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Item J2 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: Mav 20, 2009 Division: Employee Services Bulk Item: Yes No~ Department: Employee Services Staff Contact Person: Maria Z. Fernandez X4449 AGENDA ITEM WORDING: Discussion and approval of Contract Agreement with Dimension Health, Inc. to provide Network Provider Services in the areas of Dade, Broward and Palm Beach Counties. ITEM BACKGROUND: On August 20, 2008, the BOCC discussed (and approved) a request to seek proposals for Third Party Administration Services, Utilization Review, Large Case Management and Network Provider Services for the County's Self-Insured Health Plan and investigate and evaluate available alternatives. Request for Proposals completed in February 2009. PREVIOUS REVELANT BOCC ACTION: None CONTRACT/AGREEMENT CHANGES: N/A ST AFF RECOMMENDATIONS: Approval. TOTAL COST: Approx $52.107 vr INDIRECT COST: BUDGETED:Yes .......K...No COST TO COUNTY: same as above SOURCE OF FUNDS: Ad Valorem REVENUE PRODUCING: Yes No~ AMOUNT PER MONTH_ Year APPROVED BY: County Atty _ ~/PurchaSing _ Risk Management_ DOCUMENTATION: Included ~ To Follow_ Not Required _ DISPOSITION: AGENDA ITEM # cl 1-'- "t:l g~ ~ <t> 5' 8 Ci'~ ~ ~ Cll ..... g.-a .::J <:: 5' ~ Q.a.. c::: _, a..::J 5' ..... to:! ...., v, <t>"t:l to Cil s.v, Cll <t> g.~ ::J Cll V, :::!", . 0 :::::::J ~, (ij' ?lCi' g's' v, 0- ~ ~ a..Cll ~ g. C) ::J -Cll c::: _ ~,~ .Vl -g Cil ~ Ci)'v, ~ 0 .....::J ~~ o 11 c::: 0 ~ ~ C) _, o ::J ~o- 03 ~ ~Cll ~ g. 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Expiration Date: May 19,2012 Contract Purpose/Description:Approval of Contract with Dimension for Network Provider Services for Dade, Broward and Palm Beach Counties. Contract Manager:Maria Fernandez- Gonzalez 4448 Employee Services (Name) (Ext.) (Department) for BOCC meeting on Mav 20 2009 Agenda Deadline: Mav 5 2009 CONTRACT COSTS Total Dollar Value of Contract: approx $52,107 yr Current Year Portion: $_ Budgeted? Y es~ No D Account Codes: 502-08002-530-310 Grant: $_ _-_ __-_ County Match: $_ _-_ _-_-_ - - - - ----- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW DateJIJ Division Director 5~ Changes Needed ....-/ YesD NOlJ!1 Date Out Risk Managemept ~1 ~ji.L ~~ ,,~ 6.M.B./Purchasing '5~4-0<7 County Attorney 5, 4--01 a01 6'<f,lj{ sHlq 5'"-1- D9 Comments: OMB Form Revised 9/11/95 MCP #2 Board of County Commissioners Teresa E. Aguiar, {).\:. '\ Employee Services Director ~\.JV May 4, 2009 OKy,~rY ~o~~~E (305) 294-4641 Office of the Employee Services Division Director The Historic Gato Cigar Factory 1100 Simonton Street, Suite 268 Key West, FL 33040 (305) 292-4458 - Phone (305) 292-4564 - Fax TO: FROM: DATE: SUBJ: 1''' - --- ,,---..-.-- , BOARD OF COUNTY COMMISSIONERS Mayor George Neguent, District 2 Mayor Pro Tem Sylvia J. Murphy, District S Kim Wigington, District 1 Heather Carruthers, District 2 Mario DiGennaro, District 4 k" ~~. .~~- '.', \~ S >.'~I ~ --= =....'f. ~~..,:.. t""Io.. Dimension Network Contract This item requests approval to contract with Dimension Health, Inc. for the period of May 20, 2009 - May 19,2012 at the cost of $52,107 per year. Dimension is the current PPO Network for the areas of Dade, Broward & Palm Beach Counties. As part of the bid process, Dimension proposed an alternate network arrangement, "Dimension Plus Network", which would be an additional cost to the County of $28,422 per year. Utilizing the proposed network offers greater savings through higher discounts. Based on the current utilization of providers within this network, it is projected that the additional savings for FY 09/10 will be $350,000. This indicates that it is a worthwhile decision to accept the alternate network proposal. It is therefore recommended that the Board approve this request. If you have any questions on this item, please do not hesitate to contact me at X4458. CLIENT SERVICE AGREEMENT FOR DIMENSION PLUS CLIENTS THIS SERVICE AGREEMENT effective the 20 day of May ,2009 by and between MONROE COUNTY (herein after the "Client") and Dimension Health, Inc. (hereinafter"PPO") for the purpose of facilitating PPO's costs containment services with respect to the Client's Benefit Plan in consideration for the payment by the Client, of a service fee, the parties agree as follow: ARTICLE 1. DEFINITIONS Section 1.1 Client Benefit Plan. Plan shall mean the plan of health insurance benefits adopted by the Client. Section 1.2 Participant. Participant shall mean any person who is entitled to receive benefits under the Plan. Section 1.3 Emplovee. Employee shall mean any person working for an employer with respect to whose employment it is required to permitted to make contributions to the Client. Section 1.4 Administrator. Administrator shall mean the Client's/Employer Group Third Party Administrator for the Client/Employer Group Health Insurance Program. Section 1.5. Consultant. Consultant shall mean the Client/Employer Group representative. ARTICLE 2. TERM OF AGREEMENT Section 2.1. This agreement shall be in effect for a period of three (3) years commencing on the date first written above unless sooner terminated as provided in this Agreement. Section 2.2. This agreement may be terminated by either party at any time by giving ninety (90) days prior written notice to the other party of its desire to terminate. Section 2.3. This Agreement shall be automatically renewed for successive one- year periods until either party gives the other notice of cancellation in accordance with the terms set forth below. Section 2.4. If any party is in default with respect to any provIsIon of this 'Agreement, then the non-defaulting party shall be entitled to immediate termination of this Agreement by giving written notice to the defaulting party. The defaulting party shall have ten (10) days from receipt of such written notice to cure any default. If the default is not cured, this Agreement shall terminate effective upon receipt of this notice. Any fees due from the Client to PPO shall be prorated through the effective date of such termination. ARTICLE 3. CLIENT / EMPLOYER OBLIGATIONS Section 3.1. The Client or Employer Group shall: (a) Prior to the effective date, .furnish PPO with a detailed description of the Current Benefit Plan and prior to the renewal date, provide PPO with any changes or provisions that affect how PPO services the Benefit Plan. (b) Prior to the effective date of a new benefit plan or renewal of the benefit plan, provide PPO with a complete and accurate covered employee/participants eligibility listing. 2 (c) Assist PPO, when applicable, in coordinating meetings with covered employees/participants to present and explain the PPO program. (d) Client or Employee Group hereby advises PPO that the name(s), addressees), telephone numbers(s) and contact person(s) of its Third Party Administrator (TPA) is (are): WELLS FARGO THIRD PARTY ADMINISTRATOR 602 Virginia Street East Charleston, WV 25301 c/o Rick Leg.g, COO And, Client or Employer Group will promptly advise PPO, in writing, of any change before such change becomes effective. ARTICLE 4. PPO OBLIGATIONS Section 4.1. The PPO shall: (a) Prepare and distribute provider directories to communicate to covered employees/participants the name, location, phone number and specialty of participating physicians, hospitals and ancillary providers. (b) Provide when applicable identification card stickers for Client Participants. (c) Perform such activities as may be desired by the Client and which are normally part of PPO's services. 3 (1) PPO will gIve the County access to the Dimension Plus provider network and to the provider discounts that they have negotiated with the physicians and hospitals that participate in the Dimension Plus network as set forth in Exhibit A hereto, the contents of which are incorporated by reference. . (2) PPO will provide or arrange to provide utilization Management services for proper administration of the client's benefit plan. (3) PPO will facilitate the orderly flow of claims processing through prompt review by the PPO Medical Director's office of any dispute arising out of its costs containment program. (e) Arrange for the proVIsIon of provider reimbursement information, provider demo graphic information and management information reports in formats and time schedules as may be agreed. (f) Provide advice on benefit and plan modifications to the Client's consultant, as appropriate. ARTICLE 5. SERVICE FEE Section 5.1. The Client or Employer Group shall pay to PPO a Service Fee of $2.75 per covered employee per month either directly to PPO or to PPO through its TPA. The Service Fee shall be due within 15 days of the end of the previous calendar month. The Service Fee shall be calculated on the basis of the monthly head count as computed 4 by the client's Third Party Administrator of the Plan. Payments will be made III accordance with the Florida Local Government Prompt Payment Act. ARTICLE 6. ASSIGNMENT Section 6.1. This Agreement shall not be assignable by either party without the express written consent of the other party prior to any assignment. Section 6.2. If this Agreement is assigned pursuant to Section 5.1 above, the terms and conditions of this Agreement shall remain in full force and effect. ARTICLE 7. NOTICES Section 7.1. Any notice pursuant to this Agreement shall be in writing and shall be hand delivered or sent by certified mail, return receipt requested, addressed as follows: Dimension Health, Inc. 5881 N. W. 151 Street, Suite 201 Miami Lakes, FL 33014 Att: Office of the President To Client MONROE COUNTY 1100 Simonton Street. Suite 2-268 Key West. FL 33040 Attn: Marie Z. Fernandez-Gonzales. Sf. Administrator. Benefits 5 or such other address as either party may designate in writing. ARTICLE 8. INDEPENDENT PARTIES. Client and PPO are independent entities. Nothing in this Agreement shall be construed or deemed to create a relationship other than that of independent parties contracting with each other solely for the purpose of carrying out the provisions of this Agreement. ARTICLE 9. CONFIDENTIALITY. PPO agrees that the list of eligible covered employees/participants will be kept confidential, and neither it nor its contents shall be released by PPO, its agents or employees to any entity or person not authorized in writing by the Client to receive such information. ARTICLE 10. INSURANCE. PPO agrees to provide insurance coverage as specified in Exhibit B to this Agreement. PPO agrees to provide proof of insurance within ten (10) days following execution of this Agreement. Failure to provide proof of insurance shall be grounds for termination of this Agreement. PPO shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced and/or termination of this Agreement and for damages to the COUNTY. The PPO shall provide, to the COUNTY, as satisfactory evidence of the required insurance, either: · Certificate of Insurance or · A Certified copy of the actual insurance policy. All insurance policies must specify that they are not subject to cancellation, non-renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation and professional liability. 6 ARTICLE 11. MISCELLANEOUS Section 11.1 Section headings contained in this Agreement are for reference purposes only and shall not in any way affect the meaning or interpretation of this Agreement. Section 11.2 This Agreement shall be interpreted and given effect in accordance with the laws of the State of Florida. Section 11.3 This Agreement expresses the whole agreement between the parties. No change, modifications or addition to this Agreement shall be valid unless in writing and signed by all of the parties hereto. Section 11.4 Each party agrees that it will execute and deliver such further documents and instruments and will take such other action as may be reasonably necessary to in order to effectively consummate and implement the matters addressed or transactions contemplated under this Agreement and to discharge or carry our any of their respective obligations and agreements hereunder. Section 11.5 The provisions of the Agreement shall be regarded as divisible and shall be operative only to the extent that they are justifiably enforceable. In the event that any such provisions declared invalid or unenforceable, the validity and enforceability of the remainder of he terms and conditions of this Agreement shall not in any way be affected hereby. Section 11.6 PPO shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. If an auditor employed by Client or Clerk determines that monies paid to PPO pursuant to this Agreement were spent for purposes not authorized by this Agreement, PPO shall repay 7 the monies together with interest calculated pursuant to Sec. 55.03, FS, running from the date the monies were paid to PPO. Section 11.7 Client and PPO shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by Client and PPO in conjunction with this Agreement; and Client shall have the right to unilaterally cancel this Agreement upon violation of this provision by PPO. Section 11.8 PPO covenants and agrees to indemnify and hold harmless Client from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Client) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by PPO occasioned by the negligence, errors, or other wrongful act of omission of PPO, its employees, or agents. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. Prior to execution of this agreement, PPO shall furnish Client Certificates of Insurance indicating the minimum coverage limitations as indicated by an "X" on the attached forms identified as INSCKLST 1-5, as further detailed on forms WC1, GL1, GIR 1, and VL1, each attached hereto and incorporated as part of this contract document, and all other requirements found to be in the best interest of Client as may be imposed by the Monroe County Risk Management Department. Non-Waiver of Immunity. Notwithstanding the prOVISIons of Sec. 786.28, Florida Statutes, the participation of Client and PPO in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by Client be required to contain any provision for waiver. Section 11.9 Client and PPO agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the art of any party, effective the date of the 8 court order. Client and PPO agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on the basis of disability; and 10) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. Section 11.9 Disclosure and Conflict of Interest. PPO represents that it, its directors, principles and employees, presently have no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required by this contract, as provided in Sect. 112.311, et. seq., Florida Statutes. Client agrees that officers and employees of Client recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Upon execution of this contract, and thereafter 9 as changes may require, PPO shall notify Client of any financial interest it may have in any and all programs in Client which PPO sponsors, endorses, recommends, supervises, or requires for counseling, assistance, evaluation, or treatment. This provision shall apply whether or not such program is required by statute, as a condition of probation, or is provided on a voluntary basis. The Client and PPO warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, PPO agrees that Client shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. Section 11.10. Client is exempt from payment of Florida State Sales and Use taxes. PPO shall not be exempted by virtue of Client's exemption from paying sales tax to its suppliers for materials used to fulfill its obligations under this contract, nor is PPO authorized to use Client's Tax Exemption Number in securing such materials. PPO shall be responsible for any and all taxes, or payments of withholding, related to services rendered under this agreement. Section 11.1e PPO agrees to execute such documents as Client may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace Statement. Section 11.12. Ethics Clause. PPO warrants that hefit has not employed, retained or otherwise had act on his/its behalf any former Client officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any Client officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the Client may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise 10 recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former Client officer or employee. Section 11.13. Non-Reliance By Third Parties. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or program contemplated hereunder, and Client and the PPO agree that neither Client nor the PPO nor any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. Section 11.14. Mediation. Client and PPO agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. Venue shall be in Monroe County, Florida. Section 11.15 Convicted Vendor. A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a Agreement with a public entity for the construction or repair of a public building or public work, may not perform work as a contractor, supplier, or subcontractor under Agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category Two for a period of 36 months from the date of being placed on the convicted vendor list. 11 ........, ~... v.........t..v OJ.... J.. .11'-'1 1 .LJ..LLU......l~..LI.JJ.' 1)1....-4....l. 1...., 1 .l UI(JU .1 lUJ.-..J/ ~.L..J 1. U(.JI(J IN WITNESS WHEREOF, each of the parties has caused this Agreement to be duly executed in dupli<:ate, as of the date first above written. DIMENS10N BEAL mt INC. Charles A. Liodgren Print Name President I CEO Title MONRQE COUNTY BOARD Of COQNTY COMMISSIONERS Signature Print name Mayor/Chairman 12 Exhibit A Reimbursement Schedule DIMENSION PLUS (Only PLUS groups have access to University of Miami Affiliates and providers) Physician Fees 110% of Medicare Allowable (with some exceptions for hospital based groups and high risk specialists) Ancillary Fees See attached spreadsheet Hospital Fees Baptist Hospital South Miami Hospital Homestead Hospital Mariners Hospital Doctors Hospital Mount Sinai Medical Center Mercy Hospital Miami Children's Hospital Jackson Memorial University of Miami (formerly Cedars) 13 75% of billed charges 75% of billed charges 75% of billed charges 75% of billed charges 75% of billed charges Per diems/case rates Per diems/case rates 70% of billed charges Per diems/case rates Per diems rn w l- e:( et:: i2 ~ z Q rn z w :E - c 5 '0 " 5~O:: !-;::E ~ .2 g ~ 0. 2'''::0 = u Ul i>..J l1l ..J ~ - ..I.t'} C ~~o ; .~: 1iI :ll .2 N 4>' Cu.o3: a: '0 :io:: 'E:i'tl ~.!!! ~ o e: 0 ~ 'tl ~ a:l _!Xl ... .c <l> .c ' ~ C '$: 04>0' C/l ~ .~_; 1 ~I 01 zi ..., -SI c' QI U C tll (J C/l it: :i .t:: -"5 Ul 0 SC/l ~- ::J 0 ~o:: ~:E 'tl c o 4> o 0. ~o tll, 'tl. tll .- 15e.2 :x::"Ou. a, U') " ~ co en U) co en N 6r:- ~ ~' :> 0' W (j) i Z "'I, <') <P, .....' o N I/) '7 I/) ..., en o J, "-~~ .t:: :i o C/l ... 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I ! ~ L 'I,' $! IIi: 1.5;;::;- le'cUi ~.~: ~(~ IZ'I.I,:. :. W 1-----.-.--...,....- . -t- .2! :::l "C Q.) ..c (,) en 4l 4l l.I.. OJ OJ CO Q.. ~ o o N CO ro c .>:: OJ Q.. If> Q.)' 0) ... CU .c U :"0 ~: 'm :::: 0, ... c: ::J o t,) CII i5 '<!- ,... , ~ ..c (5 (0 ..9:! Q) E Q) 'i .c -r- ~ - Co f'oo, -r- .... .2 - tJJ at) ~ <l: (1) ... :>. ~ ~ 0 oX " a.. (1) .... f'oo, :e CO 0 .... .- '''It C (1) OM f'oo, (1) 00 CoM f'oo, ... ::J ..c:..J 00 ... " '''It I ::J N t::u. 00 0 (1) 00 0 f'oo, ..c: X 'lit Z.c '''It ..... 0 !X:f'oo, 0 (J) 0 0 - CUN at) CU -r- :::e Q) Q) I (0 0 J:~ N Q) at) 0 Q) -r-CQ - Q) U. w Q) ..J .... ::> ... CU 0 Q) .c 0 Q) w e Q) tJJ C :c: > 0 () (1)0 ::J :;: tJJ .c: Z Q) Co (J) e- o ... a: :! "C ..9:! w CU >< " Q) w z~ z w <l: l- LL Exhibit B INSURANCE REQUIREMENTS Worker's Compensation $ 100.000 Bodily Injury by Ace. $ 500.000 Bodily Inj. by Disease, policy Imts $ 100.000 Bodily Inj. by Disease, each emp. General Liability, including $ 300.000 Combined Single Limit Premises Operation Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage Professional Liability Insurance Professional liability including errors and omissions $500.000 per Occurrence The Monroe County Board of County Commissioners shall be named as Additional insured on all policies issued to satisfy the above requirements except Workers' Compensation and Professional Liability insurance. 14