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16 <br /> ADDENDUM C <br /> FEE SCHEDULE AND CONDITIONS OF OFFER <br /> BASIC FEES Fee PEPM <br /> Basic Services <br /> [Choose only one] $ 1.54 <br /> X Face to Face Employee Assistance Program <br /> Model--Choose selected model below: <br /> ®3-session ❑6-session <br /> ❑5-session ❑ 8-session <br /> Or <br /> Telephonic Only Services <br /> Optional Services <br /> MagellanAssist Coached Services <br /> X_ Legal Consultation Services Included in EAP <br /> rate <br /> Work Life Resource and Referral Included in EAP <br /> Services--Choose model below: rate <br /> L::: Basic <br /> Full <br /> Full,with Convenience Services <br /> urse Line Services <br /> inancial Consultation Services <br /> SUPPLEMENTAL FEES <br /> Additional Services <br /> Additional Trainings $125 per clinician <br /> hour <br /> Additional Mandatory Referrals $700 per referral <br /> Additional CISDs $200 per clinician <br /> per hour <br /> Additional Sessions $90.00 per Session <br /> Run-Off Services $100.00 per Session <br /> Additional Communications Materials <br /> Postcard and refrigerator magnet $0.60 per unit <br /> Additional Videos $14.00 per unit <br /> Additional Wallet Cards $0.10 per unit <br /> Additional Brochures $0.40 per unit <br /> Additional Posters $1.60 per unit <br /> Magellan Behavioral Health,Inc. 13 Rev.07127101 <br /> Growing Business Services Agreement <br />