docVERIFY — Service Proposal

Configure proposal

Client name

BE — Benefits Eligible

NBE — Not Benefits Eligible

TRM — Terminations

RET — Retired

BE enrollment tiers (must not exceed BE total)

EE Waived

EE Waived rate ($/dV ID) $0.25

EE Only

EE Only rate ($/dV ID) $0.50

EE + SP (Employee + Spouse)

EE + CH (Employee + Child/ren)

EE + DP (Employee + Dom. Partner)

EE + DPC (Dom. Partner Child/ren)

EE + FAM (Employee + Family)

Pricing

Rate per dV ID / mo $1.00

Administrative dashboard ($)

Technology systems ($)

Commission %

Margin %

Proposal date

Hardware lease — on-site kiosk (optional)

Include hardware lease

Tablet / device lease ($)

Stand / enclosure ($)

Table ($)

Number of kiosks

Available add-ons (optional)

Robot call outreach

Est. calls / mo

Cost per call ($)

Appointment scheduling

Platform fee ($/mo)

SMS notifications

Est. messages / mo

Cost per message ($)

Expedite processing

Per-case fee ($)

Est. cases / mo

MED Opt Out verification

Members opting out

Rate per member ($)

EOY Medicare Eligible

docVERIFY

Dependent Eligibility Verification Platform

Service Proposal

Dependent Documentation Verification & Benefits Eligibility Management

Prepared for

Acme Corporation

Prepared by

docVERIFY

Date

—

Proposal ref

—

Census overview

Total census

—

BE + NBE + TRM + RET

Benefits eligible (BE)

—

All enrolled members

Published rate / dV ID

—

Monthly all-in per BE life

dV ID Billable

—

EE+SP/CH/DP/DPC/FAM

dV ID Issued

—

EE Waived + EE Only

dV ID Inactive

—

NBE + TRM + RET · $0

BE — Benefits Eligible (billable)

NBE + TRM + RET — dV ID Inactive · $0

How docVERIFY works

Census file

Client submits BE + NBE census monthly

Identity verify

Employee confirms dV ID + 2 PII fields

Secure upload

Time-limited tokenized link delivered by email + SMS

Expert review

Cutoff 2 AM EST · dispatched 7 AM EST daily · 24–48 hr decision · federal holidays excluded

Decision

Approved, rejected, or pending — benefits updated

Monthly census change billing

Additions

(NH) New hire× 0.75

(JSC) Job status change — NBE → BE× 0.75

(QLE) Life event — document processing× 0.75

(AOD) Aging out — notifications & services× 0.50

Removals

(JSC) Job status change — BE → NBE$0.00

(TRM) Termination$0.00

(RET) Retirement$0.00

All changes are calculated based on the flat per dV ID rate of —. Credits and charges are net-settled on a single monthly invoice — no separate credit memo is required. Census Files are due by the last business day of each month and processed within 5 business days.

Service level commitments

Document turnaround

24–48 hrs

From 7:00 AM EST dispatch · cutoff 2:00 AM · federal holidays excluded

Review accuracy

98%+

Guaranteed monthly

Census processing

5 days

From month-end submission

SLA breach credit

Of monthly fee per breach

Proposal acceptance

Validity: This proposal is valid for 30 days from the date of issue. To proceed, please sign below and return a countersigned copy to docVERIFY. A Services Agreement will be issued upon acceptance.

Client — authorized signature

Signature

Printed name

Title

Date

docVERIFY — authorized signature

Signature

Printed name

Title

Date