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2nd Amendment 12/14/2016 KEVIN MADOK, CPA MONROE COUNTY CLERK OF THE CIRCUIT COURT & COMPTROLLER DATE: January 10, 2017 TO: Maria Fernandez - Gonzalez, Sr. Benefits Administrator FROM: Pamela G. Hanco4peputy Clerk SUBJECT: December 14th BOCC Meeting Attached is a duplicate original, of the following item, from the above - mentioned meeting date: Item C8 Second Amendment to Administrative Services Agreement with Blue Cross and Blue Shield of Florida to include Teladoc Services effective January 1, 2017, at an additional cost of $1.00 per employee per month, through December 31, 2020. Should you have any questions, please feel free to contact me at ext. 3130. Thank you. cc: County Attorney w/o document Finance File/ • SECOND AMENDMENT TO ADMINISTRATIVE SERVICES AGREEMENT THIS AMENDMENT, entered into on December 14 , 2016 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, as amended on October 21, 2015, is amended as follows: 1. 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. Exhibit B, Financial Arrangements, to the Agreement is hereby amended, effective January 1, 2017. The revised Exhibit B is attached to this Amendment and replaces the Exhibit B previously attached to the Agreement. 3. 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 MONROE COUNTY BOARD OF OF FLORIDA, INC. D /B /A FLORIDA COUNTY COMMISSIONERS BLUE /- / 4.12fr By: � Title: V E s G i ', -mac —w r..;_ Title: George Neugent, Mayor 00 " f. 1 • Date: 1 12-el 4,AW II n �- .• eV M..1. IC". o _ . ----:,,,--5- , , Cl e rk _ c___ Pi c. '""'"..)... ,..., 4r 'D r- — - " 14-1.-.%....e)-1-w-C-7 - - - 1 -.A ...... Deputy Clerk N --7 -- C . - 3 C.., MONROE COUNTY ATTORNEY , PPRO, ED AS Ts F P M : ALA CYNTHIA L. HALL ASST ANT COUNTY ATTORNEY Date_ — �- "-th • 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 I. Effective Date The effective date of this Exhibit is January 1, 2017. 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. Funding Information A. Method of Funding Transfer: CHECK IV. Administrative Fees: A. Administrative fees during the term of the Agreement: $46.75 per employee per month from January 1, 2017 through December 31, 2017. This fee includes 1.00 PEPM for Teladoc Services. B1- $48.25 per employee per month from January 1, 2018 through December 1, 2019. This fee includes 1.00 PEPM for Teladoc Services. $49.50 per employee per month from January 1, 2020 through December 31, 2020. This fee includes 1.00 PEPM for Teladoc Services. B. Florida Blue will pay the Employer a a $75,000 wellness contribution on January 1, 2017, and a $50,000 wellness contribution on each of January 1, 2018 and January 1, 2019, provided the Agreement remains in force and effect on the date on which payment is due. These funds may be utilized by Employer at its sole discretion for any wellness related 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. C. Administrative fees after the termination of the Agreement: 15% of claims paid. V. 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 %). B2-