HealthMAPS®

2018 Order Form (Please check all products ordered)

Product Additional
Base Health Rating Products Price(*) Cost
Medical Rating Manual and Software $35,450
— includes Detail Census Entry/Import feature, Rx Card, & State Mandated Benefits manual
Dental Rating Manual and Software 18,300
— includes Detail Census Entry/Import feature
Medical and Dental Rating Manuals and Software 47,300
— also includes Group Life Insurance component
Add Medical Simulation Software to Medical Purchase $2,750
Add Referenced Based Pricing Tool to Medical Purchase 7,500
Medical Simulation Software 6,650
Referenced Based Pricing Tool 15,000
State Mandated Benefits Manual 8,600
Stop Loss Products
Specific Stop Loss Manual and Software $23,600
— includes Detail Census Entry/Import feature, and Quoting System/Group Life Insurance component
Would you like the early release version? Yes___ No___
Aggregate Stop Loss Manual and Software 19,700
–includes medical claim costs for common medical plans and Detail Census Entry/Import feature
Specific and Aggregate Stop Loss Manuals and Software 37,600
Add Advanced Medical Rating Manual and Software $16,050
Add Rx Card Rating Manual and Software 5,350
Add Medical Simulation Software 3,900
Add Referenced Based Pricing Tool 7,500
Add Dental Rating Manual and Software
Basic 4,750
Advanced 12,900
*Discounts for prior purchases of same product; 33% if purchased within last 2 years; 20% if purchased prior to year 2016.
To request information about other Willis Towers Watson products, please check one or more of the following boxes:
Stop Loss Survey Dental Rate and Experience Surveys

To request information about Third-Party products, please check one or more of the following boxes:
Stop Loss Administrative Systems PPO Discounts/Medicare Data/ACA Rating Tool

Contact Person
Name of Company
Address
City, State, ZIP Code
Phone & Fax Number
E-mail address
Please visit our Web site at www.towerswatson.com/healthmaps for product information.
Willis Towers Watson, 101 South Hanley Road, St. Louis, MO 63105
Telephone: 314/719-5777, Fax: 314/719-5853
Email: hmaps@willistowerswatson.com