RTW, INC. CONSULTING SERVICES AGREEMENT APPENDIX B STATEMENT OF WORK ALL OTHER SERVICES AMENDED AND RESTATED AS OF JANUARY 1, 2013
EXHIBIT 10.35
RTW, INC.
CONSULTING SERVICES AGREEMENT
APPENDIX B
STATEMENT OF WORK – ALL OTHER SERVICES
AMENDED AND RESTATED AS OF JANUARY 1, 2013
RTW shall perform other workers compensation and disability management services for CLIENT or CLIENT’s policyholders as agreed upon by the parties.
Claims Management Services
RTW will provide claims management services for CLIENT or CLIENT’s policyholders on a cost basis for the following types of claims: Incident Only, Medical Only and Indemnity.
RTW’s fees for the following services are as stated below:
| Nurse Case Management | Up to $100 per hour | |
| Medical Bill Review | Actual expense of vendor partner, Coventry, under its then-current agreement | |
| Medical Director | $275 per hour | |
RTW PlaceRite
RTW will provide the RTW PlaceRite alternative return-to-work services to CLIENT and CLIENT’s policyholders at a rate of $500 per referral.
| State Automobile Mutual Insurance Company | ||
| State Auto Property & Casualty Insurance Company | ||
| Meridian Security Insurance Company | ||
| Meridian Citizens Mutual Insurance Company | ||
| Milbank Insurance Company | ||
| RTW, Inc. | ||
| By: | /s/ Susan Bowron-White | |
| Susan Bowron-White, Assistant Secretary | ||
