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1st Amendment 10/21/2015AMY REAVILIN, CPA CLERK OF CIRCUIT COURT &COMPTROLLER Mom COUNTY, FLORIDA DATE: October 27, 2015 TO: Teresa Aguiar Division Director of Employee Services ATTN.• Maria Fernandez - Gonzalez FROM: Cheryl Robertson Executive Aide to the Clerk of Court & Comptroller UA4U0L-e dSM At the October 21, 2015, Board of County Commissioner's meeting the Board granted approval and execution of Item D6 Amendment to Administrative Services Agreement with Blue Cross and Blue Shield of Florida (BCBSF) effective November 1, 2015. Attached is a duplicate original of the above - mentioned for your handling. Should you have any questions please do not hesitate to contact this office. CC. County Attorney Finance File J 500 Whitehead Street Suite 101, PO Box 1980, Key West, FL 33040 Phone: 305 - 295 -3130 Fax: 305- 295 -3663 3117 Overseas Highway, Marathon, FL 33050 Phone: 305 -289 -6027 Fax: 305 - 289 -6025 88820 Overseas Highway, Plantation Key, FL 33070 Phone: 852 -7145 Fax: 305- 852 -7146 t AMENDMENT TO ADMINISTRATIVE SERVICES AGREEMENT THIS AMENDMENT, entered into on October 21, 2015 is by and between Blue Cross and Blue Shield of Florida, Inc. d /b /a Florida Blue (hereinafter called "Florida Blue ") and Monroe County Board of County Commissioners (hereinafter called the "Employer "). In consideration of the mutual and reciprocal promises herein contained, the Administrative Services Agreement between Florida Blue and the Employer (hereinafter "Agreement ") effective November 1, 2011 is amended as follows: Section I, subsection 1. 1, is hereby amended to extend the term of the Agreement until December 31, 2020 unless the Agreement is terminated earlier in accordance with the terms of the Agreement. 2. Section IV, subsection 4.2., is hereby amended deleting the second and third sentence and replacing it as follows: Either party may terminate this Agreement with or without cause upon one hundred and eighty (180) days written notice to the other party. 3. Exhibit B, Financial Arrangements, to the Agreement is hereby amended, effective October 21, 2015. The revised Exhibit B is attached to this Amendment and replaces the Exhibit B previously attached to the Agreement. 4. Exhibit E, Performance Guarantees, to the Agreement is hereby amended, effective October 21, 2015. The revised Exhibit E is attached to this Amendment and replaces the Exhibit E previously attached to the Agreement. 5. Exhibit F, Discount Guarantees, is hereby attached and made part of the Agreement, effective October 21, 2015. 6. Except as otherwise specifically noted in this Amendment, all other terms and conditions of the Agreement shall remain unchanged and in full force and effect. IN WITNESS WHEREOF, this Amendment has been executed by the duly authorized representatives of the parties. BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. D /B /A FLORIDA BLUE By: Title: Date: 17 L ' l MONROE COUNTY BOARD OF COUNTY COMMISSIONERS By: T Title: M D Date: MqPROE COUNTY ATTORNEY PPR VED A TO ORM: CYNTHIA L. HALL ASSISTANT COUNTY ATTORNEY Date to 1 3 - " is EXHIBIT "B" to the ADMINISTRATIVE SERVICES AGREEMENT between BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. D /B /A FLORIDA BLUE and MONROE COUNTY BOARD OF COUNTY COMMISSIONERS FINANCIAL ARRANGEMENTS Effective Date The effective date of this Exhibit is October 21, 2015. II. Weekly Payments A. Each week, Florida Blue will notify the Employer of the amount due to satisfy the previous week's paid claims liability. The Employer agrees to pay the full amount of the bill within thirty (30) business days of the written notification consisting of a proper invoice and supporting documentation. If the payment is not received by Florida Blue by the payment due date, the payment will be considered past due. Florida Blue will immediately suspend claims until payment is received by Florida Blue. B. The Employer agrees to pay to Florida Blue, each month during and after the term of this Agreement, an administrative fee, as set forth below. The Employer agrees to pay to Florida Blue, each month, the administrative fee within thirty (30) business days of the written notification consisting of a proper invoice and supporting documentation of the amount due. If payment is not received by Florida Blue by the due date, the payment will be considered past due. Florida Blue will immediately suspend claims until payment is received by Florida Blue. III. Fundinq Information A. Method of Funding Transfer: CHECK IV. Administrative Fees A. Administrative fees during the term of the Agreement: $48.27 per employee per month from November 1, 2014 through December 31, 2015 $45.75 per employee per month from January 1, 2016 through December 31, 2017. $47.25 per employee per month from January 1, 2018 through December 31, 2019. $48.50 per employee per month from January 1, 2020 through December 31, 2020. B. Florida Blue will pay the Employer a 2015, upon Board approval and wellness contribution on January $50,000 wellness contribution on provided the Agreement remains payment is due. These funds m discretion for any wellness relate execu 1,2 Janu $100,000 wellness contribution in tion of this Amendment; a $75,000 016 and January 1, 2017, and a ary 1, 2018 and January 1, 2019, in force and effect on the date on which ay be utilized by Employer at its sole J initiatives or activities. If the Employer terminates the Agreement without cause on or before January 1, 2020, Employer will pay Florida Blue a $150,000 early termination fee. V C. Administrative fees after the termination of the Agreement: 15% of claims paid. Expected Enrollment A. The administrative fees referenced above are based on an expected enrollment of: 1,600. B. If the actual enrollment is materially different from this expected enrollment, Florida Blue reserves the right to adjust the administrative fees as set forth in the Agreement. Administrative fees will be charged based on actual enrollment. For purposes of this paragraph, the term "materially" means an increase or decrease of greater than ten percent (10 %). EXHIBIT "E" to the ADMINISTRATIVE SERVICES AGREEMENT between BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. D /B /A FLORIDA BLUE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS PERFORMANCE GUARANTEES Number of calls that reach the call center and are placed in queue but do not reach the final destination because the caller :55% 2% h u before a re b ecomes available. Average ACD Phone Queue Time Actual length of time a member waits to speak with a customer 2 % 530 seconds service as after all ACD options have been chosen. Blockage Rate Percentage of calls blocked during business hours. ! <_8% 2% Enrollment Timeliness Percentage of ID cards mailed by effective date provided that the enrollment data is received from the employer 30 days prior ?99% to the effective date of coverage. Claims Processing Timeliness Percentage of provider and subscriber claims processed within 30 calendar days from receipt to the date that a claim has passed all edits and is pending the issuance of a check, voucher or denial. Claims Processing Accuracy Percentage of clai processed a Claims Dollar Accuracy Percentage of claim dollars paid accurately. - Inquiry Timeliness -- - -- Per centa ge o inquiri fin alize within 7 days Maximum at Risk is 10 %. 2% I 2% " >_97% I ?97% 2% " >_98% 2 %` >_90% 2% Guarantees are based on National Strategic /Public Sector book of business results. Performance Guarantees are from January 1, 2016 through December 31, 2016 EXHIBIT "F" to the ADMINISTRATIVE SERVICES AGREEMENT between BLUE CROSS AND BLUE SHIELD OF FLORIDA. INC. D /B /A FLORIDA BLUE and MONROE COUNTY BOARD OF COUNTY COMMISSIONERS DISCOUNT GUARANTEES Assumptions: • Applies to In- network provider claims only. • BCBSF Network and Program Savings Report will be used for validation of results. • No significant benefit or contribution changes or membership changes by geographic regions. • Based on enrollment provided in the RFP. • Blue products only, excluding RX. • Inpatient hospital claims in excess of $100,000 will be removed in their entirety from the discount guarantee calculation. • Does not include COB. • Does not include ACO /PCMH surcharge. • Does not include any ancillary products or AOR fees. • Does not include nationwide BlueCard claims. • Discount ranges are account specific and apply to total discounts only. • Results will be provided on a quarterly basis with a final settlement no earlier than the second quarter of the following year. • One year offer. Subject to the foregoing assumptions, the "Network Discount Achieved" will be calculated by dividing the savings in claim dollars by the Network Provider's Billed Charges, using the following formulas: Provider Billed Charges — Network Allowed Charges = Savings Savings / Provider Billed Charges = Network Discount Achieved. Discount Guarantees are from January 1, 2016 through December 31, 2016