Common use of Attachment J Clause in Contracts

Attachment J. Please provide the results of the GeoAccess analysis requested in Section II, Part 3, Section E. Summary results should be provided in hard copy. Full results should be provided on CD-ROM. While we understand eligibility for each product will differ, please use the total census population for all GeoAccess reports Include the number of providers who meet the access criteria outlined in the table for each plan you are providing a response for: Medicare advantage HMO (medicare risk/medicare choice) California only Medicare Advantage PPO/PFFS (private fee-for- service) NATIONAL commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO California only 1 PCP 5 MILES 2 PCPS 8 MILES 2 OB/GYNS 10 MILES Please provide a total count for the number of providers for each plan from the GeoAccess analysis: Medicare advantage HMO (medicare risk/medicare CHOICE) Medicare Advantage PPO/PFFS (private fee-for- SERVICE) commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO OB/GYNS

Attachment J. Please provide the results of the GeoAccess analysis requested in Section II, Part 3, Section E. Summary results should be provided in hard copy. Full results should be provided on CD-ROM. While we understand eligibility for each product will differ, please use the total census population for all GeoAccess reports Include the number of providers who meet the access criteria outlined in the table for each plan you are providing a response for: Medicare advantage HMO (medicare risk/medicare choice) California only Medicare Advantage PPO/PFFS (private fee-for- service) NATIONAL commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO California only 1 PCP 5 MILES 2 PCPS 8 MILES 2 OB/GYNS 10 MILES 1 Hospital 15 MILES 1 Hospital 20 MILES Please provide a total count for the number of providers for each plan from the GeoAccess analysis: Medicare advantage Medicare COMMERCIAL ADVANTAGE HMO Advantage NON-MEDICARE COMMERCIAL (medicare risk/medicare CHOICE) Medicare Advantage MEDICARE PPO/PFFS Narrow NON-MEDICARE RISK/MEDICARE (private feePRIVATE FEE-for- FOR- Network HMO HMO CHOICE) SERVICE) commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO PCP’S OB/GYNS

Attachment J. Please provide the results of the GeoAccess analysis requested in Section II, Part 3, Section E. Summary results should be provided in hard copy. Full results should be provided on CD-ROM. While we understand eligibility for each product will differ, please use the total census population for all GeoAccess reports GeoAccess Summary – As appropriate‌ Include the number of providers who meet the access criteria outlined in the table for each plan you are providing a response for: Medicare advantage HMO (medicare risk/medicare choice) California only Medicare Advantage PPO/PFFS (private fee-for- service) NATIONAL commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO California only 1 PCP 5 MILES 2 PCPS 8 MILES 2 OB/GYNS 10 MILES Please provide a total count for the number of providers for each plan from the GeoAccess analysis: Medicare advantage HMO (medicare risk/medicare CHOICE) Medicare Advantage PPO/PFFS (private fee-for- SERVICE) commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO OB/GYNS