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CARVE-OUT MENTAL HEALTH AND SUBSTANCE ABUSE AGREEMENT CARVE-OUT MENTAL HEALTH AND SUBSTANCE ABUSE AGREEMENT This Agreement, entered into thiS.J.i! day of~,,; Sl ,2001 between CITY MAR 2 8 2001 OF CLEARWATER (herein referred to as "CLEARWATER") and UNIPSYCH BENEFITS OF FLORIDA, INC., a Florida corporation which contracts with duly licensed providers of psychological and psychiatric services, other mental health professionals and inpatient facilities for the provision of mental health and/or substance abuse treatment, (hereinafter referred to as "UPB"): WITNESSETH: WHEREAS, CLEARW A TER desires to provide for the examination and treatment of mental health and substance abuse conditions to its employees and their authorized dependents as dermed by CLEARW A TER (hereinafter referred to as "Eligible Employees and Dependents"); and WHEREAS, UPB is a Florida corporation which contracts with duly registered and duly licensed providers of psychological and psychiatric services, other mental health professionals and inpatient facilities; and WHEREAS, UPB is willing and able to arrange for examination and treatment for mental health and substance abuse conditions to those Eligible Employees and Dependents for whom CLEARW A TER desires to provide such benefits; and WHEREAS, CLEARW A TER and UPB wish to enter into an Agreement relating to the provision of such mental health and substance abuse examination and treatment to said Eligible Employees and Dependents by UPB; NOW, THEREFORE, in consideration of the promises and mutual covenants herein contained, the parties hereto covenant and agree as follows. 1 (03/21/01) 9() 1. SERVICES TO BE PROVIDED UPB agrees to provide those benefits necessary for the treatment of mental health and substance abuse conditions as they are set forth in the "Summary Plan Description" attached hereto as "EXHIBIT A", and as further described in CLEARWATER'S RFP and UPB's Proposal in response to CLEARWATER'S RFP, which are incorporated herein by reference. UPB also agrees to the Performance Guarantees set forth in and attached hereto as "EXHIBIT C". CLEARWATER acknowledges that the benefits being provided hereunder are limited in nature and that there might be treatment necessary for mental health and substance abuse conditions for Eligible Employees and Dependents covered hereby which will not be provided pursuant to this Agreement and the Exhibits hereto. In the event that CLEARW A TER wishes to have UPB cover any additional services for Eligible Employees and Dependents, which are not covered under the terms of this Agreement, then CLEARW A TER agrees to pay UPB additionally for those services at the rate of 80% of UPB's usual and customary charges. 2. PAYMENT FOR SERVICES CLEARW A TER shall compensate UPB according to the fee schedule attached hereto. UPB agrees to look solely to CLEARW A TER for payment for such services rendered during the term of this Agreement and shall not seek to collect any sums from Eligible Employees and Dependents, notwithstanding CLEARWATER's failure to pay sums due under this Agreement for any reason provided, however, that UPB may charge and collect copayments (a fIXed dollar amount to be paid by Eligible Employees and Dependents receiving treatment) in addition to any payments received 2 (03/21/01) j) from CLEARWATER from Eligible Employees and Dependents as set forth in "EXHIBIT A" hereto. 3. INDEMNIFICATION a) Indemnification of CLEARW A TER: UPB agrees to indemnify and hold harmless CLEARWATER, its agents, employees and other authorized representatives against any and all invoices, causes of action, suits or demands including but not limited to legal fees and costs incurred in defending any such action which might arise out of the furnishing of or the failure to furnish the services contemplated hereunder. b) Indemnification of UPB: CLEARWATER agrees to indemnify and hold harmless UPB, its agents, employees and other authorized representatives against any and all claims, causes of action, suits or demands including, but not limited to legal fees and costs incurred in defending any such action which arises out of the sole negligence of CLEARW A TER. c) Any language in this Agreement to the contrary notwithstanding, the maximum sum that CLEARW A TER shall be liable to reimburse UPB under any theory of liability shall not exceed $100,000 per person and $200,000 per incident as expressed in Section 768.28, Florida Statutes. 4. NON-INTERFERENCE OF CLEARWATER CLEARWATER and UPB agree that UPB is an independent contractor hereunder and that CLEARW A TER has no right or obligation of control over the activities of UPB. CLEARW A TER agrees that it shall not interfere nor attempt to interfere with UPB's professional judgment as to the benefits to be afforded to any Eligible Employees and Dependents receiving services hereunder. 3 (03/21/01) /'P 5. REFERRALS CLEARW A TER acknowledges that UPB might be required to refer Eligible Employees and Dependents for medical treatment not provided hereunder and agrees that UPB shall not be liable for paying for such services unless such services are listed in the "Summary Plan Description", "EXIDBIT A" hereto. UPB or its authorized providers shall inform CLEARW A TER or its Health Plan of any such instances within two (2) business days. 6. TERM OF AGREEMENT The initial term of this Agreement shall be for three (3) years and this Agreement shall run from the commencement date as set forth in Paragraph Eleven (11) herein. Said Agreement shall automatically renew for another period of three (3) years. However, either party hereto may cancel this Agreement by written notice to the other, delivered at least ninety (90) days prior to the expiration of the term, providing that, in the event of a termination of this Agreement, UPB shall continue to treat those Eligible Employees and Dependents who are undergoing treatment, at the time of termination, until satisfactory arrangements are made between CLEARW A TER and Eligible Employees and Dependents undergoing treatment, for the continuation of care by a similar provider and UPB has been notified by such similar provider, in writing, that it has undertaken the responsibility to render such services to Eligible Employees and Dependents undergoing treatment in question. 7. DEFINITIONS a) An Eligible Employee or Dependent: Is any person who has been authorized by CLEARW A TER to receive services hereunder and whose authorization to receive services has been communicated to UPB by 4 (03/21/01) ~14 CLEARW A TER in the manner required by this Agreement and all Exhibits hereto, together with such person's name, address and such other identifying factors as are required by UPB for proper records keeping. b) Mental Health and Substance Abuse Condition: Means an illness, disorder or condition listed in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), as it might be revised from time to time, not including V-Codes. c) Services Necessary for Treatment of Mental Health and Substance Abuse Condition: Means those services which are appropriate for the treatment of a mental health or substance abuse condition and within the standards of practice recognized by the local mental health professional communities. d) Similar Provider: Means a person, professional association or other entity, licensed to render mental health and/or substance abuse services under applicable State laws and duly registered and authorized to provide those services set forth in the "Summary Plan Description". e) Undergoing Treatment: Means that Eligible Employees and Dependents have been treated for a mental health and/or substance abuse condition by a UPB authorized provider and have not yet been released from such treatment by that provider. 8. ENROLLMENT a) Determination and Notice of Eligibility: During the term of this Agreement, CLEARW A TER shall be solely responsible for determining whether an individual is eligible to receive services hereunder, to communicate 5 (03121/01) (Xl such eligibility to UPB, along with such identifying factors as are required by UPB for proper records keeping and CLEARW A TER shall be solely responsible to communicate, to all Eligible Employees and Dependents, the services provided hereunder as well as all restrictions and limitations applicable thereto. b) Roll of Eligible Employees and Dependents: CLEARWATER agrees to provide UPB with a list of those employees and eligible dependents entitled to receive care hereunder, to update said list monthly and to continuously supplement said list of Eligible Employees and Dependents as is necessary due to the termination or inception of memberships or otherwise. CLEARWATER further agrees to reimburse UPB, at 80% of UPB's usual and customary rate for such services, for any and all services provided under this Agreement to a person who is not an Eligible Employee or Dependent, when such services are provided due to erroneous, incomplete or delayed communication of the roll of Eligible Employees and Dependents by CLEARW A TER to UPB. Eligibility information and notices are to be submitted by CLEARW A TER to the Vice President of Administration at UPB in a mutually agreed format. 9. MISCELLANEOUS PROVISIONS a) Amendment: This Agreement may be amended only by written instrument signed by both CLEARWATER and UPB. b) Entire Agreement: This Agreement, attached Exhibits and any documents incorporated by reference herein constitute the entire Agreement between the parties and supersedes any prior Agreement, representations, warranties or promises between the parties that are not set forth herein or 6 (03/21/01) fYJ otherwise incorporated into this Agreement by express reference. c) Applicable Law: This Agreement and the covenants set forth herein, as well as any Exhibit hereto, are to be construed in accordance with the Statutory, Regulatory and Common Laws of the State of Florida as well as any applicable Federal Laws and Regulations. d) Non-Assignability: Neither party may assign either the obligations or the benefits hereof without the written consent of the other party hereto. e) Captions: Captions appearing in this Agreement are inserted only as a matter of convenience and, in no way, defme or describe the provisions of this Agreement nor do they affect the construction hereof. g) Partial Invalidity: In the event any provision of this Agreement shall be found to be invalid or unenforceable by any Court of competent jurisdiction, such invalid or unenforceable provision shall be severed from this Agreement and shall not affect the remaining provisions of this Agreement. h) Pronouns: All pronouns shall be deemed to refer to the masculine, feminine or neuter, singular or plural, as the identity or the number of the person or persons, entity or entities might require. i) Venue: Any and all actions arising out of this Agreement or the transactions contemplated hereby shall lie in the Courts of the State of Florida situated in Pinellas County, Florida. j) Successor Parties: This Agreement shall inure to the benefit of and be binding upon the parties hereto and their successors and permitted assigns. k) Representations: No representations, negotiations, understandings or communications between the parties shall be binding thereon, unless expressly 7 (03/21/01) ()(} set forth in this Agreement. 10. NOTICES a) Notices to UPB: All notices to UPB hereunder shall be hand delivered or sent by certified mail, return receipt requested, to: Denise M. Scott Vice President, Administration UniPsych Benefits of Florida, Inc. 7777 Davie Road Extension, Suite 100 Hollywood, FL 33024 b) Notices to: All notices to CLEARWATER hereunder shall be hand delivered or sent by certified mail, return receipt requested, to the following address: City of Clearwater Human Resources Department Attn: Cynthia Bender 100 South Myrtle Avenue Clearwater, FL 33756 11. COMMENCEMENT DATE The commencement date of this Agreement shall be the 1st day of January, 2001. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. UNIPSYC(iENEFITS O~ FLORIDA, INC. BY: I f)JAALa-~ - Its: Vice President, Administration C~J-~ Brian J. A~st Mayor-Commissioner CL~R'FLOR]DA By u.~:g.~.:IL William B. Horne, II Interim City Manager 8 (03/21/01) ~ Approved as to form: Attest: rt~ Assistant City Attorney Cy t ia E. Goudeau Cit lerk ;;.. --- '. -- - 9 (03/21/01) (I> EXHIBIT A SUMMARY PLAN DESCRIPTION This is the Summary Plan Description which outlines those mental health and substance abuse benefits which are being rendered pursuant to an Agreement entered into lxtwem CITY OF CLEARWATER (heninafter referred to as "CLEARWATER") and UNIPSYCH BENEFITS OF FLORIDA, INC., (hereinafter referred to as "UPB"). A. MENT AL HEALTH AND/OR SUBSTANCE ABUSE BENEFITS: This Agreement provides for both office visits and inpatient care for mental health and/or substance abuse disorders. Covered services must be authorized by UPB. UPB shall have sole discretion as to determining coverage and authorized providers. Outpatient therapy is covered at Network Rates up to a maximum of 30 visits per contract year with a copayment to be made by Eligible Employees and Dependents, at the time of each service, in the amount of $10.00. Inpatient care and the associated services of psychiatrists and other mental health professionals are covered at Network rates up to a limit of 30 days per contract year with a $100.00 co payment made by Eligible Employees and Dependents, at the time of each admission. The maximum limitations of available services are included in the Health Plan lifetime dollar maximum for Mental Disorders and the maximum limitation of available services for Substance Abuse Disorders is a lifetime maximum of $25,000.00. B. MIXED SERVICES UPB is responsible only for those services associated with the treatment of mental health and/or substance abuse conditions. UPB shall not be responsible for 10 (03/21/01) ()IJ the cost of any medical or surgical services or supplies, that are provided concurrently or in conjunction with the treatment of mental health or substance abuse conditions pursuant to this Agreement, whether or not UPB makes referrals or recommendations for such medical or surgical services. These include but are not limited to all services and supplies relating to neurological conditions and all ancillary services and supplies relating to medical conditions. All determinations as to whether services rendered are primarily for mental health or substance abuse conditions or, in the alternative, for medical conditions, shall be determined as set forth under Section J herein. C. SERVICE AREA The Service Area covered under this Agreement is the continental United States of America and the services covered under this Agreement are available to Eligible Employees and Dependents in this Service Area. In order to obtain mental health and/or substance abuse services outside of the Service Area, Eligible Employees and Dependents shall be required to obtain such services with prior authorization of UPB. UPB is available 24 hours per day through its national toll-free number, 1-800- BRADMAN or 1-800-272-3626. UPB shall not be responsible for any cost of transportation related to the transfer of Eligible Employees and Dependents to facilities authorized by UPB. D. EMERGENCY ADMISSIONS In the event Eligible Employees and Dependents require emergency mental health and/or substance abuse treatment and/or admissions, UPB shall be responsible for the cost thereof only in the event that: 1. UPB is notified within 24 hours of the inception thereof. 11 (03/21/01) ~ 2. UPB specifically authorizes the admission/treatment. 3. The admission/treatment is for the purposes of acute crisis intervention and stabilization only. The maximum coverage allowable for non-authorized emergency, out-of- network services will be up to $500.00 for services within the Service Area and up to $1,500.00 for services outside the Service Area. E. MEDICAL NECESSITY A determination of the medical or clinical necessity for the provision of mental health and/or substance abuse services to Eligible Employees and Dependents under this Agreement shall be in the sole discretion of UPB authorized mental health/substance abuse providers. F. INFORMATION AND REPORTS UPB agrees to make available to CLEARWATER, statistical information compiled and retained by UPB, which CLEARW A TER reasonably requests for reporting purposes. Detailed utilization reports shall be provided to CLEARWATER on a regular basis. G. LIMITATION ON BILLING ELIGIBLE EMPLOYEES & DEPENDENTS UPB agrees that, in no event, including but not limited to non-payment by CLEARW A TER for any reason including but not limited to insolvency of CLEARWATER or breach of this Agreement by CLEARWATER, shall UPB bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from or have any recourse against Eligible Employees and Dependents or person other than CLEARWATER acting on Eligible Employees and Dependents' behalf for covered services provided pursuant to this Agreement. This provision shall not 12 (03/21/01) tOO prohibit collection of co payments made in accordance with the terms of the Agreement. This provision shall not prohibit collection for non-covered services or from third parties when such parties are primarily responsible for paying for covered services. UPB shall aggressively and fully pursue and process any coordination of benefit or subrogation invoices which relate to services provided by UPB. UPB shall be entitled to any amounts collected by UPB, through coordination of benefits or subrogation, related to mental health and substance abuse services. UPB further agrees that (1) this provision shall survive the termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of Eligible Employees and Dependents and that (2) this provision supersedes any oral or written agreement to the contrary now existing or hereafter entered into between UPB and Eligible Employees and Dependents or persons acting on Eligible Employees and Dependents' behalf. H. GRIEVANCE SYSTEM/LITIGA TION UPB shall cooperate with CLEARW A TER in resolving any grievances by Eligible Employees and Dependents and shall comply with the grievance system established. UPB shall comply with the decision reached through the grievance system established as to coverage and responsibility for payment of covered services rendered to Eligible Employees and Dependents. A representative of UPB shall be present and participate in all proceedings involving grievances regarding the provision of services covered by this Agreement. I. EXCLUSIONS AND LIMITATIONS All medically or clinically necessary Mental Health and Substance Abuse 13 (03121/01) ~ Services and conditions as defined in this Agreement shall be covered only for the period of evaluation, initial stabilization, case management and referral. The following specific conditions or services are excluded, or limited, and may require coordination of benefits. 1. Treatments rendered or conditions covered under the auspices or funding of any governmental program. 2. A formal psychiatric disability which is covered under Disability Benefits. 3. A chronic condition requiring custodial, assisted living, long-term residential or institutional care. 4. A neurological condition or treatment or a permanent organic brain syndrome. 5. Relationship, family, marriage, or divorce counseling when such services extend beyond the period necessary for crisis intervention and short-term evaluation. 6. Psychiatric or psychological examinations, testing or treatments for any of the following: a. Services sought for the purposes of obtaining or maintaining employment or insurance coverage; b. Services sought in connection with, or in regard to, Judicial or Administrative proceedings; c. Services sought pursuant to a Court Order or as a condition of parole or probation; d. Treatment of a sex offender. 7. Sex therapy will only be covered when it is an adjunct to therapy 14 (03/21/01) .A-4 for other mental health conditions for which benefits are afforded under this Agreement. 8. Inpatient services for detoxification more than two times in anyone calendar year for the removal of toxic substances from the system. 9. Educational or vocational counseling or testing, remedial education, learning disabilities, speech therapy, behavioral training, hearing therapy. 10. Attention Deficit Hyperactivity Disorder and therapy when services are provided by a non-psychiatric physician. 11. Diet counseling, weight reduction therapy, or nutritional counseling. Treatment for smoking cessation. 12. Psychotherapy or other mental health intervention for pain or other medical conditions when such services are covered under the Medical/Surgical portion of the Health Plan. 13. Electro-Convulsive Treatment (ECT) requires special pre- authorization and a second psychiatric opinion or review. Each ECT session is counted as a hospital day. Services shall be rendered only by UPB authorized providers. Coverage shall include reasonable follow-up consistent with the total benefit. J. MEDICAL vs. MENTAL HEALTH DETERMINATIONS I. HOSPITALIZATION The intent of this Section is to establish guidelines to help avoid payment disputes. UPB shall only be fmancially responsible for the hospital room and board charges in the event that the primary treatment for which the patient has been 15 (03/21/01) ,4il hospitalized is mental health and/or substance abuse and the primary treatment is being provided by a psychiatrist. Individual physician charges and charges for psychological or psychiatric tests that the physician orders or causes to be ordered shall only be the responsibility of UPB when the physician is a UPB-approved psychiatrist. The following guidelines shall be used in utilization review and in processing provider invoices when the services rendered include a combination of mental health and medical care: 1) When a patient is admitted with a primary medical diagnosis and a mental health consultation is requested, UPB shall be fmancially responsible only for the consultation. 2) When a patient is admitted for the treatment of a medical problem and there is a concomitant psychiatric problem, UPB shall not be responsible for the medical care rendered. In the event the patient is medically cleared subsequent to admission and then transferred to a Psychiatric Unit, UPB shall be fmancially responsible for only that part of the admission occurring after the transfer to the Psychiatric Unit. For example, if a patient ingests a toxic substance in a suicide attempt and requires medical care in an ICU, UPB shall not be responsible for the patient's care until the patient is medically cleared and transferred to a Psychiatric Unit. In the event medical care continues following transfer to a Psychiatric Unit, UPB shall not be financially responsible for such medical treatment including but not limited to tests ordered by a 16 (03/21/01) pi) (03/21/01) pO non-psychiatrist physician. 3) UPB shall be fmancially responsible only for that portion of the provider invoice incurred due to the mental health diagnosis. For example, if a patient is being treated for alcoholism with a secondary diagnosis of hepatitis, the care rendered for the hepatitis by a medical consultant, including ancillary charges, shall not be the responsibility of UPB; the care rendered by a mental health professional, including ancillary charges, shall be the responsibility of UPB. Financial responsibility for the hospital room and board will be determined by where the patient is housed and who the primary care giver is (i.e. if the patient is admitted to a Psychiatric Unit under the care of a psychiatrist, UPB shall be responsible; if the patient is admitted to a medical unit under the care of a non- psychiatrist physician, UPB shall not be responsible); when inpatient detoxification requires treatment on a medical unit by a non-psychiatrist physician, it shall be considered a medical expense and shall not be the clinical or fmancial responsibility of UPB. 4) If a patient is admitted for a medical complaint but the medical evaluation does not lead to a medical diagnosis and a psychiatric diagnosis is then assigned to the case, the care rendered, other than for psychiatric consultations, shall not be the responsibility of UPB. When the patient is transferred to a Psychiatric Unit and the primary care giver is a psychiatrist, UPB shall be financially responsible. For example, if a patient is admitted for evaluation 17 (03121101) .tj) of pain of unknown etiology but no organic etiology is identified and the patient is then given a diagnosis of psychogenic pain, the care rendered, other than for the psychiatric consultation, shall not be the responsibility of UPB. If and when the patient has been transferred to a Psychiatric Unit, the care shall become the responsibility of UPB. 5) When a patient is admitted for a medical or a neurological problem but is placed on a Psychiatric Unit because the patient has a concomitant psychiatric diagnosis and is a management problem, UPB shall not be financially responsible. The operative criterion for determining payment responsibility shall be which diagnosis is the condition which required the inpatient treatment which could only be provided in a hospital setting. For example, in the case where a patient with Alzheimer's Disease or mental retardation is housed on a Psychiatric Unit for management purposes but the primary care giver is a neurologist, UPB shall not be financially responsible. Another example would be a patient with diabetes mellitus who is also a stable chronic schizophrenic. If a patient is admitted because his diabetes is out of control but is placed on a Psychiatric Unit, UPB shall not be fmancially responsible since the chronic schizophrenia would not have required hospitalization. 6) When the above guidelines are insufficient, the following additional general principles shall be used to determine payment responsibility: 18 (03/21/01) {)/) a) What is the primary cause for hospitalization? Which condition could only be treated in a hospital setting? b) What does the cover sheet on the medical record list as the primary diagnosis for the admission? c) Is the attending physician of record a psychiatrist or a medical consultant? d) Has the patient been admitted to a Psychiatric Unit or a Medical/Surgical Unit? e) Who is the primary care giver? f) What condition is causing the patient to remain in the hospital and who is treating this problem? II. EMERGENCY ROOM If Eligible Employees and Dependents are referred to or self-refer to an Emergency Room, the cost of the emergency room evaluation shall not be the responsibility of UPB. If a psychiatric consultation is requested, UPB shall pay for the cost of the psychiatric assessment and/or treatment. UPB shall not be responsible for the cost of ambulance transfers. III. BIOFEEDBACK UPB shall not be responsible for the cost of Biofeedback unless same is utilized by a UPB therapist as an adjunctive modality in the course of treatment when specifically treating a DSM diagnosis (for example, in the treatment of selected patients with anxiety, panic or phobic disorders). 19 K. PRE-EXISTING CONDITIONS: Benefits are not provided for symptomatology related to any mental health or substance abuse (DSM diagnosis) condition for which Eligible Employees and Dependents have received treatment within three months prior to the inception of Eligible Employees and Dependent's coverage under this Agreement. Coverage for such conditions shall be provided under this Agreement only after: a) Eligible Employees and Dependents have had three consecutive months without any treatment for said condition after such inception; or b) Eligible Employees and Dependents have been covered under this Agreement for twelve consecutive months. This exclusion of pre-existing conditions shall be waived for all Eligible Employees and Dependents who are on CLEARWATER's rolls as of the first effective date of this Agreement. 20 (03/21/01) (/) EXHIBIT B - FEE SCHEDULE CLEARW ATER agrees to pay to UniPsych Benefits of Florida, Inc. as follows: Mental Health/Substance Abuse Benefits Per Employee Per Month ..............$6.41 Employee Assistance Program (5 Visits)... .............. ....... ............... ......... ...... ..$1.48 Such fee is to be paid to UPB by the 1st day of each month commencing January 1, 2001 and shall be paid on a monthly basis thereafter based upon the number of employees of CLEARWATER and their respective dependents which are on CLEARWATER's membership rolls each month. Adjustments shall be made for additional Eligible Employees and discontinued Eligible Employees during each month. If Eligible Employees and Dependents are either added or dropped from the membership rolls between the 1st and 15th of the month, there shall be an appropriate adjustment on the payment provided in the following month. If the adjustment on the membership rolls takes place on the 16th of the month or thereafter, there shall be no adjustment for that particular month. The above-noted Per Employee Per Month cost shall be construed as a per employee fee for both inpatient and outpatient benefits provided in accordance with the Summary Plan Description attached hereto as EXlDBIT A. Such fee shall include coverage for all dependents participating in the Group Medical Plan in accordance with this Agreement. In addition to the above-noted fee, UPB shall collect from each Eligible Employee and Dependent, the agreed upon co-payments as outlined in such Summary Plan Description attached hereto. Also, the above-noted fee includes up to 25 hours of training and other on-site activities per contract year to be provided upon request of CLEARWATER. 21 (03/21/01) {0 EXHIBIT C PERFORMANCE GUARANTEES TO THE CITY OF CLEARWATER, FLORIDA Overview The Bradman/UniPsych Companies (UniPsych) will provide mental health, substance abuse, and Employee Assistance Program benefits to the City of Clearwater, Florida, commencing January 1, 2001 and ending December 31, 2001 as described in its proposal response to RFP 45-00, and subsequent clarifications. Renewability The contract will renew annually, with UniPsych providing at minimum a 180 day notice of cancellation. The City will provide a 30 day notice of cancellation. Services will continue at the discretion of the City, with UniPsych's rates guaranteed for a period of three (3) years. UniPsych's blended rates will be as follows for the City: Benefit Category Per Employee~ Per Month Cost $6.41 · Mental Health & Substance Abuse · Employee Assistance Program Combined $1.48 $7.89 The Bradman/UniPsych Companies are willing to provide guarantees of: Untimely Cancellation Number of County Providers Claims Processing Time Time to see an EAP Counselor Penalties for Failure to Perform: The performance of the Bradman/UniPsych Companies shall be reviewed within 45 days of the end of each calendar quarter and the following penalties shall apply for failure to perform during that quarter. Number of Pinellas County Providers - 0.5% of the earned premium for that quarter; Claims Processing Time - 25% of the value of each claim not processed on a timely basis; 22 (03/21/01) ptJ ~ Time to see an EAP counselor - $100 for each EAP appointment not available on a timely basis; Customer Service Standard - $1,000 for each major problem (to be defined by the City) not timely resolved. Untimely Cancellation Except for non-payment by the City of Clearwater, should UniPsych cancel its contract with the City with less than 180 days formal written notice, UniPsych will pay the City $25,000 within 30 days after contract termination. Specific Performance Guarantees Nmnber of Specified County Providers Guarantee: The number of authorized providers located in each of the following counties will be at least twenty (20) at all times and within 10 miles of participating member zip codes: Pinellas, Pasco and Hillsborough. Definition: A provider is a licensed psychiatrist or psychologist, a licensed social worker, a licensed mental health counselor, or a licensed marriage and family therapist treating mental and nervous disorders, alcoholism or drug abuse. Measurement Criteria: The Bradman Network listing of participating providers on fIle with the Human Resources Department of The City of Clearwater. Claims Processing Time Guarantee: Authorized out-of-network claims will be processed within 45 days of the ending of the month received. Definition: A claim is processed when a check is issued, or a notice is sent to an appropriate party requesting additional information necessary to the proper determination of benefits, or an audit is scheduled to determine the correct amount payable. Measurement Criteria: UniPsych processing reports or employee complaints documented to the City's Human Resources Department. Time to see an EAP. Mental Health or Substance Abuse Counselor: Guarantee: Persons calling the 800 telephone number and requesting an appointment time with the following time limits, based upon request and need. 23 (03121/01) !;() Emergency: a) Life or Death Situations - Direct referral to emergency facility or authorities. b) Other emergencies - 24 hours Two (2) business days Four (4) business days Emergency means the patient is facing a crisis situation that requires rapid intervention. Urgent means the patient feels they are unable to conduct normal life activities without direct assistance. Routine means the patient feels that assistance is necessary to deal with pressing problems. Urgent: Routine: Definitions: Both routine and emergency calls can be processed through the 24-hour toll-free number. After hours, the toll-free number is lived answered by a medical answering service with strict instructions to immediately page the on-call clinician. In addition, BradmanlUniPsych shall make available at least two mental health professionals for direct access for after-hours on-call emergencies. Measurement Criteria: UniPsych processing reports or employee complaints documented to the City's Human Resources Department. Customer Service Standard Guarantee: All significant problems affecting customer satisfaction with the programs will be resolved on a timely basis, but no later than 45 days from the date that written notice of the problem is delivered to Bradman/UniPsych Companies. Definition: A significant problem is a continuing situation adversely affecting the quality or availability of care afforded to plan members and not consistent with the representations made by Bradman/UniPsych Companies. Measurement Criteria: Representations made to City of Clearwater either in writing or on voice recordings. 24 (03/21/01) p()