CMS-R-267.Attachments 2a-2b (Structure Submission Form)-11-7-08

Attachment 2a - Description of Compensation Structure for Plans Using Contracted Marketing Organizations

The structures to be provided are the initial and renewal compensation amounts paid by the plan to the contracted marketing organization(s).

(Optional form - if your organization has the schedule(s) in a workbook, or some other format, you may submit that documentation in lieu of Attachment 2a)

Contracted Marketing Organization Compensation Schedule (Submit one per schedule)

<MA or PDP Organization Name>

<Contract Number(s)>

<Year>

<Unique Identifying Number>

Initial Compensation Structure:

Renewal Compensation Structure:

Attachment 2b - Description of Compensation Structure for Writing Agents Paid Directly by the MA or PDP Organization, and by Contracted Marketing Organizations

The structures to be provided are the initial and renewal compensation amounts paid directly to the writing agents by MA and PDP organizations. In addition, provide structures for the initial and renewal compensations amounts paid directly to the writing agents by marketing organization(s) contracted by the plans.

(Optional form - if your organization has the schedule(s) in a workbook, or some other format, you may submit that documentation in lieu of Attachment 2b)

Writing Agents Compensation Schedule

(Submit one per schedule)

<MA or PDP Organization Name>

<Contract Number(s)>

<Year>

<Unique Identifying Number>

Initial Compensation Structure:

Renewal Compensation Structure:

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