HomeMy WebLinkAboutContract 54095-A3 DocuSign Envelope ID:2CF10805-7AC5-4F1 B-BECD-63C68348B086 CSC No. 54095-A3
THIRD AMENDMENT
TO THE BUSINESS SERVICES AGREEMENT
BETWEEN ACCOLADE, INC.AND CITY OF FORT FORTH
This "Third Amendment" is to the BUSINESS SERVICES AGREEMENT(the ("BSA"),dated June 30, 2020, by
and between Accolade, Inc. ("Accolade") and City of Fort Worth ("Customer"). Accolade and Customer
are each a "Party" and collectively referred to as the "Parties." Capitalized terms used but not defined
herein shall have the respective meanings ascribed thereto in the BSA. Section references herein, if any,
shall refer to Section references in the BSA.
WHEREAS,the Parties wish to make a revision to the Return on Investment Performance Guarantee.
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged,the Parties hereby agree to amend the BSA as follows:
1. Effective with the calculation of the Return on Investment Performance Guarantee for the
Service Year ended December 31, 2021,the Expert Second Opinion line of the Savings Per
Interaction table in Footnote 2 in Appendix 1 Fee Adjustments shall be removed and replaced
with the following:
Calculation of Savings for Expert Medical Opinion:
• "Cost Savings" for any period means the sum for all Expert Medical Opinions rendered of
(i)the cost that Members and Customer would have incurred, in the absence of obtaining the
Services,to treat Members' medical conditions based on their current local provider's
recommendation and treatment plan; minus (ii)the cost that such Member and Customer is
estimated or expected to have incurred, after obtaining the Services,to treat such medical
conditions.
• Calculation of Cost Savings: Accolade Expert MD will utilize episode of care methodology
and credible third-party data sources to determine the cost of all clinically related services and
will consider member location and treatment specifics to determine the most appropriate cost
estimate.Accolade Expert MD will obtain cost estimates from peer reviewed publications and
other credible third-party data sources,such as Healthcare Bluebook, FH Consumer Cost Lookup,
GoodRx.com, Drugs.com, and Elsevier.
2. This Third Amendment shall be deemed executed as of the last date of execution by the Parties
hereto. Except as amended hereby and by any prior amendments to the BSA, the original BSA
shall remain in full force and effect in accordance with the terms thereof. In the event of a conflict
between the terms of this Third Amendment and the BSA,the terms of this Third Amendment will
govern.
IN WITNESS WHEREOF, the Parties hereto, by their duly authorized representatives, have executed this
Third Amendment.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
DocuSign Envelope ID:2CF10805-7AC54F1 B-BECD-63C68348B086
CITY:
City of Fort Worth Contract Compliance Manager:
By signing I acknowledge that I am the person
responsible for the monitoring and
administration of this contract, including ensuring
Name: JeSICa MCEaChern all performance and reporting requirements.
Title: Assistant City Manager
Date: Sep 20, 2022
Approval Recommended: By:
N,I1 26U1�`G�610`�1 Name: Joanne Hinton
By: Nathan Gregory(Sep 13, 0221:3o CDT)
Title: Benefits Manager
Name: Nathan Gregory -
Title: Deputy Director of Human Resources
Approved as to Form and Legality:
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��TEX ASaa By:
Tanneffe s. Goodall Name: John B. Strong
By: Jannette S.G-daUl Sep 21,2022 o9:31 CDT)
Name:
Jannette S. Goodall Title: Assistant City Attorney
Title: City Secretary
Contract Authorization:
M&C: 20-0444
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
DocuSign Envelope ID:2CF10805-7AC5-4F1 B-BECD-63C68348B086
VENDOR:
Accolade, Inc.
F
,,D`ocuSigned by:
By: N7 gFe�s St
Name: Rajeev Singh
Title: CEO
Date: 6/14/2022
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
9/13/22,2:26 PM M&C Review
Official site of the City of 3rt Worth,Texas
CITY COUNCIL AGENDA FORT oun
Create New From This M&C
DATE: 6/23/2020 REFERENCE**M&C 20- LOG 13P 20-0109 MEDICAL TPA/ASO, EAP
NO.: 0444 NAME: AND PC-DM SERVICES HR JPB
CODE: P TYPE: CONSENT PUBLIC NO
HEARING:
SUBJECT: Authorize Execution of Agreements with Meritain Health, Inc., for the Medical Third Party
Administrator/Administrative Services Only Services in the Amount Up to $1,475,000.00
Annually, Aetna Behavioral Health, LLC for the Employee Assistance Program in the
Amount Up to $157,000.00 Annually and Accolade, Inc., for the Plan Concierge-Disease
Management Services in the Amount Up to $1,550,000.00 Annually with an Additional
Implementation Fee Up to $98,600.00 in the First Year, for a Three-year Initial Term with
Option to Renew Up to an Additional Two Year Term at the City's Sole Discretion (ALL
COUNCIL DISTRICTS)
RECOMMENDATION:
It is recommended that the City Council authorize the execution of agreements with Meritain Health,
Inc., for the Medical Third Party Administrator/Administrative Services Only Services in the amount up
to $1,475,000.00 annually, Aetna Behavioral Health, LLC, for the Employee Assistance Program in
the amount up to $157,000.00 annually and Accolade, Inc., for the Plan Concierge-Disease
Management Services in the amount up to $1,550,000.00 annually, with an additional implementation
fee up to $98,600.00 in the first year, for a three-year initial term with option to renew up to an
additional two year term at the City's sole discretion.
DISCUSSION:
The Human Resources Department (HRD) approached the Purchasing Division to secure
agreements for the Medical Third Party Administrator (TPA)/Administrative Services Only (ASO)
Services, the Employee Assistance Program (EAP) and the Plan Concierge-Disease Management
(PC-DM) Services.
The City's Medical and Disease Management Programs are self-funded and utilize a third party
administrator to process claims. The United Healthcare Services, Inc. has been providing these
services since January 1, 2016 under its previous Agreement (City Secretary Contract (CSC)
No. 47393; Mayor and Council communication (M&C) C-27347 & C-28386) with the City.
This agreement expires on December 31, 2020.
The EAP services are a minimum of six face-to-face visits to assist employees in addressing personal
issues, make referrals to qualified professionals for specialized issues such as mental health and
stress, parenting, midlife and retirement, disability, financial issues, addictive behaviors, education,
caring for older adults, health and wellness, and legal issues. Welcome packets for all new
employees and unlimited 24/7/365 telephonic support services are included. Aetna Behavioral
Health, LLC has been providing administration of the City's Employee Assistance Program under its
previous Agreement (CSC 47547; M&C C-27334) with the City. This agreement expires on December
31, 2020.
Staff determined it would be in the City's best interest to ensure it was getting the best overall product
and price by going out to the market and giving all providers the opportunity to compete for the City's
business and issuing a Request for Proposals (RFP) that consisted of detailed scope of services. The
RFP was designed to solicit proposals for the following services individually or in combination with
each other: (1) Medical TPA/ASO Services; (2) EAP; and (3) PC-DM Services. The RFP was
advertised in the Fort Worth Star-Telegram every Wednesday starting on March 18, 2020 through
April 22, 2020. Sixteen vendors were solicited from the purchasing database; eleven responses were
received.
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The proposals were evaluated separately for Medical TPA/ASO Services, EAP and PC-DM Services.
The evaluation team was provided with resources and assistance by the City's benefits consultant,
Holmes Murphy.
(1) Medical TPA/ASO Services:
An Evaluation team consisting of staff from the different departments and a retiree evaluated
proposals received for Medical TPA/ASO Services. The evaluation team ranked the proposals based
on pre-defined factors. Finalists were selected for presentations. Following the presentations, the
evaluation team determined Meritain Health, Inc. provides the best overall solution for the
TPA/ASO Services and recommended that the City Council authorize the execution of agreement for
an initial three year period term with option to renew up to an additional two year term at the City's
sole discretion.
The associated cost and fees for Medical TPA/ASO Services is $926.20 per month per employee and
non-medicare eligible retirees. The benefit plan operates on a plan calendar year basis and the
expected overall total administrative costs are $1,475,000.00 for Calendar Year 2021. Prices will
remain flat for the base three years of the Agreement. The estimated medical claims for Calendar
Year 2020 are $64,000,000.00 and anticipated to trend at about a 1 percent increase in years two to
five. Trend projections may vary depending on Calendar Year 2020 claims experience. It is
anticipated that Staff will make a recommendation to the City Manager on premium contribution rates
and plan design. Open enrollment for the 2021 medical plan is scheduled to begin on October 2020.
(2) EAP:
An Evaluation team consisting of staff from the Human Resources Department evaluated proposals
received for EAP. The evaluation team ranked the proposals based on pre-defined factors and
determined Aetna Behavioral Health, LLC provides the best overall solution for EAP and
recommended that the City Council authorize the execution of agreement for an initial three year
period term with option to renew up to an additional two year term at the City's sole discretion. The
associated cost and fee is $1.59 per month per employee (PEPM) for the 1 st year, $1.69 PEPM for
the 2nd year, $1.79 PEPM for the 3rd year, and $1.89 PEPM for the 4th & 5th years. The annual cost
(Calendar Year) is $132,000.00 for year 1, $140,000.00 for year 2, $149,000 for year 3, and
$157,000.00 for year 4 and year 5.
(3) PC-DM Services:
An Evaluation team consisting of staff from the different departments and a retiree evaluated
proposals received for PC-DM Services. The evaluation team ranked the proposals based on pre-
defined factors. Finalists were selected for presentations. Following the presentations, the evaluation
team determined Accolade, Inc. provides the best overall solution for the PC-DM Services and
recommended that the City Council authorize the execution of agreement for an initial three year
period term with option to renew up to an additional two year term at the City's sole discretion.
The associated cost and fee is up to $1,550,000.00 per year for PM-DC Services with an additional
implementation fee up to $98,600.00 in the first year.
An administrative change order or increase may be made by the City Manager up to the amount
allowed by relevant law and the Fort Worth City Code and does not require specific City Council
approval as long as sufficient funds have been appropriated.
A waiver of the goal for MBE/SBE subcontracting requirements was requested by the Department
and approved by the M/WBE Office, in accordance with the BDE Ordinance, because the purchase of
goods or services from source(s) where subcontracting or supplier opportunities are negligible.
Upon City Council approval, the three-year term of this contracts shall begin on January 1, 2021 and
expire on December 31, 2023. The contract may be renewed for up to one successive two-year
term at the City's option. This action does not require specific City Council approval, provided that the
City has appropriated sufficient funds to satisfy the City's obligations during the renewal term. The
contract will include a standard fiscal funding out clause that would comply with state law
requirements by allowing the City to terminate the Agreement without penalty, if in the future, the
Council elects not to appropriate funds for contracted services.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of this recommendation, funds are available
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within existing appropriations in the current operating budget of the Group Health Insurance and
Retiree Healthcare Trust Funds and anticipates, upon adoption of the Fiscal Year 2021 Budget by the
City Council, to include the recommended payments mandated by state statutes, the funds will be
available in the Fiscal Year 2021 budget, as appropriated. Prior to any expenditure being incurred, the
Human Resources Department has the responsibility to validate the availability of funds.
BQN\\
TO
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year (Chartfield 2)
FROM _
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year (Chartfield 2
Submitted for City Manager's Office by_ Jay Chapa (5804)
Originating Department Head: Reginald Zeno (8517)
Additional Information Contact: Cynthia Garcia (8525)
John Padinjaravila Baby (2279)
ATTACHMENTS
1295-Meritain-Aetna-Accolade.pdf (CFW Internal)
20-0109 RFP Waiver RFP Medical ASO or TPA Services.pdf (CFW Internal)
EAP Concierge funding availability at category.PNG (CFW Internal)
SAMs 6-1-2020 Meritain-Aetna-Accolade.pdf (CFW Internal)
TPA ASO EAP Concierge FID.XLSX (CFW Internal)
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