FOURTH AMENDMENT TO PROFESSIONAL SERVICES AGREEMENTFOURTH AMENDMENT TO
PROFESSIONAL SERVICES AGREEMENT
This is the Fourth Amendment ("Fourth Amendment") to the Professional Services Agreement ("Agreement")
between City of Clearwater ("Client") with offices located at 100 South Myrtle Avenue, Clearwater, Florida 33756
and Cigna Onsite Health, LLC ("Cigna") with offices located 26500 North Norterra Drive, Phoenix, Arizona 85085
effective October 1, 2015, whereby Cigna agreed to provide for a Cigna Onsite Health Clinic ("Clinic") providing
low acuity, urgent and episodic care and ancillary services for the benefit of Client employees and others (as
defined in the Agreement). This Fourth Amendment is effective October 1, 2020 ("Fourth Amendment Effective
Date"). Client and Cigna are sometimes referred to herein individually as a "Party" and collectively as the
"Parties."
WHEREAS, the Client and Cigna previously entered into the Agreement, effective October 1, 2015, and as
amended by the First Amendment, effective January 1, 2018, and as amended by the Second Amendment,
effective September 19, 2018, and as amended by the Third Amendment, effective October 1, 2019.
WHEREAS, pursuant to Section 28 of the Agreement, the Parties wish to amend the Agreement in accordance
with the terms stated herein.
NOW, THEREFORE, for valuable consideration, the receipt and sufficiency of which is hereby acknowledged, as
of the Fourth Amendment Effective Date, the Agreement is hereby amended as follows:
1. For purposes of this Fourth Amendment, capitalized terms used herein shall be as defined in the Agreement,
as amended, or in any of the Schedules or Appendices attached thereto, unless otherwise specified.
2. Pursuant to Section 3, the Parties agree to a Renewal Term of twelve (12) months from 10/1/2020 through
9/30/2021.
3. The Operating Budget (Appendix 1) attached to Schedule B — Fees of the Agreement is hereby deleted in its
entirety and replaced with the Operating Budget (Appendix 1) attached to this Fourth Amendment for the
Renewal Term of 10/1/2020 through 9/30/2021.
4. The recitals and representations are true and accurate and are incorporated herein by reference.
jTHIS SECTION INTENTIONALLY LEFT BLANK]
1
5. Except as modified by this Fourth Amendment, all other terms and provisions of the Agreement, as
amended, and all Schedules and Appendices attached thereto, shall continue in full force and effect.
IN WITNESS THEREOF, the Parties hereto have caused this Fourth Amendment to be executed and signed
by their respective officers duly authorized to do so.
CIGNA ONSITE HEALTH, LLC
Signature:
. „ / P
P
P '4,
/�
Print Name:
J r - .. - rry, DBA,,
Title:
Chief Operating Officer, VP
Date:
August 11, 2020
Countersigned:
F nk Hibbard
Mayor
CITY OF CLEARWATER, FLORIDA
Approved as to form:
wen Kohler
Assistant City Attorney
William B. Horne II
City Manager
Attest:
Rosemarie Call
City Clerk
2
Appendix 1
Cigna,
CIGNA Onsite Health
Cost Projection Estimates Prepared for: City of Clearwater - Budget Renewal
Description
10/1120 - 9130121
Participants - Eligible for Access
Potential Visits
Penetration Rate
Projected Primary Care Visits
Prevention/Health Promotion Visits
FTE's Physician
Nurse Practitioner
Medical Assistant
Front Office
LPN & Office Manager
Total FTE's
Salaries & Benefits
Supplies
Other Direct Expenses
System Expenses
3,140
7,850
67.0%
5,260
1,577
1.00
1.00
2.00
1.00
1.00
6.00
812,000
234,000
103,000
71,000
Total Operational Expense Estimate
Ain Fee
Management Fee
Infrastructure Costs
'Total Fee Estimate
1,220,000
19,000
81,0(X)
284,000
384.000
Notal On Site Health Center Cost Estimate 1,604,000
Assumptions
1) The facility is staffed as indicated in the FTE section above, temporary staff is not included in FTE court.
2) Full-time is considered b be 40 hours per week and represented by 1.00 FTE
3) Operating costs include system licensure based on the number of professional staff
4) Marketing for eomnti rrcalions b those eligible for access to be site is planned at 85000 per year (pass thru exp, only charged if used)
5) Recruitment cost for staff is projected at $10000 per year (pass Ihni exp, only charged if used)
6) Assumes 50% of eigbte particgarts receive a au shot in the clinic.
7) Visits include medical and health promotion (estineAe 2.5 visits per participant per year)
6) Lab vendor trill be paid through ditto instead of lab vendor submitting claim directly to insurance. Estimated at $4K per mo. (pass thru exp)
9) Includes coat of prepackaged medlcine at 813.25 per script assuming 1.3 scripts per visit.
10) The projection does not Include an estimate for temporary labor coverage (pees thru exp if approved and incurred)
11) Does not include data conversion.
12) High Speed Internet mist be evadable b the handing and extended b denwk *Min vendor service distance requirements. Additional
comedivity charges for Internet/DSL/Telephone Svcs could apply if clinic carrot use client's existing service providers.
13) Radiology expenses are induded and average 53,000 per month (pass thru exp)
14) Other Direct Expenses indudes Audiometer, Spirorneter and Hearing Booth equipment purchases & shipping in Year 1 (Approx. 68,300)
15) Includes cost of temporary PA
3