONOMIC DEVELOPMENT CORP 17000 11 4261 LONGVIEW SAFETY CITY INC' • 1,000 12 4261 MARSHALL ECONOMIC DEVELOPMENT CORP 24,000 13 4261 MINDEN, CITY OF 10,000 14 4261 PRESCOTT-NEVADA COUNTY ECONOMIC DEVELOPM 10,000 15 4261 SHREVEPORT AIRPORT AUTHORITY 12,000 16 4261 SHREVEPORT-BOSS1ER 2,500 17 4261 SILOAM SPRINGS CHAMBER pF COMM 850 18 4261 TEXAMERICAS CENTER 18,000 19 4265 ATLANTA AREA CHAMBER OF COMMERCE 350 20 4265 CHAMBER OF COMMERCE 500 21 4265 FAYE1TEVILLE CHAMBER OF COMMERCE 300 22 4265 HISTORIC DISTRICT BUSINESS 2,000 23 4265 MARSHALL CHAMBER OF COMMERCE 2,500 24 4265 MEMPHIS CHAMBER OF COMMERCE 250 25 4265 MINDEN-SOUTH WEBSTER 1,000 26 4265 NORTH LOUISIANA ECONOMIC PARTNERSHIP 5,000 27 4265 SILOAM SPRINGS CHAMBER OF COMM 1,400 28 5060 NORTH SHREVEPORT BUSINESS ASSOICATION 3,000 29 9302 SHAMROCK CHAMBER OF COMMERCE 120 30 Subtotal 133,220
31 Sch G-4.2C.1Billed from AEP Service Corporation 52,631
32 Amounts not included in cost of service (859)
33 Total Economic Development Contributions/Donations 184,992 Subject to Limitation G-4.2
The purpose is indicated in the title in the Description Column. ** These Items are hot being requested in cost of service.
Sponsored by: Brian Bond/Randall Hamlett
.2481
PUG Docket No. 46449 Schedule G-4.2c.1
Page 1 of 1
American Elect,lc Power Service Corporation Billings to Southwestern Electric Power Company Summary of Economic Development Contributions & Donations For the Test Year Ended June 30, 2016
Line No.
FERC ACCT Category
Test Year Amount
Brief Purpose of Organization"
1 4261 CENTER FOR ENERGY WORKFORCE DEVELOPMENT $ 5,997 2 4261 CLEAN ENERGY TRUST 1,799 3 4261 COUNCIL OF STATE GOVERNMENTS 1,199 4 4261 HERITAGE OHIO 30 5 4261 NATIONAL ASSOCIATION OF SECRETARIES OF 1,199 6 4261 NCSL FOUNDATION FOR STATE LEGISLATURES 859 " 7 4261 SOUTHERN STATES ENERGY BOARD 2,999 8 4265 NATIONAL JOURNAL GROUP INC 23.204 9 4265 NATIONAL LEAGUE OF CITIES 1,799 10 4265 NATIONAL PETROLEUM COUNCIL 2,961 11 4265 NEW YORK FINANCIAL WRITERS ASSOCIATION 441 12 4265 PENNWELL CORPORATION 4,849 13 4265 PUBLIC AFFAIRS COUNCIL 1,374 14 4265 RIPON SOCIETY 3,920 15
16
Subtotal
ft* Amount Not Included in Cost of Service
52,831
(859)
17 Total Economic Development Contributions/Donations 51,772 Subject to Limitation G-42c
* The purpose is indicated in the title in the Description column. " These items are not being requested in cost of service.
Sponsored by: Brian Bond/Brian Frantz
2482 . .
PUC Docket No. 46449 Schedule G-4.3
SOUTHWESTERN ELE6TRIC POWER COMPANY Summary of Membership Dues Expense For the Test Year Ended June 30, 2016
Line No.
, (1) (2) FERC ACCT Categoty
(3) Schedule
No.
(4) Test Year Amount
1 industry Organizations G-4.3a 79,461 2 Business/Economic Organizations G-4.3b 86,952 3 Professional Organizations G-4.3c 47,785 4 Social/Recreational/Religious G-4.3d 26,074 5 Patical G-4.3e 94,537
6 Total Membership Dues $ 334,808
7 Less: Social/Recreational/Religious G-4.3d 26,074 8 Less: Political G-4.3e 94,537
9 Total Membership Dues Subject to Limitation $ 214,197 G-4
Sponsored by: Brian Bond/Randall Hamlett
2483
PUC Docket No. 46449 Schedule G-4.3a
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Industry Organization Dues For the Test Year Ended June 30, 2016
(1) (2) (3) (4) Line FERC Test Year Brief Purpose of No. ACCT Description Amount Organization*
1 9302 SOUTHEASTERN ELECTRIC EXCHANGE 8,713 2 Subtotal 8,713
3 Sch G-4.3a.1 BiHed from AEP Service Corporation 127,231
4 Amounts not included in cost of service (56,483)
5 Total industry Organization Dues Subject to Limitation 79,461 G-4.3
* The purpose is indicated in the title in the Description column. ** These items are not being requested in cast of service.
Sponsored by: Brian Bond/Randall Hamlett
PUC'Docket No. 46449 Schedule G-4.3a.1
Page 1 or 3 American Electric Power Service Corporation Billings to Southwestern Electric Power Company Summary of Industry Organization Dues For the Test Year Ended June 30, 2016
Une No.
(1) FERC ACCT
(2)
Category
(3) (4) Test Year Brief Purpose of Amount Organization*
1 9210 ABIH.ORG $ 114 2 9302 AHC GROUP INC 3,801 3 9302 AMERICAN COAL ASH ASSOCIATION 2,728 4 9302 AMERICAN COALITION FOR CLEAN 21,140 ** 5 5000 AMERICAN FISHERIES SOC 37 ** 6 9302 AMERICAN WIND ENERGY ASSOC 734 7 5000 ASHRAE 48 8 9210 ASIS INTERNATIONAL. ONL 62 9 9210 ASIS INTERNATIONAL. ONL 17 —
10 5000 ASM INTERNATIONAL 29 — 11 1070 ASME 166 — 12 5000 ASME 144 13 5000 ASME 15 ** 14 5060 ASME 29 — 15 9302 ASSOCIATION OF EDISON 1,777 16 9210 BE i TER INVESTING 461 ** 17 9210 CENTER FOR ENERGY WORKFORCE DEVELOPMENT 434 18 5570 CENTRAL OHIO AS FD 39 19 5660 CENTRAL OHIO ASTD 21 20 9210 CHEMTREC 308 21 1880 COAL UTILIZATION RESEARCH COUNCIL 11,555 — 22 5000 COOLING TOWER INSTITUT 136 23 5880 CYBERTECH INC 2,373 24 5000 DALLASELECT 16 ** 25 9210 EAPDIS LLC 404 — 26 9210 EB TECH TALKS-DIVERSI 2 .".
27 9070 EDISON ELECTRIC INSTITUTE 2,932 28 9302 EDISON ELECTRIC INSTITUTE 1,651 29 9302 EDISON ELECTRIC INSTITUTE 97 ** ao 9302 EDISON WELDING INSTITUTE INC 861 31 9301 EMRC 14 . 32 1880 ENERGY STORAGE ASSOCIATION 316 — 33 9302 GLOBAL SUSTAINABLE ELECTRICITY PARTNRSHP 13,872 34 9210 HEALTH ACTION COUNCIL 679 35 9210 HR CERTIFICATION INSTI 42 36 9210 HR CERTIFICATION INSTI 15 ** 37 9230 HR CERTIFICATION INSTI 13 ** 38 1070 IEEE 55 • — 39 1880 IEEE 60 ** 40 5660 IEEE 13 — 41 1070 IEEE PRODUCTS & SERVIC 9 ** 42 5570 IEEE PRODUCTS & SERVIC 255 43 5600 IEEE PRODUCTS & SERVIC 119 44 5600 IEEE PRODUCTS & SERVIC 23 — 45 5660 IEEE PRODUCTS & SERVIC 104 46 5660 IEEE PRODUCTS & SERVIC 31 47 5800 IEEE PRODUCTS & SERVIC 65 48 9230 IEEE PRODUCTS & SERVIC 105
Sponsored by: Brian Bond/Brian Frantz
2485
PUC Docket No. 46449 Schedule G-4.3a.1
Page 2 or 3
American Electric Power Service Corporation Billings to Southwestern Electric Power Cornpany Summary of Industry Organization Dues For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
2)
Category
(3) (4) Test Year Brief Purpose of Amount Organization*.
49 9250 IEEE PRODUCTS & SERVIC 17 50 9302 IEEE PRODUCTS & SERVIC 49 51 9302 IEEE STANDARDS ASSOCIATION 4 " 52 9302 IEEENEMBERSHIP 16 53 1520 IHS GLOBAL INC 6,563 ** 54 9230 IHS GLOBAL INC 13,212 55 5600 IN PROFESSIONAL LI 12 56 9210 1N-PLANT PRINTING AND 38 57 5660 IN&rrUTE OF ELECTRICAL & ELECTRONICS 1,088 58 9302 INTERNATIONAL EIVIISSIONS TRADING ASSOC 2,525 59 9210 INTERNATIONAL ENERGY CREDIT ASSOCIATION (1) 60 9302 INTERNATIONAL ENERGY CREDIT ASSOCIATION 394 61 5060 ISA 22 62 1880 ISACA 29 ** 63 9210 1SACA 138 64 9230 ISACA 75 65 1630 ISM 44 — 66 5600 KS.GOV ONLINE PAYM 8 67 9210 MIDWEST SECURITIES TRANSFER ASSOCIATION 18 ** 68 5000 NACE INTERNATIONAL 71 ** 69 9302 NATIONAL COAL COUNCIL 698 — 70 9302 NATIONAL COAL TRANSPORTATION ASSOCIATION 291 71 9210 NATIONAL INVESTOR 79 72 9302 NATIONAL SAFETY COUNCIL 966 73 9210 NCARB 2 74 5612 NERC PCGC 81 75 5612 NERC PCGC 26 — 76 1070 NFPA NATL FIRE PROTECT 61 — 77 5000 NFPA NATL FIRE PROTECT 82 78 9302 NORTH AMERICAN ENERGY MARKETS ASSOC 1,117 79 5000 NORTH AMERICAN GENERAT 392 80 1630 NTEA 62 — 81 9210 OHIO ARCHITECTS BOARD „ 13 *4 82 5660 OHIO BOARD OF ENGINEERING 5 " 83 '5000 OHIO EPA, TREASURER, STATE OF OHIO 7 ** 84 4264 OHIO FORUM 53 ** 85 9210 OHIO SELF-1NSURERS ASSOCIATION 9 86 1520 PIRA ENERGY GROUP 7,298 ** 87 9230 PIRA ENERGY GROUP 6,238
.86 9210 Puns . 95 89 1070 POWER UNE 188 ** 90 1880 POWER SYSTEMS ENGINEERING RESEARCH CENTE 5,919 ** 91 5060 PFIOJECT MANAGEMENT INS 51 92 1510 ROCKY MOUNTAIN COAL MI 88 — 93 5000 SETAC NORTH AMERICA 38 ** 94 1510 SOCIETY FOR MINING MET 76 " 95 9302 SOUTHEAST LABOR & MANAGEMENT PUBLIC 581 96 9302 SOUTHERN STATES ENERGY BOARD 581
Sponsored by: Brian Bond/Brian Frantz
2486,
PUC Docket No. 46449 Schedule G-4.3a.1
Page 3 or 3 American Electric Power Service Corporation Billings to Southwestern Electric Power Company , Summary of Industry Organization Dues For the Test Year Ended June 30, 2016
(1) (2) Line FERC No. ACCT Category ,
(3) Test Year Amount
-- (4) Brief Purpose of Organization*
97 5000 SSPC 19 ** 98 9302 UNITED STATES ENERGY ASSOCIATION 581 99 5600 USOLN 30
100 9302 WILDLIFE HABITAT COUNCIL INC 1,174 . 101 9302 WIRES 8,086 102 Subtotal 127,231
103 Amount Not Included in Cost of Service (56,483)
104 Total Industry,Organizetion Dues Subject to Limitation 70,74-8 G-4.3a
* The purpOse is indicated in the tftle in ihe Description column. *.* These items are not being requested in cost of service.
Sponsored by: Brian Bond/Brian Frantz
2487_,
PUC Docket No. 46449 Schedule G-4.3b
Page 1 of 2 SOUTHWESTERN FI FCTRIC POWER COMPANY Sumrnary of Business/Economic Dues For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
(2)
Description
(3) (4) Test Year Brief Purpose of Amount Organization'
1840 ALLIANCE CHAMBER OF COMMERCE 636 2 1840 BOX BUTTE DEVELOPMENT CORPORATION 300 3 4264 LOUISIANA ELECTRIC UTILITY 4,000 4 4265 NORTHWEST LOUISIANA HOME BUILDERS ASSOC 350 5 5700 BOONEVILLE RURAL FIRE DEPT 50 6 9080 NWA HOMEBUILDERS ASSOCIATION 450
9210 INTERNATIONAL ECONOMIC DEV COUNCIL 405 9302 ARKANSAS ECONOMIC DEVELOPERS 300 9302 ARKANSAS ENVIRONMENTAL FEDERATION 1,800
10 9302 ATLANTA AREA CHAMBER OF COMMERCE 250 11 9302 BENTONVILLE/BELLA VISTA CHAMBER 500 12 9302 BOONEVILLE DEVELOPMENT CORP 500 13 9302 BOSSIER CHAMBER OF COMMERCE 1,000 14 9302 CHAMBER OF COMMERCE 7,760 15 9302 COMMITTEE OF 100 1,320 16 9302 DAINGERFIELD CHAMBER OF COMMERCE 300 17 9302 DEOUEEN/SEVIER COUNTY 400 18 9302 DOWNTOWN SHREVEPORT UNLIMITED 150 19 9302 FARMINGTON CHAMBER OF COMMERCE 200 20 9302 FAYETTEVILLE CHAMBER OF COMMERCE 3,692 21 9302 FOUR STATES FAIR ASSOCIATION 100 22 9302 FRANKLIN CO CHAMBER OF COMMERCE 120 23 9302 FRANKLIN COUNTY INDUSTRIAL FOUNDATION 100 24 9302 GENTRY MAIN STREET 300 25 9302 GILMER AREA CHAMBER OF COMMERCE 150 28 9302 GLADEWATER CHAMBER OF COMMERCE 150 27 • 9302 GRAND SALINE CHAMBER OF COMM 125 28 9302 GRANT CHAMBER OF COMMERCE 200 29 9302 GREATER BOSSIER EGON DEV FOUND 1,000 30 9302 GREATER EUREKA SPRINGS 750 31 9302 GREATER SHREVEPORT CHAMBER OF 2,900 32 9302 GREENWOOD CHAMBER OF COMMERCE 800 33 9302 HAWKINS CHAMBER OF COMMERCE 50 34 9302 HEMPSTEAD couNre ECONOMIC DEVELOPMENT 1,200 35 9302 HENDERSON AREA CHAMBER OF COMMERCE 500 36 9302 HOPE-HEMPSTEAD couNr( CHAMBER 400 37 9302 KILGORE CHAMBER OF COMMERCE 530 38 9302 LA STATE COMMITTEE 6,500 39 9302 UTME RIVER CHAMBER OF COMMERCE 500 40 9302 LITTLE ROCK REGIONAL CHAMBER OF COMMERCE 350 41 9302 LONGVIEW 2020 FORUM 250 42 9302 LOUISIANA ASSOCIATION OF BUSINESS & INDUSTRY (LABI) 5,500 43 9302 LOUISIANA HEAT PUMP ASSOCIATION 300 44 9302 LOUISIANA INDUSTRIAL DEVELOPMENT 250 45 9302 MANUFACTURING MANAGERS COUNCIL 600 46 9302 MARION courirr CHAMBER OF COMMERCE 225 47 9302 MARSHALL CHAMBER OF COMMERCE 1,000 48 9302 MARTIN LUTHER KING COMMUNITY DEVELOPMENT 500 49 9302 MEMPHIS CHAMBER OF COMMERCE 180 50 9302 MENIA/POLK COUNTY CHAMBER OF 750 51 9302 MOUNT PLEASANT /TITUS COUNTY 308 52 9302 NASHVILLE CHAMBER OF COMMERCE 450 53 9302 NATCHITOCHES CHAMBER OF COMMERCE 985 54 9302 NEW BOSTON CHAMBER OF COMMERCE 130 55 9302 NORTHEAST TEXAS ECONOMIC 150 56 9302 NORTHWEST ARKANSAS COUNCIL 5,500
Sponsored by: Brian Bond/Randall Hamlett
2488
SOUTHWESTERN ELECTRIÇ POWER COMPANY Summary criBusIness/Economic Dues For the Test Year Ended June 30, 2016
PUC Docket No. 46449 Schedule G-4.3b
Page 2 of 2
Line No.
(1) (2) FERC ACCT Description
(3) (4) Test Year Brief Purpose of Amount Organization*
57 9302 NORTHWEST LOUISIANA HOME BUILDERS ASSOC 1,504 58 9302 PANOLA COUNTY 60 59 9302 PANOLA COUNTY CHAMBER OF COMMERCE 175 60 9302 PRESCOTT-NEVADA COUNTY CHAMBER 500 61 9302 ROGERS-LOWELL AREA CHAMBER OF COMMERCE 1,801 62 9302 SHELBY COUNTY 150 63 9302 SHREVEPORT ASSOCIATION OF BOMA 460 64 9302 SHREVEPORT-BOSSIER 275 65 9302 SHREVEPORT-BOSSIER MILITARY AFFAIRS CNCL 550 66 9302 SILOAM SPRINGS CHAMBER OF COMM 705 67 9302 SOUTHERN ECONOMIC DEVELOPMENT COUNCIL 250 68 9302 SOUTHWEST ARKANSAS DEVELOPMENT ALLIANCE 1,000 69 9302 SPRINGDALE CHAMBER OF COMMERCE 2,000 70 9302 TEXARKANA CHAMBER OF COMMERCE 4.007 71 9302 TEXAS ECONOMIC DEVELOPMENT CORP 1,000 72 9302 TEXAS WATER CONSERVATION ASSOC 3,520 73 9302 VERNON PARISH 530 74 9302 VIVIAN CHAPABER OF COMMERCE 60 75 9302 WALDRON AREA CHAMBER OF COMMERCE 100 76 Subtotal 75,813
77 Sch G4.3b.1 Billed from AEP Service Corporation 163,586
78 .. Amounts not included in cost of service (152,446)
79 Total Business and Economic Dues Subject to Limitation 5 86,952 G-4.3
The purpose is indicated in the title In the Description column. *" These items are not being requested In cost of service.
Sponsored br, Brian Bond/RandaIl Hamlett
2489
PUC Docket No. 46449 Schedule G-4.3b.1
Page 1 of 1 American Electric Power Service Corporation Billings to Southwestem Electric Power Company Summary of Business/Economic Dues For the Test Year Ended June 30, 2016
line No.
(1) (?) FERC ACCT Category
(3) Test Year Amount
(4) Brief Purpose of Organization*
1 1880 BLOOMBERG FINANCE LP $ 2,609 2 9302 BUSINESS ROUNDTABLE 15,098 3 9210 CEB INC 9,762 4 5
9210 CORPORATE EXECUTIVE BOARD 9302 COUNCIL OF GREAT LAKES INDUSTRIES
1,915 930
**
**
6 9210 COUNCIL ON STATE TAXATION 579 7 5000 ENVIROCERT INTERNATIONAL 41 8 5600 ENVIROCERT INTERNATIONAL 14 *
9 9120 GERMAN AMERICAN CHAMBE 386 10 9210 NATIONAL ASSOC FOR BUS 65 11 4264 NATIONAL ASSOCIATION OF MANUFACTURERS 3,925 **
12 9302 NATIONAL ASSOCIATION OF MANUFACTURERS 10,611 **
13 5600 OSU EXECUTIVE EDUCATIO 172 14 9210 NERO 47 15 9210 SECURITIES TRANSFER ASSN INC 118 16 1630 SUPREME COURT OF OHIO 3 17 9210 THE CONFERENCE BOAR 722 18 19
4264 UNITED STATES CHAMBER OF COMMERCE 9302 UNITED STATES CHAMBER OF COMMERCE
37,802 78,501 **
20 5600 VA DPOR 9 **
21 5660 VA DPOR 22 22 23 24
1070 WELD 4265 WELD 5660 WELD
15 14 4
*- .*
25 5600 WOMEN FOR ECONOMIC & LEADERSHIP 14 *
26 9302 WOMEN FOR ECONOMIC & LEADERSHIP 208 27 Subtotal 163,586
28 ArnOunt Not Included in Cost of Service (152,446)
29 Total Business and Economic Dues Subject to limitation 11,139 G-4.3b
The purpose is indicated in the title in the Description column. ** These items are not being requested in cost of service.
Sponsoned by: Brian Bond/Brian Frantz
2490
PUC Docket No. 46449 Schedule G-4.3c
Page 1 of 1
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Professional Dues For the Test Year Ended June 30, 2016
Line (1) (2)
FERO ACCT Description
(3) Test Year Arnount
(4) Brief Purpose of
Organization"
1 1070 JP MORGAN CHASE CORPORATE CARD ACTIVITY 589 2 1080 JP MORGAN CHASE CORPORATE CARD ACTIVITY 22 3 1510 BURTON, TIM 100 4 1510 JP MORGAN CHASE CORPORATE CARD ACTIVITY 872 5 1510 SHURBET, GREGORY G 20 6 1840 JP MORGAN CHASE CORPORATE CARD ACTIVITY 915 7 4265 JP MORGAN CHASE CORPORATE CARD ACTIVTTY 1 go
4265 SHREVEPORT TOASTMASTERS CLUB 49 9 4265 SILOAM SPRINGS TOASTMASTERS 80 10 5000 JP MORGAN CHASE CORPORATE CARD ACTIVITY 617 11 5060 JP MORGAN CHASE CORPORATE CARD ACTIVITY 354 12 5710 INTERNATIONAL SOCIETY OF ARBORICULTURE 200 13 5800 JP MORGAN CHASE CORPORATE CARD ACTIVITY 446 14 5880 JP MORGAN CHASE CORPORATE CARD ACTIVITY 363 15 5880 OWEN, EDWIN C so 16 5880 TROWLER, DEM W 196 17 5900 JP MORGAN CHASE CORPORATE CARD ACTIVITY 408 18 5930 JP MORGAN CHASE CORPORATE CARD ACTIVITY 873 19 5930 RUSHING. JEROMY B 20 20 9080 JP MORGAN CHASE CORPORATE CARD ACTIVITY 1,650 21 9210 ARKANSAS PRESS ASSOCIATION 225 22 9210 ASSOCIATION OF ENERGY ENGINEERS 460 23 9210 ASSOCIATION OF LOUISIANA 300 24 9210 BRICE, THOMAS P 446 25 9210 GLASGOW, RICHARD K 502 26 9210 INTERNATIONAL FACILITY MANAGEMENT ASSOCIATION 209 27 9210 JP MORGAN CHASE CORPORATE CARD ACTIVITY 3,786 28 9210 LOUISIANA PRESS ASSOCIATION 200 29 9210 NATIONAL SOCIETY OF PROFESSIONAL ENGINEERS 356 30 9210 SOCIETY FOR MINING, METALLURGY & EXPLORATION 152 31 9210 TEXAS PRESS ASSOCIATION 300 32 9302 ARKANSAS SOCIETY OF PROFESSIONAL LOBBYISTS 100 33 9302 JP MORGAN CHASE CORPORATE CARD ACTIVITY 250 34 1070 LE VASSEUR, SANDI G 10 " 35 1080 LE VASSEUR, SANDI G 2 " 36 1510 JP MORGAN CHASE CORPORATE CARD ACTIVITY 35 ** 37 5880 LE VASSEUR, SANDI G 9 ** 38 9210 JP MORGAN CHASE CORPORATE CARD ACTIVITY 300 ** 39 9210 MCCLOUD, sccn-r R 15 ** 40 15 ** 9210 MILFORD, JEti-tRY A 41 Subtotal 15,694
42 Sch G-4.30.1 Billed tun, AEP Service Corporation 43,534
43 Amounts not included in cost of service (11,443)
44 Total Professional Dues Subject to Limitation $ 47,785 5-4.3
• The putpose is indicated in the title in the Description column. ** These items are not being requested in cost of service.
Sponsored by: Brian BondtRandall Hamlett
PUC Docket No. 46449 Schedule G-4.3c.1
Page 1 of 6
Amedcan Electric Power Service Corporation . Billings to Southwestern Electric Power Cornpany Summary of Professional Dues For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
(2)
Categoiy
(3) (4) Test Year Brief Purpose of Amount Organization'.
1 5660 AABE 13 2 9210 AABE 31 ** 3 9210 AABE ;44 4 5000 AACE INC 40 5 9010 AACE INC 18 *" 6 9210 ACCOUNTANCY BOARD 17 7 9210 ACCOUNTANCY BOARD 21 8 5880 ACCOUNTANCY BOARD 15 9 9210 ACCOUNTANCY BOARD 16 **
10 9302 ACCOUNTANCY BOARD 13 11 9210 ACFE 39 12 9230 ACFE 20 13 5060 ACFE 20 14 9230 ACFE (20) 15 9210 ACGIH 16 16 9210 ACN1P 20 17 9210 AIA PRODUCTS / DUES 74 18 9210 AICHE 85 19 5570 A1C PA 109 '** 20 5880 . AICPA 24 21 9030 A1CPA 25 22 9210 AICPA 218 23 9210 A1GPA 219 — 24 9230 A1CPA 28 ** 25 9302 AICPA 21 26 5000 AIHA 58 . 27 9210 AIHA 31 28 9210 AIHA 30 ** 29 5000 AIR & WASTE MGMT ASSOCIATION 53 30 5600 AMER SOC CIVIL ENGINEE 58 31 1630 AMERICAN ASSOCIATION OF BLACKS IN ENERGY 20 ** 32 9210 AMERICAN BAR ASSOCIATION 351 ** 33 9210 AMERICAN CHEMICAL SOO 35 34 5660 AMERICAN CONCRETE INST 15 35 1070 AMERICAN 1NST OF STEEL 12/ ** 36 1630 AMERICAN LAW INSTITUTE 186 — 37 5570 AMERICAN METEOROLOGICA 44 38 9210 AMERICAN PAYROLL ASSOC 38 39 1070 AMERICAN SOCIETY OF SAFETY ENGINEERS 77 ** 40 5000 AMERICAN SOCIETY OF SAFETY ENGINEERS 22 41 5700 AMERICAN SOCIETY OF SAFETY ENGINEERS 22 42 5920 AMERICAN SOCIETY OF SAFETY ENGINEERS 30 43 9210 AMERICAN SOCIETY OF SAFETY ENGINEERS 175 44 1070 AMERICAN TRUCKING ASSOCIATIONS (ATA) 235 ** 45 9210 APEX CPE 11 46 9210 ARDC 45 — 47 9302 ARKANSAS DEPARTMENT OF HEALTH 13 48 5660 ARKANSAS 16
Sponsored by: Brian Bond/Brian Frantz
PUC Docket No. 46449 Schedule G-4.3Q1
Page 2 of 6
American Electric Power Service Corporation Billings to Southwestern Electric Power Company
Line No.
Summary of Professional Dues - For the Test Year Ended June 30, 2016
(1) (2) FERC ACCT Category
(3) Test Year Amount
(4) Brief Purpose of
Organization*
49 50 51
9210 5000 9210
ARKANSAS ARMA INTERNATIONAL ARMA INTERNATIONAL
11 13 13
** ** **
52 9230 ARMA INTERNATIONAL 23 53 5000 ASA-SSSA-CSSA 164 54 1070 ASCE 16 55 9210 ASCP 4 56 9210 ASM INTERNATIONAL 21 57 5060 ASME 29 58 59
5660 9210
ASME ASSOC CORP COUNSEL LBO
83 343
" **
60 9210 ASSOC FOR FINANCIAL PR 75 61 5000 ASSOCIATION FOR TALENT DEVELOPMENT-AM 287 62 5600 ASSOCIATION FOR TALENT DEVELOPMENT-ATD 126 63 5880 ASSOCIATION FOR TALENT DEVELOPMENT-AM 21 64 ' 9210 ASSOCIATION FOR TALENT DEVELOPMENT-ATD 43 65 66
9070 9210
ASSOCIATION OF ENE ASSOCIATION OF ENE
38 17 **
67 9210 AUSTIN BAR ASSOCIATION 114 ** 68 5000 AWS E-COMMERCE 92 69 5600 BD OF RFPE & LAND SURV 53 70 5660 • BD OF RFPE & LAND SURV 52 71 9210 BOARD CERT SAFE PRO 182 72 9260 BOARD CERT SAFE PRO
• 150
73 9210 BOARD OF CERTIFIED SAFETY PROFESSIONALS 18 74 9210 BUREAU OF NATIONAL AFFAIRS INC ' 858 75 5600 CEAT PROF DEV 81 76 9230 CENTER FOR OPERATIONAL.. EXCELLENCE 2,291 77 9210 CENTRAL OHIO ACFE 3 ** 78 9230 CERTIFICATION PARTNERS as 79 1880 CERTIFIED FRAUD EXAMINER • 26 ** 80 9210 CHARLESBARNES.COM 2 ** 81 5880 COLLEGE TRANSCRIPT 1 " 82 9210 COLLEGE TRANSCRIPT . 2
83 9302 208 'COMMI t hE OF 200 84 1070 DAVIS, TAMA A • 13 ** 85 5600 DC BAR 34 86 9210 DC BAR 73 ** 87 1070 DEPT OF LICENSING AND REGULATORY AFFAIRS 393 ** 88 5060 'DORA LICENSING 10 89 9210 EUTE CONTINUING EDUCATION 49 " 90 9210 EMPLOYEE RELOCATION CO ' 26 91 9230 ENERGY AND MINERAL LAW 36 " 92 9210 ENERGY BAR ASSOCIATION 53 ** 93 5000 EPRI 39 94 9210 EXECUTIVE WOMEN INTERNATIONAL 102 95 9302 G100 INC 19,797 96 5060 MARS, THOMAS J 109 Or.
Sponsored py: Brian Bondl8rian Frantz
2493
PUC Docket No. 46449 Schedule G-4.3c.1
Page 3 of 6 American Electric Power Service Corporation Billings to Southwestern Electric Power Company Summary of Professional Dues For the Test Year Ended June 30, 2016
Line No.
(I) FERC ACCT
(2)
dategory
(3) (4) Test Year Brief Purpose of Amount Organization*
97 9210 HUMAN RESOURCE 2 98 9210 HUMAN RESOURCE 11 ** 99 5880 IEEE PRODUCTS & SERVIC 72
100 9230 IIA CIA LRNG SYSTMS 90 101 5060 IL PROF LICENSE & FEE 20 102 5660 IN PROFESSIONAL LI 12 103 9210 IN PROFESSIONAL LI 21 104 5000 INDIANA PROFESSIONAL LICENSING AGENCY 120 — 105 9210 INDIANA PROFESSIONAL UCENSING AGENCY 24 ** 106 9210 INDIANA STATE BAR ASSOCIATION 23 ** 107 9210 INSTITUTE FOR PROFESSI 44 108 1880 INSTITUTE OF INTERNAL AUDITORS 37 — 109 9210 INTERNATIONAL RIGHT OF WAY ASSOCIATION 24 110 9210 INTERNATIONAL SECURITY 129 111 4264 INTERNATIONAL SWAPS & DERIVATIVES ASSOC 30 ** 112 9302 INTERNATIONAL SWAPS & DERIVATIVES ASSOC 2,069 113 9210 INTERNATL SOCIETY 27 114 5710 INTL SOC ARBORICULTURE 11 ** 115 1630 IRA 48 — 116 1070 IFIWA 348 ** 117 5600 IRWA 91 118 5660 IRWA 24 119 5600 KENTUCKY BOARD OF ENGINEERS & LAND SURVE 17 ** 120 5660 LAPELS 14 121 9210 LAPELS 24 122 5000 NATIONAL GROUND WATER 71 123 9210 NATIONAL SCIENCE TEACH 49 124 9210 NATIONAL SOCIETY OF PR 26 ** 125 5000 NATL BOARD OF BOILER 12 ** 126 5060 NATL SOC OF PROF ENGIN 70 127 5600 NATL SOC OF PROF ENGIN 39 128 1070 NCEES 6 ** 129 5000 NCEES 42 — 130 5660 NCEES 3 131 5000 NCEES 7 132 5060 NCEES 24 133 5600 IsICEES 44 134 5660 NCEES 35 135 9210 NEW YORK, STATE OF 94 136 1070 NGUYEN, CHRISTINA M 4 ** 137 1070 NSPE 27 Vk.
138 9210 NYS ATTY REGISTRATION 43 ** 139 1630 NYSEIA 80 ** 140 9210 OHIO BOARD OF ENGINEERS 15 ** 141 5680 OHIO BOARD OF ENGINEERS & SURVEYORS 9 •** 142 5000 OHIO ENG SUR BOARD 150 143 5000 OHIO ENG SUR BOARD 31 — 144 5060 OHIO ENG SUR BOARD 173
Sponsored try: Brian Bond/Brian Frantz
2494-
PUC Docket No. 46449 Schedule 0-4.3c.1
Page 4 of 6
American Electric Power Service Corporation Billings to Southwestern Electric Power Company Summary of Professional Dues For the Test Year Ended June 30, 2016
Line No.
(1) FERC ACCT
(2)
CategorY
(3) (4) Test Year Brief Purpose of Amount Organization*
145 5060 OHIO ENG SUR BOARD 16 * 146 5600 OHIO ENG SUR BOARD 53 147 5600 OHIO ENG SUR BOARD 14 ** 148 5660 OHIO ENG SUR BOARD 82 149 5660 OHIO ENG SUR BOARD 3 " 150 5860 OHIO ENG SUR BOARD 4 151 9210 OHIO ENG SUR BOARD 31 152 9210 OHIO ENG SUR BOARD 16 ** 153 1630 OHIO MINORITY SUPPLIER DEVELOPMENT 330 ** 154 5660 OHIO SOCIETY OF PROFL ENGINEERS 18 " 155 9210 OHIO STATE BAR ASSOC 337 " 156 9230 OHIO STATE BAR ASSOC as — 157 5660 OHIO'S ENGINEERS AND SURVEYORS BOARD 9 ** 158 1070 OK PE 9 ** 159 9210 OKLAHOMA BAR ASSOCIATI 165 ** 160 9230 OSC 37 161 1070 OSCP 53 ** 162 9210 PA ATTRNY 62 ** 163 9120 JASCO 158 164 5000 KMTREASURER 19 " 165 5600 KMTREASURER 18 166 5606 KMTREASURER 9 ** 167 9210 RELOCATIONC 8 168 1070 PE 45 ** 169 1630 PE 4 ** 170 5000 PE 8 171 1070 PE 15 * 172 1630 PE 55 ** 173 9302 PE 10 ** 174 1070 PE 36 — 175 5600 PMI COC 22 176 5000 PMI GLOBAL OPERATIONS CENTER 168 ** 177 1070 PMP 9 ** 178 1880 PMP CERTIFICATION 8 ** 179 1630 PMP RE-CERTIFICATION 5 ** 180 9302 PRB COAL USERS GROUP 196 181 1630 PROFESSIONAL SURVERYOR'S 13 * 182 1070 PROJECT MANAGEMENT INS 422 " 183 1630 PROJECT MANAGEMENT INS 80 184 1880 PROJECT MANAGEMENT INS 21 185 5000 PROJECT MANAGEMENT INS 213 186 5000 PROJECT MANAGEMENT INS 109 187 5060 PROJECT MANAGEMENT INS 183 188 5570 PROJECT MANAGEMENT INS 32 189 5603 PROJECT MANAGEMENT INS 515 190 5630 PROJECT MANAGEMENT INS 15 191 5660 PROJECT MANAGEMENT INS 65 192 5660 PROJECT MANAGEMENT INS 17
Sponsored by: Brian Bond/Brian Frantz
2495
PUC Docket No. 46449 Schedule G4.3c.1
Page 5 of 6
American Electric Power Service Corporation Billings to Southwestem Electric Power Company Summary of Professional Dues For the Test Year Ended June 30. 2016
Line No.
(I) FERC ACCT
(2)
Category
(3) (4) Test Year Brief Purpose of Amount Organization*
193 5800 PROJECT MANAGEMENT INS 13 194 9210 PROJECT MANAGEMENT INS 55 ** 195 9230 PROJECT MANAGEMENT INS 13 196 9302 PROJECT MANAGEMENT INS 79 197 9302 PROJECT MANAGEMENT INS 18 ** 198 1070 PROJECT MGMT INSTITUTE 34 ** 199 5000 PROJECT MGMT INSTITUTE 149 200 5000 PROJECT MGMT INSTITUTE 53 ** 201 5600 PROJECT MGMT INSTITUTE 146 202 5660 PROJECT MGMT INSTITUTE 99 203 5660 PROJECT MGMT INSTITUTE 46 ** 204 9210 PUBLIC RELATIONS SOCIE 44 235 9301 PUBLIC RELATIONS SOCIE 43 206 9302 RISK & INSURANCE MANAGEMENT SOCIETY INC 217 207 9210 SCCE 60 ** 208 5600 SECRETARY OF STATE 3 ** 209 9210 SHAREHOLDER SERVICES ASSOCIATION 98 — 210 1520 SHRM 62 211 5000 SHRM 56 212 9210 SHRM 32 213 9210 SHRM 141 ** 214 9230 SHRM 32 215 9210 SOCIETY FOR HUMAN RESO 17 216 9210 SOCIETY FOR HUMAN RESOURCE MANAGEMENT 17 217 9210 SOCIEre OF CORPORATE S 81 **
218 9210 SOCIETY OF DEPRECIATIO 43 219 9210 SOUTHEASTERN ASSOCIATION 116 220 9120 SOUTHERN ECONO 24 — 221 9210 STATE BAR OF ARIZONA 56 — 799 9210 STATE BAR OF MICHIGAN 72 — 223 9210 STATE BAR TX 445 ** 224 moo STATE OF MI LICENSING 16 225 5060 STATE OF MI LICENSING 16 226 5600 STATE OF MI LICENSING 9 227 5600 STATE OF OHIO 5 -* 228 5660 STATE OF OHIO 5 229 9210 STATE OF OHIO 8 4" 230 9210 SUPREME COURT OF OHIO 77 231 9210 SUPREME COURT OF OHIO 875 ** 232 9260 SUPREME COURT OF OHIO 48
233 5600 TEES FI FCTRICAL&COMPUT 52 234 1070 TEXAS BOARD OF ENGINEERS 8 ** 235 5000 TEXAS BOARD OF ENGINEERS 8 ** 236 1070 TEXAS REAL ESTATE COMMISSION 325 237 92/0 THE INST OF INT AUDITO 856 ** 238 9230 THE INST OF INT AUDITO 21 239 9230 THE MST OF INT AUDITO 760 240 9210 THE WEST VIRGINIA STAT 29 **
Sponsored by: Bdan den Frantz
2496
PUC Docket No. 46449 Schedule G-4.3c.1
Page 6 of 6
American Electric Power Service Corporation Billings to Southwestern Electric Power Company Summary of Pmfessional Dues For the Test Year Ended dune 30, 2016
Line No.
(1) FERC ACCT
(2)
CategorY
(3) Test Year Amount
(4) Brief Purpose of
Organization*
241 9210 TREASURER OF VIRGINIA 25 242 9210 TSBPA IND LC RENE 142 243 5060 TX BD ENG LIC RENE 7 244 5600 TX BD ENG UC RENE 19 245 5660 TX BD ENG LIC RENE 33 246 5660 TX BD ENG UC RENE 5 •-* 247 9210 TX BD ENG LIC RENE 248 1070 TXPE 13 *• 249 9210 VA BOARD OF ACCOUNTANC 7 250 5060 VA DPOR 16 251 9210 VIRGINIA STATE BAR 122 ** 252 5600 VWCC WORKFORCE 56 253 1070 WINUP 36 254 5000 WINUP 19 255 5000 WINUP 9 ** 256 5100 WINUP 16 ** 257 5600 WINUP 10 258 9210 WINUP 7 *Yr
259 9302 WINUP 9 260 1630 WOMEN'S INTERNATIONAL NETWORK 20 ** 261 9210 WOMEN'S INTERNATIONAL NEIWORK 6 262 9210 WORLD AT WORK 30 263 9210 WORLD AT WORK 21 264 1070 WORLD SAFETY ORGANIZ 25 ** 265 5000 WORLD SAFETY ORGANIZ 33 266 9210 WPUS CC IN CLERK O 38 267 5000 WV BOARD OF PROFESSIONAL ENGINEERS 16 268 5060 WV BOARD OF PROFESSIONAL ENGINEERS 8 269 5660 WV BOARD OF PROFESSIONAL ENGINEERS 5 270 9210 WV TREASURY a 271 5000 WVSPS 56
272 Subtotal 43,534
273 Amount Not Included in Cost of SenAce (10,958)
274 Total professional Dues Subject to Limitation 32,$76 G-4.3c
The purpose is indicated in the title in the Description column. — These items are not being requested in cost of service.
Sponsored by: Brian Bond/Brian Frantz
2497
PUC Docket No. 46449 Schedule G-4.3d
Page 1 of 1
SOUTHWESTERN ELECTRIC POWER COMPANY Summary of Social, Recreational, Fratemal or Religious Expenses For the Test Year Ended June 30, 2016
Une No.
(1) (2) FERO ACCT Description
(3) Test Year Arnount
(4) " Brief Purpose of
Organization*
1840 JP MORGAN CHASE CORPORATE CARD ACTIVITY 50 **
2 4261 HOPE LIONS CLUB 500 **
3 4261 JP MORGAN CHASE CORPORATE CARD ACTIVITY 500 **
4 4264 LONGVIEW GREGGTON ROTARY CLUB 1,000 **
5 4265 DOWNTOWN SHREVEPORT LIONS CLUB 1,500 6 4265 EASTERLING, CHARLES K 800 **
7 4265 JP MORGAN CHASE CORPORATE CARD ACTIVITY 5,363 **
8 4265 LITTIE ROCK CLUB 840 It*
9 4265 OPTIMIST CLUB 2,624 10 4265 PETROLEUM CLUB OF SHREVEPORT 25 11 4265 ROTARY CLUB 758 **
12 4265 SHREVEPORT CLUB 1,697 **
13 5060 JP MORGAN CHASE CORPORATE CARD ACTIVITY 181 **
14 5060 LONGVIEW LIONS CLUB 240 **
15 9210 JP MORGAN CHASE CORPORATE CARD ACTIVITY 448 **
16 9302 JP MORGAN CHASE CORPORATE CARD ACTIVITY 107 **
17 Subtotal 16,634
18 Sch G-4.3d.1 Billed from AEP Service Corporation 9,440
19 *ft Amounts not included in cost of service (26,074)
20 Total Social/Recreational/Fraternal or Religious Expenses G-4.3
The purpbse is indicated in the title in the Description column. **These items are not being requested in cost of service.
Sponsored by: Brian BOnd/Randell Hamlett
2498