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SEVENTH AMENDMENT TO PROFESSIONAL SERVICES AGREEMENTSEVENTH AMENDMENT TO PROFESSIONAL SERVICES AGREEMENT This is the Seventh Amendment ("Amendment") to the Professional Services Agreement ("Agreement") between City of Clearwater ("Client") with offices located at 100 South Myrtle Avenue, Clearwater, Florida 33756 and Evernorth Direct Health, LLC ("Evernorth") with offices located 26500 North Norterra Drive, Phoenix, Arizona 85085 effective October 1, 2015. This Amendment is effective July 27, 2022 ("Amendment Effective Date"). Client and Evernorth are sometimes referred to herein individually as a "Party" and collectively as the "Parties." 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 Amendment Effective Date, the Agreement is hereby amended as follows: 1. For purposes of this 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. Section 3, Term, of the Agreement is hereby renewed for the Renewal Term of twelve (12) months from 10/1/2022 through 9/30/2023. 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 Amendment for the Renewal Term of 10/1/2022 through 9/30/2023. 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 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 Amendment to be executed and signed by their respective officers duly authorized to do so. Electronic signatures are acceptable and have the same binding effects as original signatures. EVERNORTH DIRECT HEALTH, LLC Signature: / /644 Pae4 Print Name: r� - , . ' - rry, DBA,, P Title: Chief Operating Officer, VP Date: July 27, 2022 Countersigned: CITY OF CLEARWATER, FLORIDA Frank Hibbard/C/r 4'" „e.JC;"2 Jon Jennings Mayor City Manager App_ved as to fo wen Kohl - r Assistant City Attorney Attest: Rosemarie Call City Clerk 2 Appendix 1 €VERNORTH-, Evernorth Direct Health Cost Projection Estimates Prepared for: City of Clearwater - Budget Renewal Temp Labor Identified Separately r Description 10/1/22 - 9/30/23 Participants - Eligible for Access Potential Visits Penetration Rate Projected Primary Care Visits PreventionHealth Promotion Visits FTE's Physician Nurse Practitioner Medical Assistant Front Office LPN & Office Manager Total FTE's Salaries & Benefits Temp Labor Supplies Other Direct Expenses System Expenses 3,140 7,850 68.0% 5,339 1,602 1.00 1.00 2.00 1.00 1.00 6.00 808,000 57,000 234,000 110,000 79,000 Total Operational Expense Estimate Admin Fee Management Fee Infrastructure Costs 1,288,000 21,000 86,000 303,000 Total Fee Estimate 410,000 Total On Site Health Center Cost Estimate 1,698,000 CHC - Operating funding incentive Total Cost Estimate After Cigna Contribution 161,177 1,536,823 Assumptions 1) The facility is staffed as indicated in the FTE section above, temporary staff is not included in FTE count. 2) Full-time is considered to be 40 hours per week and represented by 1.0D FTE. 3) Operating costs include system licensure based an the number of professional staff. 4) Marketing for communications to those eligible for access to the site is planned at $5000 per year (pass thru exp, only charged if used). 5) Recruitment cost for staff is projected at $10000 per year (pass thru exp. only charged if used). 0) Assumes 5D% of eligible participants receive a flu shot in the clinic. 7) Visits include medical and heahh promotion (estimate 2.5 visits per participant per year). 8) Lab vendor will be paid through clinic instead of lab vendor submitting claim directly to insurance. Estimated at $4K per mo. (pass thru exp). 9) Includes cost of prepackaged medicine at $13.25 per scnpt assuming 1.3 scripts per visit 10) The projection does not Include an estimate for temporary labor coverage (pass thru exp if approved and incurred). 11) Does not include data conversion. 12) High Speed Internet must be available to the building and extended to demark within vendor service distance requirements. Additional connectivity charges for Internet/DSL(relephone svcs could apply if clinic cannot use client's existing service providers. 13) Radiology expenses are included and average $3.000 per month (pass thru exp) 14) Other Direct Expenses includes Audiometer, Spirometer and Hearing Booth equipment purchases 8 shipping in Year 1 (Approx. $8,300) 15) Includes cost of temporary PA. 3